Diabetes self-management, depressive symptoms, metabolic control and satisfaction with quality of life over time in Chinese youth with type 1 diabetes.
AIMS AND OBJECTIVES
To describe the patterns of diabetes self-management, depressive symptoms, metabolic control and satisfaction with quality of life over time in a cohort of Chinese youth with type 1 diabetes and to determine the relationships between these variables over time.


BACKGROUND
Nurses have an important role in facilitating optimal self-management and health outcomes in youth with type 1 diabetes. Only a few studies have focused on patterns of diabetes adaptation over time in youth with type 1 diabetes, especially in China. Understanding changes in diabetes self-management, depressive symptoms, metabolic control and satisfaction with quality of life can facilitate assessment and intervention.


DESIGN
This is a multi-site longitudinal descriptive study. Data for this report were collected at baseline with 136 eligible Chinese youth and 86 of them were followed up for the second time, 6-12 months after baseline data collection.


METHODS
Instruments to measure diabetes self-management, depressive symptoms, metabolic control and satisfaction with quality of life were collected at two time points. The data were collected from July 2009-October 2010. Linear mixed model analysis was used to analyse the longitudinal data.


RESULTS
Self-management decreased over time; however, depressive symptoms, metabolic control and satisfaction with quality of life did not change from baseline to 6-12 months in this sample of Chinese youth with type 1 diabetes. A decrease in diabetes self-management over time was associated with worse metabolic control, while an increase in depressive symptoms over time was associated with poorer quality of life satisfaction in this sample.


CONCLUSIONS
Chinese youth faced difficulties with diabetes adaptation, especially with the deterioration of diabetes self-management. Improving self-management and decreasing depressive symptoms may enhance diabetes adaptation with respect to metabolic control and quality of life.


RELEVANCE TO CLINICAL PRACTICE
The deterioration of diabetes self-management over time in youth with type 1 diabetes in China deserves nurses' careful surveillance. Clinical interventions appropriate to the Chinese culture and health care system are needed to improve self-management and depressive symptoms in Chinese youth with type 1 diabetes.
['Guo|Jia|J|', 'Whittemore|Robin|R|', 'Jeon|Sangchoon|S|', 'Grey|Margaret|M|', 'Zhou|Zhi-Guang|ZG|', 'He|Guo-Ping|GP|', 'Luo|Zi-Qiang|ZQ|']
D000293:Adolescent D044466:Asians D002648:Child D002681:China D003863:Depression D003922:Diabetes Mellitus, Type 1 D005260:Female D006801:Humans D008137:Longitudinal Studies D008297:Male D010549:Personal Satisfaction D011788:Quality of Life D012648:Self Care D055815:Young Adult
diabetes self-management depressive symptoms metabolic control quality of life youth type 1 diabetes nursing longitudinal survey