Diabetes problem solving by youths with type 1 diabetes and their caregivers: measurement, validation, and longitudinal associations with glycemic control

Wysocki, T.; Iannotti, R.; Weissberg-Benchell, J.; Laffel, L.; Hood, K.; Anderson, B.; Chen, R.; Family Management of Childhood Diabetes Steering, Committee

J Pediatr Psychol. 2008 Mar 19; 33(8):875-84

Abstract

OBJECTIVES: This article introduces a new measure of problem-solving skills of youths with type 1 diabetes (T1DM) and adult caregivers in correcting glycemic fluctuations. METHODS: The Diabetes Problem Solving Interview (DPSI), a structured interview, was validated during a pilot study of a behavioral intervention. DPSI data and measures of diabetes management were obtained at baseline from 114 youths (ages 9-14.5) and 109 caregivers. Glycosylated hemoglobin (HbA(1c)) was measured quarterly over 9 months. RESULTS: Results confirmed the psychometric adequacy of the DPSI. For caregivers, but not youths, low DPSI scores (indicating poor problem-solving skills) were significantly associated with worse HbA(1c) over 9 months. CONCLUSIONS: The DPSI has clinical and research utility as a measure of diabetes problem-solving skills. Identification and targeted remediation of caregivers' deficient diabetes problem-solving skills or promotion of youths' utilization of these skills could possibly enhance glycemic control in youths with T1DM.

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