ABSTRACT
OBJECTIVE: To devise and implement a structured intervention for integrating peers into diabetes care in a healthy and adaptive manner. METHODS: Adolescents with diabetes (n = 21) and their best friends (n = 21) participated in a group intervention aimed at increasing diabetes knowledge and social support of diabetes care. Measures of social support, knowledge about diabetes and support, diabetes functioning, and social functioning were obtained prior to and following intervention. RESULTS: Following the intervention, adolescents and their friends demonstrated higher levels of knowledge about diabetes and support, as well as a higher ratio of peer to family support, and friends demonstrated improved self-perception. Parents reported decreased diabetes-related conflict. CONCLUSIONS: Peer group intervention approaches may result in increased positive peer involvement in adolescents' diabetes care.
Subject(s)
Diabetes Mellitus, Type 1/psychology , Interpersonal Relations , Peer Group , Psychotherapy, Group , Social Support , Adaptation, Psychological , Adolescent , Child , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Patient Compliance/psychology , Personality Inventory , Self Care/psychology , Sick RoleABSTRACT
OBJECTIVE: To describe the short-term results of a controlled trial of Behavioral Family Systems Therapy (BFST) for families of adolescents with diabetes. METHODS: We randomized 119 families of adolescents with diabetes to 3 months' treatment with either BFST, an education and support Group (ES), or current therapy (CT). Family relationships, psychological adjustment to diabetes, treatment adherence and diabetic control were assessed at baseline, after 3 months of treatment (reported here), and 6 and 12 months later. RESULTS: Compared with CT and ES, BFST yielded more improvement in parent-adolescent relations and reduced diabetes-specific conflict. Effects on psychological adjustment to diabetes and diabetic control were less robust and depended on the adolescent's age and gender. There were no effects on treatment adherence. CONCLUSIONS: BFST yielded some improvement in parent-adolescent relationships; its effects on diabetes outcomes depended on the adolescent's age and gender. Factors mediating the effectiveness of BFST must be clarified.
Subject(s)
Behavior Therapy/methods , Diabetes Mellitus, Type 1/psychology , Family Therapy/methods , Mental Disorders/etiology , Mental Disorders/therapy , Adolescent , Female , Follow-Up Studies , Health Status , Humans , Male , Parent-Child Relations , Social Adjustment , Surveys and QuestionnairesABSTRACT
BACKGROUND: C282Y hereditary haemochromatosis is an appropriate condition for population screening. Transferrin saturation, the best screening test to date, is relatively expensive, labour intensive, and cannot be automated. Unsaturated iron binding capacity is a surrogate marker of transferrin saturation and its measurement can be automated. AIMS: To evaluate a screening strategy for C282Y hereditary haemochromatosis in a tertiary hospital environment based on unsaturated iron binding capacity as the initial screening test. METHODS: Measurement of unsaturated iron binding capacity was adapted to the main laboratory analyser. An unsaturated iron binding capacity of less than 30 micromol/l was identified as an appropriate decision point and 5182 consecutive subjects were screened over 28 consecutive days. RESULTS: Of those screened, 697 had an unsaturated iron binding capacity less than 30 micromol/l. Of these, transferrin saturation was greater than 40% in 294. A total of 227 were able to be genotyped for the C282Y mutation. Nine subjects homozygous for C282Y were identified. Based on full cost recovery, affected persons were identified at a cost of Aus$2268.77 per case (approximately US$1496). CONCLUSION: Automated measurement of unsaturated iron binding capacity enables a cost effective, large scale population screening programme for C282Y hereditary haemochromatosis to be developed.
Subject(s)
Genetic Testing/methods , Hemochromatosis/diagnosis , Iron/metabolism , Transferrin/metabolism , Adult , Aged , Aged, 80 and over , Cost-Benefit Analysis , Evaluation Studies as Topic , Female , Genetic Markers , Genetic Testing/economics , Genotype , Hemochromatosis/genetics , Hemochromatosis/metabolism , Humans , Male , Middle AgedABSTRACT
Compared the social validity of behavior therapy vs. support group interventions for reduction of parent-adolescent conflict among families of adolescents with diabetes. Families were randomized to 10 sessions of an Education and Support group (ES) or 10 sessions of Behavioral Family Systems Therapy (BFST). We compared participants' social validity ratings of BFST and ES using the Treatment Evaluation Questionnaire (TEQ). Mean TEQ scores were significantly more positive for BFST than ES and, for 13 of 20 items, BFST was rated significantly more positively by parents and/or adolescents. Adolescents rated ES less positively than did parents. Fathers' responses reflected fewer differences between ES and BFST. Results extend previous research on BFST and confirm its superiority over ES for targeting family conflict.