背景:我们旨在确定护理人员对优势和困难问卷(SDQ)的反应是否可以预测1型糖尿病儿童和青少年的HbA1c轨迹成员,当调整协变量时。
方法:对于2009年丹麦国家1型糖尿病儿童和青少年队列,我们分析了2010-2020年期间的年度HbA1c随访数据,包括来自丹麦国家登记处的社会人口统计学数据.使用基于组的轨迹建模和多项逻辑回归,我们测试了护理人员SDQ评分是否预测了调整性别时的HbA1c轨迹成员资格,诊断为糖尿病的年龄,糖尿病持续时间,家庭结构,和看护者教育。
结果:总计,835名儿童和青少年(52%为女性),平均(SD)年龄为12.5(3.3)岁,平均糖尿病持续时间为5.2(3.1)年,包括在内。基于7247HbA1c的观察,确定了四个HbA1c轨迹:(1)在目标上,逐渐减少(26%),(2)\'以上目标,轻度增加,然后减少(41%),(3)\'以上目标,适度增加,然后减少(24%),和(4)\'远高于目标,大幅增加,然后减少(9%)。较高的SDQ总困难分数预测轨迹3和4(分别为p=0.0002和p<0.0001)。关于SDQ分量表得分,情绪症状预测轨迹3和4,行为问题和多动/注意力不集中预测轨迹2、3和4。单亲家庭和低照顾者教育水平都预测了轨迹3和4。
结论:看护者的SDQ反应和社会人口统计学信息可能有助于发现儿童和青少年患有1型糖尿病,他们需要密集的多学科医学和心理干预。
We aimed to determine whether caregiver responses to the Strengths and Difficulties Questionnaire (SDQ) are predictive of HbA1c trajectory membership in children and adolescents with type 1 diabetes, when adjusting for covariates.
For a Danish 2009 national cohort of children and adolescents with type 1 diabetes, we analyzed yearly HbA1c follow-up data during 2010-2020 including sociodemographic data from Danish national registries. Using group-based trajectory modeling and multinomial logistic regression, we tested whether caregiver SDQ scores predicted HbA1c trajectory membership when adjusting for sex, age at diabetes diagnosis, diabetes duration, family structure, and caregiver education.
In total, 835 children and adolescents (52% females) with a mean (SD) age of 12.5 (3.3) years, and a mean diabetes duration of 5.2 (3.1) years, were included. Based on 7247 HbA1c observations, four HbA1c trajectories were identified: (1) \'on target, gradual decrease\' (26%), (2) \'above target, mild increase then decrease\' (41%), (3) \'above target, moderate increase then decrease\' (24%), and (4) \'well above target, large increase then decrease\' (9%). Higher SDQ total difficulties scores predicted trajectories 3 and 4 (p=0.0002 and p<0.0001, respectively). Regarding the SDQ subscale scores, emotional symptoms predicted trajectories 3 and 4, and conduct problems and hyperactivity/inattention predicted trajectories 2, 3, and 4. Single-parent family and low caregiver education level both predicted trajectories 3 and 4.
Caregiver SDQ responses and sociodemographic information may help detect children and adolescents with type 1 diabetes, who need intensive multidisciplinary medical and psychological interventions.