
Contents
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Introduction Introduction
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Diabetes mellitus in children and adolescents Diabetes mellitus in children and adolescents
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Assessment of adherence and self-management Assessment of adherence and self-management
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Conceptual questions Conceptual questions
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Global clinical impressions Global clinical impressions
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Self-report questionnaires Self-report questionnaires
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Structured Interviews Structured Interviews
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Automated data collection Automated data collection
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Epidemiology of adherence and self-management Epidemiology of adherence and self-management
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Suboptimal diabetes management as a normative characteristic Suboptimal diabetes management as a normative characteristic
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Characteristics of individual youths with diabetes Characteristics of individual youths with diabetes
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Special populations: Youth with T2D and emerging adults with T1D Special populations: Youth with T2D and emerging adults with T1D
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Individual parents of youth with diabetes Individual parents of youth with diabetes
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Families of youth with diabetes Families of youth with diabetes
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Other social systems influencing diabetes management Other social systems influencing diabetes management
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Intervention trials Intervention trials
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Interventions targeting families as the unit of treatment Interventions targeting families as the unit of treatment
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Behavioral contracting and behavior modification Behavioral contracting and behavior modification
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Interventions targeting family communication and problem solving Interventions targeting family communication and problem solving
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Clinic-integrated interventions Clinic-integrated interventions
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Interventions Targeting Stress, Coping, and Psychological Adjustment in T1D Interventions Targeting Stress, Coping, and Psychological Adjustment in T1D
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Stress Management/Coping Skills Interventions Stress Management/Coping Skills Interventions
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Cognitive-Behavioral Therapy and Self-Monitoring Interventions Cognitive-Behavioral Therapy and Self-Monitoring Interventions
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Motivational Interviewing Motivational Interviewing
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Social Support Interventions Social Support Interventions
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Interventions utilizing telecommunications technology Interventions utilizing telecommunications technology
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T2D Interventions T2D Interventions
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Conclusions Conclusions
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Future Directions: What’s Missing? Future Directions: What’s Missing?
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Author Notes Author Notes
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References References
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25 Managing Complex Regimens: The Psychological Context of Family Management of Pediatric Diabetes
Get accessTim Wysocki, Division of Pediatric Behavioral Health, Department of Pediatrics, Nemours Children's Clinic.
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Published:16 December 2013
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Abstract
This chapter reviews the extensive empirical literature on diabetes self-management behavior among children, adolescents, and their families, including an overview of assessment methods, the epidemiology of suboptimal diabetes management, variables influencing the effectiveness of diabetes management and trials of appropriate behavioral and psychological interventions. Substantial research shows that suboptimal family management of diabetes, particularly during adolescence, is so common as to be virtually normative. Additional research shows that management of diabetes among children and adolescents is essentially a family enterprise and outcomes are optimized when families are able to recruit and utilize a variety of effective coping resources such as affiliative, organizational, communicative, problem-solving, and conflict-resolution skills. Trials of behavioral and psychological interventions targeting individual children or adolescents and targeting families have shown some promise, but there remain many important barriers to the efficient integration of the body of psychological knowledge and research into routine clinical care for pediatric diabetes.
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