Marital Satisfaction as a Predictor of Paternal Involvement in Adolescent Diabetes Management

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2012-07-20

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Abstract

Type 1 diabetes mellitus (DM1) is a common disease in pediatric populations that becomes especially hard to manage during the adolescent years. The family context plays an important role in facilitating adolescent diabetes management. This prospective, longitudinal observation study examined whether marital satisfaction promotes aspects of adolescent health adjustment (e.g., pediatric quality of life, adherence to diabetes regimen, and metabolic control) by facilitating paternal involvement (e.g., general and diabetes specific monitoring) in a sample of adolescents with type 1 diabetes. A sample of 188 adolescents aged 10 – 14 years (M=12.49) who had been diagnosed with DM1 for at least one year, and their mothers and fathers, were assessed every six months for one year. Participants individually completed a packet of questionnaires measuring the primary study constructs. Multiple regression analyses showed mother reports of greater marital satisfaction predicted heightened paternal involvement six months later (i.e., teen reports of paternal monitoring, father reports of diabetes monitoring), and higher father reported adherence across the subsequent year. Father reports of greater marital satisfaction similarly predicted heightened father reports of diabetes specific paternal monitoring, as well as better diabetes management across the subsequent year (i.e., improvements in teen reported quality of life, mother and father reported adherence, and HbA1c). Bootstrapping mediation analyses were conducted to determine whether marital satisfaction predicted enhanced adolescent adjustment by promoting heightened paternal involvement. Maternal marital satisfaction predicted teen reports of adherence across the subsequent year, and this association was mediated by heightened paternal monitoring at six months. Supplemental analyses on the subsample of families where fathers completed measures at all three time points further indicated that both mothers’ and fathers’ marital satisfaction predicted heightened metabolic control across the subsequent year, and this was mediated by greater paternal diabetes monitoring at six months. Marital satisfaction sets an important context for facilitating paternal involvement in diabetes and promoting adolescent adjustment.

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