RESUMEN
OBJECTIVE: To document the existence and prevalence of adolescent-generated diabetes management techniques. RESEARCH DESIGN AND METHODS: One hundred forty-four adolescents completed the confidential questionnaire developed for this study. Glycohemoglobin was also obtained for each individual. RESULTS: Within the 10 days before their clinic visit, many adolescents admitted to engaging in various mismanagement behaviors, with 25% admitting to missing shots. Parents tend to underestimate adolescent mismanagement. Missing shots was significantly related to poor control (P < 0.01). Older adolescents engaged in more mismanagement than their younger cohorts (P < 0.001). The questionnaire factored into two subscales: blatant mismanagement and faking. CONCLUSIONS: This study shows the importance of recognizing the prevalence of mismanagement among adolescents.
Asunto(s)
Conducta del Adolescente/psicología , Diabetes Mellitus Tipo 1/psicología , Cooperación del Paciente , Adolescente , Adulto , Factores de Edad , Glucemia/análisis , Niño , Diabetes Mellitus Tipo 1/sangre , Diabetes Mellitus Tipo 1/etnología , Diabetes Mellitus Tipo 1/terapia , Dieta para Diabéticos/psicología , Femenino , Humanos , Insulina/administración & dosificación , Insulina/sangre , Masculino , Encuestas y CuestionariosRESUMEN
The characteristics of children with diabetes readmitted to Children's Hospital during a 5-year period, 1984 to 1989, were compared with those characteristics of new-onset patients admitted for stabilization and education and to outpatients in the Children's Hospital diabetes program to determine which characteristics were associated with patients who were readmitted. Changes in the frequency of readmissions were examined to determine whether the introduction of a diabetes team and a program that emphasizes the importance of ensuring that patients at risk of readmission consistently received insulin injections resulted in a reduction of readmissions. Readmissions occurred more frequently in patients who were black (71% compared with 38% of new-onset patients and 31% of outpatients) (P less than .001), from one-parent homes (56% compared with 27% of new-onset patients and 24% of outpatients) (P less than .001), and without third-party insurance (45% compared with 18% of new-onset patients and 15% of outpatients) (P less than .001). Readmissions were very common at 14 to 15 years of age (39% of readmissions vs 18% of outpatients) and very uncommon in children younger than age 9 (6% of readmissions vs 27% of outpatients) (P less than .001). Fewer readmissions for ketoacidosis occurred in the summer than in any other season (P less than .05). Readmissions fell by 47% over the 5-year period while new-onset patients increased by 85%. The reduction in frequency of readmissions was due to fewer readmissions for ketoacidosis and fewer readmissions in blacks, in patients from one-parent homes, and in patients without third-party insurance.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Diabetes Mellitus Tipo 1/epidemiología , Hospitales Pediátricos/estadística & datos numéricos , Readmisión del Paciente/estadística & datos numéricos , Factores de Edad , Distribución de Chi-Cuadrado , Niño , District of Columbia/epidemiología , Humanos , Incidencia , Readmisión del Paciente/tendencias , Factores de Riesgo , Factores SocioeconómicosAsunto(s)
Diabetes Mellitus Tipo 1/psicología , Madres/psicología , Niño , Preescolar , Femenino , HumanosRESUMEN
Neurobehavioral evaluation of the high-risk neonate represents an important advance in early detection of behavioral anomalies which may give rise to later neuropsychological sequelae. In the present study neonates comprising three diagnostic categories (i.e., respiratory distressed, seizure-disordered, normals) were evaluated with the Brazelton Neonatal Behavior Assessment Scale (BNBAS) to determine the extent to which differences in neurobehavioral organization could be detected with the scale, and how they were related to diagnostic classification. Average conceptional age at testing for the three groups was within the range usually considered full term: e.g., 38.81 weeks (respiratory distressed), 40.18 weeks (normal healthy) and 42.54 weeks (seizure disorder). Infants who had been diagnosed with neonatal seizures exhibited consistently less optimal behavior than did either of the other two groups. Infants with respiratory distress and normal controls did not differ significantly on most summary measures of neurobehavioral organization scored with the BNBAS. The study offers support for the discriminative validity of the BNBAS and its potential usefulness in the assessment of clinically ill newborns.