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Updated and Revised Diabetes Family Conflict Scale

¹ Pediatric, Adolescent, and Young Adult Section, Genetics and Epidemiology Section, Behavioral Research and Mental Health Section, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
² Children's Nutrition Research Center, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas

Address correspondence and reprint requests to Lori Laffel, MD, MPH, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215. E-mail: lori.laffel{at}joslin.harvard.edu

OBJECTIVE— The purpose of this study was to update the Diabetes Family Conflict Scale (DFCS) in the era of intensive diabetes management and provide an indication of its psychometric properties.

RESEARCH DESIGN AND METHODS— The revised DFCS and measures of negative emotions around blood glucose monitoring (BGM), quality of life, and perceived parental burden from diabetes management were completed by 202 children and adolescents with type 1 diabetes and their primary caregivers. Insulin regimen, adherence, and glycemic control were also assessed.

RESULTS— The revised DFCS demonstrated strong psychometric properties. There was acceptable internal consistency for child and caregiver forms of the DFCS. Factor analysis revealed two factors related to direct and indirect management tasks. Both child (r = 0.27, P < 0.01) and caregiver (r = 0.26, P < 0.01) DFCS scores were correlated with A1C values. Multivariate analysis of factors usually associated with A1C values showed an additive, independent contribution of diabetes-specific family conflict to the prediction of glycemic control: F (12,189) = 6.17, P < 0.01, R² = 0.28. Conflict around direct management tasks (e.g., BGM) was a more important predictor of higher A1C levels than conflict around indirect management tasks (e.g., telling friends about diabetes).

CONCLUSIONS— The revised and updated DFCS demonstrates strong psychometric properties and can be used as a tool for measuring the level of diabetes-specific conflict in families with children and adolescents with type 1 diabetes.

Abbreviations: BGM, blood glucose monitoring • BGMC, Blood Glucose Monitoring Communication • DCCT, Diabetes Control and Complications Trial • DFCS, Diabetes Family Conflict Scale • PAID, Problem Areas in Diabetes • PedsQL, Pediatric Quality of Life Inventory

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