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Updated and Revised Diabetes Family Conflict Scale

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

lori.laffel{at}joslin.harvard.edu

ABSTRACT

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: 202 children and adolescents with type 1 diabetes and their primary caregivers completed the revised DFCS and measures of negative emotions around blood glucose monitoring, quality of life, and perceived parental burden from diabetes management. Assessment of insulin regimen, adherence, and glycemic control was also conducted.

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., blood glucose monitoring) 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.

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