Testing a model of eight factors as predictors of glycemic control in children with diabetes

The purpose of this study was to test a model of hope, self-esteem, insulin regimen, diabetes duration, socioeconomic status, clinic attendance, nutritional compliance, family support, and glycemic control in children aged eight to twelve with Type 1 diabetes using path analysis. The research question was: What is the relationship between the variables hope, self-esteem, insulin regimen, diabetes duration, socioeconomic status, clinic attendance, nutritional compliance and family support and the variable glycemic control? The hypotheses included: (1) Hope is positively related to self-esteem, clinic attendance, nutritional compliance and glycemic control; (2) Self-esteem is positively related to clinic attendance, nutritional compliance and glycemic control; (3) Insulin regimen is positively related to clinic attendance and glycemic control; (4) Insulin regimen is inversely related to hope, self-esteem and nutritional compliance; (5) Socioeconomic status is positively related to hope, self-esteem, social support, nutritional compliance and glycemic control; (6) Diabetes duration is positively related to clinic attendance; (7) Diabetes duration is inversely related to self-esteem, hope and glycemic control; (8) Clinic attendance is positively related to nutritional compliance and glycemic control; (9) Nutritional compliance is positively related to glycemic control; and (10) Family support is positively related to hope, clinic attendance, and glycemic control.; Based on analysis of critical ratios (CR), five significant paths were identified. The significant paths included (1) Hope → Self-Esteem (CR = 7.995), (2) Insulin Regimen → Glycemic Control (CR = 2.943), (3) Insulin Regimen → Nutritional Compliance (CR = −3.188), (4) Socioeconomic Status → Nutritional Compliance (CR = 3.575) and (5) Nutritional Compliance → Glycemic Control (CR = −7.945).; Implications for nursing practice include: (1) nursing practice that focuses on a thorough assessment of nutritional compliance in the diabetic child and an understanding of the relation between nutritional compliance and glycemic control, (2) nursing practice that focuses on the relation between socioeconomic status and nutritional compliance and the indirect relation it has on glycemic control when assessing children with diabetes, (3) nursing practice that focuses on education of patients and families regarding specific insulin regimens and its relation to glycemic control and (4) nursing practice that recognizes the relation between hope and self-esteem. (Abstract shortened by UMI.)...