Facilitation of diabetes adaptation and psychosocial adjustment by fitting parental monitoring and independence encouragement to an adolescent's competence

The study examined 1) if optimal physical and psychosocial development of adolescents with type 1 diabetes occurred when parents fit their independence encouragement and monitoring to the self-efficacy, competence, or age of their child and 2) directly compared the effects of mothers' versus fathers' fit of monitoring and independence encouragement to developmental markers of skill in disease management on adolescent health and emotional outcomes. 252 adolescents aged 10- 14 completed assessments of parental monitoring, independence encouragement, and their own competencies and self-efficacy in managing their illness. Physical outcomes were assessed by adolescents' completion of a modified version of the Self- Care Inventory and glycosolated hemoglobin (HbA1c) scores gathered from medical records. Psychosocial outcomes included the Child Depression Inventory and a measure of functional autonomy. Results from hierarchical regressions revealed that high mothers' monitoring was mainly associated with better adherence and more autonomy, but had little interaction with the various markers of developmental maturity in managing diabetes (i.e., self-efficacy, competence, and age). The effect of fathers' monitoring and independence encouragement were more frequently associated with positive developmental outcomes when they were titrated to the self-efficacy and competence of the child. Results indicate the important and interactive nature of parental, and especially father, monitoring and independence encouragement with the level of competence of the adolescent in managing their diabetes.