Date of Award
Master of Arts (MA)
Amy Hughes Lansing
Type 1 diabetes (T1D) is a complex chronic illness requiring both complex daily treatments and ongoing healthcare provider interactions to support optimal glycemic levels necessary for long-term health and quality of life. Adolescents do not manage their T1D by themselves but rather in collaboration with parents who often help in health tasks and navigating healthcare provider interactions. Although parental support is critical for the adolescent’s development of disease-management skills, it requires parents maintain a delicate balance of allowing adolescent autonomy and providing parent support. When parental support shifts to parental overprotection, i.e., restricting and limiting an adolescent’s activity engagement, it may impair adolescent’s skill development and mastery necessary to complete diabetes-management tasks independently, including healthcare provider communication. In particular, parental overprotection may impact the adolescent’s interpersonal effectiveness skills, in that adolescents may not learn how to be mindful and attentive to relationships or build a repertoire of mindfulness and self-compassion that would support effective healthcare provider communication and more independent diabetes management. Thus, adolescent experiences of interpersonal effectiveness skills, parental overprotection, and healthcare provider communication may have long-term implications for diabetes outcomes as the adolescent transitions to adulthood. Adolescents with type 1 diabetes might then benefit from an intervention targeted at interpersonal effectiveness skills to both reduce parental overprotection and improve healthcare provider communication. Adolescent participants (n=25, mean age=16.25, 56% female) completed a baseline survey for a pilot intervention study aimed at increasing mindfulness and decreasing diabetes-related stress. Adolescents reported on mindfulness, self-compassion, parental overprotection, and health care provider communication. The present study found that increased adolescent perception of parental overprotection was associated with decreased interpersonal effectiveness skills (mindfulness and self-compassion) and all were associated with increased difficulty with communicating with healthcare providers about diabetes. In addition, the potential utility of a mindfulness intervention for improving interpersonal effectiveness skills, decreasing parental overprotection, and improving adolescent healthcare provider communication was examined. The results also indicate potentially meaningful change scores for the four variables of interests between treatment and waitlist groups with very small to large effect sizes that may accrue into meaningful changes across time. Further, among adolescents who were highly engaged in the intervention program (n=11), mindfulness, self-compassion, parental overprotection, and healthcare provider communication again showed potentially meaningful change scores with small to medium effect sizes that may have long-term impact across time. These findings indicate that a mindfulness-based intervention has potential utility, especially for participants who were highly engaged in the program. Parental overprotection and interpersonal effectiveness skills may be key factors to target in interventions to support the transition of diabetes-management behaviors from parent to adolescent as the adolescent ages into young adulthood, particularly with regard to adolescents learning to communicate with their healthcare providers.
Number of Pages
Humiston, Tori, "Healthcare Provider Communication in Teens with Type 1 Diabetes: Parental Overprotection and Interpersonal Effectiveness Skills" (2021). Graduate College Dissertations and Theses. 1372.