Department of Psychology and Behavioural Sciences

Assessment of family functioning in families with a child diagnosed with type 1 diabetes - Validation and clinical relevance of the General Functioning subscale of the McMaster Family Assessment Device

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DOI

  • Maria Axtoft Munk Pedersen, Department of Paediatrics, Copenhagen Diabetes Research Center (CPH-DIRECT), Herlev University Hospital, Herlev, Denmark.
  • ,
  • Lene Juel Kristensen
  • ,
  • Stine Møller Sildorf, Department of Paediatrics, Copenhagen Diabetes Research Center (CPH-DIRECT), Herlev University Hospital, Herlev, Denmark.
  • ,
  • Svend Kreiner, Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • ,
  • Jannet Svensson, Department of Paediatrics, Copenhagen Diabetes Research Center (CPH-DIRECT), Herlev University Hospital, Herlev, Denmark.
  • ,
  • Anne Hvarregaard Mose
  • ,
  • Mikael Thastum
  • Niels Birkebaek

Background: Type 1 diabetes (T1D) can have a negative effect on family functioning, which is associated with deterioration in metabolic control. Therefore, a valid tool for assessing family functioning is clinically relevant. We assessed the quality and validity of the Danish general functioning (GF) subscale of the family assessment device (FAD). Additionally, we investigated GF scores among adolescents with T1D and their parents and the relationship between family functioning and background variables, including metabolic control. Methods: All Danish families with a child diagnosed with T1D (N = 1997) were invited to participate in a web-based survey. In total, 616 adolescents (aged 12-17 years) and 1035 parents (of children aged 2-17 years) responded. The quality and validity of measurements made using the GF subscale were assessed using the Rasch model and graphical log-linear Rasch models (GLLRMs). Differences among GF responses were also assessed using GLLRMs. The relationships between GF scores and background variables were examined by multivariate analyses. Results: A dichotomized version of the GF subscale provided essentially valid measures of family functioning. Furthermore, the GF subscale measured family functioning most accurately in families with worse family functioning than in our population. To accurately characterize family functioning, it is important to take both parent's and adolescent's perceptions into account. Family functioning was associated with glycated hemoglobin (HbA1c) levels, and discrepancies in family functioning were associated with higher HbA1c levels. Conclusions: A dichotomized GF subscale is useful for assessment of family functioning. Parent's and adolescent's scores should be kept separate. Family functioning is associated with HbA1c levels.

Original languageEnglish
JournalPediatric Diabetes
Volume20
Issue6
Pages (from-to)785-793
Number of pages9
ISSN1399-543X
DOIs
Publication statusPublished - Sep 2019

Bibliographical note

© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

    Research areas

  • HbA1c, family assessment device, family functioning, the General Functioning subscale, type 1 diabetes, ADOLESCENTS, RELIABILITY, MODEL, VALIDITY

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ID: 153702142