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Response shift and glycemic control in children with diabetes

DOI: 10.1186/1477-7525-3-38

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At year 1, thirty-eight children with type 1 diabetes attending a diabetes summer camp participated. At baseline and post-camp they completed the Problem Areas in Diabetes (PAID) questionnaire. Post-camp, the PAID was also completed using the 'thentest' method, which requires a retrospective judgment about their baseline functioning. At year 2, fifteen of the original participants reported their HbA1c.PAID scores significantly decreased from baseline to post-camp. An even larger difference was found between thentest and post-camp scores, suggesting scale recalibration. There was a significant positive correlation between year 1 HbA1c and thentest scores. Partial correlation analysis between PAID thentest scores and year 2 HbA1c, controlling for year 1 HbA1c, showed that higher PAID thentest scores were associated with higher year 2 HbA1c.Results from this small sample suggest that children with diabetes do show scale recalibration, and that it may be related to glycemic control.Diabetes is one of the most common chronic diseases of childhood. Adjustment to the disease and the demands of its complex regimen are formidable tasks even for adults. Children face these demands in the context of already challenging normative developmental tasks. Understanding children's diabetes-related problems can inform intervention designed to improve medical outcomes and quality of life for this population.Response shift is a theoretical construct that provides a framework for this investigation. In essence, it posits that people can adjust how they think about their quality of life when they encounter relevant new information. In this model, antecedents (e.g., demographics, personality), interact with a catalyst (intervention or change in health status) to elicit psychological mechanisms (e.g., social comparison) in order to accommodate the catalyst. Response shift then influences one's quality of life evaluation (see figure 1). According to Schwartz & Sprangers [1], response shift p


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