Response shift and glycemic control in children with diabetes
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Response shift and glycemic control in children with diabetes Julie A Wagner* Address: Department of Behavioral Sciences and Community Health, University of Connecticut, School of Dental Medicine, 263 Farmington Avenue, Farmington, CT 06030, USA Email: Julie A Wagner* - [email protected] * Corresponding author
Published: 14 June 2005 Health and Quality of Life Outcomes 2005, 3:38 38
doi:10.1186/1477-7525-3-
Received: 14 April 2005 Accepted: 14 June 2005
This article is available from: http://www.hqlo.com/content/3/1/38 © 2005 Wagner; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: The purpose of this study was to investigate the scale recalibration construct of response shift and its relationship to glycemic control in children with diabetes. Methods: 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. Results: 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. Conclusion: Results from this small sample suggest that children with diabetes do show scale recalibration, and that it may be related to glycemic control.
Background 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
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