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AimTo construct a model addressing the pathways from baseline diabetes distress, attribution of peer reactions, parenting style and 3-month self-management to 6-month glycated haemoglobin levels in adolescents with type 1 diabetes.DesignA prospective design was adopted.MethodsA total of 177 adolescents aged 10-19 with type 1 diabetes were enrolled from four hospitals in Taiwan. Diabetes distress, attribution of peer reactions and parenting style were collected at baseline, self-management was collected at the third month and glycated haemoglobin levels were collected at the sixth month. Data were collected from May 2015-June 2016.ResultsBaseline diabetes distress and 3-month self-management directly affected 6-month glycated haemoglobin levels. Baseline attribution of peer reactions directly affected baseline diabetes distress and 3-month self-management; also, it indirectly affected 6-month glycated haemoglobin levels through 3-month self-management. Baseline parenting style directly affected baseline diabetes distress, baseline attribution of peer reactions, 3-month self-management and 6-month glycated haemoglobin levels; it also indirectly affected 6-month glycated haemoglobin levels through baseline diabetes distress and 3-month self-management.ConclusionA model simultaneously incorporating individual, parental and peer factors to glycaemic control in adolescents with type 1 diabetes has been constructed. Improving diabetes distress and self-management should be essential strategies to improve glycaemic control in adolescents with type 1 diabetes. Encouraging adolescents with type 1 diabetes to communicate openly with peers about diabetes care and educating their parents to provide more responsive and autonomy-encouraging parenting style might be vital strategies to improve diabetes distress, 3-month self-management and glycaemic control.ImpactIndividual, parental and peer factors should be simultaneously considered to improve glycaemic control in adolescents with type 1 diabetes. Nurses should evaluate these factors to tailor interventions improving glycaemic control in adolescents with type 1 diabetes.

Introduction: Chronic physical disease (CPD) makes life filled with many negative events in adolescents, but not all adolescents experiencing negative life events proceed to develop emotional distress, only those with low emotional distress tolerance (EDT). A valid and reliable scale to measure EDT in CPD adolescents is important for caring for their emotional distress. Therefore, the purpose of this study is to translate the 15‐item English version Distress Tolerance Scale (DTS) into a Chinese version and then validate the scale for measuring EDT of adolescents with CPD. Methods: The 15‐item English version DTS was translated into a Chinese version using the translation guidelines for cross‐cultural research. Two cohorts of adolescents with CPD were recruited from four hospitals in southern Taiwan, with the first cohort including 124 adolescents with CPD employed to conduct exploratory factor analysis, corrected item‐total correlation and reliability testing, while the second cohort, consisting of 238 adolescents with CPD, was utilized to examine confirmatory factor analysis and concurrent validity. Results: The two‐factor nine‐item Chinese version DTS for Adolescents with CPD (C‐DTS‐A) was developed. Lower scores of the C‐DTS‐A were significantly associated with higher diabetes distress, poorer self‐management, and worse glycaemic control; their correlation coefficients sequentially were −.40,.17 and −.23. Cronbach's α and the test–retest reliability of the two‐factor C‐DTS‐A ranged from.81 to.87 and from.79 to.89, respectively. Conclusion: The two‐factor nine‐item C‐DTS‐A with good cross‐cultural translation quality was a reliable and valid scale to assess EDT for adolescents with CPD. [ABSTRACT FROM AUTHOR]

Background: Cancer survivors are at increased risk of long-term adverse effects related to the disease or treatment. Thus, it is important for cancer survivors to adopt a health-promoting lifestyle (HPL). This study aims to: (1) describe health behavior self-efficacy (HBSE) and HPL of adolescent survivors of childhood cancer, (2) examine the relationships between HBSE, HPL, and various demographic factors, and (3) identify determinants of HPL among adolescent survivors of childhood cancer. Method: A descriptive cross-sectional study was conducted with adolescent survivors of childhood cancer, ranged in age from 11 to 19 years (n = 82). Participants were recruited from pediatric oncology follow-up clinics at two medical centers in southern Taiwan. Data for each participant were collected from questionnaires assessing HBSE and HPL. Results: Only 61% of the adolescent survivors were considered as normal weight. The exercise was the lowest scoring HBSE subscale. Factors associated with better HPL included: education level, HBSE, well-being, and a healthy diet. Specifically, survivors diagnosed with cancer during adolescence exhibited significantly greater self-efficacy with stress management (F = 3.20, p =.04) compared with those diagnosed at pre-school ages. HBSE scores for well-being and a healthy diet were significant predictors of HPL, accounting for 43.8% of the total variance observed. Discussion: Our findings suggest that the age of diagnosis of childhood cancer significantly modulates the frequency of health-promoting behaviors of adolescent survivors. Thus, interventions designed to enhance adolescents' well-being and the management of a healthy diet may enhance HPL in survivors of childhood cancer. [ABSTRACT FROM AUTHOR]

Self‐management among adolescents with type 1 diabetes (T1D) is poorer than in other age groups during childhood. A valid and reliable short‐form scale to measure self‐management in adolescents with T1D is prudent for enhancing their self‐management in clinical settings. We used a cross‐sectional design to develop a short‐form Chinese version of the Self‐Management of Type 1 Diabetes for Adolescents Scale (C‐SMOD‐A) and test its psychometric characteristics. Two hundred adolescents with T1D were recruited from four hospitals in Taiwan through convenience sampling. Content validity, exploratory factor analysis, and corrected item‐total correlations were used to shorten the 52‐item C‐SMOD‐A. Confirmatory factor analysis, criterion‐related validity, and reliability testing were used to examine the psychometric characteristics of the short‐form C‐SMOD‐A. Finally, the 23‐item C‐SMOD‐A (C‐SMOD‐A‐23) with five inter‐correlated factors was developed. Glycated hemoglobin levels were significantly associated with each subscale of the C‐SMOD‐A‐23 with correlation coefficients ranging from −0.18 to −0.31. The composite reliability and test–retest reliability of the five subscales ranged from 0.70 to 0.88 and from 0.78 to 0.93 respectively. Accordingly, the C‐SMOD‐A‐23 has acceptable validity and reliability to measure five specific domains of self‐management for adolescents with T1D. Health‐care providers could use the C‐SMOD‐A‐23 as a clinical reference to assess specific domains of self‐management and provide interventions to enhance self‐management for adolescents with T1D. [ABSTRACT FROM AUTHOR]