Marleana M. Rolón-Sanfeliz, BA, Alejandra S. Cuff-Morales HSDG, Carlos, J. Ríos-Miranda HSDG, Eduardo Cumba-Avilés, PhD, Stephanie Ortiz-Domenech, PhD., & María I. Jiménez-Chafey, PsyD

Institute for Psychological Research, College of Social Sciences, University of Puerto Rico, Río Piedras Campus

INTRODUCTION: Between 83%–89% of caregivers of youth from Puerto Rico with type 1 diabetes (T1D) have reported being worried about their child’s health either always or most of the time. However, the content of these worries/concerns has not been explored in depth. We examined the specific content of caregivers’ worries about TID in their offspring and the relationship between reports of multiple worries and health-related criteria and family environment variables.

METHOD: Participants were 65 Hispanic caregivers (81.54% women) aged 32–58 (M=43.34) who completed an eligibility assessment for an adolescent depression treatment study. Caregivers answered an open-ended question regarding their main worries/concerns about T1D in their children (aged 12-17 years). We identified the main themes of parental worries and coded responses using categories defined based on their content. Chi-Square Test was used to compare groups in categorical variables (p≤.05) and Pearson correlation was used to assess associations with other family and health–related variables.

RESULTS: Caregiver’ responses produced 106 codable units. Inter-rater agreement between two coders was excellent (κ=.95). Categories of worries and their occurrence were: “Comorbidity and Future Functionality” (41.51%), “Psychological/Cognitive Aspects of Adolescents” (10.38%), “Issues About Self-Care” (16.98%), “Short Term Complications/Emergency Situations” (19.81%), “Repercussions on Families/Caregivers” (9.43%), and “Discrimination/Lack of Sensitivity” (1.89%). The proportion of caregivers providing responses belonging to these categories was 66.15%, 15.38%, 27.69%, 30.77%, 13.85%, and 3.08%, respectively. Reports containing ≥2 different codes were associated with less adherence to exercise and more use of psychotropic medications among adolescents. Using one-tailed Pearson correlations, these reports were associated with lower expressiveness and cohesion among families.

CONCLUSION: Our findings suggest that parental interventions should include strategies to manage Hispanic caregivers’ most common worries/concerns about T1D in their offspring (particularly diabetes-related complications) and the examination of the relationship between their worries, self-care behaviors in adolescents, and family climate.

IRB APPROVAL NUMBER: 1112-005 (UPR-Río Piedras).

ACKNOWLEDGEMENTS: This study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (R03DK092547).

KEYWORDS: Adolescents, caregivers’ worries, diabetes complications, family climate, self-care