The Relation Between Maternal Beliefs and Behavior and the Metabolic Control and Social Development of Children with Diabetes

This study examined the relation between maternal control, beliefs, and concerns and the metabolic and social development outcomes of their children with insulin dependent diabetes mellitus (IDDM). It was expected that maternal control (i.e., protectiveness, knowledge and beliefs about. diabetes, and self-efficacy) would be positively related to children's outcomes as measured by their metabolic control, social and behavioral development. Thirty mother/child dyads participated. Children met the following criteria: (a) 4 to 16 years of age, (b) continually insulin-dependent for at least four months, and (c) had no significant cognitive or emotional impairment. To examine the effects of maternal control and fears on child outcome, mothers completed the Parental Assessment of Child Monitoring Scale (PACM; Hetherington & Clingempeel, 1983) and the Protectiveness Scale (Hardy, 1990) . Mothers also completed three diabetes-specific measures assessing maternal beliefs, control, and fears as well as a family background questionnaire. To assess child outcome, four measures were administered. The mothers completed the Child Behavior Checklist (CBCL; Achenbach & Edelbrock, 1983). Mothers also were administered the Vineland Adaptive Behavior Scales Interview Edition, Survey Form (Sparrow, Balla, S Cicchetti, 19S4). The children with diabetes completed a questionnaire that examined how they felt about their diabetes care. Glycosylated hemoglobin (GHb), a measure of the average blood glucose level for the previous 2-3 months, was taken on each child. A tendency existed for maternal confidence, the mother's belief in her ability to cope with her child with IDDM and the child's low blood sugar, to be negatively correlated with glycosylated hemoglobin. Maternal self-confidence, however, was not related to child behavior. Other correlations revealed that the more protective the mother, the more frequently the child's blood glucose level was monitored. Additionally, children of very protective and/or worried mothers, exhibited more internalizing and externalizing behavior. In conclusion, diabetes is a metabolic condition and not a psychosocial developmental process, thus, it was encouraging to find that children's social development, as measured by the Vineland, was not correlated with glycosylated hemoglobin levels. Maternal self-efficacy appears related to children's health rather than social development of the child.