Browsing by Person "Noyes, Kathryn"
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Item An exploratory study of positive and incongruent communication in young children with type 1 diabetes and their mothers.(Wiley-Blackwell, 2012-10-08) Chisholm, Vivienne; Atkinson, Leslie; Bayrami, Lisa; Noyes, Kathryn; Payne, A.; Kelnar, ChrisBackground: The incidence of type 1 diabetes is increasing in young children. However, they are overlooked in treatment adherence and intervention research despite evidence that parents often experience difficulty securing their tretament cooperatoin, especially with the diet. We investigated positive and incongruent (i.e., the co-occurrence of contradictory verbal and nonverbal messages)communication in the mother-child dyad and their association wiht child adjustment and dietary adherence outcomes. Methods: Participants were 23 6-to-8 year old children with type 1 diabetes and their mothers. We conducted dietary adherence interviews with mothers and performed nutritional analyses to assess children's consumption of extrinsic sugars (e.g., confectionary). Mothers completed a standardised assessment of child psychological adjustment. Mothers and children engaged in a videotaped problem-solving task related to the dietary regimen, with maternal and child utterances and nonverbal behaviours analysed for positive dyadic and incongruent communication. Results: Positive dyadic communication correlated with lower levels of child incongruent communication, fewer behavioural problems and better overall adjustment. Higher levels of maternal and child incongruent communication correlated with more behavioural and emotional problems and poorer overall adjustment. Higher levels of maternal incongruent communication correlated with porer dietary adherence. Conclusions: Results converge to form a conceptually and empirically coherent pattern in that behavioural indices of poorer communication in both mother and child consistently correlated with poorer child adjustment outcomes. This study shows that specific features of dyadic, child and maternal communication could be targeted in developmentally-sensitive interventions to promote positive communication in the home management of type 1 diabetes care for young children.Item Maternal communication style and treatment adherence in young children with type 1 diabetes.(Sage, 2010) Chisholm, Vivienne; Atkinson, Leslie; Donaldson, Caroline; Noyes, Kathryn; Payne, A.; Kelnar, ChrisThe incidence of type 1 diabetes (T1D) in young children is increasing markedly however young children have been overlooked in paediatric adherence research despite the unique challenges their care presents. We investigated the relation between maternal communication style and adherence to the dietary regimen in 40 children with T1D, aged 2-8 years, and their mothers. Mothers completed measures of children's sugar consumption, parent-child communication quality, and child psychological functioning. Mothers and children engaged in a videotaped problem-solving task related to the dietary regimen, with maternal utterances analysed for behavioural control style (e.g., commands versus suggestions) and cognitive complexity (e.g., provision of labels versus questions). Maternal communications which engaged children, behaviourally and cognitively, in the task were associated with better adherence, medical, communication quality, and child adjustment outcomes. We conclude that adherence and health (medical and psychological) are optimised when young children are given opportunities to participate in their care.Item Maternal communication style, problem-solving and dietary adherence in young children with type 1 diabetes(2011-07) Chisholm, Vivienne; Atkinson, Leslie; Donaldson, Caroline; Noyes, Kathryn; Payne, Anne; Kelnar, ChrisThe incidence of type 1 diabetes (T1D) in young children is increasing markedly however young children have been overlooked in paediatric adherence research despite the unique challenges their care presents. We investigated the relation between maternal communication style and adherence to the dietary regimen in 40 children with T1D, aged 2-8 years, and their mothers. Mothers completed measures of children's sugar consumption, parent-child communication quality, and child psychological functioning. Mothers and children engaged in a videotaped problem-solving task related to the dietary regimen, with maternal utterances analysed for behavioural control style (e.g., commands versus suggestions) and cognitive complexity (e.g., provision of labels versus questions). Maternal communications which engaged children, behaviourally and cognitively, in the task were associated with better adherence, medical, communication quality, and child adjustment outcomes. We conclude that adherence and health (medical and psychological) are optimized when young children are given opportunities to participate in their care.Item Predictors of treatment adherence in young children with type 1 diabetes.(Blackwell Publishing Ltd, 2007) Chisholm, Vivienne; Atkinson, Leslie; Donaldson, Caroline; Noyes, Kathryn; Payne, A.; Kelnar, ChrisAim. This paper reports a study to investigate whether diabetes-specific, demographic and psychosocial variables predict adherence in young children with type 1 diabetes. Background. Paediatric diabetes rates are increasing worldwide; however, young children are neglected in treatment adherence research, despite the importance of adherence for health. Greater understanding of adherence in this group could enhance nurses' ability to provide care tailored to families' needs. Method. A cross-sectional study was carried out between 2001 and 2003 with 65 children aged 2-8 years and their mothers in Britain. Mothers were interviewed about children's diabetes care, nutritional analyses were conducted and mothers completed assessments of diabetes knowledge, parenting stress, family functioning and child psychological adjustment. Demographic and medical information was collected from patient records. Findings. Consistent with older populations, blood glucose monitoring and dietary regimens showed greater adherence variability than injection frequency and injection time consistency. Better maternal diabetes knowledge correlated with less injection time variability, more frequent blood glucose monitoring, lower percentage energy intake from extrinsic sugars, lower glycosylated haemoglobin levels and fewer relationship difficulties. Longer diabetes duration, greater injection time variability and higher percentage energy intake from extrinsic sugars predicted less frequent blood glucose monitoring. More relationship difficulties and less frequent blood glucose monitoring predicted higher percentage energy intake from extrinsic sugars. Conclusions. Nurses can facilitate treatment adherence through provision of educational, practical and socio-emotional support. Nursing interventions should target blood glucose monitoring and dietary regimens in particular, and nurses should be sensitive to the various caretaking challenges presented to parents by different components of the diabetes regimen.