BIOMEDICAL AND PSYCHOSOCIAL PREDICTORS OF EARLY REHOSPITALIZATION AMONG CHILDREN WITH INSULIN-DEPENDENT DIABETES-MELLITUS - A LONGITUDINAL-STUDY

被引:21
作者
CHARRONPROCHOWNIK, D [1 ]
KOVACS, M [1 ]
OBROSKY, DS [1 ]
STIFFLER, L [1 ]
机构
[1] UNIV PITTSBURGH,SCH MED,DEPT PSYCHIAT,PITTSBURGH,PA 15261
关键词
CHILDREN; IDDM; EARLY REHOSPITALIZATION; SURVIVAL ANALYSIS; BIOMEDICAL PSYCHOSOCIAL PREDICTORS; LONGITUDINAL STUDY;
D O I
10.1111/j.1464-5491.1994.tb00288.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The purpose of the present study was to determine the cumulative probability of the first diabetes-related rehospitalization within the initial 2.5 years after the onset of insulin-dependent diabetes mellitus (IDDM) among newly diagnosed children, and to identify risk factors that can be determined shortly after IDDM-onset. The sample consisted of 88 children, 8 to 13 years old at the onset of IDDM, who had been participating in a longitudinal study. In this sample, there was a 0.25 cumulative probability of an early readmission. Poor control was the most frequent reason for readmissions. Four variables significantly increased the risk of early rehospitalization: severity of child's externalizing symptoms at IDDM-onset, lower socio-economic status, younger age at onset of IDDM, and higher levels of glycosylated haemoglobin, reflecting poorer metabolic control. Because externalizing symptoms and poor control are amenable to change, some early rehospitalizations can potentially be prevented. Furthermore, information about the risk of early rehospitalization should be part of initial diabetes education in order to better prepare families for the possibility of such an event.
引用
收藏
页码:372 / 377
页数:6
相关论文
共 25 条
[11]  
Kovacs M., The Interview Schedule for Children (ISC), Psychopharmacol Bull, 21, pp. 991-994, (1985)
[12]  
Diagnostic and Statistical Manual of Mental Disorders, (1980)
[13]  
Kovacs M., Feinberg TL, Paulauskas S., Finkelstein R., Pollock M., Crouse-Novak M., Initial coping responses and psychosocial characteristics of children with insulin‐dependent diabetes mellitus, J Pediatr, 106, pp. 827-834, (1985)
[14]  
Kovacs M., Finkelstein R., Feinberg TL, Crouse-Novak M., Paulauskas S., Pollock M., Initial psychologic responses of parents to the diagnosis of insulin‐dependent diabetes mellitus in their children, Diabetes Care, 8, pp. 568-575, (1985)
[15]  
Kovacs M., Goldston D., Obrosky DS, Iyengar S., Prevalence and predictors of pervasive noncompliance with medical treatment among youths with insulin‐dependent diabetes mellitus, J Am Acad Child Adolesc Psychiatry, 31, pp. 1112-1119, (1992)
[16]  
Sperling MA, Diabetic ketoacidosis, Pediatr Clin North Am, 31, pp. 591-610, (1984)
[17]  
Tanner JM, Issues and advances in adolescent growth and development, J Adolesc Health Care, 8, pp. 470-478, (1987)
[18]  
Nathan DM, Singer DE, Hurxthal K., Goodson JD, The clinical information value of the glycosylated hemoglobin assay, New Engl J Med, 310, pp. 341-346, (1984)
[19]  
Daneman D., Wolfson DH, Becker DJ, Drash AL, Factors affecting glycosylated hemoglobin values in children with insulin‐dependent diabetes, J Pediatr, 99, pp. 847-853, (1981)
[20]  
Kalbfleisch JD, Prentice RL, The Statistical Analysis of Failure Time Data, (1980)