Diabetes Tipo Uno

A Peer Group Intervention for Adolescents With Type 1 Diabetes and Their Best Friends
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Abstract
Objective: To devise and implement a structured intervention for integrating peers into diabetes care in a healthy and adaptive manner.
Methods: Adolescents with diabetes (n = 21) and their bestfriends (n = 21) participated in a group intervention aimed at increasing diabetes knowledge and social support of diabetes care. Measures of social support, knowledge about diabetes and support, diabetes functioning, and social functioning were obtained prior to and following intervention.
Results: Following the intervention, adolescents and their friends demonstrated higher levels of knowledgeabout diabetes and support, as well as a higher ratio of peer to family support, and friends demonstrated improved self-perception. Parents reported decreased diabetes-related conflict.
Conclusions: Peer group intervention approaches may result in increased positive peer involvement in adolescents' diabetes care.
Key words
* type 1 diabetes 
* adolescents 
* intervention 
*social support
* peer group
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Adolescents with diabetes experience physical, emotional, and social stress due to the demands of a complicated medical regimen (Johnson, 1988) and are often noncompliant with these demands (Kovacs, Goldston, Obrosky, & Iyengar, 1992; La Greca, 1988). In fact, most serious cases of noncompliance commonly emerge in midadolescence(Kovacs et al., 1992), at the same time as rapid and continuous developmental changes. As adolescents decrease their dependence on their parents, they often rely on peers for support and behavioral norms (Berndt, 1992; Steinberg & Silverberg, 1986). Although at times peers may be negative influences (Thomas, Peterson, & Goldstein, 1997), peers can also be important sources of constructivesupport. Social support from peers has been rated as important by adolescents with type 1 diabetes (Greco et al., 1991); peers are more likely than family members to provide companionship and emotional support in relation to diabetes care (La Greca et al., 1995).
Although assessment of peer support has received some attention, no controlled studies have examined the impact of peer support onadolescents' diabetes care regimen. A structured approach to facilitating peer support may serve a useful and necessary function as adolescents with diabetes may avoid talking to peers about their illness. Jacobson and colleagues (1986) noted that among newly diagnosed children and adolescents with diabetes, over half did not talk about diabetes with peers and over a third believed that their peerswould like them less if they knew about their diabetes.
Group-based problem-solving approaches have been found to be effective with adolescents with diabetes (e.g., Anderson, Wolf, Burkhart, Cornell, & Bacon, 1989); however, these groups typically include other adolescents with diabetes. Minimal interaction may occur among these adolescents outside of the group setting. It is the influence ofpeers who are encountered on a daily basis, in school and social settings, that can adversely affect adolescents' diabetes care (Thomas et al., 1997).
Given the critical role that peers may play in adolescents' diabetes care, this pilot and feasibility study was undertaken to assess the effects of a peer group intervention on adolescents newly diagnosed with type 1 diabetes and their best friends.The specific aims of this study included (1) to devise a structured group program for integrating friends into adolescents' diabetes management in a healthy and adaptive manner; (2) to extend research that has suggested a positive benefit for social support for adolescents with type 1 diabetes by determining if this peer group intervention increases social support; and (3) to determine the...