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Survonen A, Suhonen R, Joronen K. Resilience in adolescents with type 1 diabetes: An integrative review. J Pediatr Nurs 2024:S0882-5963(24)00227-6. [PMID: 38945756 DOI: 10.1016/j.pedn.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 06/09/2024] [Accepted: 06/09/2024] [Indexed: 07/02/2024]
Abstract
PROBLEM Despite advances in diabetes technology, many adolescents with type 1 diabetes (T1D) cannot achieve target metabolic control. Resilience is associated with better outcomes in diabetes care. The aim of this review is to synthesize studies on resilience in adolescents with T1D, particularly how the concept of resilience has been explored. METHODS This integrative review was carried out according to Whittemore and Knafl's framework. A systematic search was conducted in the CINAHL, PubMed/Medline and PsycInfo databases. Eligibility criteria included studies on resilience in adolescents with T1D, aged 13 to 18 years, that were published in English in peer-reviewed scientific journals. The Mixed Methods Appraisal Tool was used to assess study quality. RESULTS The review included twenty-four studies. Resilience was defined as the ability or capacity, or the process, to maintain physical and psychological well-being despite exposure to significant stressors or distress events. Diabetes resilience was defined as achieving positive psychosocial and health outcomes despite the challenges of living with T1D. Studies were quantitative (n = 21), qualitative (n = 1) and mixed methods (n = 2). Six resilience instruments were found. The DSTAR-Teen was the most used and the only instrument for adolescents with T1D. CONCLUSIONS This review highlighted the need for an explicit definition of the concept of resilience because previous studies used different definitions or lacked a definition. In the future, a more precise concept analysis of resilience in adolescents with T1D is warranted. IMPLICATIONS The DSTAR-Teen is a promising resilience measure with good psychometric properties for further studies in adolescents with T1D.
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Affiliation(s)
- Anne Survonen
- University of Turku, Department of Nursing Science, Medisiina B, 20014, Finland; Turku University Hospital, Wellbeing Services County of Southwest Finland, POB 52, Turku 20521, Finland.
| | - Riitta Suhonen
- University of Turku, Department of Nursing Science, Medisiina B, 20014, Finland; Turku University Hospital, Wellbeing Services County of Southwest Finland, POB 52, Turku 20521, Finland.
| | - Katja Joronen
- University of Turku, Department of Nursing Science, Medisiina B, 20014, Finland.
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Chen X, Wu X, Yuan T, Guan L, Guo Q, Zheng Y, Fu J, Dong G, Wu W, Huang K, Prabhashana WB, Bai G. Prevalence of skin problems caused by insulin pump therapy and associated factors in children with type 1 diabetes mellitus: A large cross-sectional survey in China. Diabetes Res Clin Pract 2024; 212:111714. [PMID: 38763169 DOI: 10.1016/j.diabres.2024.111714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 05/21/2024]
Abstract
AIMS To document the prevalence of skin problems associated with insulin pump use and identify contributing factors among children with type 1 diabetes mellitus in China. METHODS In total, 461 children were recruited from an online community (i.e., a Wechat group) of pediatric patients with T1DM. A self-developed questionnaire was filled in by parents, collecting the information on social demographics, disease, and insulin pump therapy related characteristics and skin problems. We applied the Mann-Whitney U test, Chi square test and logistic regression analysis to identify the factors associated with skin problems. RESULTS Of the 461 responders, 308 (66.8 %) children were reported to have skin problems. More specifically, 38.8 % had pigmentation changes, 22.3 % allergy/dermatitis, 20.2 % scaring, 11.5 % pain, 10.8 % infection, 10.6 % subcutaneous lipohypertrophy, and 6.1 % lipoatrophy. Logistic regression analysis showed that independent associated factors of skin problems were the caregiver's educational level as college or above, patient having skin allergies, and using the Brand 2 insulin pump (p values < 0.05). CONCLUSIONS The present study documents the prevalence of skin problems and identifies associated factors, such as caregiver's education, patients skin allergies, and using a specific brand of pump. Health education should address these factors in addition to the traditionally emphasized factors.
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Affiliation(s)
- Xiaochun Chen
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, Zhejiang Province, PR China
| | - Xiaofei Wu
- Peking University First Hospital, Beijing 100034, PR China
| | - Ting Yuan
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, Zhejiang Province, PR China
| | - Lejing Guan
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, Zhejiang Province, PR China
| | - Qingyun Guo
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, Zhejiang Province, PR China
| | - Yan Zheng
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, Zhejiang Province, PR China
| | - Junfen Fu
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, Zhejiang Province, PR China
| | - Guanping Dong
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, Zhejiang Province, PR China
| | - Wei Wu
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, Zhejiang Province, PR China
| | - Ke Huang
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, Zhejiang Province, PR China
| | | | - Guannan Bai
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, Zhejiang Province, PR China.
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Shapiro JB, Garza KP, Feldman MA, Suhs MC, Ellis J, Terry A, Howard KR, Weissberg-Benchell J. Psychosocial Care for Youth with Type 1 Diabetes: Summary of Reviews to Inform Clinical Practice. Endocrinol Metab Clin North Am 2024; 53:107-122. [PMID: 38272590 DOI: 10.1016/j.ecl.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
The intensive demands of diabetes care can be difficult for youth with type 1 diabetes and their families to integrate into daily life. Standards of care in pediatric diabetes highlight the importance of evidence-based psychosocial interventions to optimize self-management behaviors and psychological well-being. The current review summarizes select systematic reviews and meta-analyses on evidence-based behavioral health interventions in pediatric diabetes. Interventions include strategies to strengthen youth psychosocial skills, improve family dynamics and caregiver mental health, enhance health and mental health equity, and address psychosocial factors related to diabetes technology use.
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Affiliation(s)
- Jenna B Shapiro
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA; Northwestern University Feinberg School of Medicine, Department of Psychiatry & Behavioral Sciences, 446 E Ontario Street, Chicago, IL, USA.
| | | | - Marissa A Feldman
- Johns Hopkins All Children's Hospital, Child Development and Rehabilitation Center, 880 Sixth Street South #170, Saint Petersburg, FL 33701, USA
| | - Madeleine C Suhs
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA
| | - Julia Ellis
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA
| | - Amanda Terry
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA; Northwestern University Feinberg School of Medicine, Department of Psychiatry & Behavioral Sciences, 446 E Ontario Street, Chicago, IL, USA
| | - Kelsey R Howard
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA; Northwestern University Feinberg School of Medicine, Department of Psychiatry & Behavioral Sciences, 446 E Ontario Street, Chicago, IL, USA
| | - Jill Weissberg-Benchell
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA; Northwestern University Feinberg School of Medicine, Department of Psychiatry & Behavioral Sciences, 446 E Ontario Street, Chicago, IL, USA
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Deng L, Liu Y, Wang H, Yu J, Liao L. Resilience mediates the effect of peer victimization on quality of life in Chongqing adolescents: from a perspective of positive childhood experiences. Front Psychol 2023; 14:1186984. [PMID: 37564311 PMCID: PMC10410073 DOI: 10.3389/fpsyg.2023.1186984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/29/2023] [Indexed: 08/12/2023] Open
Abstract
Background Peer victimization is a harmful experience that contributed to one's psychological problems, physical health deterioration, and so on. Quality of life (QoL) is an important indicator of adolescent health assessment. To identify potential pathways of positive experiences in preventing peer victimization's detrimental effects and then provide intervention ideas for adolescent health, this study was conducted to examine the relationship between peer victimization and QoL in Chongqing adolescents and discover whether resilience plays a mediating role and positive childhood experiences (PCEs) act as a moderating role in the relationship. Methods Data were the first follow-up of a cohort study conducted in four complete middle schools in two districts of Chongqing, China. Self-designed peer victimization items, the Connor-Davidson Resilience Scale, the Adolescent Quality of Life Scale, and the Benevolent Childhood Experiences Scale were used. We investigated the differences and correlations in peer victimization, QoL, and resilience between the two PCEs groups. Mplus version 8.3 was used to analyze the mediating role of resilience and the moderating role of PCEs in peer victimization and QoL. Results Peer victimization, resilience, and QoL differed between the two PCEs groups (P < 0.001). Peer victimization negatively correlated with QoL and resilience, while resilience positively correlated with QoL (P < 0.001). In the models with total QOL as the dependent variable, the indirect effect was -0.431 (8.08% of the total effect) in the low-PCEs group vs. -2.077 (41.97% of the total effect) in the high-PCEs group. In the models with four dimensions of QOL as the dependent variable, the indirect effects ranged from -0.054 to -0.180 (6.07-12.95% of the total effects) in the low-PCEs group and from 0.295 to -0.823 in the high-PCEs group (35.89-68.76% of the total effects). Both total and indirect effects were significant (P < 0.05). In addition, the differences in indirect effects were significant between the two PCEs groups (P < 0.05), while differences in total and direct effects were almost not apparent. Conclusion Resilience partially mediated the effect of peer victimization on QoL in Chongqing adolescents, and PCEs moderated this mediation. Schools, families, and society should focus on resilience intervention and prioritize the enhancement of PCEs for improving adolescent QoL.
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Affiliation(s)
- Liya Deng
- Department of Maternal and Child Health and Adolescent Health, School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Yang Liu
- Department of Maternal and Child Health and Adolescent Health, School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Hong Wang
- Department of Maternal and Child Health and Adolescent Health, School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Junjie Yu
- Department of Maternal and Child Health and Adolescent Health, School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Liping Liao
- Department of Maternal and Child Health and Adolescent Health, School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, Chongqing, China
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