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Karahan S, Ağadayı E, Sarı SA, Çelik N, Kömürlüoğlu Tan A, Döğer E. Psychometric Properties of the Turkish Validity and Reliability of the Parent Diabetes Distress Scale. J Clin Res Pediatr Endocrinol 2023; 15:293-301. [PMID: 37559365 PMCID: PMC10448560 DOI: 10.4274/jcrpe.galenos.2023.2023-3-20] [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: 04/19/2023] [Accepted: 07/26/2023] [Indexed: 08/11/2023] Open
Abstract
Objective The aim of this study was to evaluate the validity and reliability of the Turkish translation of the Parent Diabetes Distress Scale (PDDS). Methods The PDDS is a 5-point Likert-type scale with 20 items. After obtaining permission from the scale developers, the study commenced. First, a systematic adaptation of the scale into the Turkish language was performed including translation, expert panel review, back translation, and pilot study. Test-retest was applied to 35 participants. After these procedures, data collection was undertaken using the adapted PDDS and a demographic data collection form. The collected data were analyzed for reliability, including stability of the scale with test-retest and internal consistency of the scale (Cronbach’s α), and validity including construct validity of the scale with confirmatory factor analysis (CFA). Results The parents of 210 teenagers, aged >11 and <18 years, who had been diagnosed with type 1 diabetes mellitus for at least one year were included. Of these parents, 71.9% (n=151) were mothers and 53.3% (n=112) of the children were girls. The Cronbach’s α value was 0.906. The results of the CFA were χ2/df=4.406, p<0.001, comparative fit test 0.704, and goodness of fit tests 0.749. The mean total PDDS score was 2.2±0.7. These results indicate that scores of 1.6 points or less was evaluated as “little or no distress” 1.7-2.4 as “moderate distress,” and >2.4 points as “high distress”. This showed that the majority of the parents in the study experienced moderate or severe diabetes-related distress. Conclusion The Turkish version of the PDDS fulfilled the validity and reliability tests at an acceptable level.
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Affiliation(s)
- Seher Karahan
- Sivas Cumhuriyet University Faculty of Medicine, Department of Medical Education, Sivas, Turkey
| | - Ezgi Ağadayı
- Sivas Cumhuriyet University Faculty of Medicine, Department of Medical Education, Sivas, Turkey
| | - Seda Aybüke Sarı
- Hatay Mustafa Kemal University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Hatay, Turkey
| | - Nurullah Çelik
- Sivas Cumhuriyet University Faculty of Medicine, Department of Pediatric Endocrinology, Sivas, Turkey
| | - Ayça Kömürlüoğlu Tan
- Sivas Cumhuriyet University Faculty of Medicine, Department of Pediatrics, Sivas, Turkey
| | - Esra Döğer
- Gazi University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
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Corathers S, Williford DN, Kichler J, Smith L, Ospelt E, Rompicherla S, Roberts A, Prahalad P, Basina M, Muñoz C, Ebekozien O. Implementation of Psychosocial Screening into Diabetes Clinics: Experience from the Type 1 Diabetes Exchange Quality Improvement Network. Curr Diab Rep 2023; 23:19-28. [PMID: 36538250 PMCID: PMC9763798 DOI: 10.1007/s11892-022-01497-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/01/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW Although advances in diabetes technology and pharmacology have significantly and positively impacted diabetes management and health outcomes for some, diabetes care remains burdensome and can be challenging to balance with other life priorities. The purpose of this article is to review the rationale for assessment of psychosocial domains in diabetes care settings and strategies for the implementation of psychosocial screening into routine practice. Survey data from the Type 1 Diabetes Exchange Quality Improvement Network is highlighted. RECENT FINDINGS Implementation of psychosocial screening requires identifying the population; selecting validated tools to assess target domains; determining frequency of screening and mode of survey delivery; and scoring, interpreting, documenting, and facilitating referrals such that these processes are part of clinical workflows. Recognizing the influence of psychosocial factors for people with diabetes (PWD), professional society guidelines for comprehensive diabetes care recommend the integration of psychosocial screening into routine care.
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Affiliation(s)
- Sarah Corathers
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Desireé N Williford
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Laura Smith
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | | | | | - Priya Prahalad
- Stanford University School of Medicine, Palo Alto, CA, USA
| | - Marina Basina
- Stanford University School of Medicine, Palo Alto, CA, USA
| | - Cynthia Muñoz
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, USA
- University Center for Excellence in Developmental Disabilities, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Osagie Ebekozien
- T1D Exchange, Boston, MA, USA
- University of Mississippi School of Population Health, Jackson, MS, USA
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Case H, Williams DD, Majidi S, Ferro D, Clements MA, Patton SR. Longitudinal associations between family conflict, parent engagement, and metabolic control in children with recent-onset type 1 diabetes. BMJ Open Diabetes Res Care 2021; 9:9/1/e002461. [PMID: 34645616 PMCID: PMC8515442 DOI: 10.1136/bmjdrc-2021-002461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/26/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION We prospectively investigated the associations between diabetes-related family conflict, parent engagement in child type 1 diabetes (T1D) care, and child glycated hemoglobin (HbA1c) in 127 families of school-age children who we recruited within the first year of their T1D diagnosis. RESEARCH DESIGN AND METHODS Parents completed the Diabetes Family Conflict Scale-Revised (DFCS-R) to assess for diabetes-related family conflict and the Diabetes Self-Management Questionnaire-Brief (DSMQ-Brief) to assess parent engagement in child T1D care at the initial study visit (T1) and at 12 (T2) and 27 (T3) months later. We also collected child HbA1c at these time points. Our analyses included Pearson correlations and repeated measures linear mixed models controlling for child age, sex, and T1D duration at T1. RESULTS Parents' DFCS-R scores negatively correlated with DSMQ-Brief scores (r=-0.13, p<0.05) and positively correlated with children's HbA1c (r=0.26, p<0.001). In our linear mixed models, parents' DSMQ-Brief scores were unchanged at T2 (β=-0.71, 95% CI -1.59 to 0.16) and higher at T3 (β=8.01, 95% CI 6.89 to 9.13) compared with T1, and there was an association between increasing DFCS-R and decreasing DSMQ-Brief scores (β=-0.14, 95% CI -0.21 to -0.06). Child HbA1c values were significantly higher at T2 (β=0.66, 95% CI 0.38 to 0.94) and T3 (β=0.95, 95% CI 0.63 to 1.27) compared with T1, and there was an association between increasing DFCS-R scores and increasing child HbA1c (β=0.04, 95% CI 0.02 to 0.06). CONCLUSIONS Increasing diabetes-specific family conflict early in T1D may associate with decreasing parent engagement in child T1D care and increasing child HbA1c, suggesting a need to assess and intervene on diabetes-specific family conflict. Trial registration number NCT03698708.
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Affiliation(s)
- Hannah Case
- Mayo Clinic Alix School of Medicine, Mayo Clinic Hospital Jacksonville, Jacksonville, Florida, USA
| | - David D Williams
- Division of Health Services and Health Outcomes Research, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, USA
| | - Shideh Majidi
- Barbara Davis Center for Diabetes and the University of Colorado Anschutz School of Medicine, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, USA
| | - Diana Ferro
- Division of Health Services and Health Outcomes Research, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, USA
| | - Mark Allen Clements
- Pediatrics, Endocrinology, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, USA
| | - Susana R Patton
- Center for Healthcare Delivery Science, Nemours Children's Health System, Jacksonville, Florida, USA
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Papadakis JL, Shapiro JB, Evans M, Feldman MA, Weil LEG, Vesco AT, Thompson LG, Garza K, Weissberg-Benchell J. Psychometric properties of the diabetes skills checklist for adolescents with type 1 diabetes and their parents. Pediatr Diabetes 2021; 22:924-932. [PMID: 34173308 DOI: 10.1111/pedi.13241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/14/2021] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Among adolescents with type 1 diabetes, research has found that their perception of their diabetes management is an important predictor of actual diabetes management. There is a need for measures that assess adolescents' perception of their ability to independently complete daily diabetes self-care tasks. The current study examined the psychometric properties of the Diabetes Skills Checklist Teen-Report (DSC-T) and DSC Parent of Teen-Report (DSC-PT), which assess perceived independence in diabetes self-care skills. RESEARCH DESIGN AND METHODS Data were from 1450 adolescents aged 12 to 18 years and their parents who participated in the Diabetes Camp Matters Study. Families completed the DSC as well as other questionnaires online assessing demographic and diabetes-related information, diabetes strengths, and diabetes-specific emotional distress. RESULTS Exploratory factor analysis revealed a 14-item DSC-T and 12-item DSC-PT, both with excellent internal consistency and concurrent validity. Both the DSC-T and DSC-PT were found to be positively correlated with diabetes strengths and negatively correlated with HbA1c, and the DSC-PT was significantly correlated with parent-reported diabetes distress. Adolescents who used insulin pumps and continuous glucose monitoring reported higher perceived independence in diabetes self-care skills compared to adolescents who used insulin pens/syringes or blood glucose meters. No differences were found based on demographic characteristics. CONCLUSIONS The DSC-T and DSC-PT have strong potential to be used during diabetes clinic visits to spark discussion regarding adolescents' self-care, which would allow for a more successful transfer of diabetes care from parent to adolescent, and eventually, the transition from pediatric to adult healthcare.
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Affiliation(s)
- Jaclyn Lennon Papadakis
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jenna B Shapiro
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Meredyth Evans
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Marissa A Feldman
- Child Development and Rehabilitation Center, Johns Hopkins All Children's Hospital, Saint Petersburg, Florida, USA
| | - Lindsey E G Weil
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Anthony T Vesco
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Laurie Gayes Thompson
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kimberly Garza
- Department of Anthropology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Jill Weissberg-Benchell
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Majidi S, Reid MW, Fogel J, Anderson B, Klingensmith GJ, Cain C, Berget C, Raymond JK. Psychosocial outcomes in young adolescents with type 1 diabetes participating in shared medical appointments. Pediatr Diabetes 2021; 22:787-795. [PMID: 33838078 DOI: 10.1111/pedi.13212] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 03/20/2021] [Accepted: 04/06/2021] [Indexed: 12/11/2022] Open
Abstract
For youth with type 1 diabetes (T1D), the early adolescent period is associated with worsening diabetes management and high rates of negative psychosocial issues, including depressive symptoms and family conflict. Alternative clinical models may help improve both diabetes and psychosocial outcomes. Our study aims to investigate whether Team Clinic, a shared medical appointment model developed specifically for adolescents with T1D, will improve psychosocial outcomes for middle school-aged youth. Youth with T1D, 11-13 years of age, and their caregivers, participated in a randomized controlled trial comparing Team Clinic to traditional clinic visits (control group). Diabetes characteristics were obtained at every visit. Participants and caregivers completed depression screening and family conflict questionnaires at baseline and end of study. Changes in mean scores on clinical and psychosocial outcomes from baseline to end of study were compared between groups using linear mixed-effects models. Eighty-six youth (51% female; 74% White; 10% Hispanic) completed at least one visit during the 12-month study period. At the end of the study, control group participants reported increases in Emotional Problems compared to Team Clinic participants, including higher levels of Negative Mood/Physical Symptoms (p = 0.02). Team Clinic participants reported reduced family conflict surrounding diabetes at study end, compared to control group participants (p = 0.03). Caregivers did not report change in depressive symptoms or family conflict during the study. Hemoglobin A1C levels did not change over time in either group. Participation in Team Clinic was associated with improved psychosocial outcomes in middle school-aged participants with T1D.
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Affiliation(s)
- Shideh Majidi
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Mark W Reid
- Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Jennifer Fogel
- Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Barbara Anderson
- Baylor College of Medicine/Texas Children's Hospital, Houston, Texas, USA
| | - Georgeanna J Klingensmith
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Cindy Cain
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Cari Berget
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jennifer K Raymond
- Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA
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Tremolada M, Cusinato M, Bonichini S, Fabris A, Gabrielli C, Moretti C. Health-Related Quality of Life, Family Conflicts and Fear of Injecting: Perception Differences between Preadolescents and Adolescents with Type 1 Diabetes and Their Mothers. Behav Sci (Basel) 2021; 11:bs11070098. [PMID: 34356715 PMCID: PMC8301019 DOI: 10.3390/bs11070098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/28/2021] [Accepted: 07/01/2021] [Indexed: 01/09/2023] Open
Abstract
Good management of diabetes requires at the same time self-regulation behaviour and a balanced involvement of family components. This cross-sectional study’s aims were: understanding fear of injections and perceptions of family conflicts in preadolescents and adolescents with type 1 diabetes mellitus and their mothers, comparing their perceptions, and identifying the risk factors impacting patients’ quality of life. Eligibility criteria were: treatment for diabetes mellitus type I, currently aged 10–18 years, attending the hospital for annual hospital follow-ups. Exclusion criteria were: intellectual disabilities, inability to complete questionnaires alone and neuropsychiatric illness with active pharmacotherapy. The study design was cross-sectional. Participants were one hundred and two patients (Mean age = 14.6, SD = 2.4; age range = 10–19 years; Females = 52 and Males = 50) and their mothers (Mean age = 46.9, SD = 6.2, age range = 27–63 years), who filled in self and proxy-report questionnaires (N total= 204). The results showed that 20% of patients and 14.7% of their mothers reported clinical scores for fear of self-injection and blood testing. The mothers reported lower fear of injecting and higher family conflicts compared with the patients. Age, fear of injecting and family conflicts were significantly associated with patients’ quality of life perceptions. Clinical considerations and recommendations are given based on the empirical results.
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Affiliation(s)
- Marta Tremolada
- Department of Development and Social Psychology, University of Padua, 35131 Padova, Italy;
- Correspondence: ; Tel.: +39-3474-868-835
| | - Maria Cusinato
- Pediatric Diabetes Unit, Department of Women’s and Children’s Health, Azienda Ospedale Università di Padova, 35127 Padova, Italy; (M.C.); (A.F.); (C.G.); (C.M.)
| | - Sabrina Bonichini
- Department of Development and Social Psychology, University of Padua, 35131 Padova, Italy;
| | - Arianna Fabris
- Pediatric Diabetes Unit, Department of Women’s and Children’s Health, Azienda Ospedale Università di Padova, 35127 Padova, Italy; (M.C.); (A.F.); (C.G.); (C.M.)
| | - Claudia Gabrielli
- Pediatric Diabetes Unit, Department of Women’s and Children’s Health, Azienda Ospedale Università di Padova, 35127 Padova, Italy; (M.C.); (A.F.); (C.G.); (C.M.)
| | - Carlo Moretti
- Pediatric Diabetes Unit, Department of Women’s and Children’s Health, Azienda Ospedale Università di Padova, 35127 Padova, Italy; (M.C.); (A.F.); (C.G.); (C.M.)
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Dall’Oglio I, Gasperini G, Carlin C, Biagioli V, Gawronski O, Spitaletta G, Grimaldi Capitello T, Salata M, Vanzi V, Rocco G, Tiozzo E, Vellone E, Raponi M. Self-Care in Pediatric Patients with Chronic Conditions: A Systematic Review of Theoretical Models. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3513. [PMID: 33800684 PMCID: PMC8037526 DOI: 10.3390/ijerph18073513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/13/2021] [Accepted: 03/24/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND To improve outcomes in children and young adults (CYAs) with chronic conditions, it is important to promote self-care through education and support. AIMS (1) to retrieve the literature describing theories or conceptual models of self-care in CYAs with chronic conditions and (2) to develop a comprehensive framework. METHODS A systematic literature search was conducted on nine databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All peer-reviewed papers describing a theory or a conceptual model of self-care in CYAs (0-24 years) with chronic conditions were included. RESULTS Of 2674 records, 17 met the inclusion criteria. Six papers included a theory or a model of self-care, self-management, or a similar concept. Six papers developed or revised pre-existing models or theories, while five papers did not directly focus on a specific model or a theory. Patients were CYAs, mainly with type 1 diabetes mellitus and asthma. Some relevant findings about self-care in CYAs with neurocognitive impairment and in those living with cancer may have been missed. CONCLUSIONS By aggregating the key elements of the 13 self-care conceptual models identified in the review, we developed a new overarching model emphasizing the shift of self-care agency from family to patients as main actors of their self-management process. The model describes influencing factors, self-care behaviors, and outcomes; the more patients engaged in self-care behaviors, the more the outcomes were favorable.
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Affiliation(s)
- Immacolata Dall’Oglio
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
| | - Giulia Gasperini
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Claudia Carlin
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
| | - Valentina Biagioli
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
| | - Orsola Gawronski
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
| | - Giuseppina Spitaletta
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
| | - Teresa Grimaldi Capitello
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
| | - Michele Salata
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
| | - Valentina Vanzi
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
| | - Gennaro Rocco
- Centre of Excellence for Nursing Scholarship-Nursing Professional Order of Rome, Viale Giulio Cesare, 78, 00192 Rome, Italy;
| | - Emanuela Tiozzo
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Massimiliano Raponi
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
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Madrigal MA, López M, Sánchez A, Cao MJ, Castro MJ, Jiménez JM. Type 1 Diabetes Mellitus in Pediatric Patients and Its Impact on Relationships in the Family Environment. Diabetes Metab Syndr Obes 2020; 13:4973-4980. [PMID: 33364801 PMCID: PMC7751600 DOI: 10.2147/dmso.s281949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/29/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of this study is to assess the impact of type 1 diabetes mellitus on family environment relationships, as well as the management and approach to this disease. PATIENTS AND METHODS One hundred one children, 52.47% male and 47.52% female, with an average age of 8.55 ± 4.01 years, diagnosis of type 1 diabetes mellitus. Quantitative cross-sectional descriptive study was conducted using the validated questionnaires "Modified Diabetes Quality of Life" and "Questionnaire for the assessment of psychological impact in parents/guardians of diabetic children". RESULTS Most of the children (70.3% versus 29.7%) identified diabetes as unpleasant or not fun. The ≤5-year-olds expressed that they felt concerned about the consequences of being diabetic (8.1% by age group), as opposed to the 10-year-olds who did not feel concerned (85.1% by age group), P <0.001. The family environment was affected in 98.1% (n=99) of the cases. CONCLUSION Self-care of type 1 diabetes mellitus in pediatric patients is a complex process that impacts the family environment and their relationship with their peers, especially for children under the age of 5. Fear, concern and insecurity were prevalent feelings in children suffering type 1 diabetes mellitus.
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Affiliation(s)
- Miguel Angel Madrigal
- Faculty of Nursing, Universidad de Valladolid, Valladolid, Spain
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - María López
- Faculty of Nursing, Universidad de Valladolid, Valladolid, Spain
- Correspondence: María LópezFaculty of Nursing, Universidad de Valladolid, Avda Ramón y Cajal, Nº 7, Valladolid, SpainTel +34 983184056 Email
| | - Alicia Sánchez
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - María José Cao
- Faculty of Nursing, Universidad de Valladolid, Valladolid, Spain
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Campbell MS, Wang J, Cheng Y, Cogen FR, Streisand R, Monaghan M. Diabetes-specific family conflict and responsibility among emerging adults with type 1 diabetes. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2019; 33:788-796. [PMID: 31021129 PMCID: PMC6776682 DOI: 10.1037/fam0000537] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Emerging adulthood is a transitional period for type 1 diabetes management, and aspects of family functioning such as family conflict and responsibility for diabetes management likely change following high school graduation. This study examined changes in diabetes-specific family conflict, family responsibility for diabetes management tasks, and associations with glycemic control up to 1 year after high school. Seventy-nine emerging adults with type 1 diabetes (M age = 18.09 ± .43 years; 51% female; 71% Caucasian) and their parents (73% female) completed self-report measures on diabetes-specific family conflict and family responsibility at 3 consecutive clinic visits, beginning in the spring of their senior year of high school. Hemoglobin A1c (HbA1c) was obtained from medical records. Diabetes-specific family conflict was relatively low; scores did not significantly change from baseline to Time 3. Parent responsibility for diabetes care decreased from baseline to Time 3. Higher parent- and emerging adult-reported family conflict and higher parent responsibility for diabetes care were associated with worse glycemic control (ps < .05). Parent-reported family conflict and the interaction between parent-reported family conflict and responsibility predicted HbA1c 1 year after high school. Conversely, HbA1c did not predict diabetes-specific family conflict or responsibility 1 year after high school. Findings indicate that diabetes-specific family conflict is associated with glycemic control after high school, even when emerging adults assume greater responsibility for diabetes self-care. Diabetes-specific family conflict levels were generally low and did not change over time despite this transitional period. If diabetes-specific conflict is present, it should be an important avenue for potential intervention for emerging adults with type 1 diabetes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | - Jichuan Wang
- Children’s National Health System, Washington, DC
- George Washington University School of Medicine, Washington, DC
| | - Yao Cheng
- Children’s National Health System, Washington, DC
| | - Fran R. Cogen
- Children’s National Health System, Washington, DC
- George Washington University School of Medicine, Washington, DC
| | - Randi Streisand
- Children’s National Health System, Washington, DC
- George Washington University School of Medicine, Washington, DC
| | - Maureen Monaghan
- Children’s National Health System, Washington, DC
- George Washington University School of Medicine, Washington, DC
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