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Leite RO, Brodar KE, Saab PG, Marchetti D, Jaramillo M, Sanchez J, Davis E, Delamater AM, La Greca AM. Diabetes Care and Mental Health During the COVID-19 Pandemic: Perspectives of Adolescents with Diabetes, Parents, and Providers. J Clin Psychol Med Settings 2024:10.1007/s10880-023-09995-9. [PMID: 38281304 DOI: 10.1007/s10880-023-09995-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/30/2024]
Abstract
This study explored ways in which the COVID-19 pandemic impacted adolescents' diabetes management and psychosocial functioning, and how adolescents, parents, and providers viewed telemedicine. We present data from three studies: (1) a comparison of psychosocial functioning and glycemic levels before and after pandemic onset (n = 120 adolescents; 89% with type 1 diabetes), (2) an online survey of parents about pandemic-related stressors (n = 141), and (3) qualitative interviews with adolescents, parents, and medical providers about the pandemic's impacts on adolescents' diabetes care and mental health (n = 13 parent-adolescent dyads; 7 medical providers). Results suggested some adverse effects, including disrupting routines related to health behaviors and psychosocial functioning and impairing adolescents' quality of life. Despite these challenges, most participants did not endorse significant impacts. Some even noted benefits, such as increased parental supervision of diabetes management that can be leveraged beyond the pandemic. Furthermore, telemedicine offers benefits to continuity of diabetes care but presents challenges to care quality. These findings underscore the varied and unique impacts of the COVID-19 pandemic on adolescents with diabetes.
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Affiliation(s)
- Rafael O Leite
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Flipse Building 420, Coral Gables, FL, 33136, USA.
| | | | - Patrice G Saab
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Flipse Building 420, Coral Gables, FL, 33136, USA
| | - Daniella Marchetti
- Psychology Service, Bruce W. Carter Medical Center, Miami VA Healthcare System, Miami, FL, USA
| | - Manuela Jaramillo
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Flipse Building 420, Coral Gables, FL, 33136, USA
| | - Janine Sanchez
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Eileen Davis
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Annette M La Greca
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Flipse Building 420, Coral Gables, FL, 33136, USA
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Tremolada M, Cusinato M, D’Agnillo A, Negri A, Righetto E, Moretti C. "One and a Half Years of Things We Could Have Done": Multi-Method Analysis of the Narratives of Adolescents with Type 1 Diabetes during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2620. [PMID: 36767985 PMCID: PMC9916259 DOI: 10.3390/ijerph20032620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Public health interventions for COVID-19 forced families to adopt changes in daily routines that affected children's and adolescents' psychological well-being. In youth with type 1 diabetes (T1D), psychological symptoms may compromise glycemic control and outcomes; however, evidence of improved glycemic control in children and adolescents with T1D emerged early during the pandemic. This qualitative study aims to provide a more in-depth understanding of how the COVID-19 pandemic affected adolescents' with T1D routines, experiences, T1D management, and psychological well-being. METHODS 24 adolescents, aged 15-18 years, with T1D, joined focus-group discussions during the diabetes summer camp. Word frequency analysis and thematic analysis were conducted on adolescents' narratives. The average frequencies of use of words related to COVID-19 and to T1D were compared by t-test. RESULTS Word frequency analysis identified "friends", "family", and "home" as the most recurrent terms. Seven themes were highlighted: (1) COVID-19 and T1D; (2) emotional reactions to the COVID-19 pandemic; (3) changes in daily life; (4) feelings of loss; (5) coping with the COVID-19 pandemic; (6) the COVID-19 pandemic as opportunity; (7) return to (new) normality. COVID-19 related words were on average more frequent than words referring to T1D. CONCLUSIONS The COVID-19 pandemic may have represented a more stressful condition for adolescents with T1D, facing additional challenges compared to their healthy peers. Findings offer directions to the diabetes care team for customized interventions while the effects of the pandemic on adolescents' health continue.
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Affiliation(s)
- Marta Tremolada
- Department of Developmental Psychology and Socialization, University of Padova, 35131 Padua, Italy
| | - Maria Cusinato
- Pediatric Diabetes Unit, Department of Women’s and Children’s Health, Padua University Hospital, 35128 Padua, Italy
| | - Alessia D’Agnillo
- Pediatric Diabetes Unit, Department of Women’s and Children’s Health, Padua University Hospital, 35128 Padua, Italy
| | - Arianna Negri
- Pediatric Diabetes Unit, Department of Women’s and Children’s Health, Padua University Hospital, 35128 Padua, Italy
| | - Elena Righetto
- Pediatric Diabetes Unit, Department of Women’s and Children’s Health, Padua University Hospital, 35128 Padua, Italy
| | - Carlo Moretti
- Pediatric Diabetes Unit, Department of Women’s and Children’s Health, Padua University Hospital, 35128 Padua, Italy
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Valenzuela JM, Dimentstein K, Yee S, Pan B, Snyder MC, Wolf RM. Psychosocial Impact of the COVID-19 Pandemic in Racially/Ethnically Diverse Youth With Diabetes. J Pediatr Psychol 2022; 48:17-28. [PMID: 36137256 PMCID: PMC9673468 DOI: 10.1093/jpepsy/jsac070] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE This study examined caregiver perceived impact of the Coronavirus Disease 2019 (COVID-19) pandemic on a diverse sample of U.S. youth with diabetes and their families. METHODS Caregivers of youth with diabetes completed an electronic survey in English or Spanish at two sites. Participants provided demographic and disease characteristics and completed the COVID-19 Exposure and Family Impact Scales (CEFIS). Glycemic health was assessed via Hemoglobin A1c (HbA1c) from medical chart review. Analysis of variance and analyses of covariance were utilized to examine racial/ethnic differences in glycemic health and in COVID-19 Exposure, Impact, and Distress scales. Hierarchical linear regression was conducted to predict HbA1c. Thematic analysis was conducted on open-ended responses regarding the effects of COVID-19 on youth and families' overall and diabetes-related well-being. RESULTS Caregivers (n = 114) of youth with diabetes (M = 12.6 ± 3.5 years) completed study measures. Mean HbA1c for Non-Hispanic White youth was lowest and significantly different from Hispanic and Non-Hispanic Black youth. Exposure to COVID-19 stressors differed by race/ethnicity (p < .05) with Hispanic caregivers reporting greatest exposure. CEFIS scales did not predict HbA1c after controlling for demographic/disease variables. Caregivers described child/family changes during COVID (e.g., more time together, health-related hypervigilance), as well as differences in diabetes management during COVID-19. CONCLUSIONS Findings indicate differences in COVID-19 exposure but did not demonstrate other racial/ethnic disparities in COVID-19 impact or distress. Household income was the most important predictor of glycemic health. Addressing structural inequalities experienced by youth with diabetes and their families is critical. Recommendations to support families with diabetes are made.
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Affiliation(s)
- Jessica M Valenzuela
- All correspondence concerning this article should be addressed to
Jessica M. Valenzuela, PhD, College of Psychology, Department of Clinical & School
Psychology, Nova Southeastern University, 3301 College Avenue, Fort Lauderdale, FL 33314,
USA. E-mail:
| | - Karen Dimentstein
- College of Psychology, Department of Clinical & School Psychology, Nova
Southeastern University, USA
| | - Shanique Yee
- College of Psychology, Department of Clinical & School Psychology, Nova
Southeastern University, USA
| | - Bernard Pan
- Division of Pediatric Endocrinology, Johns Hopkins School of
Medicine, USA
| | - Meg C Snyder
- Division of Pediatric Endocrinology, Johns Hopkins School of
Medicine, USA,Department of Behavioral Psychology, Kennedy Krieger
Institute, USA
| | - Risa M Wolf
- Division of Pediatric Endocrinology, Johns Hopkins School of
Medicine, USA
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