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Alazmi A, Bashiru MB, Viktor S, Erjavec M. Psychological variables and lifestyle in children with type1 diabetes and their parents: A systematic review. Clin Child Psychol Psychiatry 2024; 29:1174-1194. [PMID: 37249210 PMCID: PMC11188552 DOI: 10.1177/13591045231177115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Diabetes may impact physical and psychosocial well-being; the diabetes incidence has seen a drastic increase globally. There is also a rise in poor mental health and well-being in children with and without chronic illness; problems are being seen at a younger age. The objective of this review was to understand the determinants of these problems in a family context. We conducted a systematic review to investigate what lifestyle and psychological factors influence children with Type 1 diabetes and their parents. A focused literature search was performed using a combination of keywords that covered the relevant terminology for diabetes, target population, and associated emotional distress, using electronic bibliographic databases containing publications until May 2022. Methodological quality was assessed using the Quality Assessment Tools for Quantitative Studies. Twenty articles met the inclusion criteria. Quality scores were weak because of a lack of comparison groups, information about the type of therapy, or adequate sample sizes. Many of the studies included a wide age range in their sample. The majority of the studies reported that parents and their children showed depression symptoms, fear of hypoglycaemia, and higher parenting stress. We conclude that sufficiently powered studies employing appropriate control groups and measures are needed to elucidate the psychological variables associated with Type1 diabetes in children and the effects on parents, especially considering primary-age children who are increasingly reported to suffer from poor mental health, and its implications. This should help to introduce better targeted interventions and improve behavioural outcomes.
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Affiliation(s)
- Afrah Alazmi
- School of Human and Behavioural Sciences, Bangor University, Bangor, UK
| | | | - Simon Viktor
- School of Human and Behavioural Sciences, Bangor University, Bangor, UK
| | - Mihela Erjavec
- School of Human and Behavioural Sciences, Bangor University, Bangor, UK
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2
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Salcudean A, Lica MM. The Role of Systemic Family Psychotherapy in Glycemic Control for Children with Type 1 Diabetes. CHILDREN (BASEL, SWITZERLAND) 2024; 11:104. [PMID: 38255417 PMCID: PMC10814833 DOI: 10.3390/children11010104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024]
Abstract
(1) Background: Family factors play an important role in the management of diabetes, establishing a relationship between conflicts and non-adherence to therapy. High values of HbA1c are involved in specific complications of the disease (retinopathy, nephropathy, neuropathy, ketoacidosis). This study aimed to determine the role of systemic family psychotherapeutic interventions in increasing the quality of parent-child/adolescent relationships and in optimizing the child's glycemic control. (2) Methods: In this prospective observational study, 64 parents of children and adolescents with type 1 diabetes were evaluated regarding their relationship with their children, using the Child-Parent Relationship Scale-Short Form (CPRS-short form). The children were divided into three groups: one participated for 6 months in systemic family psychotherapy with children and their parents (FT), the second group participated in individual psychotherapy (IT), and the control group (CG) received no intervention. HbA1c values were recorded before and after the interventions. (3) Results: HbA1c means decreased significantly after the family psychotherapy program. The scores on closeness in the family therapy group increased significantly, and the scores on conflict decreased significantly after the intervention, compared with IT and CG. (4) Conclusions: Systemic family psychotherapy produces better results in disease management and in strengthening parent-child relationships.
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Affiliation(s)
| | - Maria Melania Lica
- Department of Bioethics, Social and Human Sciences, University of Medicine and Pharmacy, Science and Technology George Emil Palade of Targu Mures, Gheorghe Marinescu Street No. 38, 540142 Targu Mures, Romania;
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3
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Wu SL, Woo PJ, Yap CC, Lim GJRY. Parenting Practices and Adolescents' Mental Health: The Mediating Role of Perceived Maternal and Paternal Acceptance-Rejection and Adolescents' Self-Efficacy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1052. [PMID: 36673804 PMCID: PMC9858990 DOI: 10.3390/ijerph20021052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Parenting practices are essential in promoting children's mental health, especially in effective and ineffective parenting. The use of ineffective parenting practices is no longer encouraged in the west; however, it remains a common practice among Asian households. Ineffective parenting consists of inconsistent discipline, corporal punishment, and poor monitoring which may result in mental health consequences. Thus, this study assessed the mediating effects of adolescents' self-efficacy and parental acceptance-rejection on the relationship between ineffective parenting practices and adolescents' mental health. The current study involved a total of 761 school-going Malaysian adolescents aged 13-18 (38.5% males; Mage = 15.65; SDage = 1.43). This study utilized a cross-sectional design where it measured adolescents' mental health, ineffective parenting practices, parental acceptance-rejection, and adolescents' self-efficacy. Both paternal and maternal parenting practices and acceptance-rejection were measured independently. Adolescents' self-efficacy and perceived paternal and maternal acceptance-rejection were found to be significant mediators for ineffective parenting practices and adolescents' mental health. Our findings suggest that ineffective parenting practices will result in perceived parental rejection and lower self-efficacy which in turn resulted in poorer mental health among adolescents. It means parents should be mindful of their parenting approaches as they have a direct and indirect impact on the mental health of their offspring.
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Affiliation(s)
- Shin Ling Wu
- Department of Psychology, School of Medical and Life Sciences, Sunway University, Petaling Jaya 47500, Malaysia
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4
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Klostermann S, Iskander J, Enlow P, Delamater AM, Dolan L, Pendley JS. Predicting healthcare utilization in youth with type 1 diabetes: The importance of family level variables. Pediatr Diabetes 2021; 22:294-302. [PMID: 33169899 DOI: 10.1111/pedi.13146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 10/29/2020] [Accepted: 11/06/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Little is known about how family factors impacting treatment adherence in type 1 diabetes are directly associated with unplanned healthcare utilization (e.g., emergency room visits and hospital admissions). Given the substantial financial burden of diabetes, understanding predictors of healthcare utilization in particular is important to inform behavioral interventions aimed toward improving adherence. RESEARCH DESIGN AND METHODS The current study examined the relationship between family-level variables and healthcare utilization in a sample of 239 youth with type 1 diabetes and their parents. Healthcare utilization was determined via parent report and chart review. Parent- and youth-reports regarding levels of family conflict, youth autonomy, and parent support related to diabetes management were obtained via questionnaire, and negative reciprocity was obtained by coding observations of parent and youth interactions. Generalized Estimating Equations were used to examine the longitudinal association between healthcare utilization and family-level factors. RESULTS Higher levels of observed negative reciprocity were associated with more frequent hospital admissions, while higher levels of youth-reported parent involvement in diabetes management were associated with fewer hospital admissions and ED visits. CONCLUSIONS These findings highlight how family-level factors are directly related to healthcare utilization and point to the continued importance of integrating family-focused behavioral interventions in routine medical care for improving type 1 diabetes outcomes and reducing healthcare costs.
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Affiliation(s)
- Susan Klostermann
- Department of Pediatrics, Nemours Children's Health System, Wilmington, Delaware, USA.,Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | - Paul Enlow
- Department of Pediatrics, Nemours Children's Health System, Wilmington, Delaware, USA.,Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Lawrence Dolan
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jennifer Shroff Pendley
- Department of Pediatrics, Nemours Children's Health System, Wilmington, Delaware, USA.,Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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5
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Butler AM, Hilliard ME, Titus C, Rodriguez E, Al-Gadi I, Cole-Lewis Y, Thompson D. Barriers and Facilitators to Involvement in Children's Diabetes Management Among Minority Parents. J Pediatr Psychol 2021; 45:946-956. [PMID: 31995219 DOI: 10.1093/jpepsy/jsz103] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 12/11/2019] [Accepted: 12/21/2019] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE This study aimed to describe parents' perceptions of the factors that facilitate or are barriers to their involvement in children's type 1 diabetes (T1D) management among African American and Latino parents. METHODS African American and Latino parents (N = 28) of 5- to 9-year-old children with T1D completed audio-recorded, semi-structured interviews that were transcribed and analyzed using thematic analysis. Themes were identified that aligned with the theoretically-derived Capability-Opportunity-Motivation-Behavior (COM-B) framework. RESULTS Parents described Capability-based facilitators of parent involvement, including positive stress management, religious/spiritual coping, organizational/planning skills, and diabetes knowledge. Capability-based barriers included child and parent distress. Interpersonal relationships, degree of flexibility in work environments, and access to diabetes technologies were both Opportunity-based facilitators and barriers; and Opportunity-based barriers consisted of food insecurity/low financial resources. Parents' desire for their child to have a "normal" life was described as both a Motivation-based facilitator and barrier. CONCLUSIONS African American and Latino families described helpful and unhelpful factors that spanned all aspects of the COM-B model. Reinforcing or targeting families' unique psychological, interpersonal, and environmental strengths and challenges in multilevel interventions has potential to maximize parental involvement in children's diabetes management.
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Affiliation(s)
| | | | | | | | - Iman Al-Gadi
- Baylor College of Medicine/Texas Children's Hospital
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6
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Savarese L, Freda MF, De Luca Picione R, Dolce P, De Falco R, Alessio M, Cancian M, Franzese A, Guarino MD, Perricone R, Petraroli A, Senter R, Traverso C, Zanichelli A, Zito E, Bova M. The experience of living with a chronic disease in pediatrics from the mothers' narratives: The Clinical Interview on Parental Sense of Grip on the Disease. Health Psychol Open 2020; 7:2055102920971496. [PMID: 33343914 PMCID: PMC7727074 DOI: 10.1177/2055102920971496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The Clinical Interview on the Sense of Grip on Chronic Disease has been administered to 68 mothers of children affected by Hereditary Angioedema (C1-Inh HAE), Type 1 Diabetes (T1D), Juvenile Rheumatoid Arthritis (JRA). The objectives are to detect general features of the experience of parenting children with chronic illness as well as the specificities of this experience related to the different conditions. Four Profiles of Sense of Grip were identified: Adempitive, Controlling, Reactive, Dynamic. The Sense of Grip Interview is an effective clinical tool for understanding the characteristics of the disease in daily life, which can help clinicians to encourage family adjustment to disease.
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Affiliation(s)
- Livia Savarese
- Department of Humanities, University of Naples Federico II, Italy
| | | | | | - Pasqaule Dolce
- Department of Public Health, University of Naples Federico II, Italy
| | - Raffaella De Falco
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Italy
| | - Maria Alessio
- Department of Translational and Medical Science, Pediatric Unit, University Federico II, Naples, Italy
| | | | - Adriana Franzese
- Department of Translational and Medical Science, Pediatric Unit, University Federico II, Naples, Italy
| | | | | | - Angelica Petraroli
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), WAO Center of Excellence., University Federico II, Naples, Italy
| | - Riccardo Senter
- Department of Humanities, University of Naples Federico II, Italy
| | - Claudia Traverso
- Department of Translational and Medical Science, Pediatric Unit, University Federico II, Naples, Italy
| | - Andrea Zanichelli
- Department of Biomedical and Clinical Science Luigi Sacco, University of Milan, Milan, Italy
| | - Eugenio Zito
- Department of Social Sciences, University of Naples Federico II
| | - Maria Bova
- Department of Translational and Medical Science, Pediatric Unit, University Federico II, Naples, Italy
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Abstract
Objective To determine the challenges, coping strategies and needs of urban and rural Jamaican caregivers of adolescents with diabetes, and suggest ways to assist coping. Methods This qualitative study comprised four focus groups (two urban and two rural) with a total of nineteen caregivers of adolescents with diabetes. Thematic analysis was conducted on the data. Results The main challenges caregivers faced were keeping their children healthy, managing conflict with their children, and financial concerns. They met these challenges with problem-focused and emotion-focused coping strategies. Caregivers used the problem-focused strategies of vigilance, advocacy, minimising their children’s negative emotions, coercion, education, and seeking support, and the emotion-focused strategies of relying on their identity as parents and turning to their faith. Caregivers wanted assistance acquiring medication and equipment, increased diabetes education, and support groups. Discussion More resources should be channelled toward provision of diabetes supplies. Diabetes education is necessary in schools and for the general public. Healthcare practitioners should explore issues beyond diabetes management, such as caregivers’ coping and the caregiver-child relationship. Support groups are needed to facilitate learning. Special attention must be paid to rural areas: rural residents appeared to be in greater need than their urban counterparts.
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Affiliation(s)
- M Anderson
- 1 Department of Sociology, Psychology and Social Work, University of the West Indies, Jamaica
| | - M K Tulloch-Reid
- 2 Caribbean Institute for Health Research, University of the West Indies, Jamaica
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8
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Freda MF, Savarese L, Dolce P, Picione RDL. Caregivers' Sensemaking of Children's Hereditary Angioedema: A Semiotic Narrative Analysis of the Sense of Grip on the Disease. Front Psychol 2019; 10:2609. [PMID: 31849744 PMCID: PMC6901968 DOI: 10.3389/fpsyg.2019.02609] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 11/05/2019] [Indexed: 12/28/2022] Open
Abstract
Background and aims: In pediatrics receiving a diagnosis of a chronic condition is a matter that involves caregivers at first. Beyond the basic issues of caring for the physical condition of the ill child, how caregivers face and make sense of the disease orients and co-constructs their children’s sensemaking processes of the disease itself. The aim of this article is to explore the experience of a rare chronic illness, a pediatric case of Hereditary Angioedema (HAE) from the caregivers’ perspective. Hereditary angioedema is characterized by subcutaneous swellings that can involve internal as well as external mucosal tissues and is highly variable and unpredictable in terms of severity, frequency, and where it occurs. A qualitative narrative semiotic analysis of n. 28 maternal narratives on their children’s disease experience. Narratives were collected by an ad hoc interview on three domains of the disease experience: (A) interpretation of disease variability, (B) dialogical processes, and (C) management of the disease. Subsequently, we executed a TwoStep cluster analysis for categorical data to detect cross-sectional profiles of the maternal sensemaking processes of the disease. Results: The coding grid was built analyzing the characteristics of the narrative links that orient the connection between the elements of the experience within each domain: (A) the connection among events, for the domain of disease variability interpretation, (B) the connection between self and other, for the dialogue domain, and (C) the connection among sensemaking and actions, for the disease management domain. Results from the cluster analysis show three narrative profiles: (1) adempitive; (2) reactive; (3) dynamic. Discussion: Profiles will be discussed in light of the general conceptual framework of the Sense of Grip on the Disease (SoGoD) highlighting the importance of those sensemaking processes which, instead of relying on a coherent and closed interpretation of the disease, are characterized by a degree of tolerance for uncertainty and the unknown.
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Affiliation(s)
| | - Livia Savarese
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Pasquale Dolce
- Department of Public Health, University of Naples Federico II, Naples, Italy
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9
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Van Allen J, Noser AE, Littlefield AK, Seegan PL, Clements M, Patton SR. Measuring Self-Efficacy in the Context of Pediatric Diabetes Management: Psychometric Properties of the Self-Efficacy for Diabetes Scale. J Pediatr Psychol 2019; 43:143-151. [PMID: 29106615 DOI: 10.1093/jpepsy/jsx094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 06/02/2017] [Indexed: 11/12/2022] Open
Abstract
Objective The Self-Efficacy for Diabetes Scale (SED) is a widely used measure of diabetes-specific self-efficacy with three subscales: diabetes-specific self-efficacy (SED-D), medical self-efficacy (SED-M), and general self-efficacy (SED-G). The present study examined the factor structure and construct validity of the SED in 116 youth, aged 10-16 years (13.60 ± 1.87), with type 1 diabetes mellitus. Methods Confirmatory factor analysis (CFA) was used to examine the factor structure of the SED. Correlational and regression analyses examined relations between subscales and select outcomes. Results CFA of the original three-factor structure provided a poor fit to the data. Factor models using rescaled items were tested. Results provided preliminary evidence for the SED-D as an independent one-factor model, and for a reduced one-factor model. Significant associations were found between the SED subscales, responsibility for diabetes management, and glycated hemoglobin. Conclusions Results provide limited support for the SED-D as a reliable and valid measure of diabetes-specific self-efficacy.
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Affiliation(s)
- Jason Van Allen
- Clinical Psychology Program, Department of Psychological Sciences, Texas Tech University
| | - Amy E Noser
- Clinical Child Psychology Program, University of Kansas
| | - Andrew K Littlefield
- Clinical Psychology Program, Department of Psychological Sciences, Texas Tech University
| | - Paige L Seegan
- Clinical Psychology Program, Department of Psychological Sciences, Texas Tech University
| | - Mark Clements
- Division of Endocrinology & Diabetes, Department of Pediatrics, Children's Mercy Hospital
| | - Susana R Patton
- Department of Pediatrics, University of Kansas Medical Center
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10
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Almeida AC, Leandro ME, Pereira MG. Adherence and Glycemic Control in Adolescents with Type 1 Diabetes: The Moderating Role of Age, Gender, and Family Support. J Clin Psychol Med Settings 2019; 27:247-255. [DOI: 10.1007/s10880-019-09662-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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11
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Emerson ND, Morrell HER, Neece C, Tapanes D, Distelberg B. Longitudinal Model Predicting Self-Concept in Pediatric Chronic Illness. FAMILY PROCESS 2019; 58:100-113. [PMID: 29663349 DOI: 10.1111/famp.12361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Although self-concept has been identified as salient to the psychosocial adjustment of adolescents dealing with a chronic illness (CI), little research has focused on its predictors it. Given that depression and parent-child attachment have been linked to self-concept in the population at large, the goal of this study was to evaluate these relationships longitudinally in a sample of adolescents with CI. Using participant data from the Mastering Each New Direction (MEND) program, a 3-month psychosocial, family based intensive outpatient program for adolescents with CI, we employed multilevel modeling to test longitudinal changes in self-concept, as predicted by depressive symptoms and parent-child attachment, in a sample of 50 youths (Mage = 14.56, SDage = 1.82) participating in MEND. Both "time spent in the program" and decreases in depressive symptoms were associated with increases in self-concept over time. Higher baseline levels of avoidant attachment to both mother and father were also associated with greater initial levels of self-concept. Targeting depressive symptoms and supporting adaptive changes in attachment may be key to promoting a healthy self-concept in pediatric CI populations. The association between avoidant attachment and higher baseline self-concept scores may reflect differences in participants' autonomy, self-confidence, or depression. Limitations of the study include variability in the amount of time spent in the program, attrition in final time point measures, and the inability to fully examine and model all potential covariates due to a small sample size (e.g. power).
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Affiliation(s)
| | | | - Cameron Neece
- Department of Psychology, Loma Linda University, Loma Linda, CA
| | - Daniel Tapanes
- Behavioral Medicine Center, Loma Linda University, Redlands, CA
| | - Brian Distelberg
- Department of Counseling and Family Sciences and Behavioral Medicine Center, Loma Linda University, Loma Linda, CA
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12
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Dempster KW, Liu A, Nansel TR. Depression and parenting in youth with type 1 diabetes: Are general and diabetes-specific parenting behaviors associated with depressive symptoms over a 2-year period? J Behav Med 2019; 42:842-850. [PMID: 30694403 DOI: 10.1007/s10865-019-00011-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 01/12/2019] [Indexed: 12/31/2022]
Abstract
To examine cross-sectional and longitudinal associations of general parenting style and diabetes-specific parenting behaviors with depression in youth with type 1 diabetes. Participants (n = 390) completed self-report measures of depression at baseline and 2-year follow-up, general parenting style at baseline, and diabetes-specific parenting (conflict, task involvement, and collaborative involvement) at baseline and every 6 months. Logistic regression examined associations of parenting with depression at baseline and 2-year follow-up. A less authoritative parenting style, lower parent collaborative involvement, and greater diabetes-related conflict were associated with baseline depression in the model simultaneously including all parenting variables and covariates. Lower parent collaborative involvement and higher diabetes-related conflict were associated with depression at 2-year follow-up, adjusting for baseline depression and covariates. Parent task involvement was not associated with depression at either time. Findings suggest a protective role of parenting in reducing the risk of depression in youth with type 1 diabetes.
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Affiliation(s)
- Katherine W Dempster
- Division of Intramural Population Health Research, Social and Behavioral Sciences Branch (KWD, TRN), Biostatistics and Bioinformatics Branch (AL), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Aiyi Liu
- Division of Intramural Population Health Research, Social and Behavioral Sciences Branch (KWD, TRN), Biostatistics and Bioinformatics Branch (AL), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Tonja R Nansel
- Division of Intramural Population Health Research, Social and Behavioral Sciences Branch (KWD, TRN), Biostatistics and Bioinformatics Branch (AL), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
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13
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Maternal Parenting Styles and Glycemic Control in Children with Type 1 Diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16020214. [PMID: 30646525 PMCID: PMC6352042 DOI: 10.3390/ijerph16020214] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 12/27/2022]
Abstract
The purpose of this study is to examine differences in parenting styles between mothers of children with type 1 diabetes and mothers of healthy children and to explore relationships between parenting styles and glycemic control of children with diabetes. Mothers of 63 children with diabetes and mothers of 83 children without diabetes reported their parenting styles using the Blocks' Child Rearing Practices Report, when their child was 9⁻10 years old. Glycemic control of the children with diabetes was evaluated 1 year after diagnosis (<6 years of age) and at the time of the study (at 9⁻10 years). Mothers of children with diabetes used more psychological control than mothers of healthy children. Among girls with diabetes, poorer early glycemic control was associated with mothers' subsequent greater use of psychological control. Behavioral control was positively associated with poorer current glycemic control. In boys, psychological control was positively associated with poorer current glycemic control. Psychological control in families with diabetes needs attention, because it has shown to be associated with poorer diabetes care.
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14
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Kristensen LJ, Birkebaek NH, Mose AH, Berg Jensen M, Thastum M. Multi-informant path models of the influence of psychosocial and treatment-related variables on adherence and metabolic control in adolescents with type 1 diabetes mellitus. PLoS One 2018; 13:e0204176. [PMID: 30235290 PMCID: PMC6147740 DOI: 10.1371/journal.pone.0204176] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 09/03/2018] [Indexed: 12/12/2022] Open
Abstract
Background We assessed the associations between metabolic control and adherence and a broad range of adolescent and family characteristics (e.g., gender, family structure), treatment-related variables (e.g., disease duration, treatment modality), and psychosocial factors (e.g., symptoms of depression and anxiety, parental support, self-efficacy) in a nationwide study of Danish adolescents (age 12–17 years) with type 1 diabetes mellitus (T1DM). Methods Sixty-four percent of invited families participated by completing a survey and providing a blood sample. Two path models of associations between generic and diabetes-related family factors, adolescent self-efficacy, emotional difficulties, and metabolic control and adherence were tested, one for adolescents and one for caregivers. Demographic variables were included as covariates. Results Both path models demonstrated a satisfying model fit. In both models, metabolic control was associated with adherence, age, and T1DM duration. In the adolescent model, metabolic control was also related to treatment modality, single-parent household, caregiver non-support, and anxiety, whereas in the caregiver model metabolic control was associated with family conflict and caregiver support. In both models, adherence was related to age, duration, treatment modality, family conflict, caregiver support, family functioning, and emotional difficulties of the adolescent. In the adolescent model, adherence was also related to adolescent self-efficacy, whereas in the caregiver model adherence was associated with adolescent gender and caregiver non-support and support. Adolescent self-efficacy, emotional well-being, and difficulties related to adolescent/caregiver interaction appeared to be particularly important, as indicated by their stronger association with adherence and/or metabolic control. Conclusion The results highlight the value of applying a multi-informant approach to address the psychosocial well-being of adolescents with diabetes in a large national sample. Self-efficacy, emotional, and family-related difficulties are important aspects to address in both clinical care and future research regarding adolescents with T1DM.
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Affiliation(s)
- Lene Juel Kristensen
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
- * E-mail:
| | | | | | - Morten Berg Jensen
- Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | - Mikael Thastum
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
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15
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Distelberg B, Tapanes D, Emerson ND, Brown WN, Vaswani D, Williams-Reade J, Anspikian AM, Montgomery S. Prospective Pilot Study of the Mastering Each New Direction Psychosocial Family Systems Program for Pediatric Chronic Illness. FAMILY PROCESS 2018; 57:83-99. [PMID: 28299791 DOI: 10.1111/famp.12288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Psychosocial interventions for pediatric chronic illness (CI) have been shown to support health management. Interventions that include a family systems approach offer potentially stronger and more sustainable improvements. This study explores the biopsychosocial benefits of a novel family systems psychosocial intervention (MEND: Mastering Each New Direction). Forty-five families participated in a 21-session intensive outpatient family systems-based program for pediatric CI. Within this single arm design, families were measured on five domains of Health-Related Quality of Life (HRQL) self-report measures; Stress, Cognitive Functioning, Mental Health, Child HRQL, Family Functioning. Both survey and biological measures (stress: catecholamine) were used in the study. Results from multivariate general linear models showed positive pre-, post-, and 3-month posteffects in all five domains. The program effects ranged from small to moderate (η2 = .07-.64). The largest program effects were seen in the domains of cognitive functioning (η2 = .64) and stress (η2 = .27). Also, between disease groups, differences are noted and future implications for research and clinical practice are discussed. Conclusions suggest that the MEND program may be useful in helping families manage pediatric chronic illnesses. Study results also add to the growing body of literature suggesting that psychosocial interventions for pediatric chronic illness benefit from a family systems level of intervention.
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Affiliation(s)
| | - Daniel Tapanes
- Department of Counseling and Family Sciences, Loma Linda University Health Behavioral Medicine Center, Loma Linda, CA
| | | | - Whitney N Brown
- Department of Psychology, Loma Linda University, Loma Linda, CA
| | - Deepti Vaswani
- Loma Linda University Health Behavioral Medicine Center, Loma Linda, CA
| | | | - Ara M Anspikian
- Loma Linda University Health Behavioral Medicine Center, Loma Linda, CA
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Berg CA, Butner J, Wiebe DJ, Lansing AH, Osborn P, King PS, Palmer DL, Butler JM. Developmental model of parent-child coordination for self-regulation across childhood and into emerging adulthood: Type 1 diabetes management as an example. DEVELOPMENTAL REVIEW 2017; 46:1-26. [DOI: 10.1016/j.dr.2017.09.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Thabrew H, McDowell H, Given K, Murrell K. Systematic Review of Screening Instruments for Psychosocial Problems in Children and Adolescents With Long-Term Physical Conditions. Glob Pediatr Health 2017; 4:2333794X17690314. [PMID: 28255576 PMCID: PMC5315369 DOI: 10.1177/2333794x17690314] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 12/27/2016] [Indexed: 01/03/2023] Open
Abstract
Children and adolescents with long-term physical conditions (LTPCs) are at greater risk of developing psychosocial problems. Screening for such problems may be undertaken using validated psychometric instruments to facilitate early intervention. A systematic review was undertaken to identify clinically utilized and psychometrically validated instruments for identifying depression, anxiety, behavior problems, substance use problems, family problems, and multiple problems in children and adolescents with LTPCs. Comprehensive searches of articles published in English between 1994 and 2014 were completed via Medline, Embase, PsycINFO, CINAHL, and Cochrane CENTRAL databases, and by examining reference lists of identified articles and previous related reviews. Forty-four potential screening instruments were identified, described, and evaluated against predetermined clinical and psychometric criteria. Despite limitations in the evidence regarding their clinical and psychometric validity in this population, a handful of instruments, available at varying cost, in multiple languages and formats, were identified to support targeted, but not universal, screening for psychosocial problems in children and adolescents with LTPCs.
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Eilander MMA, Snoek FJ, Rotteveel J, Aanstoot HJ, Bakker-van Waarde WM, Houdijk ECAM, Nuboer R, Winterdijk P, de Wit M. Parental Diabetes Behaviors and Distress Are Related to Glycemic Control in Youth with Type 1 Diabetes: Longitudinal Data from the DINO Study. J Diabetes Res 2017; 2017:1462064. [PMID: 29376080 PMCID: PMC5742467 DOI: 10.1155/2017/1462064] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/06/2017] [Accepted: 10/15/2017] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To evaluate (1) the longitudinal relationship between parental well-being and glycemic control in youth with type 1 diabetes and (2) if youth's problem behavior, diabetes parenting behavior, and parental diabetes-distress influence this relationship. RESEARCH DESIGN AND METHODS Parents of youth 8-15 yrs (at baseline) (N = 174) participating in the DINO study completed questionnaires at three time waves (1 yr interval). Using generalized estimating equations, the relationship between parental well-being (WHO-5) and youth's HbA1c was examined. Second, relationships between WHO-5, Strength and Difficulties Questionnaire (SDQ), Diabetes Family Behavior Checklist (DFBC), Problem Areas In Diabetes-Parent Revised (PAID-Pr) scores, and HbA1c were analyzed. RESULTS Low well-being was reported by 32% of parents. No relationship was found between parents' WHO-5 scores and youth's HbA1c (β = -0.052, p = 0.650). WHO-5 related to SDQ (β = -0.219, p < 0.01), DFBC unsupportive scale (β = -0.174, p < 0.01), and PAID-Pr (β = -0.666, p < 0.01). Both DFBC scales (supportive β = -0.259, p = 0.01; unsupportive β = 0.383, p = 0.017), PAID-Pr (β = 0.276, p < 0.01), and SDQ (β = 0.424, p < 0.01) related to HbA1c. CONCLUSIONS Over time, reduced parental well-being relates to increased problem behavior in youth, unsupportive parenting, and parental distress, which negatively associate with HbA1c. More unsupportive diabetes parenting and distress relate to youth's problem behavior.
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Affiliation(s)
- Minke M. A. Eilander
- Department of Medical Psychology, VU University Medical Center, De Boelenlaan 1117, 1081 HV Amsterdam, Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Blaak 6, 3011 TA Rotterdam, Netherlands
| | - Frank J. Snoek
- Department of Medical Psychology, VU University Medical Center, De Boelenlaan 1117, 1081 HV Amsterdam, Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands
- Department of Medical Psychology, Academic Medical Center, Meibergdreef 9, 1100 DD Amsterdam, Netherlands
| | - Joost Rotteveel
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands
- Department of Pediatrics, VU University Medical Center, De Boelelaan 1118, 1081 HV Amsterdam, Netherlands
| | - Henk-Jan Aanstoot
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Blaak 6, 3011 TA Rotterdam, Netherlands
| | - Willie M. Bakker-van Waarde
- Department of Pediatrics, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, Netherlands
| | - Euphemia C. A. M. Houdijk
- Department of Pediatrics, Juliana Children's Hospital/Haga Hospital, Els Borst-Eilersplein 275, 2545 AA The Hague, Netherlands
| | - Roos Nuboer
- Department of Pediatrics, Meander Medical Center, Maatweg 3, 3813 TZ Amersfoort, Netherlands
| | - Per Winterdijk
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Blaak 6, 3011 TA Rotterdam, Netherlands
| | - Maartje de Wit
- Department of Medical Psychology, VU University Medical Center, De Boelenlaan 1117, 1081 HV Amsterdam, Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands
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Lohan A, Mitchell AE, Filus A, Sofronoff K, Morawska A. Positive parenting for healthy living (Triple P) for parents of children with type 1 diabetes: protocol of a randomised controlled trial. BMC Pediatr 2016; 16:158. [PMID: 27659518 PMCID: PMC5034659 DOI: 10.1186/s12887-016-0697-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 09/14/2016] [Indexed: 11/28/2022] Open
Abstract
Background Type 1 diabetes is a serious, life-long condition which causes major health, social and economic burden for children, their families and the community. Diabetes management involves strict adherence to a complex regimen, and poor management and non-adherence are a persistent problem among children. Parent-child interactions and parenting have been identified as crucial points of intervention to support children’s health and emotional well-being, yet few parenting interventions have been developed or evaluated for parents of young children. This paper describes a randomised controlled trial of a brief, group-based parenting intervention for parents of young children (2-10 years) with type 1 diabetes compared against care as usual (CAU). Methods/design Families will be randomised to either Positive Parenting for Healthy Living Triple P or CAU. Positive Parenting for Healthy Living Triple P involves 2 × 2 h group sessions. Outcomes will be assessed via parent and child questionnaire, home observations and blood glucose monitoring at baseline, 1-month and 6-months post-intervention. Primary outcomes will be parent- and child-reported parenting behaviour, parent-reported child behaviour and adjustment, and parent-reported child quality-of-life. Secondary outcomes will include parental self-efficacy with diabetes management, illness-specific and general parenting stress, parent-reported child illness behaviour, family quality-of-life, observed parenting and child behaviour, and child’s illness control. Discussion The theoretical background, study hypotheses, methods and planned analyses are discussed. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12613001281785. Registered 20 November, 2013.
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Affiliation(s)
- Aditi Lohan
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Amy E Mitchell
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Ania Filus
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, QLD, 4072, Australia.,Center for Self-Report Science, Center for Social & Economic Research, University of Southern California, Los Angeles, USA
| | - Kate Sofronoff
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Alina Morawska
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, QLD, 4072, Australia.
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Adolescents’, mothers’, and fathers’ reports of adherence across adolescence and their relation to HbA1c and daily blood glucose. J Behav Med 2016; 39:1009-1019. [DOI: 10.1007/s10865-016-9771-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 07/12/2016] [Indexed: 10/21/2022]
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Walker SC, Bishop AS, Pullmann MD, Bauer G. A Research Framework for Understanding the Practical Impact of Family Involvement in the Juvenile Justice System: The Juvenile Justice Family Involvement Model. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2015; 56:408-21. [PMID: 26407854 DOI: 10.1007/s10464-015-9755-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Family involvement is recognized as a critical element of service planning for children's mental health, welfare and education. For the juvenile justice system, however, parents' roles in this system are complex due to youths' legal rights, public safety, a process which can legally position parents as plaintiffs, and a historical legacy of blaming parents for youth indiscretions. Three recent national surveys of juvenile justice-involved parents reveal that the current paradigm elicits feelings of stress, shame and distrust among parents and is likely leading to worse outcomes for youth, families and communities. While research on the impact of family involvement in the justice system is starting to emerge, the field currently has no organizing framework to guide a research agenda, interpret outcomes or translate findings for practitioners. We propose a research framework for family involvement that is informed by a comprehensive review and content analysis of current, published arguments for family involvement in juvenile justice along with a synthesis of family involvement efforts in other child-serving systems. In this model, family involvement is presented as an ascending, ordinal concept beginning with (1) exclusion, and moving toward climates characterized by (2) information-giving, (3) information-eliciting and (4) full, decision-making partnerships. Specific examples of how courts and facilities might align with these levels are described. Further, the model makes predictions for how involvement will impact outcomes at multiple levels with applications for other child-serving systems.
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Affiliation(s)
- Sarah Cusworth Walker
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 2815 Eastlake Ave E Ste 200, Seattle, WA, 98102, USA.
| | - Asia S Bishop
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 2815 Eastlake Ave E Ste 200, Seattle, WA, 98102, USA.
| | - Michael D Pullmann
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 2815 Eastlake Ave E Ste 200, Seattle, WA, 98102, USA.
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Lohan A, Morawska A, Mitchell A. A systematic review of parenting interventions for parents of children with type 1 diabetes. Child Care Health Dev 2015; 41:803-17. [PMID: 26268836 DOI: 10.1111/cch.12278] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 06/02/2015] [Accepted: 06/28/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To summarize the parenting intervention literature for parents of children aged 2-10 years (mean age <10 years) with type 1 diabetes and to evaluate intervention efficacy in improving a range of parent, family and child outcomes. The present review de-emphasizes the traditional medical approach to illness management summarized in previous reviews and focuses on parenting factors identified in the literature as important to diabetes management. This review article is important as it outlines the present state of parenting intervention literature for this population. METHODS Electronic searches were conducted for seven databases (Cumulative index to nursing and allied health literature, MEDLINE, PsycINFO, PubMed, Scopus, The Cochrane library and Web of Science) from their start dates until April 2014. Reference lists of all included papers were also searched for potentially relevant articles. RESULTS Seven papers, representing six studies, met the inclusion criteria. Three studies primarily focused on improving parenting practices. The intervention programmes described in the remaining studies comprised multiple components; thus, it is difficult to establish the contribution of the parenting components to improving outcomes. CONCLUSIONS Parenting interventions may help to improve responsibility sharing and cooperation in diabetes management, child behaviour difficulties, parental behaviour, parents' psychological distress and child health outcomes. This review suggests the need for further well-designed trials of parenting interventions to determine their specific contribution to improving outcomes for this population.
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Affiliation(s)
- A Lohan
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Australia
| | - A Morawska
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Australia
| | - A Mitchell
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Australia
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Herbert LJ, Monaghan M, Cogen F, Streisand R. The impact of parents' sleep quality and hypoglycemia worry on diabetes self-efficacy. Behav Sleep Med 2015; 13:308-23. [PMID: 24738994 PMCID: PMC4199924 DOI: 10.1080/15402002.2014.898303] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Parents of young children with type 1 diabetes (T1D) may experience poor sleep quality, possibly impacting their confidence in T1D management. This study investigated sleep characteristics among parents of children with T1D and relationships among parents' sleep quality, hypoglycemia worry, and diabetes self-efficacy. As part of baseline assessment for a randomized clinical trial (RCT) to promote parental management of T1D, 134 parents of children ≤ age 6 reported on demographics, parent sleep characteristics, hypoglycemia worry, and diabetes self-efficacy. Parents reported they slept less time than recommended by the National Sleep Foundation and endorsed greater global sleep problems than standardized norms of healthy adults; one third of parents reported their overall sleep quality was "fairly bad" or "very bad." Hypoglycemia worry and parents' sleep quality were both significantly related to diabetes self-efficacy, but parents' sleep quality did not mediate the relationship of hypoglycemia worry and diabetes self-efficacy. Many parents experience disrupted sleep that impacts their perceived ability to perform T1D management. Interventions designed to improve parental T1D self-efficacy should consider sleep and concerns about children's hypoglycemia.
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Affiliation(s)
| | - Maureen Monaghan
- Center for Translational Science, Children’s National Health System
| | - Fran Cogen
- Department of Endocrinology and Diabetes, Children’s National Health System
| | - Randi Streisand
- Center for Translational Science, Children’s National Health System
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24
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Moulton CD, Pickup JC, Ismail K. The link between depression and diabetes: the search for shared mechanisms. Lancet Diabetes Endocrinol 2015; 3:461-471. [PMID: 25995124 DOI: 10.1016/s2213-8587(15)00134-5] [Citation(s) in RCA: 352] [Impact Index Per Article: 39.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 01/23/2015] [Accepted: 01/27/2015] [Indexed: 02/07/2023]
Abstract
Depression is twice as common in people with type 1 or type 2 diabetes as in the general population, and is associated with poor outcomes. Evidence is growing that depression and type 2 diabetes share biological origins, particularly overactivation of innate immunity leading to a cytokine-mediated inflammatory response, and potentially through dysregulation of the hypothalamic-pituitary-adrenal axis. Throughout the life course, these pathways can lead to insulin resistance, cardiovascular disease, depression, increased risk of type 2 diabetes, and increased mortality. Proinflammatory cytokines might directly affect the brain, causing depressive symptoms. In type 1 diabetes, mediators of depression are not well studied, with research hindered by inconsistent definitions of depression and scarcity of observational, mechanistic, and interventional research along the life course. Despite few studies, evidence suggests that familial relationships and burden of a lifelong disorder with an onset early in personality development might contribute to increased vulnerability to depression. Overall, longitudinal research is needed to identify risk factors and mechanisms for depression in patients with diabetes, particularly early in the life course. Ultimately, improved understanding of shared origins of depression and diabetes could provide the potential to treat and improve outcomes of both disorders simultaneously. These shared origins are targets for primary prevention of type 2 diabetes.
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Affiliation(s)
- Calum D Moulton
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK.
| | - John C Pickup
- Diabetes and Nutritional Sciences Division, King's College London, London, UK
| | - Khalida Ismail
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK
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Tapanes D, Distelberg BJ, Williams-Reade J, Montgomery S. Mastering Each New Direction (MEND): A Biopsychosocial Intervention for Pediatric Chronic Illness. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/08975353.2015.1002735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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26
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Amiri F, Vafa M, Gonder-Frederick L. Glycemic Control, Self-Efficacy and Fear of Hypoglycemia Among Iranian Children with Type 1 Diabetes. Can J Diabetes 2015; 39:302-7. [PMID: 25797114 DOI: 10.1016/j.jcjd.2014.12.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 12/14/2014] [Accepted: 12/15/2014] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This study was designed to test the reliability of a Persian version of 2 questionnaires to assess the level of fear of hypoglycemia (FoH) and self-efficacy in diabetes management and their association with glycated hemoglobin (A1C) and parents' demographic characteristics in a sample of children with type 1 diabetes. DESIGN We assessed 61 children with type 1 diabetes (35 boys and girls, 6.0 to 12.7 years of age) using the Hypoglycemia Fear Survey-Child version (HFS-C) and Self-Efficacy for Diabetes Scale-Child version (SED-C). Their glycemic control was evaluated by A1C levels. RESULTS The internal consistency of the Persian version of HFS-C and SED-C were very good. Our results showed that children older than 10 years of age report lower levels of FoH, which are related to higher levels of self-efficacy (r=-.30, p=0.025 and r=-.30, p=0.02, respectively). Of the children, 42.3% of girls and 31.4% of boys reported that low blood sugar is a big problem for them. These findings suggest that FoH is a significant concern for this target group. Only 19.7% of children had controlled diabetes based on A1C levels. There was no significant association between higher A1C levels and other variables, including HFS-C, SED-C and parents' demographic characteristics. CONCLUSIONS The Persian version of HFS-C and SED-C are reliable and valid measures of the fear of hypoglycemia and of self-efficacy in children with type 1 diabetes, and these questionnaires could be used in our country for identifying those children who may need diabetes education and other supports. The association between greater self-efficacy and lower fear of hypoglycemia suggests that addressing self-efficacy in diabetes education courses may be effective in helping to overcome FoH.
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Affiliation(s)
- Fatemehsadat Amiri
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Vafa
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Linda Gonder-Frederick
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia Health System, Charlottesville, Virginia, USA
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Rasbach L, Jenkins C, Laffel L. An integrative review of self-efficacy measurement instruments in youth with type 1 diabetes. DIABETES EDUCATOR 2014; 41:43-58. [PMID: 25216655 DOI: 10.1177/0145721714550254] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE The purpose of this study is to assess the extant literature on instruments used to measure self-efficacy in youth with type 1 diabetes (T1DM) and their caregivers and to critically evaluate these measurements. METHODS An integrative review (2003-2013) was conducted searching PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and US National Library of Medicine PubMed service (PubMed) databases using key words diabetes, type 1 diabetes, and self-efficacy. The authors reviewed the resulting 294 references for inclusion criteria of (a) sample of youth with T1DM or sample of caregivers of youth with T1DM, (b) description of the self-efficacy instrument as primary research, and (c) the instrument measured self-efficacy specifically related to diabetes management. Forty-five articles out of the initial 294 met criteria. RESULTS Of the 45 articles, 10 different self-efficacy instruments were identified. The primary theoretical framework used was Bandura's social cognitive theory and model of self-efficacy. Most participants were white middle-class T1DM youth. Evaluations to assess validity often were not reported; however, a majority of studies reported high internal consistency of the instruments. CONCLUSIONS Sample homogeneity could limit the applicability of results to certain patient populations. Further psychometric analysis, including validity assessments, should be conducted in more diverse samples. Development of valid and reliable instruments for measuring self-efficacy that are sensitive to change across a wider caregiver base over time is necessary. While this review examined reliable and valid instruments used in research, future opportunities include evaluation of measuring self-efficacy in T1DM youth exposed to recent advances in diabetes management technologies.
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Affiliation(s)
- Lisa Rasbach
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina (Mrs Rasbach, Dr Jenkins),Joslin Diabetes Center, Boston, Massachusetts (Mrs Rasbach, Dr Laffel)
| | - Carolyn Jenkins
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina (Mrs Rasbach, Dr Jenkins)
| | - Lori Laffel
- Joslin Diabetes Center, Boston, Massachusetts (Mrs Rasbach, Dr Laffel)
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Distelberg B, Williams-Reade J, Tapanes D, Montgomery S, Pandit M. Evaluation of a family systems intervention for managing pediatric chronic illness: Mastering Each New Direction (MEND). FAMILY PROCESS 2014; 53:194-213. [PMID: 24635346 PMCID: PMC4486080 DOI: 10.1111/famp.12066] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Family systems play a crucial, albeit complex, role in pediatric chronic illness. Unfortunately, very few psychosocial interventions are available to help these stressed families navigate the developmental steps of chronic illness. A new intervention (MEND) addresses the needs of these families and applies to a broad range of chronic illnesses. This article presents this family systems intervention as well as includes preliminary program evaluation data on 22 families that graduated from the program. Results show consistently strong effects across an array of psychosocial measures. Conclusions from this preliminary study suggest that families entering MEND present with high levels of stress due to the child's chronic illness, but after MEND, the level of stress and other functioning measures are comparable to those seen in healthy families, suggesting that the program offers a significant benefit to families with pediatric chronic illness.
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Affiliation(s)
- Brian Distelberg
- Department of Counseling and Family Sciences, Loma Linda University, Loma Linda, CA
| | | | - Daniel Tapanes
- Department of Counseling and Family Sciences, Loma Linda University, Loma Linda, CA
| | | | - Mayuri Pandit
- Behavioral Medical Center, Loma Linda University, Loma Linda, CA
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29
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Kristensen LJ, Birkebaek NH, Mose AH, Hohwü L, Thastum M. Symptoms of emotional, behavioral, and social difficulties in the danish population of children and adolescents with type 1 diabetes--results of a national survey. PLoS One 2014; 9:e97543. [PMID: 24842772 PMCID: PMC4026318 DOI: 10.1371/journal.pone.0097543] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 04/22/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To assess the prevalence of psychological difficulties in Danish children and adolescents with type 1 diabetes using both child/adolescent and caregiver reports, and to investigate associations between these symptoms and metabolic control, adherence, and quality of life. RESEARCH DESIGN AND METHOD A total of 786 children and adolescents (8-17 years) recruited through the Danish Registry of Childhood Diabetes completed subscales of the Beck's Youth Inventories (BYI-Y), while 910 caregivers completed the Strength and Difficulties Questionnaire (SDQ). The participants also completed questionnaires assessing adherence and quality of life. BYI-Y and SDQ responses were compared with results from normative samples. RESULTS Children with diabetes generally reported a lower level of symptoms of depression and anxiety, while older adolescents in most cases were comparable to the normative samples. However, the numbers of patients with elevated scores were similar to normative groups, especially regarding the proportion of participants with 'Extremely elevated' scores. Caregivers of children and adolescents with diabetes generally reported the prevalence of elevated scores on the SDQ to exceed the prevalence observed in the norm sample--particularly with regard to older boys. Both BYI-Y and SDQ responses were significantly correlated with HbA1c, adherence, and quality of life. CONCLUSIONS This study finds Danish children and adolescents with diabetes to report lower or comparable levels of emotional difficulties compared to norms, while caregiver reports are less positive. The results therefore support the value of a multi-informant approach to the assessment of symptoms of psychological difficulty in girls and boys with diabetes.
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Affiliation(s)
- Lene J. Kristensen
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
- * E-mail:
| | - Niels H. Birkebaek
- Department of Pediatrics, Aarhus University Hospital, Aarhus N., Denmark
| | - Anne H. Mose
- Department of Pediatrics, Aarhus University Hospital, Aarhus N., Denmark
| | - Lena Hohwü
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Mikael Thastum
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
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Marchante AN, Pulgaron ER, Daigre A, Patiño-Fernandez AM, Sanchez J, Sanders LM, Delamater AM. Measurement of Parental Self-Efficacy for Diabetes Management in Young Children. CHILDRENS HEALTH CARE 2014. [DOI: 10.1080/02739615.2014.849957] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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31
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Sweenie R, Mackey ER, Streisand R. Parent-child relationships in Type 1 diabetes: associations among child behavior, parenting behavior, and pediatric parenting stress. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2014; 32:31-42. [PMID: 24294984 PMCID: PMC3950351 DOI: 10.1037/fsh0000001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Interactions between parents and children can influence behavioral and emotional functioning related to Type 1 diabetes (T1D), yet have been relatively unexplored during preadolescence. The present study examined associations among child problem behaviors, critical parenting behaviors, and pediatric parenting stress in a sample of preadolescent youth with T1D. Data are available from 86 preadolescent-parent dyads who participated in the initial baseline assessment of a randomized controlled trial designed to assess the efficacy of an adherence promotion program. Measures included the Eyberg Child Behavior Inventory, the Diabetes Family Behavior Checklist, and the Pediatric Inventory for Parents. After controlling for significant demographic and medical characteristics, parents who reported their child's behavior as more problematic reported more difficulty with pediatric parenting stress, which was also associated with more child-reported critical parenting behaviors. Child problem behaviors and critical parenting behaviors were associated with one another, partially via their association with increased pediatric parenting stress. Potential clinical applications include interventions geared toward helping parents manage difficult child behaviors as well as cope with pediatric parenting stress, with the ultimate goal of improving the parent-child relationship and management of T1D.
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Young MT, Lord JH, Patel NJ, Gruhn MA, Jaser SS. Good cop, bad cop: quality of parental involvement in type 1 diabetes management in youth. Curr Diab Rep 2014; 14:546. [PMID: 25212099 PMCID: PMC4283591 DOI: 10.1007/s11892-014-0546-5] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Sustained parental involvement in diabetes management has been generally advised to counteract the deteriorating adherence and glycemic control often seen during adolescence, yet until recently, little attention has been given to the optimal amount, type, and quality of parental involvement to promote the best health outcomes for adolescents with type 1 diabetes (T1D). This review synthesizes research regarding the involvement of caregivers-primarily mothers and fathers-of youth with T1D, with a focus on biopsychosocial outcomes. The recent literature on parental involvement in diabetes management highlights a shift in focus from not only amount but also the types (e.g., monitoring, problem-solving) and quality (e.g., warm, critical) of involvement in both mothers and fathers. We provide recommendations for ways that both parents can remain involved to facilitate greater collaboration in shared direct and indirect responsibility for diabetes care and improve outcomes in youth with T1D.
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Robinson LR, Bitsko RH, Schieve LA, Visser SN. Tourette syndrome, parenting aggravation, and the contribution of co-occurring conditions among a nationally representative sample. Disabil Health J 2012; 6:26-35. [PMID: 23260608 DOI: 10.1016/j.dhjo.2012.10.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Revised: 09/24/2012] [Accepted: 10/23/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Previous research suggests that parents of a child with Tourette Syndrome (TS) have lower self-concepts, higher caregiver burden, and more difficulties with home activities. However, the contributions of TS and mental, emotional, or behavioral (MEB) conditions to family functioning are difficult to identify from previous research due to relatively small TS sample sizes and high rates of co-occurring conditions within samples of children with TS. OBJECTIVE The current study hypothesized that families of children with TS would report significantly more family functioning difficulties (more parenting aggravation, more difficulty with coping with the child's care, less parent-child communication, and less consistent family routines). Specifically, co-occurring conditions would contribute substantially to reported parenting aggravation. METHOD Parent-reported data from the 2007 National Survey of Children's Health were analyzed, including whether the child had been diagnosed with TS or an MEB. Weighted analyses were restricted to US children 6-17 years of age (n = 64,034) and adjusted for child age, sex, race and ethnicity. RESULTS Parents of children with TS were more likely to fall into the high parenting aggravation index category compared with parents of children without TS (aPR = 3.8, 95% CI: 2.2-6.6). Controlling for the co-occurring MEB conditions attenuated the relations between TS and parenting aggravation; however, a significant effect for TS remained in some cases. CONCLUSION Parents of children with TS may face significant challenges in raising their children, leading to increased parenting aggravation; these challenges appear to be primarily associated with the presence of co-occurring MEB conditions.
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Affiliation(s)
- Lara R Robinson
- Child Development Studies Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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