Group versus Individual Care in Patients with Long-Standing Type 1 and Type 2 Diabetes: A One-Year Prospective Noninferiority Study in a Tertiary Diabetes Clinic

Filial Maturity, Resolution of a Parent's Disease, and Well-Being in Offspring of Parents Diagnosed with Alzheimer's Disease

BACKGROUND

Alzheimer's Disease (AD) is one of the most common forms of dementia. However, research dealing with the experience of adult children of a parent diagnosed with AD, regardless of whether the offspring is a caregiver, is not well developed.

OBJECTIVE

The current research is a cross-sectional study that examines the associations between filial maturity, offspring's coming to terms with their parent's AD, and the well-being of the offspring.

METHOD

one hundred and forty Israeli adult children of parents with AD participated in the study and completed self-report questionnaires assessing their filial maturity, resolution of their parent's diagnosis with AD, the adult children's well-being, and the severity of the parent's AD according neurologist's report.

RESULTS

Results showed that higher resolution of the parent's disease was positively associated with well-being. In addition, filial maturity was negatively associated with resolution of the parent's disease, and resolution of the parent's disease mediated the association between filial maturity and well-being.

CONCLUSION

Resolution of a parent's AD is highly challenging for offspring with high filial maturity, and the lack of resolution affects their well-being. Offering prolonged emotional support for offspring of parents diagnosed with AD may improve their ability to integrate the new reality into their lives and foster their well-being.

Operationalizing and Evaluating Synchronous Virtual Group Health Interventions: Wide-Scale Implementation at a Tertiary Care Academic Hospital

Group-based health interventions are an important component of health promotion and management. To provide continuity of care throughout the COVID-19 pandemic, our institution undertook a rapid pivot to delivering group-based health interventions via a videoconferencing service which was securely embedded into both the electronic medical record and the patient portal to sustainably address immediate health service delivery needs during the pandemic and beyond. In this paper, we (1) describe the institutionally driven operationalization of a system to provide integrated synchronous video group visits across our hospital and (2) present a proposed strategy to comprehensively evaluate outcomes regarding their implementation, quality, and impact. Lessons for other institutions and the potential future role of synchronous video group visits to enhance how care can be scaled for delivery are discussed.

Self-management in patients with type 2 diabetes: Group-based versus individual education. A systematic review with meta-analysis of randomized trails

AIM

Patient education is an essential component of the treatment of type 2 diabetes mellitus (T2DM). The present meta-analysis was aimed at verifying the efficacy of group-based versus individual education for self-management in patients with T2DM.

DATA SYNTHESIS

A Medline and Embase search up to January 1st, 2021, was performed, including Randomized Controlled Trials (RCT) with duration>6 months, enrolling patients with T2DM and comparing individual-based with group-based educational programs. The primary outcome was endpoint HbA1c; secondary endpoints were lipid profile, body weight, blood pressure, patients' adherence/knowledge, and quality of life. The weighed difference in means (WMD) and Mantel-Haenzel Odds Ratio (MH-OR), with 95% Confidence Interval (CI), were calculated. We retrieved 14 RCT. No significant between-group difference in HbA1c (WMD -0.39[-0.89; 0.09] mmol/mol, p = 0.11) was observed. At metaregression analyses, longer trial duration, higher baseline mean age and duration of diabetes, and lower baseline HbA1c were correlated with greater efficacy of group-based programs in reducing HbA1c. When analyzed separately, trials excluding insulin-treated patients showed a significant reduction of HbA1c in favor of group education.

CONCLUSIONS

In patients with T2DM, group education has similar efficacy as individual education on glucose control. Group programs are associated with an improved quality of life and patients' knowledge.

PROSPERO AND OSF REGISTRATION

ID243149.

Resolution of a Parent's Disease: Attachment and Well-Being in Offspring of Parents Diagnosed with Parkinson's Disease

BACKGROUND

Parkinson's disease (PD) is one of the most common chronic, progressive neurodegenerative diseases, with well-developed research focusing on the caregiver-spouse showing low well-being along with predeath grief and feelings of loss among caregivers. However, offspring of a parent diagnosed with PD may also suffer predeath grief and loss even if they are not their parent's main caregiver. Yet, this research is not well developed.

OBJECTIVE

The objective of the current study was to examine offspring's coming to terms with their parent's PD and the well-being of the offspring, within the conceptual framework of attachment theory.

METHODS

Seventy-one Israeli adult children of parents with PD participated in the study and completed self-report questionnaires assessing their resolution of their parent's PD, attachment, well-being, and the severity of the PD symptoms.

RESULTS

Results showed that attachment anxiety negatively associated with higher resolution of the parent's disease, beyond the effect of the PD symptoms' severity. In addition, resolution of the parent's disease was positively associated with the offspring's well-being.

CONCLUSION

Resolution of a parent's PD is highly challenging for offspring with attachment anxiety. Therefore, targeting these individuals within the offspring of parents diagnosed with PD may assist them with coping during this challenging period. This may be especially impactful, as research shows that those offspring who resolve their parent's PD also have higher well-being.