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Tang TS, Sharif N, Ng C, McLean L, Klein G, Amed S. Evaluating a Digitally Delivered, Multi-Modal Intervention for Parents of Children with Type 1 Diabetes: A Proof-of-Concept Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1114. [PMID: 39334646 PMCID: PMC11430652 DOI: 10.3390/children11091114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2024] [Revised: 09/01/2024] [Accepted: 09/06/2024] [Indexed: 09/30/2024]
Abstract
Background/Objectives: We examined the feasibility, acceptability, and potential mental health impact of a digital peer support intervention involving videoconferencing and text-based support for parents of school-aged children living with T1D and analyzed posts exchanged by parents on a texting platform. Methods: Eighteen parents were recruited for Huddle4Parents, a 4-month digital intervention that involved four synchronous group-based Zoom sessions coupled with an asynchronous 24/7 peer support texting room. Primary outcomes were feasibility (i.e., ability to recruit n = 20 parents and retain at least 75%) and acceptability (i.e., satisfaction ratings of "good" to "very good"). Baseline and 4-month assessments also measured diabetes distress, quality of life, and perceived support. A content analysis of text exchanges was also performed. Results: All 15 parents who completed the intervention attended at least one Huddle and posted at least one message on the 24/7 peer support room. The retention rate was 83%, with 100% indicating that they would "definitely" or "probably yes" recommend both platforms to other parents. They also rated the topics, facilitator, and overall Huddles as "good" to "excellent." No changes were observed for psychosocial endpoints. Of the 1084 texts posted, core support themes included the following: (1) dealing with technology and devices; (2) seeking and providing emotional support; (3) managing T1D in the school setting; and (4) exchanging tips and strategies. Conclusions: Huddle4Parents, a digital T1D caregiver intervention offering synchronous and asynchronous support, is feasible based on recruitment, participation, and attrition rates and acceptable as demonstrated by engagement and satisfaction ratings for the Huddles and 24/7 peer support room.
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Affiliation(s)
- Tricia S. Tang
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
- T1D Huddle Gordon & Leslie Diamond Health Care Centre, Vancouver, BC V5Z 1M9, Canada;
| | - Niloufar Sharif
- Faculty of Education, School of Kinesiology, University of British Columbia, Vancouver, BC V6T 1Z1, Canada;
| | - Crystal Ng
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC V6H 0B3, Canada; (C.N.); (S.A.)
- BC Children’s Hospital, Vancouver, BC V6H 3N1, Canada
| | - Logan McLean
- T1D Huddle Gordon & Leslie Diamond Health Care Centre, Vancouver, BC V5Z 1M9, Canada;
| | | | - Shazhan Amed
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC V6H 0B3, Canada; (C.N.); (S.A.)
- BC Children’s Hospital, Vancouver, BC V6H 3N1, Canada
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Hamdan S, Taybeh E, Alsous MM. Determinants of self-care among Jordanian children with type 1 diabetes mellitus. J Egypt Public Health Assoc 2024; 99:19. [PMID: 39160425 PMCID: PMC11333684 DOI: 10.1186/s42506-024-00166-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 07/21/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND Diabetes Self-Care Management (DSCM) is crucial for managing diabetes mellitus and improving patients' well-being. Research on the young age group in Jordan is limited, and there is a lack of studies using an evaluation tool for understanding diabetes pharmacotherapy. This study intends to fill the information gap by examining young Jordanian patients' knowledge and comprehension of type 1 diabetes mellitus (T1DM) and its treatment modalities, evaluating their psychological well-being, and examining the relationship between children's psychological health and self-care. METHODS This cross-sectional study was conducted in the Jordanian Ministry of Health hospitals in Amman from June 2021 to January 2022. A convenience sampling method was used to select Arabic-speaking diabetic patients aged 11-a8 years who provided signed consent. A sample size of 400 was estimated. A self-administered questionnaire was developed based on a literature review to assess sociodemographic characteristics and diabetes and insulin knowledge, and validated scales were used to assess self-management (SMOD-A) and psychological well-being (ChilD-S). RESULTS Analysis of the questionnaire responses revealed varying levels of knowledge among the participants. Approximately half of the children (49.0%) demonstrated a lack of knowledge of diabetes pharmacotherapy. Psychological well-being indicators indicated moderate levels of happiness and feeling fine. The analysis of self-management indicators highlighted areas for improvement. Positive weak but significant correlations were found between children's knowledge about diabetes (r = 0.255, p < 0.01), diabetes pharmacotherapy knowledge (r = 0.125, p < 0.05), psychological well-being (r = 0.112, p < 0.05), and their diabetic self-management scores. A multivariate regression analysis identified predictors of self-management, including the child's school year (p = 0.035), ability to express feelings (p = 0.039), recent HbA1c levels (p = 0.028), and diabetes knowledge score (p < 0.001). CONCLUSION Participants exhibited varying levels of knowledge about diabetes pharmacotherapy and self-management. Knowledge about diabetes was identified as a predictor for effective self-management. Moreover, glycemic control and diabetes mellitus awareness majorly impact overall self-management behaviors. Tailored education programs are necessary to fill knowledge gaps and enhance diabetes management among children.
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Affiliation(s)
- Salam Hamdan
- Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Esra' Taybeh
- Faculty of Pharmacy, Isra University, Amman, Jordan
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Allen V, Mahieu A, Kasireddy E, Shouman W, Pourrahmat MM, Collet JP, Cherkas A. Humanistic burden of pediatric type 1 diabetes on children and informal caregivers: systematic literature reviews. Diabetol Metab Syndr 2024; 16:73. [PMID: 38515123 PMCID: PMC10956250 DOI: 10.1186/s13098-024-01310-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 03/09/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Diagnosis of children with type 1 diabetes (T1D) imposes an unprecedented burden on children and their caregivers. OBJECTIVE To assess the burden of T1D on children and their informal caregivers, both after a recent diagnosis or after a longer duration of disease. METHODS A series of systematic literature reviews were performed to explore the burden of T1D on children with the disease and their primary informal caregivers, based on the time of diagnosis. After the extraction of the qualitative and quantitative data from the included studies, two literature-based conceptual frameworks were developed: on the burden of pediatric T1D on children, and on informal caregivers. A third conceptual framework on the shared burden of pediatric T1D on both children and informal caregivers as part of the same family unit was also developed. RESULTS The review of literature has identified a series of factors that affect the quality of life of children with T1D and their informal caregivers, with a direct impact on physical, emotional, and social outcomes. Generally, female patients and older adolescents experience more worry and stress that affects their quality of life. Other categories of factors affecting the child's and caregiver's burden include social, emotional, and physical factors, treatment-related and disease-related factors, as well as their coping abilities. Anxiety, depression, stress, and worry were commonly found among children and caregivers, starting with the diagnosis of T1D and continuing over time in relation to new challenges pertaining to aging or the disease duration. CONCLUSION T1D causes a significant burden to affected children and their caregivers, both independently and through transactional interaction within the family unit. Disease burden can be reduced by strengthening individuals for the benefit of the whole family.
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Affiliation(s)
| | | | | | - Walid Shouman
- Evidinno Outcomes Research Inc., Vancouver, BC, Canada
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García-Marín E, Valero-Moreno S, Schoeps K, Postigo-Zegarra S, Pérez-Marín M. Overburden in Caregivers of Chronically Ill Adolescents: A Comparative Study between Pulmonological and Endocrinological Diseases. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1840. [PMID: 38136042 PMCID: PMC10742129 DOI: 10.3390/children10121840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/14/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023]
Abstract
Chronic pediatric disease has a major impact on the life of a child and his or her family. In this sense, the figure of the main caregiver is relevant, who may present adjustment difficulties before the disease, accompanied by high levels of stress and emotional discomfort, which interfere with the adolescent's adjustment before the new situation. The aim of this research was to carry out a comparative study among caregivers of adolescents with various diseases, analyzing the risk and protective factors for the stress presented by this population. For this purpose, a sample of 406 main caregivers of adolescents with an endocrinological or pneumological disease from different hospitals in Valencia was used, where characteristics related to the disease, attachment, type of family, and emotional distress of these caregivers were considered. In general, the results show higher levels of stress in caregivers of adolescents with an endocrinological disease, specifically DM1, and found significant predictors of anxiety-depressive symptomatology, the need for approval, and several variables related to the disease. These data reveal the importance of providing comprehensive care to the family system, offering health skills to overcome diseases, and reinforcing the protective factors offered by the family system.
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Affiliation(s)
- Elvira García-Marín
- Personality, Assessment and Psychological Treatment Department, Faculty of Psychology and Speech Therapy, University of Valencia, Avenida Blasco Ibáñez, 21, 46010 Valencia, Spain; (E.G.-M.); (K.S.); (S.P.-Z.); (M.P.-M.)
| | - Selene Valero-Moreno
- Personality, Assessment and Psychological Treatment Department, Faculty of Psychology and Speech Therapy, University of Valencia, Avenida Blasco Ibáñez, 21, 46010 Valencia, Spain; (E.G.-M.); (K.S.); (S.P.-Z.); (M.P.-M.)
| | - Konstanze Schoeps
- Personality, Assessment and Psychological Treatment Department, Faculty of Psychology and Speech Therapy, University of Valencia, Avenida Blasco Ibáñez, 21, 46010 Valencia, Spain; (E.G.-M.); (K.S.); (S.P.-Z.); (M.P.-M.)
| | - Silvia Postigo-Zegarra
- Personality, Assessment and Psychological Treatment Department, Faculty of Psychology and Speech Therapy, University of Valencia, Avenida Blasco Ibáñez, 21, 46010 Valencia, Spain; (E.G.-M.); (K.S.); (S.P.-Z.); (M.P.-M.)
- Faculty of Health Sciences, Department of Psychology, European University of Valencia, Passeig. de l’Albereda, 7, 46010 Valencia, Spain
| | - Marián Pérez-Marín
- Personality, Assessment and Psychological Treatment Department, Faculty of Psychology and Speech Therapy, University of Valencia, Avenida Blasco Ibáñez, 21, 46010 Valencia, Spain; (E.G.-M.); (K.S.); (S.P.-Z.); (M.P.-M.)
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Zeitoun MH, Abdel Reheem AA, Kharboush IF, Sheshtawy H, Assad DH, El Feky AY. Relationship between depressive and anxiety symptoms and fear of hypoglycemia among adolescents and adults with type 1 diabetes mellitus. Prim Care Diabetes 2023; 17:255-259. [PMID: 36925404 DOI: 10.1016/j.pcd.2023.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/22/2023] [Accepted: 03/05/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND AND AIMS Emotional problems including anxiety, depression and fear of hypoglycemia (FOH) are common in patients with type 1 diabetes mellitus (T1DM). The aim of this study was to determine the prevalence of depressive and anxiety symptoms among patients with T1DM and their relation to glycemic control, diabetes complications and to FOH. METHODS This study included 325 patients with T1DM. Anxiety and depressive symptoms were assessed by Hospital Anxiety and Depression Scale (HADS) and FOH was assessed by Hypoglycemia Fear Survey II (HFS-II). Glycemic control was assessed by both fasting plasma glucose and HbA1c. A subsample of 75 patients was screened for diabetes complications. RESULTS The prevalence of anxiety symptoms, depressive symptoms and FOH was 76.3%, 61.8% and 20% respectively. Female sex was related to depressive symptoms but not to anxiety symptoms. Logistic regression analysis showed that both HbA1c and HFS-II total score were independently correlated with both anxiety symptoms and depressive symptoms. Age showed independent correlation with both HFS-II (total score) and with Hypoglycemia Fear Survey-worry (HFS-W) while HbA1c showed independent correlation with Hypoglycemia Fear Survey-behavior (HFS-B). Both anxiety and depressive symptoms were positively correlated to HFS-B score, HFS-W score and HFS-II total score. CONCLUSIONS FOH is not uncommon among Egyptian patients with T1DM and it seems to be one of the factors contributing to the increased prevalence of anxiety and depressive symptoms among those individuals. Addressing and managing the different psychological aspects of diabetes should be integrated within the routine diabetes care services for people with T1DM.
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Affiliation(s)
| | | | - Ibrahim F Kharboush
- Department of Maternal and Child Health, High Institute of Public Health, Alexandria University, Egypt
| | - Hesham Sheshtawy
- Department of Neurology and Psychiatry, Alexandria University, Egypt
| | - Dalia H Assad
- Department of Internal Medicine, Abu Qir general hospital, Alexandria, Egypt
| | - Amr Y El Feky
- Department of Internal Medicine, Alexandria University, Egypt.
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ÇİFTCİ N, ÇAMTOSUN E, DÜNDAR İ, AKINCI A. Ana sınıfında veya ilkokulda okuyan tip 1 diabetes mellitus tanılı çocukların okulda hastalık yönetimi ile ilgili yaşadıkları sorunlar. EGE TIP DERGISI 2023. [DOI: 10.19161/etd.1262450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Amaç: Tip 1 diabetes mellitus (T1DM) tanılı çocuklar diyabet öz bakımında gözetime ihtiyaç duymaktadırlar ve günün önemli bir kısmını geçirdikleri okuldaki koşullar hastalık yönetimini
etkilemektedir. Bu çalışmanın amacı, T1DM tanılı ana sınıfı ve ilkokul çağındaki çocukların okulda hastalık yönetimi ile ilgili karşılaştıkları sorunları ortaya koymaktır.
Gereç ve Yöntem: Bu kesitsel çalışmaya T1DM tanılı 5-10 yaş aralığındaki 50 hasta dahil edildi. Literatür doğrultusunda araştırmacı tarafından geliştirilen okulda diyabet yönetimiyle ilgili anket,
Google anket formu aracılığıyla hasta ve/veya ebeveynleri tarafından dolduruldu. Elde edilen veriler tanımlayıcı istatistiksel yöntemlerle analiz edildi.
Bulgular: Hastaların ortalama diyabet süreleri 5,39±2,56 yıldı. Olguların %94’ü devlet okuluna gidiyordu. Okulların %78’inde sağlık bakım odası, %92’sinde hemşire/sağlık personeli yoktu. Olguların %86’sı okulda ana öğün alıyordu, ancak bunların büyük çoğunluğu öğününü evden getiriyor veya eve gidip yiyordu. Beslenme ile ilgili en sık sorun okulda diyete uygun olmayan gıdaların tüketilmesiydi. Çocukların %6’sında okulda kan şekeri ölçümü yapılmıyordu. Okulda hipoglisemi yaşamış olanların sıklığı %40 olup en sık müdahale eden kişi öğretmendi (%55). Okulda insülin uygulanan çocukların %77,5’inde uygulamayı anne veya baba yapıyordu. İnsülin uygulamada yaşanan en sık sorunlar okulda uygulayabilecek kişinin ve uygun ortamın olmaması idi. Beden eğitimine katılım %98’di. Çocuklar öğretmen ve okul yönetiminden yüksek oranda olumlu yaklaşım görürken, %18 çocuk,arkadaşlarının olumsuz yaklaşımına maruz kalmaktaydı.
Sonuç: T1DM tanılı çocuklar okulda beslenme, kan şekeri ölçümü ve insülin uygulama konularında zorluklar yaşamaktadırlar. Okullarda sağlık bakım odası ve/veya sağlık personeli çoğunlukla
bulunmamaktadır. Okulda insülin uygulama konusunda deneyimli kişi olmaması nedeniyle bunu genellikle ebeveynler yapmaktadır.
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Affiliation(s)
- Nurdan ÇİFTCİ
- Malatya Eğitim ve Araştırma Hastanesi Pediatrik Endokrinoloji Kliniği, Malatya, Türkiye
| | - Emine ÇAMTOSUN
- İnönü Üniversitesi Tıp Fakültesi Pediatrik Endokrinoloji Kliniği, Malatya, Türkiye
| | - İsmail DÜNDAR
- İnönü Üniversitesi Tıp Fakültesi Pediatrik Endokrinoloji Kliniği, Malatya, Türkiye
| | - Ayşehan AKINCI
- İnönü Üniversitesi Tıp Fakültesi Pediatrik Endokrinoloji Kliniği, Malatya, Türkiye
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Sense of Coherence as a Resource in Promoting Well-Being and Managing Type 1 Diabetes Mellitus: A Pilot Study. PSYCHIATRY INTERNATIONAL 2023. [DOI: 10.3390/psychiatryint4010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
When investigating the feelings of caregivers to patients with T1DM, parental stress, anxiety, and depression are found to be most prevalent, especially in the diagnostic phase and in the first months after diagnosis. In this pilot study, we research various significant elements regarding the well-being of mothers with children between 10 and 15 years of age with a chronic condition. The study focuses on a period of at least three years after the child’s diagnosis. The aims of the study are to describe our sample’s levels of satisfaction (SWLS) and subjective happiness (SHS) and to evaluate possible associations. A sample of 40 mothers was offered a series of assessment tools about psychological skills that could play a role in improving mothers’ well-being: the use of specific coping mechanisms (CISS), the methods of narrating the experience of life with a son/daughter with diabetes, the sense of coherence (SOCS 29), health parameters vs. child’s disease (HbA1c, CBCL), and socio-demographic, such as education and work. The most significant associations with respect to subjective happiness are with the sense of coherence, as a unitary value and as distinct factors, and with task-oriented coping. Sense of coherence is also associated with satisfaction.
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8
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Chatzinikolaou A, Kazakos K, Owens DA, Galli-Tsinopoulou A, Kleisarchaki A, Lavdaniti M. Parental Resilience and Physical Health in Parents of Children With Type 1 Diabetes in Northern Greece. Cureus 2023; 15:e35149. [PMID: 36949972 PMCID: PMC10027411 DOI: 10.7759/cureus.35149] [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: 02/18/2023] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND Type 1 diabetes mellitus (T1DM) is the most common endocrine and metabolic disorder in children. On the other hand, little is known regarding the health of parents whose children suffer from T1DM. AIM The study aims to investigate the mental resilience and physical health of parents of children with type 1 diabetes. METHODS The sample consisted of 80 parents of children and adolescents with T1DM.The study was conducted with the contribution of associations of parents of children with type 1 diabetes in a large hospital in Northern Greece between April 2021 and September 2021. A demographic and clinical questionnaire, the Wagnild and Young Resilience Scale-14 (RS-14), and the General Health 28 Physical Health Measurement Questionnaire (GHQ-28) were used to collect the research data. RESULTS Of the parents, 18.8% were male while 65% were female. The mean age of the parents was 44.02±6.71 years while the age of their children with diabetes was 13.13±6.05 years. Almost half of the children followed intensive insulin treatment (47.5%) whereas 22,5% reported that their children received insulin via a pump. A higher percentage of parents reported measuring their children's blood sugar more than six times a day (46,3%) and having their glycated hemoglobin (HbA1c) levels checked four times a year (51.2%). Finally, statistically significant effects on the physical symptoms and severe depression of parents of children with type 1 diabetes were observed. CONCLUSIONS Additional research is needed to assess the Greek parent population's resilience and physical health. This study will help healthcare providers to expand their knowledge and meet parents' needs.
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Affiliation(s)
| | - Kyriakos Kazakos
- Diabetes Mellitus Care, Department of Nursing, International Hellenic University, Thessaloniki, GRC
| | - Dimitra-Anna Owens
- Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | - Assimina Galli-Tsinopoulou
- 2nd Department of Pediatrics, Department of Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Aggeliki Kleisarchaki
- 2nd Department of Pediatrics, Department of Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Maria Lavdaniti
- Diabetes Mellitus Care, Department of Nursing, International Hellenic University, Thessaloniki, GRC
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Yeo AJ, Ledsham V, Halpern LF, Lin B, Riddick L, Sima D, Wohlfahrt KM, Jones N. Differential Contributions of Parental Warmth and Mindfulness to Child Executive Function and Pediatric Type 1 Diabetes Management. J Dev Behav Pediatr 2022; 43:e598-e604. [PMID: 35976702 DOI: 10.1097/dbp.0000000000001117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 06/20/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Positive parenting (e.g., parental warmth, mindful parenting) has been posited to promote effective pediatric type 1 diabetes mellitus (T1DM) management. This promotive effect may partly be conferred by fostering child self-regulatory development, such as executive function (EF). However, no research has examined whether better child EF serves as a mechanism underlying associations between positive parenting and child blood glucose levels (HbA1c). Moreover, it is unclear whether mindful parenting offers a unique benefit beyond that of parental warmth-a key pillar of effective parental involvement in T1DM management. METHODS Primary caregivers of children with T1DM (N = 101; Mage = 12.02) reported on parenting behaviors and child EF. Children's medical information was obtained through chart review. Path analysis was used to examine direct and indirect relations in the cross-sectional data. RESULTS The path analysis indicated that only parental warmth, not mindful parenting, was significantly associated with lower HbA1c. Both parental warmth and mindful parenting were significantly related to better child EF, but child EF did not mediate the associations between parenting and HbA1c. CONCLUSION Parental warmth may constitute a key parenting behavior promoting effective pediatric T1DM management. Enhancing parental warmth may be an important target of interventions aiming to improve HbA1c. Although child EF was unrelated to HbA1c in this sample, given positive associations between parental warmth and mindfulness and child EF, longitudinal research is warranted to examine whether these positive parenting behaviors may confer long-term benefits for T1DM self-management through improved EF.
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Affiliation(s)
- Anna J Yeo
- Department of Psychology, University at Albany, State University at New York, Albany, NY
| | - Victoria Ledsham
- Department of Psychology, University at Albany, State University at New York, Albany, NY
| | - Leslie F Halpern
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY; and
| | - Betty Lin
- Department of Psychology, University at Albany, State University at New York, Albany, NY
| | - Linda Riddick
- Pediatric Endocrinology Division, Albany Medical Center, Albany, NY
| | - Daniela Sima
- Pediatric Endocrinology Division, Albany Medical Center, Albany, NY
| | | | - Nancy Jones
- Pediatric Endocrinology Division, Albany Medical Center, Albany, NY
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Lawrence SE, Albanese-O'Neill A, Besançon S, Black T, Bratina N, Chaney D, Cogen FR, Cummings EA, Moreau E, Pierce JS, Richmond E, Mahmud FH. ISPAD Clinical Practice Consensus Guidelines 2022: Management and support of children and adolescents with diabetes in school. Pediatr Diabetes 2022; 23:1478-1495. [PMID: 36537526 DOI: 10.1111/pedi.13432] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 10/08/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Sarah E Lawrence
- Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | | | | | - Taryn Black
- Strategy Division, Diabetes Australia, Brisbane, Queensland, Australia
| | - Nataša Bratina
- Department of Endocrinology, Diabetes and Metabolism, UMC, University Children's Hospital, Ljubljana, Slovenia
| | - David Chaney
- Local Impact, Operations Directorate, Diabetes UK, London, UK
| | - Fran R Cogen
- Division of Endocrinology and Diabetes, Children's National Hospital, Washington, DC, USA
| | - Elizabeth A Cummings
- Department of Pediatrics, Dalhousie University, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Elizabeth Moreau
- Department of Communications & Knowledge Translation, Canadian Paediatric Society, Ottawa, Ontario, Canada
| | - Jessica S Pierce
- Center for Healthcare Delivery Science, Nemours Children's Health, Orlando, Florida, USA
| | - Erick Richmond
- Department of Pediatrics, National Children's Hospital, San José, Costa Rica
| | - Farid H Mahmud
- Department of Pediatrics, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada
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da Silva AP, Araujo ACMC, Mesquita IMR, Fonseca ECR, Tomé JM, Palhares HMDC, Silva ÉMC, Borges MDF. Religious/spiritual coping, symptoms of depression, stress, and anxiety in caregivers of children and adolescents with type 1 diabetes. Fam Pract 2022; 39:1017-1023. [PMID: 35477768 DOI: 10.1093/fampra/cmac032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND It was verified the level of religiosity and spirituality, and symptoms of depression, stress, and anxiety of caregivers of children and adolescents with type 1 diabetes, and its interference in glycaemic control. METHODS Socio-economic and demographic data were collected from caregivers of 59 children and adolescents with type 1 diabetes and obtained dosages of fasting glucose (FG); postprandial glycaemia (PPG); fructosamine (FRUTO); and HbA1c, as well as the glycaemic variability-∆HbA1c. Levels of religiosity were obtained by the DUREL scale; the use of religious/spiritual coping was verified by the SRCOPE-Brief scale. Symptoms of depression, anxiety, and stress were analysed by the DASS-21 scale. The correlations between the variables were analysed by the Pearson coefficient, with significance at 5% level. RESULTS Inverse correlations were observed between caregivers' schooling with PPG (r = -0.30; P = 0.002) and FRUTO (r = -0.34; P = 0.008) and between family income and FRUTO (r = -0.37; P = 0.004). Direct, moderate correlations were observed between negative religious/spiritual coping (NSRCOPE) with symptoms of depression (r = 0.588; P < 0.0001), stress (r = 0.500; P < 0.0001), and anxiety (r = 0.551; P < 0.0001). CONCLUSION The direct association between NSRCOPE with symptoms of depression, stress, and anxiety was the highlighted item in the present study emphasizing the need for greater attention to the emotional health of informal caregivers of children and adolescents with DM1. It is necessary to reflect on the religious/spiritual support especially for the main caregiver of children and adolescents with DM1.
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Affiliation(s)
| | | | | | | | | | | | - Élida Mara Carneiro Silva
- Integrative and Complementary Practices Center of Clinical Hospital, Federal University of Triângulo Mineiro, Uberaba, Brazil
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12
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Zhang L, Xu H, Liu L, Bi Y, Li X, Kan Y, Liu H, Li S, Zou Y, Yuan Y, Gong W, Zhang Y. Related factors associated with fear of hypoglycemia in parents of children and adolescents with type 1 diabetes - A systematic review. J Pediatr Nurs 2022; 66:125-135. [PMID: 35716460 DOI: 10.1016/j.pedn.2022.05.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/09/2022] [Accepted: 05/27/2022] [Indexed: 12/16/2022]
Abstract
PROBLEM Fear of hypoglycemia is a significant concern for parents of children/ adolescents with type 1 diabetes. Although some studies have explained the parental fear of hypoglycemia, the related factors were yet to be determined. This systematic review aims to identify the related factors of fear of hypoglycemia in the parents of children and adolescents with type 1 diabetes and provide a theoretical basis for further intervention. ELIGIBILITY CRITERIA PubMed, MEDLINE, EMBASE, Scopus, CINAHL, EBSCO, Web of Science, and Cochrane Library were systematically searched from 2010 to 2021. Studies evaluating the fear of hypoglycemia of parents and its associated factors were included. SAMPLE Twenty-three observational articles met the criteria. RESULTS Significant associations were found between fear of hypoglycemia and specific factors, including motherhood, nocturnal hypoglycemia, and the number of blood glucose monitoring. Psychological factors, including anxiety, depression, pediatric parenting stress, mindfulness, self-efficacy, quality of life, and sleep disorders, were conclusive and associations with parental fear of hypoglycemia. CONCLUSIONS Understanding parental fear of hypoglycemia can help parents prevent potential problems in diabetes management, thus promoting children's growth. According to current evidence, effective targeted interventions based on modifiable relevant factors can be developed to reduce the fear of hypoglycemia in parents while maintaining optimal blood glucose control in children/ adolescents. IMPLICATIONS Health professionals should pay more attention to the mental health of parents, and parents should be involved in the care plan and have the opportunity to discuss their fear of hypoglycemia in the most appropriate way to manage type 1 diabetes.
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Affiliation(s)
- Lu Zhang
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Huiwen Xu
- School of Nursing, Yangzhou University, Yangzhou, China; Nagano College of Nursing, Komagane, Nagano 399-4117, Japan
| | - Lin Liu
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yaxin Bi
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Xiangning Li
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yinshi Kan
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Hongyuan Liu
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Shuang Li
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yan Zou
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yuan Yuan
- Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Weijuan Gong
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yu Zhang
- School of Nursing, Yangzhou University, Yangzhou, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, China.
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13
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Neyra Marklund I, Rullander AC, Lindberg K, Ringnér A. Initial Education for Families with Children Diagnosed with Type 1 Diabetes: Consensus from Experts in a Delphi Study. Compr Child Adolesc Nurs 2022. [DOI: 10.1080/24694193.2022.2033351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Isabel Neyra Marklund
- Department of Nursing and Clinical Department of Paediatrics, Umeå University, Umeå, Sweden
| | - Anna-Clara Rullander
- Department of Nursing and Clinical Department of Paediatrics, Umeå University, Umeå, Sweden
| | - Karolina Lindberg
- Department of Nursing and Clinical Department of Paediatrics, Umeå University, Umeå, Sweden
| | - Anders Ringnér
- Department of Nursing and Clinical Department of Paediatrics, Umeå University, Umeå, Sweden
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Chapman K, Hughes AS, Bispham J, Leon C, Nguyen H, Wolf WA. Emergency Glucagon: a Focused Review of Psychosocial Experiences of Rescue Drugs for Type 1 Diabetes. Curr Diab Rep 2022; 22:189-197. [PMID: 35171447 DOI: 10.1007/s11892-021-01443-y] [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] [Accepted: 11/19/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE OF REVIEW The purpose of this paper is to describe rescue glucagon types, safety, efficacy, and preferences, as well as to review articles regarding emergency glucagon usage, severe hypoglycemia, and the emotions of both phenomena. We conducted a review of current literature on glucagon usage and the emotional impact of severe hypoglycemia on people with diabetes (PwD) and the caregivers of people with type 1 diabetes (T1D). RECENT FINDINGS Minimal research exists pertaining to glucagon and severe hypoglycemic experiences in PwD, which is troubling considering the severity of risks and possible side effects. Recent articles described negative emotions such as fear, anxiety, stress, helplessness, shame, embarrassment, loneliness, frustration, hopefulness, and uncertainty surrounding glucagon usage. There is scarce research regarding PwD's emotions surrounding severe hypoglycemia and rescue glucagon use. Additional research is needed to investigate the emotions and feelings people with T1D and their caregivers' experience pertaining to severe hypoglycemia and emergency glucagon use.
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Affiliation(s)
- Katherine Chapman
- T1D Exchange, 11 Ave de Lafayette, 5th Floor, Boston, MA, 02111, USA.
| | - Allyson S Hughes
- Department of Primary Care, Ohio University, Heritage College of Osteopathic Medicine, Athens, OH, USA
| | | | - Carolina Leon
- T1D Exchange, 11 Ave de Lafayette, 5th Floor, Boston, MA, 02111, USA
| | - Huyen Nguyen
- T1D Exchange, 11 Ave de Lafayette, 5th Floor, Boston, MA, 02111, USA
| | - Wendy A Wolf
- T1D Exchange, 11 Ave de Lafayette, 5th Floor, Boston, MA, 02111, USA
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15
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Bassi G, Mancinelli E, Dell’Arciprete G, Salcuni S. The Impact of the Covid-19 Pandemic on the Well-Being and Diabetes Management of Adolescents With Type 1 Diabetes and Their Caregivers: A Scoping Review. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:835598. [PMID: 36992752 PMCID: PMC10012096 DOI: 10.3389/fcdhc.2022.835598] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/04/2022] [Indexed: 11/13/2022]
Abstract
The Covid-19 pandemic and its related restriction measures might negatively impact diabetes management and well-being of adolescents with Type 1 Diabetes Mellitus (T1DM) and their caregivers. Accordingly, the present scoping review is aimed at mapping the literature in line with the question “How has the Covid-19 influenced diabetes management and well-being of adolescents with T1DM and their caregivers?”. A systematic search has been conducted through three academic databases. Studies carried out during the Covid-19 pandemic focused on adolescents aged between 10 and 19 years with T1DM and/or their caregivers were included. A total of 9 studies, performed between 2020 and 2021, have been identified. In particular, N = 305 adolescents with T1DM and N = 574 caregivers were considered. Overall, studies were not specific in reporting adolescents’ age, and only 2 studies were primarily focused on the adolescent population with T1DM. In addition, studies were mainly focused on evaluating adolescents’ glycemic control, which remained stable or has improved throughout the pandemic. Contrarily, psychosocial variables have been marginally considered. Indeed, only one study investigated adolescents’ diabetes distress, which remained stable from pre-to during post-lockdown, albeit improving among girls, specifically. As regards caregivers of adolescents with T1DM, studies showed mixed results concerning their psychological state during the Covid-19 pandemic. Prevention measures, which are aimed at supporting adolescents with T1DM during the lockdown, were considered by one study only, showing the favorable role of telemedicine during lockdown for adolescents’ glycemic control. Altogether, the current scoping review has identified many shortcomings of the available literature, which are given by the limited specificity of the age group considered and by the limited consideration of psychosocial variables, particularly their interplay with the medical ones.
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Affiliation(s)
- Giulia Bassi
- Department of Developmental and Socialization Psychology, University of Padova, Padova, Italy
- Digital Health Lab, Centre for Digital Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
- *Correspondence: Giulia Bassi,
| | - Elisa Mancinelli
- Department of Developmental and Socialization Psychology, University of Padova, Padova, Italy
- Digital Health Lab, Centre for Digital Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Gaia Dell’Arciprete
- Department of Developmental and Socialization Psychology, University of Padova, Padova, Italy
| | - Silvia Salcuni
- Department of Developmental and Socialization Psychology, University of Padova, Padova, Italy
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16
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de Abreu JM, de Souza RA, Viana-Meireles LG, Landeira-Fernandez J, Filgueiras A. Effects of physical activity and exercise on well-being in the context of the Covid-19 pandemic. PLoS One 2022; 17:e0260465. [PMID: 35081122 PMCID: PMC8791524 DOI: 10.1371/journal.pone.0260465] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/10/2021] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) was discovered in China and characterized by the World Health Organization as a pandemic in March 2020. Many countries worldwide implemented stringent social isolation as a strategy to contain virus transmission. However, the same physical distancing that protects against the spread of COVID-19 may negatively impact mental health and well-being of the population. The present study sought to shed light on this phenomenon by assessing the relationship between physical activity and subjective well-being (SWB) among individuals who were subjected to social isolation during the COVID-19 pandemic. Data were collected in Brazil between March 31 and April 2, 2020. All of the volunteers agreed to participate by digitally checking the option of agreement after reading consent terms. The inclusion criteria were participants who had been in social isolation for at least 1 week and agreed to the consent terms. Three instruments were applied. A questionnaire was constructed for this study that assessed the participants’ exercise routines. The Psychosocial Aspects, Well-being, and Exercise in Confinement (PAWEC) scale was created by researchers of this study that assessed the relationship between well-being and physical activity during social isolation. The Brazilian Portuguese-adapted version of the Positive and Negative Affect Schedule (PANAS) was also used. A total of 592 participants (371 female, 220 male, 1 transgender), 14–74 years old (M = 32.39 years, SD = 10.5 years), reported being in social isolation for an average of 14.4 days (SD = 3.3 days). Well-being that was related to the practice of physical activity during quarantine was linked to an established routine of physical activity before the social isolation period. Participants who already practiced physical exercises previously and reported continuing the practice during the quarantine period had higher positive affect scores. Participants who engaged in physical activity without direct guidance only during the quarantine period had higher negative affect scores. Participants who already practiced physical activity felt more motivated to continue practicing physical activity during the social isolation period, resulting in positive affect, unlike participants who began exercising only during quarantine. Our results suggest that negative affect can occur among individuals who only just begin exercising during social isolation, indicating that physical activity should be habitual and not only occur during periods of social isolation. Engaging in exercise only during social isolation may contribute to an increase in malaise.
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Affiliation(s)
| | | | | | - J. Landeira-Fernandez
- Departamento de Psicologia, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alberto Filgueiras
- Departamento de Cognição e Desenvolvimento, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail:
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17
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Alavi M, Najafi M, Akbari M, Gezelbash S. The effectiveness of self-compassion based training program on resilience of mothers of children with type 1 diabetes in Isfahan, Iran. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2022; 27:193-197. [PMID: 36237958 PMCID: PMC9552585 DOI: 10.4103/ijnmr.ijnmr_69_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/31/2021] [Accepted: 11/28/2021] [Indexed: 11/19/2022]
Abstract
Background: Concerns about the complications of diabetes and the responsibility of constantly managing a child's blood glucose are stressful for parents, especially for mothers, and can reduce their resilience. This study aimed to investigate the effectiveness of a self-compassion-based training program on the resilience of mothers of children with type 1 diabetes. Materials and Methods: This is a randomized clinical trial study. The statistical population of the study consisted of all mothers of children with type 1 diabetes who were being treated at the Isfahan Endocrine and Metabolism Research Centre, Iran. The study samples were recruited conveniently, 64 of whom were randomly divided into two groups (compassion training program = 32; control group = 32). The intervention group participated in eight training sessions. Data were analyzed using t-test, and Analysis of Covariance (ANCOVA) tests for between-group comparisons of dependent variables. Results: There was no significant difference between the mean scores of resilience before intervention (p > 0.05). Mean scores of resilience in the intervention group were significantly higher than the control group immediately (F1,60 = 9.726 p = 0.003) and 1 month after intervention (F1, 60 = 13.146, p = 0.001). Conclusions: It may be worthwhile to suggest compassion-based training program for mothers of children with type 1 diabetes to improve their resilience.
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18
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Dehn-Hindenberg A, Saßmann H, Berndt V, Biester T, Heidtmann B, Jorch N, Kim-Dorner SJ, Konrad K, Lilienthal E, Nellen-Hellmuth N, Neu A, Ziegler R, Lange K. Long-term Occupational Consequences for Families of Children With Type 1 Diabetes: The Mothers Take the Burden. Diabetes Care 2021; 44:2656-2663. [PMID: 34697032 DOI: 10.2337/dc21-0740] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 09/26/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the occupational and financial consequences for parents following the onset of type 1 diabetes in their child. RESEARCH DESIGN AND METHODS A questionnaire assessing occupational and financial situations before and in the first year after the onset of diabetes was distributed to all families with a child ≤14 years of age at diagnosis with a diabetes duration of at least 12 months in nine German pediatric diabetes centers. RESULTS Data of 1,144 children (mean age at diagnosis 6.7 [3.6] years; 46.5% female) and their families were obtained. Mothers' occupational status reflected in paid working hours was significantly reduced in the first year after their child's diabetes diagnosis (P < 0.001). Overall, 15.1% of mothers stopped working, and 11.5% reduced working hours. Mothers of preschool children were particularly affected. Fathers' working status hardly changed (P = 0.75). Nearly half of the families (46.4%) reported moderate to severe financial losses. Compared with an earlier similar study in 2003, significant negative occupational consequences for mothers and financial burden on families remained unchanged in 2018 (P = 0.59 and 0.31, respectively). CONCLUSIONS Mothers of young children with newly diagnosed diabetes experienced negative consequences in their occupational situation. This inequality for mothers can have long-term negative consequences for their mental health and future economic situation. There is an urgent need for action to reduce the burden on families and to provide professional, social, and regulatory support, especially for mothers of young children with diabetes.
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Affiliation(s)
| | - Heike Saßmann
- Medical Psychology, Hannover Medical School, Hannover, Germany
| | - Verena Berndt
- Social-Pediatric Centre Lichtenberg, Sana Hospital Group Berlin-Brandenburg, Berlin, Germany
| | - Torben Biester
- Diabetes Centre for Children and Adolescents, Children's Hospital Auf der Bult, Hannover, Germany
| | | | - Norbert Jorch
- University Clinic for Pediatrics, Evangelisches Klinikum Bethel, Bielefeld University, Bielefeld, Germany
| | | | - Katja Konrad
- Pediatrics, Elisabeth-Hospital Essen, Essen, Germany
| | - Eggert Lilienthal
- University Clinic, University Children's Hospital, Ruhr-University Bochum, Bochum, Germany
| | | | - Andreas Neu
- Pediatric Endocrinology and Diabetes, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Ralph Ziegler
- Diabetes Clinic for Children and Adolescents Muenster, Muenster, Germany
| | - Karin Lange
- Medical Psychology, Hannover Medical School, Hannover, Germany
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19
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Patton SR, Feldman K, Majidi S, Noser A, Clements MA. Identifying HbA1c trajectories and modifiable risk factors of trajectories in 5- to 9-year-olds with recent-onset type 1 diabetes from the United States. Diabet Med 2021; 38:e14637. [PMID: 34240466 PMCID: PMC8373785 DOI: 10.1111/dme.14637] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/17/2021] [Accepted: 07/07/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To explore glycated haemoglobin (HbA1c) patterns in 5- to 9-year-olds in the recent-onset period of type 1 diabetes and identify parent psychosocial factors that may predict children's HbA1c trajectory using a prospective, longitudinal design. RESEARCH DESIGN AND METHODS We measured family demographics and parent psychosocial factors at baseline. We collected HbA1c levels from children every 3 months for up to 30 months. Deriving several features around HbA1c trends, we used k-means clustering to group trajectories and linear and logistic regressions to identify parent psychosocial predictors of children's HbA1c trajectories. RESULTS The final cohort included 106 families (48 boys, mean child age 7.50 ± 1.35 years and mean diabetes duration 4.71 ± 3.19 months). We identified four unique HbA1c trajectories in children: high increasing, high stable, intermediate increasing and low stable. Compared to a low stable trajectory, increasing parent-reported hypoglycaemia fear total score was associated with decreased odds of having a high stable or intermediate increasing trajectory. Increasing parent-reported diabetes-specific family conflict total score was associated with increased odds of having a high stable or intermediate increasing trajectory. CONCLUSIONS We are the first to identify distinct HbA1c trajectories in 5- to 9-year-olds with recent-onset type 1 diabetes as well as parent psychosocial factors that may predict high stable or increasing trajectories and could represent future treatment targets.
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Affiliation(s)
- Susana R Patton
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Keith Feldman
- Division of Health Outcomes and Health Services Research, Children's Mercy Hospital and Clinics, Kansas City, MO, USA
| | - Shideh Majidi
- Barbara Davis Center for Childhood Diabetes, University of Colorado Anschatz Medical Campus, Aurora, CO, USA
| | - Amy Noser
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
| | - Mark A Clements
- Division of Endocrinology, Children's Mercy Hospital and Clinics, Kansas City, MO, USA
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20
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Cardinali P, Rapetti E, Migliorini L. Fear of hypoglycemia in Italian mothers of children with type 1 diabetes: the mediating role of resilience. Health Psychol Res 2021; 9:27439. [PMID: 34746495 PMCID: PMC8567761 DOI: 10.52965/001c.27439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/07/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Fear of hypoglycemia for children with diabetes influences parental life and could increase parental stress. The present study aimed to explore the association between resilience, the self-perception of the parental role, and fear of hypoglycemia in mothers of children with type I diabetes (T1DM). METHODS Ninety mothers (mean age: 44.20 years) of children with a T1DM diagnosis (mean age: 11.48 years) were recruited from an association for parents and completed an online self-report questionnaire packet that includes: Fear of Hypoglycemia Survey, Self-Perception of the Parental Role and Resilience Scale for Adults. Participants were recruited in 2017. Data collection lasted 10 months. Data analysis was performed using the SPSS statistical package, version 22, and the PROCESS macro program by Hayes. RESULTS The analysis of the mediation model shows that resilience assumes a mediational role in the relationships between the parental role and preoccupation with hypoglycemia. In particular, the mother's perceived competence and role balance can influence the development and increase of the mother's resilience, which in turn can allow a decrease in the mother's worry about the possible hypoglycemic episode of her child. CONCLUSION The findings suggest that resilience is a significant topic to focus on in interventions designed to increase the self-perception of the parental role and reduce fear of hypoglycemia in mothers.
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Abstract
Hypoglycaemia (blood glucose concentration below the normal range) has been recognised as a complication of insulin treatment from the very first days of the discovery of insulin, and remains a major concern for people with diabetes, their families and healthcare professionals today. Acute hypoglycaemia stimulates a stress response that acts to restore circulating glucose, but plasma glucose concentrations can still fall too low to sustain normal brain function and cardiac rhythm. There are long-term consequences of recurrent hypoglycaemia, which are still not fully understood. This paper reviews our current understanding of the acute and cumulative consequences of hypoglycaemia in insulin-treated diabetes.
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Affiliation(s)
- Stephanie A Amiel
- Department of Diabetes, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
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22
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Babiker A, Al Aqeel B, Marie S, Omer H, Bahabri A, Al Shaikh A, Zahrani N, Badri M, Al Dubayee M, Al Alwan I. Quality of Life and Glycemic Control in Saudi Children with Type 1 Diabetes at Different Developmental Age Groups. CLINICAL MEDICINE INSIGHTS-ENDOCRINOLOGY AND DIABETES 2021; 14:1179551421990678. [PMID: 33628072 PMCID: PMC7883141 DOI: 10.1177/1179551421990678] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/06/2021] [Indexed: 12/14/2022]
Abstract
Background: Children with type 1 diabetes (T1D) at different stages of development have age-specific needs, which can influence their perception of quality of life (QoL). In our study, we aimed to emphasize these age-specific needs and assess the perception of QoL in Saudi children with T1D, as well as their parents correlating QoL scores with children’s glycemic control. Methods: This is a cross-sectional study in which children with T1D and their parents from 2 tertiary institutes in Saudi Arabia have answered a standard diabetes-specific QoL questionnaire (PedsQL™ 3.0 diabetes module, translated in Arabic). We also reported glycated hemoglobin (HbA1c) results for these children within a month of completing the questionnaire. The QoL total aggregate and domain scores for self (children) and proxy (parents’) reports were compared and correlated with children’s HbA1c. Results: A sample was 288 self and proxy reports from 144 children with T1D of 3 age groups: 5 to 7 years (7%), 8 to 12 years (49%), and 13 to 18 years (44%), and their parents. QoL differed significantly between self and proxy reports in the total aggregate and domain scores (P-values range from .02 to <.001). The impact on QoL was significantly higher in female patients (P = .043). Insulin pump users had better HbA1c (P = .007), and HbA1c level was worse in those who intended to fast at Ramadan (P = .005). Conclusion: Children with T1D at different developmental age groups perceive QoL differently than their parents. Adjusting management as per age-specific challenges could potentially improve these children’s QoL and glycemic control.
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Affiliation(s)
- Amir Babiker
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah Specialized Children's Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Saudi Arabia
| | - Bothainah Al Aqeel
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Sarah Marie
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Hala Omer
- King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Aban Bahabri
- King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Adnan Al Shaikh
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Saudi Arabia.,King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Nada Zahrani
- King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Motasim Badri
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Saudi Arabia
| | - Mohamed Al Dubayee
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah Specialized Children's Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Saudi Arabia
| | - Ibrahim Al Alwan
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah Specialized Children's Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Saudi Arabia
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23
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Aalders J, Hartman E, Pouwer F, Winterdijk P, van Mil E, Roeleveld-Versteegh A, Mommertz-Mestrum E, Aanstoot HJ, Nefs G. The division and transfer of care responsibilities in paediatric type 1 diabetes: A qualitative study on parental perspectives. J Adv Nurs 2021; 77:1968-1979. [PMID: 33591623 PMCID: PMC8048668 DOI: 10.1111/jan.14781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 01/04/2021] [Accepted: 01/27/2021] [Indexed: 12/17/2022]
Abstract
Aim To determine which factors other than child age play a role in the division and transfer of diabetes care responsibilities between parents and children with type 1 diabetes. Design Qualitative focus group study. Methods Across four sites in the Netherlands, 18 parents (13 mothers) of children (9–14 years) with type 1 diabetes participated in four focus groups in 2015–2016, as part of the research project 'Whose diabetes is it anyway?'. Qualitative content analysis and the constant comparison method were used to analyse the data. Results According to parents, the transfer process included both direct and indirect tasks, had different levels (remembering, deciding, performing), was at times a difficult and stressful process, and showed large variation between families. A large number of child, parent and context factors were identified that affected the division and transfer of diabetes care responsibilities according to parents. Both positive and negative consequences of the transfer process were described for parental and child health, behaviour and well‐being. Parental final evaluations of the division and transfer of diabetes care responsibilities appeared to be dependent on parenting values. Conclusion How families divide and transfer diabetes care tasks appeared to be affected by a complex interplay of child, parent and context characteristics, which had an impact on several parent and child domains. Impact Parents struggle with the right timing of transfer, which calls for more support from diabetes nurses. The identified factors can be used as input for integrating a more family‐based approach into current age‐based guidelines, to improve regular care.
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Affiliation(s)
- Jori Aalders
- Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders [CoRPS], Tilburg University, Tilburg, The Netherlands.,Department of Psychology, University of Southern Denmark, Odense, Denmark.,Steno Diabetes Center Odense, Odense, Denmark
| | - Esther Hartman
- Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders [CoRPS], Tilburg University, Tilburg, The Netherlands
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,Steno Diabetes Center Odense, Odense, Denmark.,School of Psychology, Deakin University, Geelong, Australia
| | - Per Winterdijk
- Diabeter, Center for pediatric and adolescent diabetes care and research, Rotterdam, The Netherlands
| | - Edgar van Mil
- Kidz&Ko, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | | | | | - Henk-Jan Aanstoot
- Diabeter, Center for pediatric and adolescent diabetes care and research, Rotterdam, The Netherlands
| | - Giesje Nefs
- Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders [CoRPS], Tilburg University, Tilburg, The Netherlands.,Diabeter, Center for pediatric and adolescent diabetes care and research, Rotterdam, The Netherlands.,Department of Medical Psychology, Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
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Uhm JY, Kim MS. Predicting Quality of Life among Mothers in an Online Health Community for Children with Type 1 Diabetes. CHILDREN (BASEL, SWITZERLAND) 2020; 7:children7110235. [PMID: 33218148 PMCID: PMC7698800 DOI: 10.3390/children7110235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 12/29/2022]
Abstract
Quality of life of parents of children with chronic disease is important for disease self-management. This study aimed to identify predictors of quality of life among mothers of children with type 1 diabetes. A cross-sectional study was conducted. A total of 208 mothers of children with type 1 diabetes were recruited from an online health community. Online health community collective empowerment and social support, diabetes self-efficacy, diabetes-related burden, and quality of life were measured. A multiple regression analysis was conducted to determine predictive factors for quality of life. Multiple regression analysis showed that diabetes-related burden and the child’s age were predictors of quality of life, and total variance explained by the model was 64.1% using two factors. In mothers of younger children, it is important to reduce the diabetes-related burden. Factors that increase the diabetes-related burden should be identified, and strategies to reduce the diabetes-related burden must be established.
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Fried L, Chetty T, Cross D, Breen L, Davis E, Roby H, Jackiewicz T, Nicholas J, Jones T. The Challenges of Being Physically Active: A Qualitative Study of Young People With Type 1 Diabetes and Their Parents. Can J Diabetes 2020; 45:421-427. [PMID: 33223421 DOI: 10.1016/j.jcjd.2020.09.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/25/2020] [Accepted: 09/17/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Benefits of physical activity are well recognized for youth with type 1 diabetes mellitus (T1DM), but being active is challenging. In this study, we aimed to investigate the challenges experienced by adolescents, their parents and young adults with T1DM when they are physically active. METHODS Six focus groups involving adolescents (13 to 18 years old, n=14) and young adults (19 to 25 years old, n=7) and 4 focus groups with parents (n=14) of the adolescents (13 to 18 years) were established. Data were analyzed using content analysis. RESULTS Adolescents and young adults with T1DM identified challenges of unpredictability, knowledge, trust and stigma when they were physically active. Parent challenges were specifically unpredictability and trust. CONCLUSIONS Interventions are needed that provide adolescents and young adults with T1DM and parents of adolescents with T1DM more in-depth information about managing physical activity in a manner that enhances their perceived competence and builds autonomy. Interventions can also target peer and community support.
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Affiliation(s)
- Leanne Fried
- Telethon Kids Institute, Perth Children's Hospital, Nedlands, Western Australia, Australia.
| | - Tarini Chetty
- Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Donna Cross
- Telethon Kids Institute, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Lauren Breen
- Curtin University, Bentley, Western Australia, Australia
| | - Elizabeth Davis
- Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Heather Roby
- Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Tanyana Jackiewicz
- Telethon Kids Institute, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | | | - Tim Jones
- Perth Children's Hospital, Nedlands, Western Australia, Australia
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Predieri B, Bruzzi P, Bigi E, Boncompagni A, Bocchi F, Cenciarelli V, Madeo SF, Poluzzi S, Pugliese M, Toffoli C, Lucaccioni L, Iughetti L. Health-related quality of life and metabolic control in immigrant and Italian children and adolescents with type 1 diabetes and in their parents. Pediatr Diabetes 2020; 21:1031-1042. [PMID: 32418308 DOI: 10.1111/pedi.13042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/23/2020] [Accepted: 05/08/2020] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To determine if the diabetes-specific health-related quality of life (D-HRQOL) of young people with type 1 diabetes (T1D) and their parents is influenced by migrant status. SUBJECTS AND METHODS One hundred and twenty-five patients (12.4 ± 3.55 years, males 53.6%) with T1D and their parents (102 mothers, 37 fathers) were enrolled and categorized into: group A (both foreign parents) and group B (both native Italian parents). The Pediatric Quality of Life Inventory™ 3.0 Diabetes Module (PedsQL™ 3.0 DM) was used to evaluate the D-HRQOL. Data on diabetic ketoacidosis (DKA) at T1D onset, insulin therapy, and glycosylate hemoglobin (HbA1c) were also collected. RESULTS Group A (n = 40), compared to group B (n = 85), had higher frequency of DKA at T1D onset (P < .001) and a lower use of sensor augmented insulin pump (P = .015). HbA1c values were higher in group A than in group B (P < .001). Patients' "Diabetes symptoms" (P = .004), "Treatment barriers" (P = .001), and "Worry" (P = .009) scales scores were lower in group A than in group B. Mothers of group A had lower scores in "Diabetes symptoms" (P = .030), "Treatment barriers" (P < .001), "Treatment adherence" (P = .018), "Communication" (P = .009) scales, and total score (P = .011) compared to the group B ones. High PedsQL™ 3.0 DM was significantly associated with being Italian, being prepubertal, and having lower HbA1c mean levels. CONCLUSIONS Being a migrant confers disadvantages in terms of D-HRQOL and metabolic control in children and adolescents with T1D. Specific educational interventions should be considered in the clinical care of patients with migration background, to improve D-HRQOL and health status.
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Affiliation(s)
- Barbara Predieri
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit - University of Modena and Reggio Emilia, Modena, Italy.,Post-Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Patrizia Bruzzi
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit - University of Modena and Reggio Emilia, Modena, Italy
| | - Elena Bigi
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit - University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandra Boncompagni
- Post-Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Federica Bocchi
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit - University of Modena and Reggio Emilia, Modena, Italy
| | - Valentina Cenciarelli
- Post-Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Simona F Madeo
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit - University of Modena and Reggio Emilia, Modena, Italy
| | - Silvia Poluzzi
- Post-Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Marisa Pugliese
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit - University of Modena and Reggio Emilia, Modena, Italy
| | - Carlotta Toffoli
- Post-Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Laura Lucaccioni
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit - University of Modena and Reggio Emilia, Modena, Italy
| | - Lorenzo Iughetti
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit - University of Modena and Reggio Emilia, Modena, Italy.,Post-Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
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When Low Blood Sugars Cause High Anxiety: Fear of Hypoglycemia Among Parents of Youth With Type 1 Diabetes Mellitus. Can J Diabetes 2020; 45:403-410.e2. [PMID: 33046404 DOI: 10.1016/j.jcjd.2020.08.098] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 08/10/2020] [Accepted: 08/12/2020] [Indexed: 01/29/2023]
Abstract
OBJECTIVES Hypoglycemia is the most common acute complication of type 1 diabetes (T1D), and the potential short- and long-term sequelae can cause children and parents to develop significant fear of hypoglycemia (FOH). FOH and associated anxiety can be disruptive to activities of daily living and lead to reduced quality of life. We sought to determine the extent of FOH among parents of children with T1D within our clinic and to identify factors associated with greater FOH. METHODS Two hundred sixty-four parents of youth (2 to 18 years of age; mean ± standard deviation, 12.4±3.5 years) with T1D completed a survey that included demographic and disease-specific questions, the Spielberger State-Trait Anxiety Inventory and the Hypoglycemia Fear Survey---Parent version (HFS-P). RESULTS Of the 264 participants, 207 completed the full HFS-P, with a mean score of 67±19 (range, 31 to 119). The most frequent worries related to the child being hypoglycemic while alone or asleep. Higher HFS-P scores were also associated with more frequent and severe hypoglycemic episodes, higher state-trait anxiety scores, use of a continuous glucose monitor and more frequent blood glucose checks. Higher HFS-P scores were also associated with worse parental sleep quality and less parental engagement with treatment plans. CONCLUSIONS Parents of children with T1D experience FOH, especially during times of high vulnerability. Moreover, FOH could potentially impact clinical care (with parents being reluctant to administer suggested insulin doses) and quality of life (due to parental/child sleep disruption). Further studies are needed to develop and evaluate interventions aimed at reducing FOH in parents of youth with T1D.
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Patton SR, McConville A, Marker AM, Monzon AD, Driscoll KA, Clements MA. Reducing Emotional Distress for Childhood Hypoglycemia in Parents (REDCHiP): Protocol for a Randomized Clinical Trial to Test a Video-Based Telehealth Intervention. JMIR Res Protoc 2020; 9:e17877. [PMID: 32808936 PMCID: PMC7463405 DOI: 10.2196/17877] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 12/25/2022] Open
Abstract
Background Despite the introduction of new insulin analogs, insulin pumps, and continuous glucose monitoring (CGM), young children with type 1 diabetes mellitus (T1D) remain vulnerable to episodes of hypoglycemia because of their unpredictable eating and activity patterns and high degree of insulin sensitivity. Caregivers and young children living with T1D learn to fear hypoglycemia because it is uncomfortable, unpredictable, and dangerous. Up to 60% of caregivers of young children with T1D report moderate to severe levels of fear of hypoglycemia, and caregiver fear of hypoglycemia relates to lower quality of life for families and suboptimal child glycemic control. Yet, until recently, there have been no studies reporting on a targeted intervention to treat caregiver fear of hypoglycemia in families of young children. Objective The aim of this project is to conduct a randomized clinical trial of an innovative, video-based telehealth intervention to treat fear of hypoglycemia in caregivers of young children with T1D versus a relevant, age-appropriate attention control intervention. Methods We created the Reducing Emotional Distress for Childhood Hypoglycemia in Parents (REDCHiP) intervention by merging age-appropriate T1D education and behavioral parenting strategies with cognitive behavioral therapy strategies that are effective for reducing fear and promoting adaptive coping. REDCHiP uses 10 video-based telehealth sessions that are a combination of group and individual sessions. We will recruit up to 180 families of young children with T1D to participate in this clinical trial from two pediatric diabetes clinics located in the midwestern and southern United States. Once families have been enrolled, we will randomize caregivers based on child age (age 2-3 years or 4-5 years), child sex, and family CGM use to participate in the REDCHiP or attention control intervention. Families will complete 3 assessment visits that coincide with study entry, end of treatment, and 3-month posttreatment. At each assessment visit, we will collect questionnaire data from caregivers, accelerometry data from caregivers and children, CGM data from children, and a blood sample to measure glycated hemoglobin levels from children. Results Recruitment began in July 2019, and enrollment is ongoing. The first wave of intervention delivery began in December 2019. We anticipate completing enrollment in 2023. Final reporting of results will occur within 12 months of the primary completion date. Conclusions If the REDCHiP intervention is efficacious, next steps will be to examine multiple implementation strategies to determine how best to disseminate the intervention to pediatric diabetes clinics around the world. Trial Registration ClinicalTrials.gov NCT03914547; https://clinicaltrials.gov/ct2/show/NCT03914547 International Registered Report Identifier (IRRID) PRR1-10.2196/17877
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Affiliation(s)
- Susana R Patton
- Nemours Children's Health System, Jacksonville, FL, United States
| | - Andrew McConville
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, United States
| | - Arwen M Marker
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, United States
| | - Alexandra D Monzon
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, United States
| | - Kimberly A Driscoll
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Mark A Clements
- Children's Mercy Hospital-Kansas City, Kansas City, MO, United States
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GÜLCÜ S, ARSLAN S, ARSLANOĞLU İ. Tip 1 Diyabetli Adolesanlarda Web Tabanlı Egzersiz Eğitiminin Etkinliği. DÜZCE ÜNIVERSITESI SAĞLIK BILIMLERI ENSTITÜSÜ DERGISI 2020. [DOI: 10.33631/duzcesbed.589195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Patton SR, Clements MA, Marker AM, Nelson EL. Intervention to reduce hypoglycemia fear in parents of young kids using video-based telehealth (REDCHiP). Pediatr Diabetes 2020; 21:112-119. [PMID: 31610073 PMCID: PMC7393613 DOI: 10.1111/pedi.12934] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/16/2019] [Accepted: 10/07/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy of a new video-based telehealth intervention to reduce hypoglycemia fear in parents of young children with type 1 diabetes. METHODS We randomized 42 parents to either immediate treatment (reducing emotional distress for childhood hypoglycemia in parents, REDCHiP; n = 22) or a waitlist control (WAITLIST; n = 21) condition. REDCHiP parents completed a 10-session video-based telehealth intervention, while WAITLIST parents continued in usual care. After 14-weeks, WAITLIST parents completed the telehealth treatment. We examined for between group changes in parental hypoglycemia fear and parenting stress (n = 18 per condition), 3-month maintenance of treatment effects for parents randomized to REDCHiP (n = 15), and pre-post changes for the entire sample (n = 36). RESULTS Mostly mothers participated (97.6%). They reported a mean age of 35.2 ± 5.0 years at pre-treatment. Children were 4.4 ± 1.4 years old and 59.5% boys. Between group comparisons showed a significant reduction in hypoglycemia fear (P = .04) and a trend toward reduction in parenting stress-frequency (P = .092) for REDCHiP parents compared to WAITLIST parents. After the three-month maintenance period, REDCHiP parents reported significant reductions in hypoglycemia fear, parenting stress-frequency, and parenting stress-difficulty (P's < .01) compared to pre-treatment. When all parents received the telehealth treatment, we also observed significant reductions in hypoglycemia fear, parenting stress-frequency, and parenting stress-difficulty (P's < .001), and sensitivity analyses revealed a significant reduction in child glycated hemoglobin for children who entered the treatment above target (P < .05). CONCLUSION Our new video-based telehealth intervention appears to reduce hypoglycemia fear and parenting stress and may help parents of very young children with T1D to better achieve optimal child glycemic control when children are above target.
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Affiliation(s)
- Susana R. Patton
- University of Kansas Medical Center, Department of Pediatrics, Kansas City, KS;,Center for Children’s Healthy Lifestyles and Nutrition, Kansas City, MO
| | - Mark A. Clements
- Center for Children’s Healthy Lifestyles and Nutrition, Kansas City, MO;,Children’s Mercy-Kansas City, Division of Endocrinology, Kansas City, MO
| | - Arwen M. Marker
- University of Kansas, Clinical Child Psychology Program, Lawrence, KS
| | - Eve-Lynn Nelson
- University of Kansas Medical Center, Department of Pediatrics, Kansas City, KS
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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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Burckhardt MA, Fried L, Bebbington K, Hancock M, Nicholas JA, Roberts A, Abraham MB, Davis EA, Jones TW. Use of remote monitoring with continuous glucose monitoring in young children with Type 1 diabetes: the parents' perspective. Diabet Med 2019; 36:1453-1459. [PMID: 31257642 DOI: 10.1111/dme.14061] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2019] [Indexed: 12/21/2022]
Abstract
AIM Remote monitoring with continuous glucose monitoring (CGM) in children with Type 1 diabetes mellitus has recently become available, but little is known about caregivers' experiences of its use, particularly in younger children. The aim of this study was to explore parents' everyday experiences of using this technology. METHODS The parents of children with Type 1 diabetes diagnosed for > 1 year, aged 2-12 years were invited to participate in a semi-structured interview. Interviews were the second phase of a randomized cross-over study using standard insulin therapy with or without CGM and remote monitoring for two 3-month periods. Open-ended questions were used to explore parents' real-life experiences of the remote monitoring and CGM system. Interviews were analysed using thematic analysis. RESULTS Five themes related to remote monitoring emerged: (i) impact on sleep quality for the parents, (ii) peace of mind, (iii) impact on anxiety, (iv) freedom and confidence for the parents and children, and (v) impact on relationships. Furthermore, parents reported on themes related to CGM in general, such as better understanding of how to manage and control their child's diabetes and experiences related to physical or technical aspects. CONCLUSION Overall, parents of primary school children reported that using remote monitoring and CGM was a mostly beneficial experience. However, negative aspects within the themes were also reported. These findings will help to provide a structure to discuss parent and child expectations and provide targeted education at the start of using remote monitoring and CGM.
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Affiliation(s)
- M-A Burckhardt
- Children's Diabetes Centre, Telethon Kids Institute, Perth, WA, Australia
- Division of Paediatrics, The University of Western Australia, Perth, WA, Australia
- Department of Endocrinology and Diabetes, Perth Children's Hospital, Perth, WA, Australia
| | - L Fried
- Children's Diabetes Centre, Telethon Kids Institute, Perth, WA, Australia
| | - K Bebbington
- Children's Diabetes Centre, Telethon Kids Institute, Perth, WA, Australia
| | - M Hancock
- Division of Paediatrics, The University of Western Australia, Perth, WA, Australia
| | - J A Nicholas
- Children's Diabetes Centre, Telethon Kids Institute, Perth, WA, Australia
- Department of Endocrinology and Diabetes, Perth Children's Hospital, Perth, WA, Australia
| | - A Roberts
- Children's Diabetes Centre, Telethon Kids Institute, Perth, WA, Australia
- Department of Endocrinology and Diabetes, Perth Children's Hospital, Perth, WA, Australia
| | - M B Abraham
- Children's Diabetes Centre, Telethon Kids Institute, Perth, WA, Australia
- Division of Paediatrics, The University of Western Australia, Perth, WA, Australia
- Department of Endocrinology and Diabetes, Perth Children's Hospital, Perth, WA, Australia
| | - E A Davis
- Children's Diabetes Centre, Telethon Kids Institute, Perth, WA, Australia
- Division of Paediatrics, The University of Western Australia, Perth, WA, Australia
- Department of Endocrinology and Diabetes, Perth Children's Hospital, Perth, WA, Australia
| | - T W Jones
- Children's Diabetes Centre, Telethon Kids Institute, Perth, WA, Australia
- Division of Paediatrics, The University of Western Australia, Perth, WA, Australia
- Department of Endocrinology and Diabetes, Perth Children's Hospital, Perth, WA, Australia
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Mueller-Godeffroy E, Vonthein R, Ludwig-Seibold C, Heidtmann B, Boettcher C, Kramer M, Hessler N, Hilgard D, Lilienthal E, Ziegler A, Wagner VM. Psychosocial benefits of insulin pump therapy in children with diabetes type 1 and their families: The pumpkin multicenter randomized controlled trial. Pediatr Diabetes 2018; 19:1471-1480. [PMID: 30302877 DOI: 10.1111/pedi.12777] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 07/28/2018] [Accepted: 09/04/2018] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Continuous subcutaneous insulin infusion (CSII) is on the rise among pediatric patients with type 1 diabetes mellitus. Metabolic effects alone cannot explain this rising popularity. From the patient's perspective, the main benefits of CSII may be found in subjective psychosocial health outcomes (patient-reported outcomes [PRO]). SUBJECTS AND METHODS In a multicenter open randomized controlled trial, children and adolescents aged 6 to16 years currently treated with multiple daily injections (MDI) were randomized 1:1, stratified by center, to either starting with CSII immediately after the baseline interview or to continuing MDI while waiting 6 months for transmission to CSII. The primary outcomes were patient-reported diabetes-specific health-related quality of life (DHRQOL) and diabetes burden of the main caregiver. Secondary outcomes were caregiver stress, fear of hypoglycemia, satisfaction with treatment, and HbA1c. RESULTS Two-hundred and eleven patients were randomized between February 2011 and October 2014, and 186 caregivers and 170 patients were analyzed using the intention-to-treat principle for primary outcomes. Children 8 to 11 years in the CSII group reported improved DHRQOL at follow-up compared to MDI (median difference [MD] 9.5, 95% confidence interval [CI] 3.6-16.7, P = 0.004). There were no treatment differences in the adolescent age-group 12 to 16 years (MD 2.7; 95% CI -3.2-9.5; P = 0.353). The main caregivers of the CSII group reported a significant decline of overall diabetes burden at follow-up compared to the MDI group (MD 0; 95% CI -1-0; P = 0.029). Secondary PROs also were in favor of CSII. CONCLUSIONS CSII has substantial psychosocial benefits. PROs demonstrate these benefits. Registered as NCT01338922 at clinicaltrials.gov.
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Affiliation(s)
| | - Reinhard Vonthein
- Institute of Medical Biometry and Statistics, University of Luebeck, University Medical Center Schleswig-Holstein, Luebeck, Germany.,Center for Clinical Trials, University of Luebeck, Luebeck, Germany
| | | | - Bettina Heidtmann
- Catholic Children's Hospital, Wilhelmstift gGmbH, Department of Endocrinology and Diabetology, Hamburg, Germany
| | - Claudia Boettcher
- Division of Pediatric Endocrinology and Diabeteology, Center of Child and Adolescent Medicine, Justus Liebig University Giessen, Frankfurt, Germany
| | - Miriam Kramer
- Division of Pediatric Endocrinology and Diabeteology, Center of Child and Adolescent Medicine, Justus Liebig University Giessen, Frankfurt, Germany
| | - Nicole Hessler
- Institute of Medical Biometry and Statistics, University of Luebeck, University Medical Center Schleswig-Holstein, Luebeck, Germany
| | - Doerte Hilgard
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke gGmbH, Herdecke, Germany.,Pediatric and Adolescent Medical Practice, Witten, Germany
| | - Eggert Lilienthal
- Department of Pediatrics, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Andreas Ziegler
- Institute of Medical Biometry and Statistics, University of Luebeck, University Medical Center Schleswig-Holstein, Luebeck, Germany.,Center for Clinical Trials, University of Luebeck, Luebeck, Germany.,School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Verena M Wagner
- Department of Pediatric and Adolescent Medicine, University of Luebeck, Luebeck, Germany.,Pediatric and Adolescent Medical Practice, 18055 Rostock, Germany
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Bratina N, Forsander G, Annan F, Wysocki T, Pierce J, Calliari LE, Pacaud D, Adolfsson P, Dovč K, Middlehurst A, Goss P, Goss J, Janson S, Acerini CL. ISPAD Clinical Practice Consensus Guidelines 2018: Management and support of children and adolescents with type 1 diabetes in school. Pediatr Diabetes 2018; 19 Suppl 27:287-301. [PMID: 30084519 DOI: 10.1111/pedi.12743] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 07/27/2018] [Indexed: 12/13/2022] Open
Affiliation(s)
- Natasa Bratina
- Department of Endocrinology, Diabetes & Metabolism, University Children's Hospital, Ljubljana, Slovenia
| | - Gun Forsander
- The Queen Silvia Children's Hospital and Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Tim Wysocki
- Center for Healthcare Delivery Science, Nemours Children Health System, Orlando, Florida
| | - Jessica Pierce
- Center for Healthcare Delivery Science, Nemours Children Health System, Orlando, Florida
| | - Luis E Calliari
- Department of Pediatrics, Santa Casa de Sao Paulo School of Medical Sciences, Brazil
| | - Danièle Pacaud
- Division of Diabetes and Endocrinology, Alberta Children's Hospital, Department of Paediatrics, University of Calgary, Calgary, Canada
| | - Peter Adolfsson
- Department of Pediatrics, The Hospital of Halland, Kungsbacka and Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Klemen Dovč
- Department of Endocrinology, Diabetes & Metabolism, University Children's Hospital, Ljubljana, Slovenia
| | - Angie Middlehurst
- International Diabetes Federation Life for a Child Program, Sydney, Australia
| | - Peter Goss
- Team Diabetes, Geelong, Victoria, Australia
| | | | - Staffan Janson
- Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden
| | - Carlo L Acerini
- Department of Paediatrics, University of Cambridge, Cambridge, UK
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Casaña-Granell S, Lacomba-Trejo L, Valero-Moreno S, Prado-Gasco V, Montoya-Castilla I, Pérez-Marín M. A brief version of the Pediatric Inventory for Parents (PIP) in Spanish population: Stress of main family carers of chronic paediatric patients. PLoS One 2018; 13:e0201390. [PMID: 30048532 PMCID: PMC6062103 DOI: 10.1371/journal.pone.0201390] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 07/13/2018] [Indexed: 02/07/2023] Open
Abstract
A chronic illness in childhood has a negative impact on the paediatric patient and on family functioning. Psychological stress in parents influences the level of adjustment to the illness of their children. The Pediatric Inventory for Parents (PIP) was designed to measure stress in parents whose child has a chronic illness or requires prolonged medical monitoring. The main objective of this study is to provide a brief version of the Spanish translation of the PIP, across a sample consisting of 465 main familial caregivers (85.2% female, n = 396) between 27 and 67 years old ( X¯ = 44.13; SD = 5.35) of paediatric patients between 9 and 18 years old ( X¯ = 12.10, SD = 2.20; 56.8% men, n = 264) diagnosed with diabetes mellitus type I (20.9% of the sample; n = 97), short stature (32.5% of the sample; n = 151), or a chronic respiratory disease (asthma, cystic fibrosis, bronchiolitis obliterans and bronchiectasis) (46.6% of the sample; n = 217). After performing several EFAs (Exploratory Factor Analyses) and CFAs (Confirmatory Factorial Analyses), it was decided that 30 items need to be removed. Reliability and validity results suggest that the new 12-item version possesses appropriate psychometric properties. Cronbach’s alpha value ranging between α = .42 and α = .81 and fit values obtained indicate a good fit: χ2/df (88.393/48) = 1.84 (α < .01); S-B χ2(df) = 88.393 (48); CFI = .95; IFI = .95; RMSEA = .05 (.033 - .074) for the frequency scales and χ2/df (72.002/48) = 1.5 (α < .01); S-Bχ2(df) = 72.002 (48); CFI = .97; IFI = .97; RMSEA = .04 (.011 - .063) for the difficulty scales. The PIP also showed predictive ability in regards to anxiety and depression, a positive relationship between the instrument's own scales and a negative relationship with the caregiver's age. Finally, depending on the paediatric patient's diagnosis, differences in stress levels were found.
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Affiliation(s)
- Sara Casaña-Granell
- Departament of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Laura Lacomba-Trejo
- Departament of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Selene Valero-Moreno
- Departament of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Vicente Prado-Gasco
- Departament of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Inmaculada Montoya-Castilla
- Departament of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Marián Pérez-Marín
- Departament of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Valencia, Valencia, Spain
- * E-mail:
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Affiliation(s)
| | - Tadej Battelino
- 2 UMC-University Children's Hospital Ljubljana , Slovenia
- 3 Faculty of Medicine, University of Ljubljana , Ljubljana, Slovenia
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Martinez K, Frazer SF, Dempster M, Hamill A, Fleming H, McCorry NK. Psychological factors associated with diabetes self-management among adolescents with Type 1 diabetes: A systematic review. J Health Psychol 2016; 23:1749-1765. [PMID: 27663288 DOI: 10.1177/1359105316669580] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This review aims to synthesise the literature examining the psychosocial variables related to self-management (insulin adherence, non-adherence and administration, blood sugar monitoring, dietary behaviour, exercise behaviour) in adolescents with type 1 diabetes. A systematic search of three electronic databases was carried out and, after the application of eligibility criteria, 21 articles were assessed for quality prior to data extraction. Numerous psychological factors were found to be associated with self-management; however, correlations were typically small to moderate. The strongest associations were found between social anxiety and diet (among males); greater intrinsic motivation, conscientiousness and diet; and extraversion and exercise.
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