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Evans M, Ellis DA, Vesco AT, Feldman MA, Weissberg-Benchell J, Carcone AI, Miller J, Boucher-Berry C, Buggs-Saxton C, Degnan B, Dekelbab B, Drossos T. Diabetes distress in urban Black youth with type 1 diabetes and their caregivers: associations with glycemic control, depression, and health behaviors. J Pediatr Psychol 2024; 49:394-404. [PMID: 38216126 DOI: 10.1093/jpepsy/jsad096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVES Adolescents with type 1 diabetes (T1D) and their caregivers endorse high diabetes distress (DD). Limited studies have documented the impact of DD on Black youth. The aims of the present study were to (1) describe DD among a sample of Black adolescents with T1D and their caregivers, (2) compare their DD levels with published normative samples, and (3) determine how DD relates to glycemic outcomes, diabetes self-management, parental monitoring of diabetes, and youth depressive symptoms. METHODS Baseline data from a multicenter clinical trial were used. Participants (N = 155) were recruited from 7 Midwestern pediatric diabetes clinics. Hemoglobin A1c (HbA1c) and measures of DD, parental monitoring of diabetes care, youth depression and diabetes management behaviors were obtained. The sample was split into (1) adolescents (ages 13-14; N = 95) and (2) preadolescents (ages 10-12; N = 60). Analyses utilized Cohen's d effect sizes, Pearson correlations, t-tests, and multiple regression. RESULTS DD levels in youth and caregivers were high, with 45%-58% exceeding either clinical cutoff scores or validation study sample means. Higher DD in youth and caregivers was associated with higher HbA1c, lower diabetes self-management, and elevated depressive symptoms, but not with parental monitoring of diabetes management. CONCLUSIONS Screening for DD in Black youth with T1D and caregivers is recommended, as are culturally informed interventions that can reduce distress levels and lead to improved health outcomes. More research is needed on how systemic inequities contribute to higher DD in Black youth and the strategies/policy changes needed to reduce these inequities.
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Affiliation(s)
- Meredyth Evans
- Pritzker Department of Psychiatry and Behavioral Health, Ann and Robert H. Lurie Children's Hospital and Psychiatry and Behavioral Sciences, Northwestern Feinberg School of Medicine, Chicago, IL, United States
| | - Deborah A Ellis
- School of Medicine, Wayne State University, Detroit, MI, United States
| | - Anthony T Vesco
- Pritzker Department of Psychiatry and Behavioral Health, Ann and Robert H. Lurie Children's Hospital and Psychiatry and Behavioral Sciences, Northwestern Feinberg School of Medicine, Chicago, IL, United States
| | - Marissa A Feldman
- Division of Psychology, Johns Hopkins, All Children's Hospital, St Petersburg, FL, United States
| | - Jill Weissberg-Benchell
- Pritzker Department of Psychiatry and Behavioral Health, Ann and Robert H. Lurie Children's Hospital and Psychiatry and Behavioral Sciences, Northwestern Feinberg School of Medicine, Chicago, IL, United States
| | | | - Jennifer Miller
- Pritzker Department of Psychiatry and Behavioral Health, Ann and Robert H. Lurie Children's Hospital and Psychiatry and Behavioral Sciences, Northwestern Feinberg School of Medicine, Chicago, IL, United States
| | - Claudia Boucher-Berry
- Division of Pediatric Endocrinology, University of Illinois at Chicago, Chicago, IL, United States
| | | | - Bernard Degnan
- Pediatric Endocrinology, Ascension St John Children's Hospital, Detroit, MI, United States
| | - Bassem Dekelbab
- Pediatric Endocrinology, Beaumont Health Care, Royal Oak, MI, United States
| | - Tina Drossos
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States
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Merlo EM, Tutino R, Myles LAM, Lia MC, Minasi D. Alexithymia, intolerance to uncertainty and mental health difficulties in adolescents with Type 1 diabetes mellitus. Ital J Pediatr 2024; 50:99. [PMID: 38755698 PMCID: PMC11100042 DOI: 10.1186/s13052-024-01647-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 04/07/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Type 1 Diabetes Mellitus (T1DM) represents a serious chronic condition affecting a wide number of people. Discussion of the physical issues associated with T1DM pervades the literature, however, there is less discussion of the psychological consequences. Mental health difficulties, alexithymia and uncertainty are present in this population, and known to be harmful for the onset, maintenance and worsening of T1DM. This study aimed to evaluate the presence of these phenomena in people with T1DM. METHODS 105 participants aged between 11 and 17 years old (M: 13.88; SD: 2.16) affected by T1DM were included in the sample. To assess the presence of mental health difficulties, SAFA scales (Depression, Anxiety and Somatic symptoms) were included in the protocol together with TAS-20 and IUS-12, which evaluate the presence and role of alexithymia and intolerance to uncertainty in the sample, respectively. RESULTS A concerning presence of anxiety, depression and somatic symptoms was found in the sample. Mental health difficulties appeared to be consistently present in the sample, often overcoming pathological thesholds. Alexithymia and uncertainty were also common, highlighting their role in T1DM. CONCLUSIONS Active mental health difficulties together with high rates of alexithymia and intolerance to uncertainty were prevalent in the sample of adolescents with diabetes.
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Affiliation(s)
- Emanuele Maria Merlo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
| | - Rita Tutino
- Pediatric Unit of Ospedali Riuniti Presidium, Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Reggio Calabria, Italy
| | | | - Maria Carmela Lia
- Pediatric Unit of Ospedali Riuniti Presidium, Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Reggio Calabria, Italy
| | - Domenico Minasi
- Pediatric Unit of Ospedali Riuniti Presidium, Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Reggio Calabria, Italy
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Carosi Arcangeli I, Celia G, Girelli L, Fioretti C, Cozzolino M. A Study on the Sense of Parental Competence, Health Locus of Control and Levels of Anxiety, Depression and Somatization in Parents of Children with Type 1 Diabetes: Evidence on a Possible Relationship. J Clin Med 2024; 13:2259. [PMID: 38673532 PMCID: PMC11050957 DOI: 10.3390/jcm13082259] [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: 03/03/2024] [Revised: 03/28/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Parents of children with chronic conditions face challenges that go beyond basic care and parenting responsibilities. Parents' experiences can be influenced by perceived stress, emotional experiences, feelings of helplessness, low sense of self-efficacy, anxiety and depression, reducing their quality of life. It is therefore not surprising that parents of children with chronic illnesses are more likely to experience stress, anxiety and depression than parents of healthy children. A prevalent chronic condition is type 1 diabetes. Methods: Parents (31 with children with type 1 diabetes diagnosis and 71 with children without chronic illness) were recruited to complete the measures of the Brief Symptom Inventory-18 (BSI-18), the Parent Health Locus of Control (PHLOC) and Parenting Sense of Competence (PSOC). Results: Significant differences in depression and internal locus of control were found; there was a positive correlation between internal LOC and efficacy in both samples; furthermore, there was a negative correlation between somatization and satisfaction in the experimental group. Conclusions: The ongoing experiences and challenges faced daily make parents perceive themselves as capable. Active involvement in supporting and managing the needs of child with type 1 diabetes could be a source of empowerment for the parent, contributing to the maintenance of their sense of competence. It is important, therefore, to consider the well-being and perception of the parent at a personal level, regardless of the child's situation.
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Affiliation(s)
- Ivonne Carosi Arcangeli
- Department of Humanities, Philosophy and Education, University of Salerno, 84084 Fisciano, Italy; (L.G.); (C.F.); (M.C.)
| | - Giovanna Celia
- Scupsis—Scuola di Psicoterapia Strategica Integrata Seraphicum, 00142 Rome, Italy;
| | - Laura Girelli
- Department of Humanities, Philosophy and Education, University of Salerno, 84084 Fisciano, Italy; (L.G.); (C.F.); (M.C.)
| | - Chiara Fioretti
- Department of Humanities, Philosophy and Education, University of Salerno, 84084 Fisciano, Italy; (L.G.); (C.F.); (M.C.)
| | - Mauro Cozzolino
- Department of Humanities, Philosophy and Education, University of Salerno, 84084 Fisciano, Italy; (L.G.); (C.F.); (M.C.)
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Sato J, Nakajima K, Mita T, Koshibu M, Sato A, Goto H, Ikeda F, Nishida Y, Aso K, Watada H. Protocol of a Prospective Observational Study on Lifestyle and Quality of Life in Adults with Type 1 Diabetes in Japan. Diabetes Ther 2024; 15:883-892. [PMID: 38363542 PMCID: PMC10951137 DOI: 10.1007/s13300-024-01539-0] [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: 12/25/2023] [Accepted: 01/25/2024] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION Recent studies have shown that the quality of life (QOL) of people living with type 1 diabetes (T1D) is poor and must be improved. However, the living situation and QOL of adults living with T1D in Japan have not been fully clarified. This study will examine their lifestyle, QOL, and clinical situation, as well as the relationships between them. METHODS This is a prospective, 5-year follow-up observational study. Between December 2019 and September 2021, we enrolled adults in Japan who were living with T1D and receiving insulin therapy, and are acquiring longitudinal clinical data and the responses to seven questionnaires regarding lifestyle and QOL. The primary study outcomes are (1) the relationship between Problem Areas in Diabetes (PAID) scores and various factors including demographic data, clinical characteristics, medical history, lifestyle habits, treatment history, biochemical data, and the scores of questionnaires; and (2) the relationship between Beck Depression Inventory (BDI)-II scores and various factors aforementioned. The secondary outcomes are the relationships between various factors aforementioned and each of the following: (1) blood glucose control, (2) blood lipid control, (3) dietary patterns, (4) fear of hypoglycemia, (5) sleep patterns, and (6) physical activity. PLANNED OUTCOME We registered 352 participants. The median age was 49 (41-63) years, and the median duration of T1D was 13 (8-20) years. All the results will be available in 2026. We expect to clarify the factors associated with decreased QOL, and that this knowledge will contribute to improving QOL in adults in Japan who are living with T1D and receiving insulin therapy. TRIAL REGISTRATION Clinical Trials.gov identifier, UMIN000044088.
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Affiliation(s)
- Junko Sato
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Kenichi Nakajima
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Tomoya Mita
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Mami Koshibu
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Ayako Sato
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hiromasa Goto
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Fuki Ikeda
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Yuya Nishida
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Katsumi Aso
- Aso Clinic, 11-1 Tsutsui-cho, Numazu-shi, Shizuoka, 410-0041, Japan
| | - Hirotaka Watada
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
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Schlarb P, Büttner JM, Tittel SR, Mönkemöller K, Müller-Godeffroy E, Boettcher C, Galler A, Berger G, Brosig B, Holl RW. Family structures and parents' occupational models: its impact on children's diabetes. Acta Diabetol 2024; 61:235-244. [PMID: 37847378 PMCID: PMC10866793 DOI: 10.1007/s00592-023-02187-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/15/2023] [Indexed: 10/18/2023]
Abstract
AIMS This study examines how family-related factors influence the management of children and adolescents with type 1 diabetes (T1DM). We investigate the relationship between family patterns, parental work schedules and metabolic control. MATERIALS AND METHODS We analysed data from a nationwide diabetes survey (DPV) focusing on HbA1c, severe hypoglycaemia, diabetic ketoacidosis, hospital admissions and inpatient treatment duration. We used linear regression and negative binomial regression models. Our study includes 15,340 children under the age of 18 with data on family structure and parental division of labour. RESULTS Children from two-parent households have better HbA1c outcomes than children from single-parent, blended or no-parent households (p < .0001). Higher HbA1C levels are associated with children living with an unemployed father, as opposed to those with full-time working parents or with a full-time working father and a part-time working mother (p < .001). CONCLUSIONS These findings emphasise the importance of carefully considering family structure and working time models in the management of paediatric T1DM. Our results highlight risk factors within the family environment and emphasise the need for family-focused counselling of high-risk patients or severe cases in clinical practice.
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Affiliation(s)
- Pauline Schlarb
- Centre of Child and Adolescent Medicine, Division of Family- and Child-Psychosomatics, Justus Liebig University, Klinikstrasse 36, 35392, Giessen, Germany
| | - Janina M Büttner
- Centre of Child and Adolescent Medicine, Division of Family- and Child-Psychosomatics, Justus Liebig University, Klinikstrasse 36, 35392, Giessen, Germany
| | - Sascha R Tittel
- ZIBMT, Institute of Epidemiology and Medical Biometry, University of Ulm, Albert Einstein Alle 41, 89075, Ulm, Germany
- German Centre for Diabetes Research (DZD), Ingolstädter Landstrasse, 185764, Munich-Neuherberg, Germany
| | - Kirsten Mönkemöller
- Department of Pediatric and Adolescent Medicine, Kliniken Der Stadt Köln gGmbH, Amsterdamer Strasse 59, 50735, Cologne, Germany
| | - Esther Müller-Godeffroy
- Department of Pediatric and Adolescent Medicine, University of Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany
| | - Claudia Boettcher
- Pediatric Endocrinology and Diabetology, University of Berne, University Children's Hospital, Freiburgstrasse 15, 3010, Berne, Switzerland
| | - Angela Galler
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Sozialpädiatrisches Zentrum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Gabriele Berger
- Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Pediatric Diabetes Outpatient Clinic, Health Care Centre Vienna Floridsdorf, Karl-Aschenbrenner-Gasse 3, 1210, Vienna, Austria
| | - Burkhard Brosig
- Centre of Child and Adolescent Medicine, Division of Family- and Child-Psychosomatics, Justus Liebig University, Klinikstrasse 36, 35392, Giessen, Germany.
| | - Reinhard W Holl
- ZIBMT, Institute of Epidemiology and Medical Biometry, University of Ulm, Albert Einstein Alle 41, 89075, Ulm, Germany
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Salcudean A, Lica MM. The Role of Systemic Family Psychotherapy in Glycemic Control for Children with Type 1 Diabetes. CHILDREN (BASEL, SWITZERLAND) 2024; 11:104. [PMID: 38255417 PMCID: PMC10814833 DOI: 10.3390/children11010104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024]
Abstract
(1) Background: Family factors play an important role in the management of diabetes, establishing a relationship between conflicts and non-adherence to therapy. High values of HbA1c are involved in specific complications of the disease (retinopathy, nephropathy, neuropathy, ketoacidosis). This study aimed to determine the role of systemic family psychotherapeutic interventions in increasing the quality of parent-child/adolescent relationships and in optimizing the child's glycemic control. (2) Methods: In this prospective observational study, 64 parents of children and adolescents with type 1 diabetes were evaluated regarding their relationship with their children, using the Child-Parent Relationship Scale-Short Form (CPRS-short form). The children were divided into three groups: one participated for 6 months in systemic family psychotherapy with children and their parents (FT), the second group participated in individual psychotherapy (IT), and the control group (CG) received no intervention. HbA1c values were recorded before and after the interventions. (3) Results: HbA1c means decreased significantly after the family psychotherapy program. The scores on closeness in the family therapy group increased significantly, and the scores on conflict decreased significantly after the intervention, compared with IT and CG. (4) Conclusions: Systemic family psychotherapy produces better results in disease management and in strengthening parent-child relationships.
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Affiliation(s)
| | - Maria Melania Lica
- Department of Bioethics, Social and Human Sciences, University of Medicine and Pharmacy, Science and Technology George Emil Palade of Targu Mures, Gheorghe Marinescu Street No. 38, 540142 Targu Mures, Romania;
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Huang MF, Chang YP, Chou WJ, Yen CF. A 4-year prospective investigation of predictive effects of prepandemic sexual stigma, affective symptoms, and family support on fear of COVID-19 among lesbian, gay, and bisexual individuals. Front Public Health 2024; 11:1297042. [PMID: 38259737 PMCID: PMC10800656 DOI: 10.3389/fpubh.2023.1297042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Aim This prospective study examined whether prepandemic sexual stigma, affective symptoms, and family support can predict fear of coronavirus disease 2019 (COVID-19) among lesbian, gay, and bisexual (LGB) individuals. Methods Data of 1,000 LGB individual on prepandemic sociodemographic characteristics, sexual stigma (familial sexual stigma [FSS] measured by the Homosexuality-Related Stigma Scale, internalized sexual stigma [ISS] measured by the Measure of Internalized Sexual Stigma for Lesbians and Gay Men, and sexual orientation microaggression [SOM] measured by the Sexual Orientation Microaggression Inventory), affective symptoms (i.e., depression measured by the Center for Epidemiologic Studies-Depression Scale and anxiety measured by the State-Trait Anxiety Inventory-State version), and family support measured by the Adaptability, Partnership, Growth, Affection, and Resolve Index were collected. Four years later, the fear of COVID-19 was assessed using the Fear of COVID-19 Scale and the associations of prepandemic sexual stigma, affective symptoms, and perceived family support on fear of COVID-19 4 years later were analyzed using multiple linear regression analysis. Results In total, 670 (67.3%) participants agreed and completed the follow-up assessment. Greater prepandemic FSS, ISS, SOM, affective symptoms, and perceived family support were significantly associated with a greater fear of COVID-19 at follow-up. Conclusion The identified predictors should be considered when designing interventions aimed at preventing and reducing the fear of COVID-19 in LGB individuals.
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Affiliation(s)
- Mei-Feng Huang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, New York, NY, United States
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan
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Ryan H, Burgess A, Jackson C, Hewson-Ravenscroft A, Meiser-Stedman R. High prevalence of depression in parents of children with Type 1 diabetes in a meta-analysis of data from five continents. Acta Paediatr 2023. [PMID: 38140731 DOI: 10.1111/apa.17059] [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: 06/13/2023] [Revised: 11/30/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023]
Abstract
AIM This meta-analysis identified the prevalence of depression in parents of children with Type 1 diabetes. METHODS MEDLINE, PsycINFO and CINAHL databases were searched for papers published in English from 1980 to May 2022, yielding 18 studies (N = 2044 participants). The prevalence of parental depression was pooled across the studies. RESULTS The prevalence of depression among parents of children with Type 1 diabetes was high. Random-effects meta-analyses estimated the prevalence of moderate depression and above in the total sample as 18.4% (95% CI 12.8-24.6; k = 17, N = 2044), with rates of 17.3% in mothers (95% CI 12.7-22.5; k = 12, N = 1106) and 9% in fathers (95% CI 4.3-15.1; k = 6, N = 199). The estimated prevalence of mild depression and above in the total sample was 32.7% (95% CI 20.3-46.6; k = 8, N = 797), with rates of 29.4% in mothers (95% CI 17.8-42.6; k = 4 N = 330) and 13.6% in fathers (95% CI 5.2-25.2; k = 2 N = 44). All results were characterised by high levels of heterogeneity. The risk of publication bias was low. CONCLUSION More than 1 in 6 parents of children with Type 1 diabetes had depression in the moderate plus category. The limitations and implications of these results are discussed.
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Affiliation(s)
- Hayley Ryan
- Central Norfolk Stroke Services, Norwich Community Health and Care NHS Trust, Norwich Community Hospital, Norwich, Norfolk, UK
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Aaron Burgess
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Clare Jackson
- Department of Psychological Medicine, Cambridgeshire and Peterborough Foundation Trust, Cambridge, UK
- Addenbrookes Hospital, Cambridge, UK
| | - Alyssa Hewson-Ravenscroft
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
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Temple J, Fisher P, Davies C, Millar C, Gemma Cherry M. Psychosocial factors associated with anxiety and depression in adolescents with epilepsy: A systematic review. Epilepsy Behav 2023; 149:109522. [PMID: 38006843 DOI: 10.1016/j.yebeh.2023.109522] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/27/2023]
Abstract
Anxiety and depression are common in adolescents with epilepsy. Identifying psychosocial risk factors for anxiety and depression is essential for adolescents with epilepsy to receive appropriate support. This systematic review synthesised findings of studies examining the relationship between psychosocial factors and anxiety and/or depression in adolescents with epilepsy. Outcomes were anxiety, depression, and mixed anxiety & depression. Six electronic databases were searched for studies which: used cross-sectional or prospective designs; quantitatively evaluated the relationship between psychosocial factors and anxiety and/or depression; presented results for adolescents with epilepsy aged 9-18 years; and used validated measures of anxiety and/or depression. Psychosocial factors were categorised as intrapersonal, interpersonal, or parent-specific factors. Sixteen studies (23 articles) were included. All but one were cross-sectional. Regarding intrapersonal factors, alternative mental health difficulties were consistently positively associated with all three outcomes. Negative attitude towards epilepsy, lower seizure self-efficacy, lower self-esteem and stigma were consistently positively associated with depression. Interpersonal factors (i.e., lower family functioning assessed from an adolescent's perspective) and parent-specific factors (i.e., parental stigma, stress, anxiety and psychopathology) were positively associated with at least one outcome. Adolescent epilepsy management should exceed assessment of biological/biomedical factors and incorporate assessment of psychosocial risk factors. Prospective studies examining the interplay between biological/biomedical factors and the psychosocial factors underpinning anxiety and depression in adolescents with epilepsy are needed.
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Affiliation(s)
- James Temple
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK; Mersey Care NHS Foundation Trust, Liverpool, UK
| | - Peter Fisher
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK; Clinical Health Psychology Service, Liverpool University NHS Foundation Trust, Liverpool, UK
| | - Cari Davies
- Mersey Care NHS Foundation Trust, Liverpool, UK
| | - Chris Millar
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK; Mersey Care NHS Foundation Trust, Liverpool, UK
| | - Mary Gemma Cherry
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK; Clinical Health Psychology Service, Liverpool University NHS Foundation Trust, Liverpool, UK.
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Del Giudice E, Lubrano R, Bramanti SM, Babore A, Trumello C, De Maria SG, Dilillo A, Marcellino A, Martucci V, Sanseviero M, Bloise S, Ventriglia F, Manippa V. Facing Pediatric Rheumatic Diseases: The Role of Disease Activity and Parental Emotion Regulation Strategy in Parents' and Children's Psychological Adjustment. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1863. [PMID: 38136065 PMCID: PMC10741560 DOI: 10.3390/children10121863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/14/2023] [Accepted: 11/25/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Pediatric rheumatic diseases (PRDs) are a group of chronic disorders that start in childhood and are characterized by periodic exacerbations and remissions of symptoms, with limitations in family, school, and social activities. The aim of this study was to detect differences in parents' psychological adjustment and emotion regulation strategies, and parent-reported children's adjustments in families of children with active and inactive PRDs. METHODS Fifty-four parents (38 mothers and 16 fathers) of children with PRD were recruited from a pediatric unit. Disease activity was evaluated by their pediatric rheumatologist, while parents' depressive and anxiety symptoms, emotion regulation strategies, and children's emotional difficulties and hyperactivity-inattention symptoms were assessed through a web-based survey. RESULTS Parents of children with active PRDs reported higher levels of their child's emotional difficulties and hyperactivity-inattention symptoms. Linear regression analysis demonstrated that having a child in the active phases of PRD and lower use of cognitive reappraisal lead to higher children's emotional symptoms, while active disease, low use of cognitive reappraisal, and greater expressive suppression were associated with higher hyperactivity-inattention symptoms. Our study highlights that children with PRDs and their parents may be at increased risk for psychological problems, especially during the active disease phase, highlighting the importance of a multidisciplinary approach.
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Affiliation(s)
- Emanuela Del Giudice
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy
| | - Riccardo Lubrano
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy
| | - Sonia Monique Bramanti
- Department of Psychological, Health and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Alessandra Babore
- Department of Psychological, Health and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Carmen Trumello
- Department of Psychological, Health and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Sara Giovanna De Maria
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy
| | - Anna Dilillo
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy
| | - Alessia Marcellino
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy
| | - Vanessa Martucci
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy
| | - Mariateresa Sanseviero
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy
| | - Silvia Bloise
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy
| | - Flavia Ventriglia
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy
| | - Valerio Manippa
- Department of Education, Psychology and Communication, University of Bari Aldo Moro, 70122 Bari, Italy
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11
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Sari SA, Agadayi E, Celik N, Karahan S, Komurluoglu Tan A, Doger E. The Turkish version of the problem areas in diabetes-parents of teens (P-PAID-T): Cross-cultural adaptation, reliability, and validity. J Pediatr Nurs 2023; 73:e146-e153. [PMID: 37573154 DOI: 10.1016/j.pedn.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/03/2023] [Accepted: 08/03/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVE To examine the Turkish validity and reliability of the Problem Areas in Diabetes- Parents of Teens (P-PAID-T) scale and its psychometric properties for determining the parents' diabetes-related distress. METHODS The study included the parents of 200 adolescents with T1DM for at least a year. P-PAID-T and a demographic data form were used for data collection. Davis technique was used for the content validity of the scale. The scale's reliability was tested using test-retest, and its internal reliability was analyzed with Cronbach's alpha test. Exploratory Factor Analysis (EFA) was used to analyze the factor structure. Confirmatory Factor Analysis (CFA) was used to evaluate the fit of the scale. RESULTS 69.5% (n = 139) of the participants were mothers. Compared to the fathers, the mothers' mean P-PAID-T score was significantly higher. Parents of sons, who used insulin injections for their children, and had a college degree or higher education level had higher P-PAID-T scores. The test-retest correlation coefficient of the scale was 0.977. The Cronbach α value of the scale was 0.901. The results of confirmatory factor analysis were x2/df = 2.931, GFI = 0.736, CFI = 0.711, NFI = 0.628, NNFI = 0.660, RMSEA = 0.141. CONCLUSION The Turkish version of P-PAID-T was a valid and reliable screening tool for measuring diabetes stress in parents of adolescents with T1DM. PRACTICE IMPLICATIONS Nurses could use the Turkish version of P-PAID-T to monitor parental diabetes distress and organize interventions; also Turkish P-PAID-T could facilitate research on diabetes distress for parents of adolescents with T1DM.
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Affiliation(s)
- Seda Aybuke Sari
- Department of Child and Adolescent Psychiatry, Hatay Mustafa Kemal University Faculty of Medicine Hatay/Turkey (prev: Department of Child and Adolescent Psychiatry, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Turkey.
| | - Ezgi Agadayi
- Department of Medical Education, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Nurullah Celik
- Department of Pediatric Endocrinology, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Seher Karahan
- Department of Medical Education, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Ayça Komurluoglu Tan
- Department of Pediatrics, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Esra Doger
- Department of Pediatric Endocrinology, Gazi University Faculty of Medicine, Ankara, Turkey
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12
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Bamber MD, Mahony H, Spratling R. Mothers of Children With Special Health Care Needs: Exploring Caregiver Burden, Quality of Life, and Resiliency. J Pediatr Health Care 2023; 37:643-651. [PMID: 37516944 DOI: 10.1016/j.pedhc.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 07/31/2023]
Abstract
INTRODUCTION This study aimed to explore caregiver burden, quality of life (QOL), and resilience in mothers of children with special health care needs (CSHCN), compare differences between mothers of CSHCN and healthy children, and differences between mothers of CSHCN on the basis of child severity. METHOD Mothers (n = 106) with a child aged < 18 years were recruited. A cross-sectional design was used. Measures included the Caregiver Burden Inventory, Quality of Life Scale, and Brief Resilience Inventory. Pearson point-biserial correlations and independent t-tests were used to compare group differences. RESULTS Caregiver burden and QOL were negatively correlated (p < .001). Mothers of CSHCN had greater burden (p < .001) and poorer QOL (p = .006). Child severity increased caregiver burden time (p = .003). DISCUSSION Study findings expound on research indicating mothers of CSHCN experience greater burden and poorer QOL than their peers, and child severity increases burden via time commitment. Health care providers should assess risk factors for poor QOL and caregiver burden and provide appropriate resources.
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13
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Zeiler M, Wittek T, Graf T, Bozic I, Nitsch M, Waldherr K, Karwautz A, Wagner G, Berger G. Psychosocial impact of the COVID-19 pandemic for adolescents with type-1-diabetes: a qualitative interview study involving adolescents and parents. Behav Med 2023; 49:412-422. [PMID: 35816425 DOI: 10.1080/08964289.2022.2084358] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 05/02/2022] [Accepted: 05/24/2022] [Indexed: 12/23/2022]
Abstract
This study aims to investigate the psychosocial impact of the COVID-19 pandemic on adolescents with type-1-diabetes (T1D). We conducted 18 semi-structured interviews including adolescents with T1D (n = 10, 50% female, 15-18 years) and their parents (n = 8, 88% mothers). The main topics addressed were experiences during confinement regarding everyday life, lifestyle behaviors, diabetes management and treatment. We applied thematic analysis to identify common patterns of meanings. Being aware of belonging to a potential COVID-19 risk group caused worries especially in parents which resulted in strict adherence to preventive measures. Information from trustworthy sources regarding the actual risk mitigated the concerns. Digital diabetes treatment was well accepted and experienced as highly usable. The pandemic situation either facilitated or hindered the transition from parental control to diabetes self-management. While some patients managed to improve healthy lifestyle behaviors as their everyday lives seemed more predictable, others had difficulties in adapting to changed daily routines resulting in increased sedentary behavior and snacking. The perceived level of stress was directly associated with blood glucose levels. In conclusion, the implementation of psychological interventions (both for adolescents with T1D and their parents) addressing mental health literacy and media literacy seems to be important to promote positive coping skills for dealing with the pandemic situation.
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Affiliation(s)
- Michael Zeiler
- Eating Disorder Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna
| | - Tanja Wittek
- Eating Disorder Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna
| | - Theres Graf
- Eating Disorder Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna
| | - Ina Bozic
- Diabetes Unit, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna
| | - Martina Nitsch
- Ferdinand Porsche FernFH - Distance Learning University of Applied Sciences
| | - Karin Waldherr
- Ferdinand Porsche FernFH - Distance Learning University of Applied Sciences
| | - Andreas Karwautz
- Eating Disorder Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna
| | - Gudrun Wagner
- Eating Disorder Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna
| | - Gabriele Berger
- Diabetes Unit, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna
- Pediatric Diabetes Outpatient Clinic, Health Care Centre Vienna Floridsdorf
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14
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Silina E, Taube M, Zolovs M. Exploring the Mediating Role of Parental Anxiety in the Link between Children's Mental Health and Glycemic Control in Type 1 Diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6849. [PMID: 37835119 PMCID: PMC10572850 DOI: 10.3390/ijerph20196849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023]
Abstract
Pediatric diabetes type 1 diabetes mellitus (T1D), as a chronic, incurable disease, is associated with psychoemotional and socioeconomic burden for the whole family. Disease outcomes are determined by the metabolic compensation of diabetes, characterized by the level of glycated hemoglobin (HbA1c). The caregivers play a critical role in the metabolic control of children with T1D. The aim of this study was to investigate which environmental factors may explain the relationship between diabetes compensation and anxiety and depression of a child. The cross-sectional interdisciplinary study recruited dyads from adolescents and their parents (N = 251). Adolescent and parent groups were screened for anxiety and depression. General linear model (GLM) mediation analysis was performed to determine the potential mediating effect of surrounding factors on the relationship between dependent variables (glycated hemoglobin) and independent variables (the child's anxiety and depression symptoms). The study revealed that the relationship between HbA1c and the child's anxiety and depression is fully mediated (B = 0.366, z = 4.31, p < 0.001) by parental anxiety. Diabetes metabolic control in adolescents with T1D is related to adolescents' mental health via parents' anxiety. This means that parents' anxiety plays a more significant role in the level of HbA1c than the anxiety and depression of the adolescent.
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Affiliation(s)
- Evija Silina
- Department of Psychiatry and Narcology, Riga Stradins University, LV-1007 Riga, Latvia;
| | - Maris Taube
- Department of Psychiatry and Narcology, Riga Stradins University, LV-1007 Riga, Latvia;
| | - Maksims Zolovs
- Statistical Unit, Riga Stradins University, LV-1007 Riga, Latvia;
- Institute of Life Sciences and Technology, Daugavpils University, LV-5401 Daugavpils, Latvia
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15
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Liu C, Yuan GF, Li X, Fung HW, Wong MYC, Zhao J, Feng X. Associations among internalized and perceived stigma, state mindfulness, self-efficacy, and depression symptoms among men who have sex with men in China: A serial mediation model. Arch Psychiatr Nurs 2023; 45:81-88. [PMID: 37544707 DOI: 10.1016/j.apnu.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/23/2023] [Accepted: 06/01/2023] [Indexed: 08/08/2023]
Abstract
Previous research has demonstrated that stigma is strongly related to depressive symptoms among men who have sex with men (MSM). However, data are limited regarding the associations between stigma, state mindfulness, self-efficacy, and depression symptoms. The current study aimed to analyze state mindfulness and self-efficacy as possible mediators between internalized and perceived stigma and depression symptoms. A sample of 2610 Chinese MSM (Mage = 23.99, SD = 6.09, age range: 18-68 years) was recruited from an online survey platform and completed the HIV and Homosexuality Related Stigma Scale, Patient Health Questionnaire-9, the short version of Five Facet Mindfulness Questionnaire, and the Chinese General Self-Efficacy Scale. Results indicated that state mindfulness significantly mediated the linkage between internalized and perceived stigma and depressive symptoms, and self-efficacy significantly mediated the relation between state mindfulness and depression symptoms. Furthermore, internalized and perceived stigma were associated with depression symptoms through a serial mediation of state mindfulness and self-efficacy. This study highlights that state mindfulness and self-efficacy might play important roles in the psychological response of MSM to stigmatization and psychopathology symptoms.
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Affiliation(s)
- Caimeng Liu
- College of Teacher Education, Institute of Education Science, Leshan Normal University, Leshan, China
| | - Guangzhe Frank Yuan
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, USA.
| | - Xiaoming Li
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, USA
| | - Hong Wang Fung
- Department of Social Work, Faculty of Social Sciences, The Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Ming Yu Claudia Wong
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong
| | - Jingjing Zhao
- Department of Psychology, Beijing Forestry University, Beijing, China
| | - Xueyou Feng
- Center for Mental Health Education and Counseling, Guangzhou College of Commerce, Guangzhou, China
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16
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Choi S, Shin H. The burdens faced by parents of preschoolers with type 1 diabetes mellitus: an integrative review. CHILD HEALTH NURSING RESEARCH 2023; 29:166-181. [PMID: 37554085 PMCID: PMC10415842 DOI: 10.4094/chnr.2023.29.3.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/10/2023] [Accepted: 06/18/2023] [Indexed: 08/10/2023] Open
Abstract
PURPOSE This study examined the literature concerning the burdens of parents of preschool-aged children diagnosed with type 1 diabetes mellitus. METHODS We employed an integrative review methodology based on Whittemore and Knafl's framework. The literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines across four electronic databases: PubMed, Web of Science, the Cumulative Index to Nursing Allied Health Literature (CINAHL), and PsycINFO. Ultimately, 18 articles were included in the review. RESULTS The review yielded four themes: (1) parental burdens, (2) factors related to the burdens, (3) coping strategies, and (4) implications for clinical practice. Parents experienced psychological, physical, and social burdens due to the diabetes care of their children. Several factors influenced burdens, including child-related characteristics such as age, severity of diabetes, and hospitalization experience, as well as parental factors like family income, race, and residential area. Parents initially felt burdened when their child was diagnosed with type 1 diabetes, but over time, they often adapted to the situation through support and sharing of responsibilities. Parents desired education and interventions reflecting the unique characteristics of preschoolers. CONCLUSION This integrative literature review revealed that parents experience numerous burdens when their child is diagnosed with diabetes. Future research should focus on developing interventions to address parents' psychological difficulties, including tracking parental psychological changes over time. Tailored nursing interventions should also be provided to parents of preschool-aged children, as opposed to the more generic nursing interventions traditionally applied across all age groups of children in clinical settings.
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Affiliation(s)
- Sunyeob Choi
- Graduate Student, College of Nursing, Ewha Womans University, Seoul, Korea
| | - Hyewon Shin
- Assistant Professor, College of Nursing, Ewha Womans University, Seoul, Korea
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17
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Yılmaz Karaman İG, Altınöz AE, Aydın Buyruk B, Yorulmaz G, Köşger F, Kirel B. Comparison of anxiety, stress, and social support levels of female patients with type 1 diabetes and mothers whose children have type 1 diabetes. J Diabetes Metab Disord 2023; 22:333-340. [PMID: 37255808 PMCID: PMC10225375 DOI: 10.1007/s40200-022-01144-7] [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] [Received: 05/30/2022] [Revised: 08/31/2022] [Accepted: 10/10/2022] [Indexed: 06/01/2023]
Abstract
Purpose Patients with type 1 diabetes mellitus (T1DM) are insulin-dependent from diagnosis. Both the individual and their immediate circle are at risk for psychiatric morbidity. We aimed to compare the anxiety, stress, and social support levels of adult women with a diagnosis of T1DM and adult women with a child diagnosed with T1DM. Besides, the study intended to examine two groups' stress and anxiety factors. Methods The data were collected using the Sociodemographic Data Form, State-Trait Anxiety Inventory, Perceived Stress Scale, Multidimensional Scale of Perceived Social Support. Sixty-three women participated in the study. Results There was no difference between the groups regarding anxiety, stress, and perceived social support score averages (p > 0.05 each). However, clinically significant state anxiety was higher in the group of mothers (χ²=4.234 df = 1 p = 0.040). In women with T1DM, higher education was associated with lower stress, lower state, and lower trait anxiety (r=-0.455 p = 0.004, r=-0.428 p = 0.007, r=-0.317 p = 0.049); higher numbers of insulin injections were associated with higher state anxiety (r = 0.368 p = 0.021), social support was associated with lower stress and lower trait anxiety (r=-0.478 p = 0.002, r = 0.449 p = 0.004). In mothers of diabetic children, the increase in the child's HbA1c level was associated with an increase in the mother's state anxiety (r = 0.433 p = 0.035); social support was associated with lower trait anxiety (r=-0.421 p = 0.040). Conclusion Caring for a child with T1DM was stressful and anxiety-provoking as having T1DM. Interventions including social support, may benefit mental health in mothers of diabetic children and women with T1DM.
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Affiliation(s)
| | - Ali Ercan Altınöz
- Department of Psychiatry, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Betül Aydın Buyruk
- Clinic of Endocrinology and Metabolic Diseases, İzmir Çiğli Regional Training and Research Hospital, İzmir, Turkey
| | - Göknur Yorulmaz
- Division of Endocrinology, Department of Internal Diseases, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Ferdi Köşger
- Department of Psychiatry, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Birgül Kirel
- Department of Pediatric Endocrinology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
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18
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Hsu TW, Chen MH, Bai YM, Chang WH, Cheng CM, Su TP, Chen TJ, Tsai SJ, Liang CS. Family coaggregation of type 1 diabetes mellitus, major depressive disorder, attention-deficiency hyperactivity disorder and autism spectrum disorder in affected families: a nationwide study. Acta Diabetol 2023; 60:517-525. [PMID: 36637529 DOI: 10.1007/s00592-022-02025-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/21/2022] [Indexed: 01/14/2023]
Abstract
AIMS This study aimed to examine the risk of T1D, major depressive disorder (MDD), attention-deficiency hyperactivity disorder (ADHD), and autism spectrum disorder (ASD), in first-degree relatives (FDRs) of patients with T1D. METHODS We enrolled 24,555 FDRs of individuals with T1D and 1:4 matched controls (N = 98,220) based on age and sex using data from the Taiwan National Health Insurance Research Database between 2001 and 2011. Poisson regression analyses were performed to estimate the risks of MDD, attention-deficiency hyperactivity disorder (ADHD), and autism spectrum disorder among the FDRs. Finally, we assessed the impact of DKA in the familial coaggregation. RESULTS After adjusting for demographic characteristics, FDRs of individuals with T1D had higher risk of T1D (reported as relative risk with 95% confidence interval: 46.07, 33.36-63.63) and MDD (1.17, 1.04-1.32) than controls. Stratified by sex, female FDRs had increased risk of MDD (1.30, 1.13-1.51), while male FDRs had increased risk of ADHD (1.21, 1.01-1.44). Stratified by kinship, parents of individuals with T1D had increased risk of MDD (1.24, 1.06-1.44); offspring of individuals with T1D had increased risk of ADHD (1.41, 1.11-1.79). Importantly, FDRs of individuals with T1D and DKA had higher risk of MDD (1.35, 1.11-1.64) and ADHD (1.40, 1.07-1.82) than controls; however, such risks were not observed in FDRs of individuals with T1D but without DKA. CONCLUSIONS The individual risks of T1D, MDD, and ADHD were increased in families that included patients with T1D, and DKA might play a role in such coaggregation with MDD and ADHD. Future studies are warranted to investigate the underlying mechanisms.
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Affiliation(s)
- Tien-Wei Hsu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec. 2, Shihpai Road, Beitou District, Taipei, 11217, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec. 2, Shihpai Road, Beitou District, Taipei, 11217, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wen-Han Chang
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec. 2, Shihpai Road, Beitou District, Taipei, 11217, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec. 2, Shihpai Road, Beitou District, Taipei, 11217, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec. 2, Shihpai Road, Beitou District, Taipei, 11217, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Family Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec. 2, Shihpai Road, Beitou District, Taipei, 11217, Taiwan.
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, No. 60, Xinmin Road, Beitou District, Taipei, 11243, Taiwan.
- Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan.
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Montoro-Pérez N, Escribano S, Richart-Martínez M, Mármol-López MI, Montejano-Lozoya R. The Parental Stress Scale: Psychometric Properties in Pediatric Hospital Emergency Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4771. [PMID: 36981680 PMCID: PMC10049284 DOI: 10.3390/ijerph20064771] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/27/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
Parental psychological distress has been identified as a predisposing factor in attendance at and the inappropriate use of hospital pediatric emergency departments (PEDs). The aim of the study was to validate the Parental Stress Scale (PSS), a 12-item Spanish scale, in parents seeking care at PEDs. The study involved 270 participants with a mean age of 37.9 (SD = 6.76) years, of which 77.4% were women. The properties of the PSS were analyzed. The scale showed adequate internal consistency for the different factors (0.80 for the "Stressors" factor and 0.78 for the "Baby's Rewards" factor) and optimal model fit (chi-square = 107.686; df = 53; CFI = 0.99; TLI = 0.98; RMSEA = 0.028; 90% CI = 0.00-0.05). The 12-item Spanish version of the PSS is a valid and reliable instrument for assessing the stress levels of parents seeking care in PEDs.
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Affiliation(s)
- Néstor Montoro-Pérez
- Department of Nursing, Faculty of Health Sciences, University of Alicante, 03690 San Vicente del Raspeig, Spain
- Research Group GREIACC, Health Research Institute La Fe, Av. Fernando Abril Martorell, 106, Hospital La Fe, 46016 Valencia, Spain
| | - Silvia Escribano
- Department of Nursing, Faculty of Health Sciences, Institute for Health and Biomedical Research (ISABIAL), University of Alicante, 03690 San Vicente del Raspeig, Spain
| | - Miguel Richart-Martínez
- Department of Nursing, Faculty of Health Sciences, University of Alicante, 03690 San Vicente del Raspeig, Spain
| | - María Isabel Mármol-López
- Research Group GREIACC, Health Research Institute La Fe, Av. Fernando Abril Martorell, 106, Hospital La Fe, 46016 Valencia, Spain
- Nursing School La Fe, Adscript Center of University of Valencia, 46026 Valencia, Spain
| | - Raimunda Montejano-Lozoya
- Research Group GREIACC, Health Research Institute La Fe, Av. Fernando Abril Martorell, 106, Hospital La Fe, 46016 Valencia, Spain
- Nursing School La Fe, Adscript Center of University of Valencia, 46026 Valencia, Spain
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20
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Di Riso D, Spaggiari S, Gaiga G, Montanaro M, Zaffani S, Cecinati V, Maffeis C, Cellini N. Sleep and psychological characteristics of children with cancers and type 1 diabetes and their caregivers. Sleep Med 2023; 103:69-77. [PMID: 36764044 DOI: 10.1016/j.sleep.2023.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 12/29/2022] [Accepted: 01/19/2023] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Children with chronic illnesses and their parents are more at risk to develop sleep problems, which are linked to worse psychological and physical well-being. This study aimed to assess sleep patterns and their connections with psychological outcomes in children with type 1 diabetes (T1D) and cancer and their caregivers, compared to a control sample. In addition, we explored the associations between caregiver and child's sleep quality across the three groups. METHODS We enrolled 56 children with T1D, 33 children with cancer, and 61 healthy children between 7 and 15, and their respective caregivers. Caregivers filled out an ad-hoc survey assessing their sleep disturbances, parenting stress, general well-being, anxiety, and their children's sleep patterns and psychological adjustments. RESULTS Children with cancer showed lower sleep quality than the other groups. Moreover, worse psychological adjustment was associated with greater sleep disturbances in both clinical groups. As for caregivers, the cancer group reported the worst sleep quality and greater anxiety compared to the other samples. Greater anxiety was also linked to worse sleep quality. Furthermore, greater sleep problems in children were associated with poorer caregivers' sleep quality in the whole sample and the T1D group. CONCLUSIONS A better understanding of sleep patterns and problems for chronically ill children and their parents is fundamental to provide adequate care for these vulnerable populations. Furthermore, an illness-specific approach may better inform and guide the practitioners in clinical practice.
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Affiliation(s)
- Daniela Di Riso
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - Silvia Spaggiari
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - Giacomo Gaiga
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - Maria Montanaro
- Complex Structure of Pediatrics and Pediatric Oncohematology "Nadia Toffa", Central Hospital Santissima Annunziata, Taranto, 74121, Italy
| | - Silvana Zaffani
- Pediatric Diabetes and Metabolic Disorders, Department of Surgical Sciences, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, 37134, Italy
| | - Valerio Cecinati
- Complex Structure of Pediatrics and Pediatric Oncohematology "Nadia Toffa", Central Hospital Santissima Annunziata, Taranto, 74121, Italy
| | - Claudio Maffeis
- Pediatric Diabetes and Metabolic Disorders, Department of Surgical Sciences, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, 37134, Italy
| | - Nicola Cellini
- Department of General Psychology, University of Padova, Padova, Italy.
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21
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Lewis LF, Brower PM, Narkewicz S. "We Operate as an Organ": Parent Experiences of Having a Child With Type 1 Diabetes in a Rural Area. Sci Diabetes Self Manag Care 2023; 49:35-45. [PMID: 36594452 DOI: 10.1177/26350106221144962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE The purpose of this study is to explore the experiences of parents of children with type 1 diabetes mellitus (T1DM) who are living in rural areas. Individuals living in rural areas face barriers to accessing health care that lead to significant health disparities with increased morbidity and mortality. There is a need to understand the unique experiences of those living in rural communities to support their health needs. METHODS In this qualitative study, a convenience sample of 11 parents of children who were diagnosed with T1DM in the last 10 years living in Vermont were recruited through connections with local health professionals and family support networks and interviewed about their experiences. Interviews were transcribed verbatim and analyzed using Braun and Clarke's 6-step approach to reflexive thematic analysis. RESULTS Five themes were identified to capture the experience of parenting a child with T1DM in a rural community, including enduring emotional traumas, living life on call, adapting to everyday challenges, lacking a safety net for support, and finding a rhythm. CONCLUSIONS Although findings echo many themes found in previous studies on experiences of parents of children with T1DM, participants also identified unique barriers such as physical distance from formal and informal support systems, unreliable and/or insufficient technological resources, and lack of understanding of T1DM by their communities, including among child care and schools. Diabetes care and education specialists working with families living in rural areas must explore ways to educate key supports to these families to minimize isolation, stigma, and burnout among parents.
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Affiliation(s)
| | | | - Sarah Narkewicz
- Department of Nursing, University of Vermont, Burlington, Vermont
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22
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Chen Z, Wang J, Carru C, Coradduzza D, Li Z. The prevalence of depression among parents of children/adolescents with type 1 diabetes: A systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1095729. [PMID: 36936139 PMCID: PMC10014558 DOI: 10.3389/fendo.2023.1095729] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/14/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Emerging research indicates that depression among parents of children/adolescents with type 1 diabetes mellitus (T1DM) has increased significantly. However, the prevalence rates reported by different studies vary substantially. METHODS Seven databases were systematically searched (Pubmed, Embase, MEDLINE, Scopus, Web of Science, Cochrane Library, PsycInfo) from the inception to 15th October 2022. We pooled prevalence rates from each study with a random-effect model. We conducted a stratified meta-analysis to identify the potential sources of heterogeneity among studies. The GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach was utilized to evaluate the quality of evidence. RESULTS Twenty-two studies were included, with a total of 4639 parents living with type 1 diabetic children. Overall, the pooled prevalence rate of depression or depressive symptoms was 22.4% (95%CI 17.2% to 28.7%; I 2 = 96.8%). The prevalence was higher among mothers (31.5%) than fathers (16.3%) as well as parents of children (aged < 12 years) with T1DM (32.3%) than those with adolescents (aged ≥ 12 years) (16.0%). CONCLUSION Our research suggests that more than 1 in 5 parents of type 1 diabetic children/adolescents worldwide suffer from depression or depressive symptom. Depression screening and interventions are required for parents of children with T1DM. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/, identifier (CRD42022368702).
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Affiliation(s)
- Zhichao Chen
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Jing Wang
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
- Department of Obstetrics and Gynecology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | | | - Zhi Li
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
- *Correspondence: Zhi Li,
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23
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Wang Y, Chen H, Cao J, Li M, Wang J, Jing R. Psychometric validation of the Chinese version of the Adolescent Asthma Self-Efficacy Questionnaire. Front Psychol 2022; 13:1013989. [PMID: 36619064 PMCID: PMC9814505 DOI: 10.3389/fpsyg.2022.1013989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Background Self-efficacy was considered as a promising target for the self-management of symptoms for adolescents with asthma. The measurement of self-efficacy in adolescents with asthma requires effective self-report tools, which have not been met with at present. So, the aim of this study was to cross-culturally validate the Adolescent Asthma Self-Efficacy Questionnaire (AASEQ). Methods As many as 408 adolescents with asthma were invited to take up the psychometric properties test between July 2021 and June 2022. We conducted the confirmatory factor analysis (CFA) to determine the structure of the AASEQ. The relationship between the AASEQ and General Self-Efficacy Scale was tested to evaluate the construct validity. The reliability was evaluated by retest reliability, internal consistency, and interfactor correlation. Results The results of the present study showed that the confirmatory factor analysis indicated a significantly good fit for a four-factor model, which explained 62.697% of the total variance. The fit indices of the four-factor model were acceptable, and the standardized factor loading ranged from 0.631 to 0.880. The C-AASEQ showed an acceptable internal consistency (Cronbach's α = 0.810-0.927) and test-retest reliability (intraclass correlation coefficient = 0.64-0.89). Content validity index at the scale level was 0.96, and content validity index at the item level was 0.86 to 1. Conclusion The Chinese version of Adolescent Asthma Self-Efficacy Questionnaire showed consistently acceptable positive psychometric properties and can be used as an instrument to assess the self-efficacy of adolescents with asthma in China, as corroborated in the present study.
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Affiliation(s)
- Yuanyuan Wang
- Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Hongyu Chen
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
| | - Jinjin Cao
- Department of Gastroenterology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Mei Li
- Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing, China,*Correspondence: Mei Li ✉
| | - Jianan Wang
- Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Ruochen Jing
- Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing, China
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24
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Challenges of Caregivers Regarding Homecare to Type 1 Diabetic Children in Vhembe District, South Africa: A Qualitative Study Report. NURSING REPORTS 2022; 12:884-893. [PMID: 36412804 PMCID: PMC9680399 DOI: 10.3390/nursrep12040085] [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: 10/15/2022] [Revised: 11/08/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Worldwide, type 1 diabetes mellitus disease is a devastating health condition for both the diagnosed children and caregivers taking care of them. These challenges were drastically affecting caregivers in rendering the required homecare service for their patients. Caring for a child with diabetes mellitus often hurts the caregivers and other family members. Aim: This study aimed to explore the challenges experienced by caregivers during the provision of care to type 1 diabetic children. Setting: The study was conducted in selected health facility of Vhembe District, South Africa. Methods: A qualitative design that was both descriptive and exploratory was used. Non-probability purposive sampling was used to select the caregivers who were taking care of children with type 1 diabetes mellitus at their homes. Semi-structured interviews were conducted with 15 participants from the Vhembe district of Limpopo province. Results: Caregivers experienced various challenges related to re-admission, poor understanding of medication, low level of literacy, committed mistakes, poor adherence, and fear of giving an injection. Conclusion: It is imperative to educate the caregivers on the care of children with type 1 diabetes mellitus for them to be competent and knowledgeable in assisting their diabetic children at home.
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25
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Edelstein OE, Shorer T, Shorer Z, Bachner YG. Correlates of Caregiving Burden among Bedouin-Muslim Mothers of Children Diagnosed with Epilepsy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11595. [PMID: 36141866 PMCID: PMC9517155 DOI: 10.3390/ijerph191811595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/31/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED A paucity of research exists on caregiving burden (CB) and the factors associated with it among minority groups, such as Bedouin mothers of children diagnosed with epilepsy (CDE). The aim of this study was to explore associations between CB and care-recipients' characteristics, contextual factors, and caregivers' characteristics among those mothers. METHODS A total of 50 mothers completed self-report questionnaires while visiting pediatric neurology outpatient clinic centers, using valid and reliable measures. RESULTS Bivariate associations were found between social support, number of medications, and CB. General self-efficacy and place of residence emerged as significant predictors of caregiver burden. CONCLUSIONS These findings provide health professionals with a better understanding of the factors that should be assessed in order to address caregiver burden among Bedouin mothers of CDE. Understanding the unique characteristics and culture of the Bedouin community can help professionals in targeting caregivers with a lower sense of self-efficacy, and those that reside in Bedouin cities, in order to reduce their caregiving burden.
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Affiliation(s)
- Offer E. Edelstein
- The Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Talia Shorer
- Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Zamir Shorer
- Pediatric Neurology Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Yaacov G. Bachner
- Faculty of Health Sciences, Department of Epidemiology, Biostatistics and Community Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
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26
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Inverso H, Moore HR, Rooney K, Tully CB, Monaghan M, Hilliard ME, Streisand R, Wang CH. Clinically elevated parent depressive symptoms and stress at child type 1 diabetes diagnosis: Associations with parent diabetes self-efficacy at 18-months post-diagnosis. Pediatr Diabetes 2022; 23:809-814. [PMID: 35598164 DOI: 10.1111/pedi.13365] [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] [Received: 11/10/2021] [Revised: 03/18/2022] [Accepted: 05/19/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Eighteen percent of new diagnoses of type 1 diabetes (T1D) occur in children ages 9 and younger, and the burden of diabetes management in young children predominantly falls on parents. Despite the significant amount of information parents must learn and implement quickly after diagnosis, little research has examined diabetes self-efficacy in parents of young children soon after diagnosis in a longitudinal manner. The current study examined changes in parent diabetes self-efficacy over time, and parent depressive symptoms and stress soon after child T1D diagnosis as predictors of parent diabetes self-efficacy at 12- and 18-months post-diagnosis. RESEARCH DESIGN AND METHODS One hundred fifty-seven primary caregivers (91.7% female, 62.2% White, Non-Hispanic) of young children (Mage = 4.47 ± 1.65 years, 54.8% female, 60% White, Non-Hispanic) were recruited within 2 months of their child's T1D diagnosis from two pediatric hospitals in the United States as part of a randomized clinical trial. Parents self-reported on their diabetes self-efficacy, depressive symptoms, and stress and at baseline (Mdays since diagnosis = 29) and on parent diabetes self-efficacy again 12- and 18-months post-diagnosis. RESULTS Parent diabetes self-efficacy significantly improved from baseline to 12-months and 18-months post-diagnosis (p < 0.05). Parents exhibiting clinically elevated levels of depressive symptoms and stress at baseline had significantly lower parent diabetes self-efficacy 12- and 18-months post-diagnosis compared to parents with normal levels of depressive symptoms and stress. CONCLUSIONS Brief interventions for parents with clinically elevated depressive symptoms and stress soon after their child's diagnosis may improve parents' diabetes self-efficacy and ultimately support the management of their child's diabetes.
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Affiliation(s)
- Hailey Inverso
- Children's National Hospital, Center for Translational Research, Washington, District of Columbia, USA
| | - Hailey R Moore
- Children's National Hospital, Center for Translational Research, Washington, District of Columbia, USA
| | - KellyAnn Rooney
- Children's National Hospital, Center for Translational Research, Washington, District of Columbia, USA
| | - Carrie B Tully
- Children's National Hospital, Center for Translational Research, Washington, District of Columbia, USA.,The George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Maureen Monaghan
- Children's National Hospital, Center for Translational Research, Washington, District of Columbia, USA.,The George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Randi Streisand
- Children's National Hospital, Center for Translational Research, Washington, District of Columbia, USA.,The George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Christine H Wang
- Children's National Hospital, Center for Translational Research, Washington, District of Columbia, USA
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27
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Rikos N, Mpalaskas A, Fragiadaki M, Frantzeskaki C, Kassotaki A, Linardakis M. Quality of Life and Psychological Burden of Parents of Children, Adolescents, and Young Adults with Type 1 Diabetes: A Cross-Sectional Study during the Lockdown Period of COVID-19. NURSING REPORTS 2022; 12:564-573. [PMID: 35997463 PMCID: PMC9397070 DOI: 10.3390/nursrep12030055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/28/2022] [Accepted: 08/02/2022] [Indexed: 01/09/2023] Open
Abstract
The current study aimed to investigate how parents of children, adolescents, and young adults with DM1 perceived quality of life and psychological burden during the lockdown period of COVID-19. A cross-sectional study was carried out on 110 parents in Greece in spring 2021. Perceived quality of life was measured using the Parent Diabetes Distress Scale, and psychological burden was measured using the Spielberger State/Trait Anxiety Inventory, and both were assessed with correlational analysis. Overall, 79.1% of the parents were females ,while the mean age of all was 44.4 years (±5.8). PDDS was found to be moderate (mean 2.42 ± 0.76): 63.6% of respondents had moderate/high distress. The highest mean score was for Teen Management Distress and the lowest for Healthcare Team (3.02 vs. 1.49, p < 0.001). STAI was found to be moderate to high, with a higher mean score for state versus trait anxiety (49.8 vs. 48.0, p = 0.006). Increased distress or poorer parents’ quality of life was related with the highest number of hyperglycemic episodes (β = 0.25, p = 0.002), the fewest hypoglycemic episodes (β = −0.18, p = 0.024), and the highest parental trait anxiety (β = 0.04, p < 0.001). Parents were found with moderate-to-high distress and anxiety, and their correlation also shows that there is an urgent need for suitable education of parents on managing the disease to improve quality of life and eliminate health risks to all involved.
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Affiliation(s)
- Nikolaos Rikos
- School of Health Science, Department of Nursing, Hellenic Mediterranean University, Heraklion 71410, Greece
| | - Andreas Mpalaskas
- School of Health Science, Department of Nursing, Hellenic Mediterranean University, Heraklion 71410, Greece
| | - Maria Fragiadaki
- School of Health Science, Department of Nursing, Hellenic Mediterranean University, Heraklion 71410, Greece
| | - Chara Frantzeskaki
- School of Health Science, Department of Nursing, Hellenic Mediterranean University, Heraklion 71410, Greece
| | - Anna Kassotaki
- School of Health Science, Department of Nursing, Hellenic Mediterranean University, Heraklion 71410, Greece
| | - Manolis Linardakis
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion 70013, Greece
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28
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Reif LK, van Olmen J, McNairy ML, Ahmed S, Putta N, Bermejo R, Nugent R, Paintsil E, Daelmans B, Varghese C, Sugandhi N, Abrams EJ. Models of lifelong care for children and adolescents with chronic conditions in low-income and middle-income countries: a scoping review. BMJ Glob Health 2022; 7:bmjgh-2021-007863. [PMID: 35787510 PMCID: PMC9255401 DOI: 10.1136/bmjgh-2021-007863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 05/03/2022] [Indexed: 01/18/2023] Open
Abstract
Globally, non-communicable diseases (NCDs) or chronic conditions account for one-third of disability-adjusted life-years among children and adolescents under the age of 20. Health systems must adapt to respond to the growing burden of NCDs among children and adolescents who are more likely to be marginalised from healthcare access and are at higher risk for poor outcomes. We undertook a review of recent literature on existing models of chronic lifelong care for children and adolescents in low-income and middle-income countries with a variety of NCDs and chronic conditions to summarise common care components, service delivery approaches, resources invested and health outcomes.
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Affiliation(s)
- Lindsey K Reif
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Josefien van Olmen
- Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerpen, Belgium
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Margaret L McNairy
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Saeed Ahmed
- Baylor College of Medicine International Paediatric AIDS Initiative, Texas Children's Hospital, Houston, TX, USA
| | - Nande Putta
- Child Survival and Development, UNICEF, New York, NY, USA
| | | | - Rachel Nugent
- Center for Global NCDs, RTI International, Edmonds, Washington, USA
| | - Elijah Paintsil
- Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Bernadette Daelmans
- Department of Maternal, Newborn, Child, and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Cherian Varghese
- Department of Non-Communicable Diseases, World Health Organization, Geneva, Switzerland
| | | | - Elaine J Abrams
- ICAP at Columbia University, New York, NY, USA
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
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29
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Wan T, Li X, Fu M, Gao X, Li P, Guo W. NLRP3-Dependent Pyroptosis: A Candidate Therapeutic Target for Depression. Front Cell Neurosci 2022; 16:863426. [PMID: 35722622 PMCID: PMC9204297 DOI: 10.3389/fncel.2022.863426] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/27/2022] [Indexed: 01/20/2023] Open
Abstract
Depression, a major public health problem, imposes a significant economic burden on society. Recent studies have gradually unveiled the important role of neuroinflammation in the pathogenesis of depression. Pyroptosis, a programmed cell death mediated by Gasdermins (GSDMs), is also considered to be an inflammatory cell death with links to inflammation. Pyroptosis has emerged as an important pathological mechanism in several neurological diseases and has been found to be involved in several neuroinflammatory-related diseases. A variety of chemical agents and natural products have been found to be capable of exerting therapeutic effects by modulating pyroptosis. Studies have shown that depression is closely associated with pyroptosis and the induced neuroinflammation of relevant brain regions, such as the hippocampus, amygdala, prefrontal cortex neurons, etc., in which the nucleotide-binding oligomerization domain-like receptor protein 3 inflammasome plays a crucial role. This article provides a timely review of recent findings on the activation and regulation of pyroptosis in relation to depression.
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Affiliation(s)
- Teng Wan
- Sports Medicine Department, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
- The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
- Hengyang Medical College, University of South China, Hengyang, China
- *Correspondence: Teng Wan
| | - Xiaoyu Li
- Hengyang Medical College, University of South China, Hengyang, China
| | - Mingyuan Fu
- Hengyang Medical College, University of South China, Hengyang, China
| | - Xiaoyu Gao
- Hengyang Medical College, University of South China, Hengyang, China
| | - Peiling Li
- Hengyang Medical College, University of South China, Hengyang, China
| | - Weiming Guo
- Sports Medicine Department, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
- The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
- Weiming Guo
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30
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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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31
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Stahl-Pehe A, Selinski S, Bächle C, Castillo K, Lange K, Holl RW, Rosenbauer J. Overestimation and underestimation of youths' health-related quality of life are associated with youth and caregiver positive screens for depression: results of a population-based study among youths with longstanding type 1 diabetes. Diabetol Metab Syndr 2022; 14:40. [PMID: 35264222 PMCID: PMC8905804 DOI: 10.1186/s13098-022-00809-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/23/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study aimed to analyze the extent and direction of disagreement between self- and proxy-reported quality of life (QoL) and the factors associated with QoL overestimation and underestimation by caregivers compared with self-reports. METHODS This study used data from population-based questionnaire surveys conducted in 2012-2013 and 2015-2016 with 11- to 17-year-olds with a duration of type 1 diabetes of 10 years or longer and their caregivers (n = 1058). QoL in youth was assessed via 10-item KIDSCREEN (KIDSCREEN-10) self- and proxy-reported questionnaires. The scores ranged from 0 to 100, with higher scores indicating better QoL. Depression screening was performed via the Center for Epidemiological Studies Depression Scale for Children for youths (CES-DC screen positive: score > 15) and WHO-5 Well-being Index for parents/caregivers (WHO-5 screen positive: score ≤ 50). RESULTS The mean self- and proxy-reported normalized KIDSCREEN-10 scores were 64.2 (standard deviation [SD] 11.4) and 66.1 (11.5), respectively. More caregivers overestimated (self-reported minus proxy-reported score < - 0.5*SD self-reported score) than underestimated (self-reported minus proxy-reported score > 0.5*SD self-reported score) youths' QoL (37% versus 23%, p < 0.001). Youths who screened positive for depression (18%) were at higher risk of their QoL being overestimated and lower risk of their QoL being underestimated by caregivers than youths who screened negative for depression (RROverestimation 1.30 [95% CI 1.10-1.52], RRUnderestimation 0.27 [0.15-0.50]). Caregivers who screened positive for depression (28%) overestimated the QoL of their children less often and underestimated the QoL of their children more often than caregivers who screened negative for depression (RROverestimation 0.73 [0.60-0.89], RRUnderestimation 1.41 [1.14-1.75]). CONCLUSIONS Caregivers often over- or underestimated their children's QoL. Positive screens for depression among both youths and caregivers contributed to the observed differences between self- and caregiver-reported QoL.
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Affiliation(s)
- Anna Stahl-Pehe
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany.
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany.
| | - Silvia Selinski
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Christina Bächle
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Katty Castillo
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Karin Lange
- Medical Psychology Unit, Hannover Medical School, Hannover, Germany
| | - Reinhard W Holl
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
| | - Joachim Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
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Rodríguez-Rubio P, Lacomba-Trejo L, Valero-Moreno S, Montoya-Castilla I, Pérez-Marín M. 10Vida: A Mental and Physical Health Intervention for Chronically Ill Adolescents and Their Caregivers in the Hospital Setting: An Open Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063162. [PMID: 35328851 PMCID: PMC8953533 DOI: 10.3390/ijerph19063162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/04/2022] [Accepted: 03/05/2022] [Indexed: 02/04/2023]
Abstract
Suffering from a chronic disease (CD) in adolescence can significantly impact the emotional health of adolescents and their families. MHealth can be a useful tool for these groups. However, few intervention programmes include the family system. The aim is to design an intervention programme (10Vida) for a paediatric population with a CD, and their families, to improve their adaptation to the disease. The study is a quasi-experimental repeated measures design in a open study, where the patients themselves, and their families, are their own control group. Participants will receive an intervention of seven individual sessions: five sessions with each patient, and two sessions with their caregivers. In the case of the patients, the aim is to improve their emotional state, their self-esteem, and their emotional competencies, reducing their perceived threat of illness. Furthermore, in the case of the caregivers, the aim is to improve their emotional state and reduce their burden. Indirectly, working with caregivers and those being cared for will improve family ties. The pilot study will involve 25 to 30 chronically ill adolescents aged between 12 and 16 years and their primary caregivers. Following the results, the necessary modifications will be included, and the programme will be offered to adolescents and their families who are willing to participate.
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Affiliation(s)
- Pilar Rodríguez-Rubio
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology and Speech Therapy, Universitat de València, Av. Blasco Ibáñez, 21, 46010 Valencia, Spain; (P.R.-R.); (L.L.-T.); (I.M.-C.)
| | - Laura Lacomba-Trejo
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology and Speech Therapy, Universitat de València, Av. Blasco Ibáñez, 21, 46010 Valencia, Spain; (P.R.-R.); (L.L.-T.); (I.M.-C.)
| | - Selene Valero-Moreno
- Department of Developmental and Educational Psychology, Faculty of Psychology and Speech Therapy, Universitat de València, Av. Blasco Ibáñez, 21, 46010 Valencia, Spain;
| | - Inmaculada Montoya-Castilla
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology and Speech Therapy, Universitat de València, Av. Blasco Ibáñez, 21, 46010 Valencia, Spain; (P.R.-R.); (L.L.-T.); (I.M.-C.)
| | - Marián Pérez-Marín
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology and Speech Therapy, Universitat de València, Av. Blasco Ibáñez, 21, 46010 Valencia, Spain; (P.R.-R.); (L.L.-T.); (I.M.-C.)
- Correspondence: ; Tel.: +34-963983392
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Saßmann H, Kim-Dorner SJ, Berndt V, Biester T, Dehn-Hindenberg A, Heidtmann B, Jorch N, Lilienthal E, Nellen-Hellmuth N, Neu A, Schaaf K, Ziegler R, Lange K. Understanding Daily, Emotional, and Physical Burdens and Needs of Parents Caring for Children with Type 1 Diabetes. J Diabetes Res 2022; 2022:9604115. [PMID: 36561282 PMCID: PMC9767735 DOI: 10.1155/2022/9604115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 11/07/2022] [Accepted: 11/12/2022] [Indexed: 12/15/2022] Open
Abstract
AIMS To investigate (1) daily, emotional, and physical caregiving burdens in parents of children with type 1 diabetes, (2) the sociodemographic and clinical predictors of three burdens, and (3) support measures that parents wish to receive. METHODS The study was a multicenter cross-sectional survey conducted in nine German pediatric diabetes centers. A questionnaire assessing three types of burdens and wishes for support was distributed to parents with a child with type 1 diabetes visiting one of the pediatric centers for a routine check-up. RESULTS Data from 1,107 parents (83% mothers) were analyzed. Parents reported significantly higher emotional burdens compared to daily and physical burdens (p < 0.0001). Mothers felt more burdened than fathers did. Parents of younger children reported higher daily and physical burdens compared to the parents of older children, and similarly, parents of technology users reported higher daily and physical burdens compared to the parents of nontechnology users. However, emotional burdens did not differ in both comparisons. Other demographic factors (i.e., parent's age, migration status, and single-parent family status) predicted high levels of daily or physical burdens, but only HbA1c level and the parent's gender (mother) predicted a high emotional burden. Independent of the level of burden, 78% of parents wanted additional diabetes training. CONCLUSION Despite parents reporting high emotional burdens in connection with diabetes care, HbA1c and the gender of the reporting parent were the only risk factors. As the child gets older, parents' daily and physical distress decrease but not the emotional burden. Diabetes training including regularly offered booster sessions as well as low-threshold interventions for mental health issues and practical self-care skills is recommended to provide continuous support for parents.
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Affiliation(s)
- Heike Saßmann
- Hannover Medical School, Medical Psychology, Hannover, Germany
| | | | - Verena Berndt
- Sana Hospital Group Berlin-Brandenburg, Social-Pediatric Centre Lichtenberg, Berlin, Germany
| | - Torben Biester
- Children's Hospital AUF DER BULT, Diabetes-Centre for Children and Adolescents, Hannover, Germany
| | | | | | - Norbert Jorch
- Bielefeld University, University Clinic for Pediatrics, Evang. Klinikum Bethel, Bielefeld, Germany
| | - Eggert Lilienthal
- University Clinic Ruhr-University Bochum, University Children's Hospital, Bochum, Germany
| | | | - Andreas Neu
- Eberhard Karls University Tübingen, Pediatric Endocrinology and Diabetes, Tübingen, Germany
| | - Katja Schaaf
- Elisabeth-Hospital-Essen, Pediatrics, Essen, Germany
| | - Ralph Ziegler
- Diabetes Clinic for Children and Adolescents Münster, Münster, Germany
| | - Karin Lange
- Hannover Medical School, Medical Psychology, Hannover, Germany
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Luo D, Wang Y, Cai X, Li R, Li M, Liu H, Xu J. Resilience Among Parents of Adolescents With Type 1 Diabetes: Associated With Fewer Parental Depressive Symptoms and Better Pediatric Glycemic Control. Front Psychiatry 2022; 13:834398. [PMID: 35492685 PMCID: PMC9043445 DOI: 10.3389/fpsyt.2022.834398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/22/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although pediatric resilience plays a significant role in resisting negative moods and improving glycaemic control, little research exists regarding resilience among the parents of adolescents with Type 1 diabetes. OBJECTIVE To investigate parental resilience's correlations with parental depressive symptoms, parental diabetes distress, and pediatric glycaemic control. METHODS This cross-sectional study recruited adolescents with Type 1 diabetes and their parents from two hospitals. The parents completed questionnaires. The 10-item Connor-Davidson Resilience Scale measured resilience; the Problem Areas in Diabetes Survey-Parent Revised version measured diabetes distress; the Patient Health Questionnaire-9 measured depressive symptoms. Standard glycated hemoglobin tests were performed on the adolescents. RESULTS Data from 224 parents (77.2% female, Mage = 39.88 [SD = 5.02], age range = 30-56 years) of adolescents (50.9% boys, Mage = 13.54 years [SD = 2.48], age range = 10-19 years) were available. More than half (52.7%) of parents exceeded the criterion score for high resilience. Parental resilience was significantly negatively associated with parental depressive symptoms and diabetes distress. Parents from the high-resilience group reported fewer depressive symptoms than those from the low-resilience group. In multivariate regressions, greater parental resilience is consistently related to better pediatric glycaemic control beyond parental psychological risk factors. CONCLUSIONS This study highlights the importance of parental resilience for parental mental health and glycaemic control among adolescents with Type 1 diabetes. The appropriate resilience support programme might be developed for parents, especially for those existing depressive symptoms and diabetes distress.
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Affiliation(s)
- Dan Luo
- School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
| | - Yubing Wang
- Department of Endocrinology, Children's Hospital Affiliated to Nanjing Medical University, Jiangsu, China
| | - Xue Cai
- School of Nursing, Peking University, Beijing, China
| | - Ruxue Li
- School of Nursing, Peking University, Beijing, China
| | - Mingzi Li
- School of Nursing, Peking University, Beijing, China
| | - Haiyan Liu
- Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Jingjing Xu
- Department of Endocrinology, The First Affiliated Hospital With Nanjing Medical University (Jiangsu Province Hospital), Jiangsu, China
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Wauters A, Vervoort T, Dhondt K, Soenens B, Vansteenkiste M, Morbée S, Waterschoot J, Haerynck F, Vandekerckhove K, Verhelst H, Van Aken S, Raes A, Schelstraete P, Walle JV, Van Hoecke E. Mental Health Outcomes Among Parents of Children With a Chronic Disease During the COVID-19 Pandemic: The Role of Parental Burn-Out. J Pediatr Psychol 2021; 47:420-431. [PMID: 34915562 PMCID: PMC8754736 DOI: 10.1093/jpepsy/jsab129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 11/30/2022] Open
Abstract
Objective The COVID-19 pandemic and associated quarantine measures highly impacted parental psychological well-being. Parents of children with chronic diseases might be specifically vulnerable as they already face multiple challenges to provide adequate care for their child. The research questions of the current study were twofold: (a) to examine whether parents of children with a chronic disease experienced more anxiety and depression compared to parents of healthy children and (b) to examine a series of risk factors for worsened well-being (i.e., depression, anxiety, and sleep problems), such as sociodemographic variables, COVID-19-specific variables (i.e., financial worries, living space, and perceived quality of health care), and parental psychological experiences (i.e., parental burn-out and less positive parenting experiences). Methods Parents of children with a chronic disease (i.e., the clinical sample; N = 599 and 507 for Research Questions 1 and 2, respectively) and parents of healthy children (i.e., the reference sample: N = 417) filled out an online survey. Results Findings demonstrated that the parents in the clinical sample reported higher levels of anxiety than parents in the reference sample. Analyses within the clinical sample indicated that COVID-19-specific stressors and parental psychological experiences were associated with higher levels of anxiety, depression, and sleep problems. Mediation analyses furthermore indicated that the association of COVID-19-specific stressors with all outcome measures was mediated by parental burn-out. Conclusions Parents of children with a chronic disease constitute a vulnerable group for worse well-being during the current pandemic. Findings suggest interventions directly targeting parental burn-out are warranted.
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Affiliation(s)
- Aline Wauters
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Tine Vervoort
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Karlien Dhondt
- Department of Child & Adolescent Psychiatry, Ghent University Hospital, Ghent, Belgium
| | - Bart Soenens
- Department of Developmental, Personality, and Social Psychology, Ghent University, Ghent, Belgium
| | - Maarten Vansteenkiste
- Department of Developmental, Personality, and Social Psychology, Ghent University, Ghent, Belgium
| | - Sofie Morbée
- Department of Developmental, Personality, and Social Psychology, Ghent University, Ghent, Belgium
| | - Joachim Waterschoot
- Department of Developmental, Personality, and Social Psychology, Ghent University, Ghent, Belgium
| | | | | | - Helene Verhelst
- Department of Pediatrics, Ghent University Hospital, Ghent, Belgium
| | - Sara Van Aken
- Department of Pediatrics, Ghent University Hospital, Ghent, Belgium
| | - Ann Raes
- Department of Pediatrics, Ghent University Hospital, Ghent, Belgium
| | | | | | - Eline Van Hoecke
- Pediatric Psychology, Department of Pediatrics, Ghent University Hospital, Ghent, Belgium
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Turin A, Drobnič Radobuljac M. Psychosocial factors affecting the etiology and management of type 1 diabetes mellitus: A narrative review. World J Diabetes 2021; 12:1518-1529. [PMID: 34630904 PMCID: PMC8472498 DOI: 10.4239/wjd.v12.i9.1518] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/26/2021] [Accepted: 07/26/2021] [Indexed: 02/06/2023] Open
Abstract
Type 1 diabetes (T1D) is one of the most common chronic diseases in children and adolescents worldwide. Its etiopathogenesis results from the interplay of genetic and environmental variables. Among the latter, psychological stress has been implicated in disease onset as well as disease management. Various studies, including large population-based studies, have highlighted the role of stressful life events in the etiopathogenesis of T1D. In this article, we also emphasize the importance of attachment in the early child-caregiver relationship, which can be seen as a measure of the quality of the relationship and is crucial for stress and emotional regulation. It serves as a model for all subsequent relationships in one's life. We summarize some of the few studies performed in the field of attachment and T1D etiopathogenesis or management. T1D management demands a lifelong therapeutic regimen to prevent acute and chronic complications. In addition to psychological stress, psychological factors such as family functioning, developmental adjustment, autonomy, mental health problems and other factors have been found to relate to metabolic control. Psychological factors need to be understood not as a single directional causality-based principle but as a dynamic bi- or multidirectional system that is affected by the normal developmental transitions of childhood and adolescence.
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Affiliation(s)
- Anja Turin
- Department for Child Psychiatry, University Children’s Hospital, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
- Department of Psychiatry, Faculty of Medicine, University of Ljubljana, Ljubljana 1000, Slovenia
| | - Maja Drobnič Radobuljac
- Department of Psychiatry, Faculty of Medicine, University of Ljubljana, Ljubljana 1000, Slovenia
- Unit for Intensive Child and Adolescent Psychiatry, University Psychiatric Clinic Ljubljana, Ljubljana 1000, Slovenia
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