1
|
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.
Collapse
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.)
| |
Collapse
|
2
|
Monzon AD, Clements MA, Patton SR. Group engagement in parent-focused telehealth interventions for families of children with type 1 diabetes. J Telemed Telecare 2024; 30:505-513. [PMID: 34931878 DOI: 10.1177/1357633x211067074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Group engagement is an important component of video-based telehealth interventions, yet this construct remains understudied. In the present study, we applied a multidimensional conceptualization of group engagement in two video-based telehealth interventions that either aimed to reduce fear of hypoglycemia or diabetes distress in parents of children with type 1 diabetes. We examined variability in group engagement across parents and assessed the relationship between parents' level of group engagement and their treatment outcomes. METHODS Twenty-nine parents participated in one of two manualized, closed-group, telehealth interventions and completed outcome measures pre- and post-treatment. We behaviorally coded telehealth sessions based on six dimensions of group engagement using the Group Engagement Measure (inter-rater reliability = 0.94). We examined correlations between group engagement dimensions, parent psychosocial well-being, and child hemoglobin A1c. Further, we examined independent sample t-tests to assess differences between treatment groups. RESULTS Mean parent age was 37.69 ± 6.83 years, mean child age was 7.69 ± 3.76 years, and mean child hemoglobin A1c was 8.06 ± 1.27% (41.4% had a hemoglobin A1c <7.5%). Parents who spent more time attending to other group member's issues, reported lower hypoglycemia fear at post-treatment, and parents who showed more active support of the group leader's purpose/goals during the session also reported fewer depressive symptoms at post-treatment. DISCUSSION We identify several dimensions of group engagement that are associate with improved parent psychosocial and child hemoglobin A1c outcomes. Intervention designs that use group engagement to guide treatment planning or inform treatment-related decisions in video-based telehealth interventions could help families achieve more optimal treatment outcomes.
Collapse
Affiliation(s)
- Alexandra D Monzon
- University of Kansas College of Liberal Arts and Sciences, Clinical Child Psychology, USA
| | - Mark A Clements
- Children's Mercy Hospital and Clinics, Endocrine/Diabetes Clinical Research, USA
| | - Susana R Patton
- Nemours Children's Health, Nemours Center for Healthcare Delivery Science, USA
| |
Collapse
|
3
|
Samsel C, Reichman JR, Barreto JA, Brown DW, Hummel K, Sleeper LA, Blume ED. The experience of fathers of children hospitalised with advanced heart disease. Cardiol Young 2024:1-5. [PMID: 38196389 DOI: 10.1017/s1047951123004390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
BACKGROUND There are little reported data on the perspectives of fathers caring for children with chronic conditions. Although survival of children with advanced heart disease has improved, long-term morbidity remains high. This study describes the experience and prognostic awareness of fathers of hospitalised children with advanced heart disease. METHODS Cross-sectional survey study of parents caring for children hospitalised with advanced heart disease admitted for ≥ 7 days over a one-year period. One parent per patient completed surveys, resulting in 27 father surveys. Data were analysed using descriptive methods. RESULTS Nearly all (96%) of the fathers reported understanding their child's prognosis "extremely well" or "well," and 59% felt they were "very prepared" for their child's medical problems. However, 58% of fathers wanted to know more about prognosis, and 22% thought their child's team knew something about prognosis that they did not. Forty-one per cent of fathers did not think that their child would have lifelong limitations, and 32% anticipated normal life expectancies. All 13 fathers who had a clinical discussion of what would happen if their child got sicker found this conversation helpful. Nearly half (43%) of the fathers receiving new prognostic information or changes to treatment course found it "somewhat" or "a little" confusing. CONCLUSIONS Fathers report excellent understanding of their child's illness and a positive experience around expressing their hopes and fears. Despite this, there remain many opportunities to improve communication, prognostic awareness, and participation in informed decision-making of fathers of children hospitalised with advanced heart disease.
Collapse
Affiliation(s)
- Chase Samsel
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, USA
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, USA
- Department of Psychiatry, Harvard Medical School, Boston, USA
| | | | - Jessica A Barreto
- Department of Cardiology, Boston Children's Hospital, Boston, USA
- Department of Pediatrics, Harvard Medical School, Boston, USA
| | - David W Brown
- Department of Cardiology, Boston Children's Hospital, Boston, USA
- Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Kevin Hummel
- Department of Pediatrics, University of Utah, Salt Lake City, USA
| | - Lynn A Sleeper
- Department of Cardiology, Boston Children's Hospital, Boston, USA
- Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Elizabeth D Blume
- Department of Cardiology, Boston Children's Hospital, Boston, USA
- Department of Pediatrics, Harvard Medical School, Boston, USA
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Karahan S, Ağadayı E, Sarı SA, Çelik N, Kömürlüoğlu Tan A, Döğer E. Psychometric Properties of the Turkish Validity and Reliability of the Parent Diabetes Distress Scale. J Clin Res Pediatr Endocrinol 2023; 15:293-301. [PMID: 37559365 PMCID: PMC10448560 DOI: 10.4274/jcrpe.galenos.2023.2023-3-20] [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] [Accepted: 07/26/2023] [Indexed: 08/11/2023] Open
Abstract
Objective The aim of this study was to evaluate the validity and reliability of the Turkish translation of the Parent Diabetes Distress Scale (PDDS). Methods The PDDS is a 5-point Likert-type scale with 20 items. After obtaining permission from the scale developers, the study commenced. First, a systematic adaptation of the scale into the Turkish language was performed including translation, expert panel review, back translation, and pilot study. Test-retest was applied to 35 participants. After these procedures, data collection was undertaken using the adapted PDDS and a demographic data collection form. The collected data were analyzed for reliability, including stability of the scale with test-retest and internal consistency of the scale (Cronbach’s α), and validity including construct validity of the scale with confirmatory factor analysis (CFA). Results The parents of 210 teenagers, aged >11 and <18 years, who had been diagnosed with type 1 diabetes mellitus for at least one year were included. Of these parents, 71.9% (n=151) were mothers and 53.3% (n=112) of the children were girls. The Cronbach’s α value was 0.906. The results of the CFA were χ2/df=4.406, p<0.001, comparative fit test 0.704, and goodness of fit tests 0.749. The mean total PDDS score was 2.2±0.7. These results indicate that scores of 1.6 points or less was evaluated as “little or no distress” 1.7-2.4 as “moderate distress,” and >2.4 points as “high distress”. This showed that the majority of the parents in the study experienced moderate or severe diabetes-related distress. Conclusion The Turkish version of the PDDS fulfilled the validity and reliability tests at an acceptable level.
Collapse
Affiliation(s)
- Seher Karahan
- Sivas Cumhuriyet University Faculty of Medicine, Department of Medical Education, Sivas, Turkey
| | - Ezgi Ağadayı
- Sivas Cumhuriyet University Faculty of Medicine, Department of Medical Education, Sivas, Turkey
| | - Seda Aybüke Sarı
- Hatay Mustafa Kemal University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Hatay, Turkey
| | - Nurullah Çelik
- Sivas Cumhuriyet University Faculty of Medicine, Department of Pediatric Endocrinology, Sivas, Turkey
| | - Ayça Kömürlüoğlu Tan
- Sivas Cumhuriyet University Faculty of Medicine, Department of Pediatrics, Sivas, Turkey
| | - Esra Döğer
- Gazi University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
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.
Collapse
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.
| |
Collapse
|
8
|
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).
Collapse
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,
| |
Collapse
|
9
|
Loomba LA, Hughes Lansing A, Cortez JN, Welch K, Solowiejczyk JN, Ghetti S, Styne DM, Glaser NS. Parental marital relationship satisfaction predicts glycemic outcomes in children with type 1 diabetes. J Pediatr Endocrinol Metab 2022; 35:1293-1297. [PMID: 36062303 DOI: 10.1515/jpem-2022-0392] [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: 08/07/2022] [Accepted: 08/13/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Glycemic outcomes in children with type 1 diabetes (T1D) vary widely, despite uniform care. We hypothesized that glycemic outcomes in children with T1D are affected by the marital relationship satisfaction of the child's parents. METHODS We evaluated a prospective sample of 51 families with a child with newly diagnosed T1D, including 36 married parent families. We assessed indicators of marital relationship satisfaction and used multiple regression models to determine whether marital relationship satisfaction at diagnosis was associated with mean HbA1c 18-24 months after diagnosis. RESULTS Marital status and parental relationship satisfaction at the time of the child's T1D diagnosis were associated with HbA1c 18-24 months later. These differences persisted after adjusting for demographic factors associated with glycemia. CONCLUSIONS The quality of the primary diabetes caregiver's relationship with a spouse predicts glycemic outcomes for children with T1D. Interventions to improve spousal relationships and caregiver support could improve glycemic control in children with T1D.
Collapse
Affiliation(s)
- Lindsey A Loomba
- Department of Pediatrics, Section of Endocrinology, University of California Davis Medical Center, Sacramento, CA, USA
| | - Amy Hughes Lansing
- Department of Psychological Science, University of Vermont, Burlington, VT, USA
| | - Justine N Cortez
- Department of Pediatrics, Section of Endocrinology, University of California Davis Medical Center, Sacramento, CA, USA
| | - Kearnan Welch
- Department of Pediatrics, Section of Endocrinology, University of California Davis Medical Center, Sacramento, CA, USA
| | - Joe N Solowiejczyk
- Department of Pediatrics, Section of Endocrinology, University of California Davis Medical Center, Sacramento, CA, USA
| | - Simona Ghetti
- Department of Psychology, Center for Mind and Brain, University of California Davis, Davis, CA, USA
| | - Dennis M Styne
- Department of Pediatrics, Section of Endocrinology, University of California Davis Medical Center, Sacramento, CA, USA
| | - Nicole S Glaser
- Department of Pediatrics, Section of Endocrinology, University of California Davis Medical Center, Sacramento, CA, USA
| |
Collapse
|
10
|
Smith S, Tallon M, Smith J, Angelhoff C, Mörelius E. Parental sleep when their child is sick: A phased principle-based concept analysis. J Sleep Res 2022; 31:e13575. [PMID: 35468663 PMCID: PMC9786861 DOI: 10.1111/jsr.13575] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/28/2022] [Accepted: 02/16/2022] [Indexed: 12/30/2022]
Abstract
Sleep is a common challenge for parents with sick children and can impact parents' health, wellbeing, and caregiving responsibilities. Despite the vast research around parental sleep when their child is sick, the concept is not clearly defined. A phased principle-based concept analysis that includes triangulation of methods and quality criteria assessment was used to explore how the concept is described, used, and measured in the current literature. The aim was to analyse and clarify the conceptual, operational, and theoretical basis of parental sleep when their child is sick to produce an evidence-based definition and to identify knowledge gaps. A systematic literature search including databases CINAHL, Embase, MEDLINE, PsychARTICLES, PsychINFO, Pubmed, Scopus and Web of Science, identified 546 articles. The final dataset comprised 74 articles published between 2005 and 2021 and was assessed using a criteria tool for principle-based concept analysis. Data were managed using NVivo, and thematic analysis was undertaken. A precise definition is not present in the literature. Various tools have been used to measure parents' sleep, as well as exploration via interviews, open-ended questions, and sleep diaries. The terminology used varied. Parental sleep when their child is sick is interrelated with other concepts (e.g., stress). A recommended definition is offered. A conceptual understanding of parental sleep when their child is sick will help to guide translational research and to conduct studies critical to clinical practice and research. Future research includes developing a measurement tool for parental sleep when their child is sick to be used in study design and future interventions.
Collapse
Affiliation(s)
- Stephanie Smith
- School of Nursing and MidwiferyEdith Cowan UniversityPerthWAAustralia,Perth Children's HospitalNedlands, PerthWAAustralia
| | - Mary Tallon
- School of NursingCurtin UniversityPerthWAAustralia
| | - James Smith
- Centre for Precision HealthCollaborative Genomics and Translation GroupSchool of Medical and Health SciencesEdith Cowan UniversityPerthWAAustralia,Centre for Healthcare Resilience and Implementation ScienceAustralian Institute for Health InnovationMacquarie UniversitySydneyNSWAustralia
| | - Charlotte Angelhoff
- Crown Princess Victoria's Child and Youth Hospital and Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Evalotte Mörelius
- School of Nursing and MidwiferyEdith Cowan UniversityPerthWAAustralia,Perth Children's HospitalNedlands, PerthWAAustralia
| |
Collapse
|
11
|
Mathole SH, Deacon E, van Rensburg E. Are fathers involved in diabetes management? A rapid review. JOURNAL OF PSYCHOLOGY IN AFRICA 2022. [DOI: 10.1080/14330237.2022.2120702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Simphiwe Hope Mathole
- Optentia, School for Psychosocial Health, North-West University, Potchefstroom, South Africa
| | - Elmari Deacon
- Optentia, School for Psychosocial Health, North-West University, Potchefstroom, South Africa
| | - Esmé van Rensburg
- Compres, School for Psychosocial Health, North-West University, Potchefstroom, South Africa
| |
Collapse
|
12
|
Zhang L, Xu H, Liu L, Bi Y, Li X, Kan Y, Liu H, Li S, Zou Y, Yuan Y, Gong W, Zhang Y. Related factors associated with fear of hypoglycemia in parents of children and adolescents with type 1 diabetes - A systematic review. J Pediatr Nurs 2022; 66:125-135. [PMID: 35716460 DOI: 10.1016/j.pedn.2022.05.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/09/2022] [Accepted: 05/27/2022] [Indexed: 12/16/2022]
Abstract
PROBLEM Fear of hypoglycemia is a significant concern for parents of children/ adolescents with type 1 diabetes. Although some studies have explained the parental fear of hypoglycemia, the related factors were yet to be determined. This systematic review aims to identify the related factors of fear of hypoglycemia in the parents of children and adolescents with type 1 diabetes and provide a theoretical basis for further intervention. ELIGIBILITY CRITERIA PubMed, MEDLINE, EMBASE, Scopus, CINAHL, EBSCO, Web of Science, and Cochrane Library were systematically searched from 2010 to 2021. Studies evaluating the fear of hypoglycemia of parents and its associated factors were included. SAMPLE Twenty-three observational articles met the criteria. RESULTS Significant associations were found between fear of hypoglycemia and specific factors, including motherhood, nocturnal hypoglycemia, and the number of blood glucose monitoring. Psychological factors, including anxiety, depression, pediatric parenting stress, mindfulness, self-efficacy, quality of life, and sleep disorders, were conclusive and associations with parental fear of hypoglycemia. CONCLUSIONS Understanding parental fear of hypoglycemia can help parents prevent potential problems in diabetes management, thus promoting children's growth. According to current evidence, effective targeted interventions based on modifiable relevant factors can be developed to reduce the fear of hypoglycemia in parents while maintaining optimal blood glucose control in children/ adolescents. IMPLICATIONS Health professionals should pay more attention to the mental health of parents, and parents should be involved in the care plan and have the opportunity to discuss their fear of hypoglycemia in the most appropriate way to manage type 1 diabetes.
Collapse
Affiliation(s)
- Lu Zhang
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Huiwen Xu
- School of Nursing, Yangzhou University, Yangzhou, China; Nagano College of Nursing, Komagane, Nagano 399-4117, Japan
| | - Lin Liu
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yaxin Bi
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Xiangning Li
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yinshi Kan
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Hongyuan Liu
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Shuang Li
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yan Zou
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yuan Yuan
- Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Weijuan Gong
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yu Zhang
- School of Nursing, Yangzhou University, Yangzhou, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, China.
| |
Collapse
|
13
|
Claahsen - van der Grinten HL, Speiser PW, Ahmed SF, Arlt W, Auchus RJ, Falhammar H, Flück CE, Guasti L, Huebner A, Kortmann BBM, Krone N, Merke DP, Miller WL, Nordenström A, Reisch N, Sandberg DE, Stikkelbroeck NMML, Touraine P, Utari A, Wudy SA, White PC. Congenital Adrenal Hyperplasia-Current Insights in Pathophysiology, Diagnostics, and Management. Endocr Rev 2022; 43:91-159. [PMID: 33961029 PMCID: PMC8755999 DOI: 10.1210/endrev/bnab016] [Citation(s) in RCA: 154] [Impact Index Per Article: 77.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Indexed: 11/19/2022]
Abstract
Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders affecting cortisol biosynthesis. Reduced activity of an enzyme required for cortisol production leads to chronic overstimulation of the adrenal cortex and accumulation of precursors proximal to the blocked enzymatic step. The most common form of CAH is caused by steroid 21-hydroxylase deficiency due to mutations in CYP21A2. Since the last publication summarizing CAH in Endocrine Reviews in 2000, there have been numerous new developments. These include more detailed understanding of steroidogenic pathways, refinements in neonatal screening, improved diagnostic measurements utilizing chromatography and mass spectrometry coupled with steroid profiling, and improved genotyping methods. Clinical trials of alternative medications and modes of delivery have been recently completed or are under way. Genetic and cell-based treatments are being explored. A large body of data concerning long-term outcomes in patients affected by CAH, including psychosexual well-being, has been enhanced by the establishment of disease registries. This review provides the reader with current insights in CAH with special attention to these new developments.
Collapse
Affiliation(s)
| | - Phyllis W Speiser
- Cohen Children’s Medical Center of NY, Feinstein Institute, Northwell Health, Zucker School of Medicine, New Hyde Park, NY 11040, USA
| | - S Faisal Ahmed
- Developmental Endocrinology Research Group, School of Medicine Dentistry & Nursing, University of Glasgow, Glasgow, UK
| | - Wiebke Arlt
- Institute of Metabolism and Systems Research (IMSR), College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Richard J Auchus
- Division of Metabolism, Endocrinology, and Diabetes, Departments of Internal Medicine and Pharmacology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Henrik Falhammar
- Department of Molecular Medicine and Surgery, Karolinska Intitutet, Stockholm, Sweden
- Department of Endocrinology, Karolinska University Hospital, Stockholm, Sweden
| | - Christa E Flück
- Pediatric Endocrinology, Diabetology and Metabolism, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Leonardo Guasti
- Centre for Endocrinology, William Harvey Research Institute, Bart’s and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Angela Huebner
- Division of Paediatric Endocrinology and Diabetology, Department of Paediatrics, Universitätsklinikum Dresden, Technische Universität Dresden, Dresden, Germany
| | - Barbara B M Kortmann
- Radboud University Medical Centre, Amalia Childrens Hospital, Department of Pediatric Urology, Nijmegen, The Netherlands
| | - Nils Krone
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
- Department of Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Deborah P Merke
- National Institutes of Health Clinical Center and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA
| | - Walter L Miller
- Department of Pediatrics, Center for Reproductive Sciences, and Institute for Human Genetics, University of California, San Francisco, CA 94143, USA
| | - Anna Nordenström
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Pediatric Endocrinology, Karolinska University Hospital, Stockholm, Sweden
| | - Nicole Reisch
- Medizinische Klinik IV, Klinikum der Universität München, Munich, Germany
| | - David E Sandberg
- Department of Pediatrics, Susan B. Meister Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, MI 48109, USA
| | | | - Philippe Touraine
- Department of Endocrinology and Reproductive Medicine, Center for Rare Endocrine Diseases of Growth and Development, Center for Rare Gynecological Diseases, Hôpital Pitié Salpêtrière, Sorbonne University Medicine, Paris, France
| | - Agustini Utari
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Stefan A Wudy
- Steroid Research & Mass Spectrometry Unit, Laboratory of Translational Hormone Analytics, Division of Paediatric Endocrinology & Diabetology, Justus Liebig University, Giessen, Germany
| | - Perrin C White
- Division of Pediatric Endocrinology, UT Southwestern Medical Center, Dallas TX 75390, USA
| |
Collapse
|
14
|
Supervising Without Controlling: A New Authority intervention for Adolescents with Type 1 Diabetes. JOURNAL OF CHILD AND FAMILY STUDIES 2022. [DOI: 10.1007/s10826-021-02186-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
|
15
|
Nguyen LA, Pouwer F, Lodder P, Hartman E, Winterdijk P, Aanstoot HJ, Nefs G. Depression and anxiety in adolescents with type 1 diabetes and their parents. Pediatr Res 2022; 91:188-196. [PMID: 33664478 DOI: 10.1038/s41390-021-01392-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 12/24/2020] [Accepted: 01/06/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Longitudinal studies including parental distress when examining adverse health outcomes in adolescents with type 1 diabetes are lacking. This study examined whether parental depression and anxiety predict adolescent emotional distress and glycated hemoglobin A1c (HbA1c) 1 year later and whether a relation between parental distress and HbA1c is mediated by the level of parental involvement in diabetes care and by treatment behaviors. METHODS Longitudinal path modeling was applied to data from 154 adolescents and parents from diabetes centers participating in the Longitudinal study of Emotional problems in Adolescents with type 1 diabetes and their Parents/caregivers (Diabetes LEAP). At baseline and 1-year follow-up, participants completed measures of depression and anxiety. HbA1c was extracted from medical charts. Responsibility and treatment behavior questionnaires were completed by adolescents at baseline. RESULTS Baseline parental depressive and anxiety symptoms were not associated with 1-year adolescent depressive symptoms, anxiety symptoms, and HbA1c. Responsibility division and treatment behaviors did not mediate associations between parental emotional distress and 1-year HbA1c. CONCLUSIONS Parental depressive and anxiety symptoms did not predict adolescent health outcomes 1 year later. Future studies may determine whether the link is present in case of mood/anxiety disorders or severe diabetes-specific distress, or whether adolescents are resilient in the face of parental distress. IMPACT Adolescents with T1D are a vulnerable group in terms of psychological and health outcomes. Whether parental emotional distress (i.e., depressive and anxiety symptoms) is prospectively associated with adolescent emotional distress and/or HbA1c has been understudied. Our results show that parental distress was not related to adolescent distress or HbA1c 1 year later. Responsibility division and treatment behaviors did not mediate associations between parental emotional distress and 1-year HbA1c. Future studies could determine whether these links are present in case of mood/anxiety disorders or severe diabetes-specific distress, or whether adolescents are resilient in the face of parental distress.
Collapse
Affiliation(s)
- Linh A Nguyen
- Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders (CoRPS), Tilburg University, Tilburg, The Netherlands.,Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,STENO Diabetes Center Odense, Odense, Denmark.,School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Paul Lodder
- Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders (CoRPS), Tilburg University, Tilburg, The Netherlands.,Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
| | - Esther Hartman
- Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - Per Winterdijk
- National Treatment and Research Center for Children, Adolescents and Adults with Type 1 Diabetes, Rotterdam, The Netherlands
| | - Henk-Jan Aanstoot
- National Treatment and Research Center for Children, Adolescents and Adults with Type 1 Diabetes, Rotterdam, The Netherlands
| | - Giesje Nefs
- Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders (CoRPS), Tilburg University, Tilburg, The Netherlands. .,Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands. .,National Treatment and Research Center for Children, Adolescents and Adults with Type 1 Diabetes, Rotterdam, The Netherlands.
| |
Collapse
|
16
|
Teasdale A, Limbers CA. Online assessment of problem-solving skills among fathers of young and school-age children with type 1 diabetes: Associations with parent and child outcomes. J Child Health Care 2021; 25:379-392. [PMID: 32673074 DOI: 10.1177/1367493520942711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Type 1 diabetes (T1D) is a pediatric chronic illness that is associated with significant parenting stress due to its lifelong course, burdensome disease management, and life-threatening complications. Although mothers of children with T1D have been studied extensively in relation to parenting stress, coping, and diabetes outcomes, there is a need to examine similar variables among fathers. The aim of the present study was to examine if fathers' use of problem-solving skills was related to parenting stress and diabetes regimen adherence and if problem-solving skills moderated the associations between paternal involvement in diabetes care and parenting stress in a national online sample of 215 fathers of children with T1D. Self-report measures completed by fathers through Qualtrics included a demographic and disease-related questionnaire, the Social Problem-Solving Inventory-Revised; Parenting Stress Index-Fourth Edition, Short Form; Pediatric Inventory for Parents; Dads' Active Disease Support Scale; and Self-Care Inventory-Revised. Pearson correlations were computed to assess associations among study variables. Four separate multiple linear regression analyses were conducted to determine the interactive effects of problem-solving skills and paternal involvement on parenting stress. Analyses revealed a large positive correlation between problem-solving skills and general parenting stress (r = .63), and a large negative correlation between problem-solving skills and pediatric parenting stress (r = -.52). The interaction between problem-solving skills and father involvement accounted for a significant amount of variance in a general parenting stress subscale (p < .01) and pediatric parenting stress (p < .05). These results highlight the importance of problem-solving skills for father outcomes in the context of T1D while implicating the potential benefit of a problem-solving intervention for this population.
Collapse
Affiliation(s)
- Ashley Teasdale
- Department of Psychology and Neuroscience, 14643Baylor University, TX, USA
| | | |
Collapse
|
17
|
Ansari AMA, Janahi MI, AlTourah AJ, Jahrami HA, Rajab MB. Self-reported psychological disorders among the mothers of children with autism spectrum disorder, type 1 diabetes mellitus, and typically developed children. J Neurodev Disord 2021; 13:21. [PMID: 34022801 PMCID: PMC8141116 DOI: 10.1186/s11689-021-09369-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 05/13/2021] [Indexed: 11/23/2022] Open
Abstract
Background To assess the prevalence of symptoms of depression, anxiety, and stress among mothers of children with autism spectrum disorders (ASD), type 1 diabetes (DM), and typical development (TD), in a geographical area where such data are lacking Method A descriptive study with the three groups of parents of children with and without a condition was conducted (ASD n=126, group 1; DM n=43, group 2; and TD n= 116, comparative group). Measures of depression, anxiety, and stress were collected to examine the prevalence of factors, difference between groups, and their association with demographic characteristics. Results On the DASS-21, both groups 1 and 2 had higher mean scores for depression (37.86), anxiety (4.58), and stress (29.81) than the control group (P=0.015). On the PSS-14, the mean score was higher in group 2 (28.63) than in group 1 (27.61) and the comparison group (25.87) (P=0.004). On the DASS 21, group 1 scored higher in the depression domain (P=0.046), whereas group 2 scored higher in the anxiety domain (P=0.034) and stress domain (P=0.009) than the TD group. Conclusion Mothers of children with ASD should be assessed for the presence of depression following diagnosis. Mothers of children with type 1 diabetes require careful monitoring for the effects of anxiety and stress on their mental health and therefore their ability to cope with diabetes management plans. Trial registration Not applicable.
Collapse
Affiliation(s)
- Ahmed Malalla Al Ansari
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain.
| | - Mohamed Ismael Janahi
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
| | - Abdulrahman J AlTourah
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
| | - Haitham Ali Jahrami
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain.,Governmental Hospitals, Ministry of Health, Manama, Bahrain
| | - Mansour Bin Rajab
- Department of Pediatrics-Salmaniya Medical Complex, Ministry of Health, Manama, Bahrain
| |
Collapse
|
18
|
Abstract
Studies suggest that the relationship between psychosocial well-being and type 1 diabetes (T1D) is bidirectional, with T1D typically having a negative influence on psychological functioning, which in turn negatively affects the course of T1D. Here, we investigate the potential role of the capacity for mentalizing, or reflective functioning, in children and their mothers in diabetes control. We tested differences in mentalizing as assessed by the Reflective Functioning Scale in two groups of mother-son dyads with good (GDC) versus poor (PDC) diabetes control. Fifty-five boys (8-12 years old) and their mothers were recruited from the Juvenile Diabetes Foundation in Santiago, Chile. The mothers were interviewed with the Parental Development Interview and the children with the Child Attachment Interview, and both were scored for reflective functioning by using the Reflective Functioning Scale. Self-report measures of stress and diabetes outcomes were completed by the mothers and children, and levels of glycated hemoglobin (HbA1c) were assessed as an index of diabetes control. The results showed that both maternal and child reflective functioning were higher in the GDC than the PDC group and were negatively correlated with HbA1c in the total sample. Our findings suggest an important role for mentalizing in diabetes outcomes, but further prospective research is needed.
Collapse
|
19
|
Somanadhan S, Bristow H, Crushell E, Pastores G, Nicholson E, Kroll T, Larkin PJ, Brinkley A. IMPACT study: measuring the impact of caregiving on families and healthcare professionals of children and adults living with mucopolysaccharidoses in Ireland. THERAPEUTIC ADVANCES IN RARE DISEASE 2021; 2:26330040211020764. [PMID: 37181103 PMCID: PMC10032429 DOI: 10.1177/26330040211020764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 05/05/2021] [Indexed: 05/16/2023]
Abstract
Introduction Disease trajectories are often uncertain among individuals living with mucopolysaccharidoses (MPS) due to the progressive nature of the illness and the goal of care. This study investigated the impact on caregivers and care providers of children and adults living with MPS. Methods The study used a cross-sectional design and a convenience sampling strategy which involved two sequential study components. The stage 1 quantitative component included three validated scales: the abbreviated World Health Organization Quality of Life (WHOQOL-BREF), the Paediatric Inventory for Parents (PIP) and the 14-item Resilience Scale (RS-14). The stage 2 qualitative component consisted of two focus groups with healthcare professionals (HCPs) (n = 9) working with children and adults living with MPS across three clinical sites in Ireland. Data were collected between November 2017 and July 2019. Results A total of 31 parents identified as caregivers participated in this study. The mean quality of life (QoL) score was 93.81, indicating a significantly high QoL. The PIP frequency total mean was 102.74 and difficulty mean 104.94. The mean score for the RS-14 was notably high, 81.42 out of a maximum of 98. The majority of the results showed high levels of concern for the future, with just under 50% finding themselves very often feeling scared that their child's condition will deteriorate or that their child will die and finding these thoughts very difficult. The healthcare professionals' (HCPs) perceptions were focused on the complexity of MPS, coping strategies, managing expectations and support services. Conclusion The overall findings of the study reinforced the need for sustained and enhanced psychological support to ensure both families of children and adults living with MPS and the HCPs are supported in the continued delivery of quality patient care and outcomes. Subjective and objective measures from family caregivers and HCPs yield results that can decrease stress and improve psychological support. Plain language summary Impact of caregiving on families and healthcare professionals of children and adults living with mucopolysaccharidoses in Ireland Mucopolysaccharidoses (MPS) is a group of one of the many rare inherited metabolic disorders that come under category three of life-limiting conditions. Children born with this genetic condition show no change at birth, but effects start to show in subsequent years as it is a progressive disease. The severity of the condition varies according to the specific type, ranging from very mild symptoms to, in most cases, multisystemic, restricted growth or mental and physical disabilities. Recent developments in treatments for some forms of MPS have dramatically changed the quality of life (QoL) for patients. Other forms of treatment are currently under investigation and development. This study aimed to provide a detailed and reliable evidence base on the impact of caregiving for patients living with MPS on family caregivers and healthcare providers. Paper questionnaires were completed by the family caregivers of children and adults living with MPS. These three questionnaires focused on measuring QoL, parental stress and anxiety, and resilience among these families. Two focus group interviews were carried out with healthcare professionals working with children and adults living with MPS across three clinical sites in Ireland.A total of 31 parents completed the questionnaires in this study, indicating a significantly high QoL and notably high resilience. The majority of the parental stress results were related to concern for the future, with just half of the families finding themselves very often scared that their child's condition will deteriorate or that their child will die and find these thoughts very difficult. The healthcare providers also spoke about the complexity of MPS, coping strategies, managing expectations and support services for the families of children and adults living with MPS. This study provided evidence for clinicians and policymakers to improve the availability of appropriate healthcare provisions for people living with MPS and their families.
Collapse
Affiliation(s)
- Suja Somanadhan
- UCD School of Nursing, Midwifery and Health
Systems, University College Dublin, Stillorgan Road, Belfield, County Dublin
D04 V1W8, Ireland
| | | | - Ellen Crushell
- CHI at Crumlin, Dublin, Ireland, and CHI at
Temple Street, Dublin, Ireland
| | | | | | - Thilo Kroll
- University College Dublin, Belfield, Dublin,
Ireland
| | | | | |
Collapse
|
20
|
Parental Stress, Anxiety and Depression Symptoms Associated with Self-Efficacy in Paediatric Type 1 Diabetes: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010152. [PMID: 33379307 PMCID: PMC7795592 DOI: 10.3390/ijerph18010152] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/11/2020] [Accepted: 12/22/2020] [Indexed: 01/12/2023]
Abstract
Background: Parents play a significant role in the management and monitoring of their children’s Type 1 diabetes mellitus (T1DM), being considered a family disease. The current review intends to investigate parental stress, depression and anxiety symptoms associated with self-efficacy referred to paediatric diabetes management. Method: A literature review was carried out using PsycINFO, Web of Science and PubMed where the following terms were considered: diabetes mellitus, paediatric, parent-child relationship, self-efficacy, parenting stress, perceived stress, stress, depression, anxiety. Standing a defined list of inclusion and exclusion criteria, a total of 33 papers were finally included. Results: Findings have shown that parents experience relatively high levels of anxiety, depression and stress symptoms related to managing a child with T1DM and are associated with parental self-efficacy. Parental stress predicts a worsening in the control of HbA1c levels, while parental diabetes-specific distress predicts an increase in children depression symptoms. High parental self-efficacy associates with better monitoring, allowing better adherence and more balanced HbA1c levels in the children. Conclusions: Interventions aimed at fostering social support, improving diabetes management, and decreasing perceived stress, might alleviate parents’ psychological symptoms by focusing on increasing their self-efficacy. Digital interventions might also represent valuable solutions to support parents in the management of paediatric diabetes not presented and substantiated in the main text and should not exaggerate the main conclusions.
Collapse
|
21
|
Chen CY, Lo FS, Wang RH. Roles of Emotional Autonomy, Problem-Solving Ability and Parent-Adolescent Relationships on Self-Management of Adolescents with Type 1 Diabetes in Taiwan. J Pediatr Nurs 2020; 55:e263-e269. [PMID: 32493633 DOI: 10.1016/j.pedn.2020.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND High emotional autonomy has a negative association, whereas good problem-solving ability and parent-adolescent relationships have positive association with self-management in adolescents with type 1 diabetes (T1D). Exploring roles of these variables is crucial to design specific interventions to improve self-management in such afflicted adolescents. PURPOSE To explore the roles of emotional autonomy, problem-solving ability and parent-adolescent relationships on self-management in adolescents with T1D. DESIGN AND METHODS Cross-sectional design was used in this study. A total of 242 adolescents with T1D were recruited from an outpatient clinic of a medical center by convenience sampling in Taiwan. Self-reported questionnaires were used to collect personal characteristics, self-management, emotional autonomy, problem-solving ability, and parent-adolescent relationships. RESULTS Hierarchical multiple regressions indicated that body mass index, problem-solving ability, father-adolescent relationship, and emotional autonomy were significant factors associated with self-management. The interactions of emotional autonomy with problem-solving ability and with parent-adolescents relationship were not significantly associated with self-management. The overall model explained 47.5% variance of self-management. CONCLUSIONS High emotional autonomy was significantly associated with poor self-management. Problem-solving ability and father-adolescent relationships could not moderate, but were independently and significantly associated with self-management in adolescents with T1D. PRACTICE IMPLICATION Healthcare providers should evaluate emotional autonomy earlier and provide more timely help to reduce any negative impact on self-management in adolescents with T1D. Improving problem-solving ability and encouraging fathers to develop optimal father-adolescents relationship might be promising strategies to enhance self-management in adolescents with T1D.
Collapse
Affiliation(s)
- Chia-Ying Chen
- Administration Center of Research and Education, Ditmanson Medical Foundation Chai-Yi Christian Hospital, Taiwan.
| | - Fu-Sung Lo
- Division of Endocrinology, Department of Pediatrics, Chang Gung Memorial Hospital, College of Medicine, Chung Gung University, Taiwan.
| | - Ruey-Hsia Wang
- College of Nursing, Kaohsiung Medical University, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Taiwan.
| |
Collapse
|
22
|
Macaulay GC, Boucher SE, Yogarajah A, Galland BC, Wheeler BJ. Sleep and Night-time Caregiving in Parents of Children and Adolescents with Type 1 Diabetes Mellitus - A Qualitative Study. Behav Sleep Med 2020; 18:622-636. [PMID: 31370700 DOI: 10.1080/15402002.2019.1647207] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Type 1 diabetes mellitus (T1DM) is a common chronic illness of childhood, with parents assuming considerable responsibility for night-time diabetes caregiving. This qualitative study explored diabetes-related factors affecting, and solutions proposed to improve, parental sleep. PARTICIPANTS 10 mothers and 10 fathers of children ≤18 years of age with T1DM in Otago, New Zealand. METHODS Semi-structured individual interviews were audio-recorded, transcribed, and systematically coded for themes. Parents completed the Pittsburgh Sleep Quality Index (PSQI) and habitual sleep of parents and children were assessed via 7-day actigraphy. RESULTS Parents (n = 20) and their children with T1DM (n = 16) were aged between 32 and 54 years, and 1 and 17 years, respectively. PSQI revealed poor quality sleep in 13/20 parents. A range of diabetes-related factors, including glucose monitoring and fear of hypoglycemia, contributed to parental sleep disturbance, including awakenings and the perception of "sleeping lightly". Two distinct time periods resulted in greater sleep disturbance, notably, following T1DM diagnosis and when transitioning to using a new diabetes technology. Factors influencing maternal and paternal sleep were similar, but, generally, mothers described greater night-time care burden and sleep disturbance. While the use of diabetes technologies was generally advocated to improve parental sleep and the provision of nocturnal T1DM care, they were also perceived to potentially contribute to parental sleep disturbance. CONCLUSIONS Pediatric diabetes care teams should be aware of diabetes-related factors potentially affecting parental sleep, the mixed impacts of diabetes technologies, and consider tailored parental support and education to reduce the burden of nocturnal care.
Collapse
Affiliation(s)
- Grace C Macaulay
- Department of Women's and Children's Health, University of Otago , Dunedin, New Zealand
| | - Sara E Boucher
- Department of Women's and Children's Health, University of Otago , Dunedin, New Zealand
| | - Ahrabie Yogarajah
- Department of Women's and Children's Health, University of Otago , Dunedin, New Zealand
| | - Barbara C Galland
- Department of Women's and Children's Health, University of Otago , Dunedin, New Zealand
| | - Benjamin J Wheeler
- Department of Women's and Children's Health, University of Otago , Dunedin, New Zealand.,Paediatric Endocrinology, Southern District Health Board , Dunedin, New Zealand
| |
Collapse
|
23
|
Prikken S, Raymaekers K, Oris L, Weets I, Moons P, Luyckx K. Illness intrusiveness in parents of youth with type 1 diabetes: A longitudinal study. Pediatr Diabetes 2020; 21:890-899. [PMID: 32315507 DOI: 10.1111/pedi.13030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 04/07/2020] [Accepted: 04/14/2020] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Type 1 diabetes in youth has a wide-ranging impact on families. This study aimed at a better understanding of experiences and difficulties that parents may encounter in their lives. Parental illness intrusiveness (ie, a parent's perception that the illness of one's child interferes with one's personal life) was prospectively examined in mothers and fathers. METHODS Parental dyads (n = 291) completed four annual questionnaires on parental illness intrusiveness, depressive symptoms, and treatment adherence of their child. Youth reported on their treatment adherence. RESULTS First, cross-lagged models showed that mothers' illness intrusiveness predicted relative increases in both mothers' and fathers' illness intrusiveness over time. Similar effects were found for fathers. Second, paired-samplest tests revealed higher illness intrusiveness in mothers at baseline. Latent growth curve modeling showed that mothers' illness intrusiveness generally decreased over time, while fathers' illness intrusiveness remained constant. Third, from a person-centered approach, multivariate latent class growth analysis identified three classes of parental couples: one with low and decreasing illness intrusiveness (54%), one with slightly elevated illness intrusiveness that remained stable over time (37%), and one with high illness intrusiveness that decreased in mothers but remained stable in fathers (9%). More parental depressive symptoms were reported in this latter class, while treatment adherence did not differ among the classes. CONCLUSIONS Most parents in this sample reported rather low illness intrusiveness over time, yet some experienced a major impact of the illness. Examining parental illness intrusiveness may provide a better understanding of the specific challenges parents are confronted with.
Collapse
Affiliation(s)
- Sofie Prikken
- School Psychology and Development in Context, KU Leuven, Leuven, Belgium.,Research Foundation Flanders, Brussel, Belgium
| | - Koen Raymaekers
- School Psychology and Development in Context, KU Leuven, Leuven, Belgium.,Research Foundation Flanders, Brussel, Belgium
| | - Leen Oris
- School Psychology and Development in Context, KU Leuven, Leuven, Belgium.,Research Foundation Flanders, Brussel, Belgium
| | - Ilse Weets
- Free University Brussels/University Hospital Brussels, Brussel, Belgium
| | - Philip Moons
- School Psychology and Development in Context, KU Leuven, Leuven, Belgium.,Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,Department of Paediatrics and Child Health, University of Cape Town, Rondebosch, South Africa
| | - Koen Luyckx
- School Psychology and Development in Context, KU Leuven, Leuven, Belgium.,UNIBS, University of the Free State, Bloemfontein, South Africa
| |
Collapse
|
24
|
Arabiat D, Al Jabery M, Whitehead L. A concept analysis of psychological distress in parents related to diabetes management in children and adolescents. J SPEC PEDIATR NURS 2020; 25:e12287. [PMID: 31971657 DOI: 10.1111/jspn.12287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To report a concept analysis of parents' psychological distress in the context of diabetes management among children and adolescents. A clear understanding of the possible impact of diabetes management on parents will help to inform how nurses can work with parents to support glycaemic control in children and adolescents. DESIGN AND METHOD Concept analysis using Walker and Avant's eight-stage approach was used as a guiding framework. PubMed, OVID (CINAHL, Medline, PsychInfo), the Cochrane library and the Joanna Briggs library were searched for the past 50 years. RESULTS Thirty-three studies provided data for the concept analysis. Attributes included difficulty coping, changes in emotional status and manifestations of mental health problems. PRACTICE IMPLICATION Based on the literature synthesis, we suggest all facets of distress related to diabetes can in principle be inferred through the proposed relationship between distress and other interactions of individual coping, caring burden and family relational functioning. The proposed conceptual model linking antecedents' factors and individual characteristics of parents to the concepts of psychological distress may assist researchers to design interventions for supporting diabetes management in children and adolescents.
Collapse
Affiliation(s)
- Diana Arabiat
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, western Australia, Australia.,Faculty of Nursing, Maternal and Child Nursing Department, The University of Jordan, Amman, Jordan
| | - Mohammad Al Jabery
- Faculty of Education, Department of Special Education, The University of Jordan, Amman, Jordan
| | - Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, western Australia, Australia.,Postgraduate Centre for Nursing Studies, University of Otago, Christchursch, New Zealand
| |
Collapse
|
25
|
Di Riso D, Bassi G, Mancinelli E, Zaffani S, Salcuni S, Maffeis C. Mothers and Fathers Parenting Stress and Their Perception of Children's Psychosocial Functioning in Paediatric Diabetes: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134734. [PMID: 32630232 PMCID: PMC7369791 DOI: 10.3390/ijerph17134734] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 12/26/2022]
Abstract
(1) Background: In the context of a child with Type 1 Diabetes Mellitus (T1DM), the rearrangement of the family’s lifestyle can account for an increased risk of experiencing psychosocial problems for both child and parents. Those few studies on pediatric diabetes, which focused on parents’ perception of children’s psychological strengths and weaknesses, reported significantly higher rates of children’s emotional and conduct problems associated with an imbalance in the Hemoglobin A1c (HbA1c). The main aim of this paper was to assess the role of parental perception of children’s psychosocial symptoms as a mediator of the perceived parenting stress, considering mother and father separately. (2) Methods: The study involved 12 parent couples (Mothers Mage = 40.25, SD = 6.58; Fathers Mage = 42.5, SD = 6.38) of children with T1DM aged between 7 and 11 years (Mage = 8.8, SD = 0.996). Parents completed questionnaires such as the Strengths and Difficulties Questionnaire for parents and their perspective of their child, and the Parenting Stress Index–Short Form. (3) Results: Mothers and fathers had significant differences in the perception of their child’s internalizing symptoms. Specifically, mothers present a greater perception of the mentioned symptoms compared to fathers. Mediation models showed that only for fathers’ perception of the child conduct problems has a significant role between the fathers’ perception of dysfunctional interaction with the child and the HbA1c. (4) Conclusions: The current study provides useful evidence also for clinical settings, suggesting that an interesting interplay between parenting stress, perception of children’s symptoms and glucometabolic control should be taken into consideration.
Collapse
Affiliation(s)
- Daniela Di Riso
- Department of Developmental Psychology and Socialization, University of Padova, 35122 Padova, Italy; (D.D.R.); (S.S.)
| | - Giulia Bassi
- Department of Developmental Psychology and Socialization, University of Padova, 35122 Padova, Italy; (D.D.R.); (S.S.)
- Fondazione Bruno Kessler, 38123 Trento, Italy
- Correspondence:
| | - Elisa Mancinelli
- Department of General Psychology, University of Padova, 35131 Padova, Italy;
| | - Silvana Zaffani
- Pediatric Diabetes and Metabolic Disorders Unit, Department of Surgery, Dentistry, Pediatrics and Gynaecology, University-Hospital of Verona, 37126 Verona, Italy; (S.Z.); (C.M.)
| | - Silvia Salcuni
- Department of Developmental Psychology and Socialization, University of Padova, 35122 Padova, Italy; (D.D.R.); (S.S.)
| | - Claudio Maffeis
- Pediatric Diabetes and Metabolic Disorders Unit, Department of Surgery, Dentistry, Pediatrics and Gynaecology, University-Hospital of Verona, 37126 Verona, Italy; (S.Z.); (C.M.)
| |
Collapse
|
26
|
Van Gampelaere C, Luyckx K, van der Straaten S, Laridaen J, Goethals ER, Casteels K, Vanbesien J, den Brinker M, Depoorter S, Klink D, Cools M, Goubert L. Families with pediatric type 1 diabetes: A comparison with the general population on child well-being, parental distress, and parenting behavior. Pediatr Diabetes 2020; 21:395-408. [PMID: 31697435 DOI: 10.1111/pedi.12942] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 10/18/2019] [Accepted: 10/28/2019] [Indexed: 12/14/2022] Open
Abstract
AIMS The aim of this study was to compare families with a child (2-12 years) with type 1 diabetes (T1D) to families which are not confronted with chronic illness, with regard to children's well-being, parental distress, and parenting behavior. In addition, differences were explored between families whose child has optimal vs suboptimal glycemic control. METHODS Mothers, fathers, and children of 105 families with pediatric T1D completed questionnaires assessing child well-being, parental distress, and parenting. The control group consisted of 414 families without chronic illness. RESULTS With regard to child well-being, children with T1D had more adjustment difficulties (as reported by mothers) and lower quality of life (QoL) (as reported by mothers and fathers), whereas children themselves (8-12 years) reported higher QoL compared to controls. In terms of parental distress, mothers, but not fathers, of children with T1D reported more stress, anxiety symptoms, and depressive symptoms than controls. With regard to parenting behavior, parent reports revealed less protectiveness in fathers and less autonomy support and responsiveness in both parents as compared to controls. No differences were found in parent-reported psychological control between parents of children with and without T1D, but children with T1D perceived lowered parental psychological control. Lastly, secondary analyses indicated that especially families with suboptimal child glycemic control showed more maternal distress and worse child well-being (according to parents). CONCLUSIONS Families confronted with pediatric T1D differ from families without chronic illness: childhood T1D impacts parental perceptions of child well-being and differentially affects mothers' and fathers' distress levels and behaviors.
Collapse
Affiliation(s)
- Cynthia Van Gampelaere
- Department of Experimental, Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Koen Luyckx
- Department of School Psychology and Development in Context, University of Leuven, Leuven, Belgium.,UNIBS, University of the Free State, Bloemfontein, South Africa
| | - Saskia van der Straaten
- Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Jolien Laridaen
- Department of Medical Child and Adolescent Psychology, Ghent University Hospital, Ghent, Belgium
| | - Eveline R Goethals
- Department of School Psychology and Development in Context, University of Leuven, Leuven, Belgium.,Department of Pediatric Diabetes, University Hospital Leuven, Leuven, Belgium.,Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
| | - Kristina Casteels
- Department of Pediatric Diabetes, University Hospital Leuven, Leuven, Belgium.,Department of Development and Regeneration, University of Leuven, Leuven, Belgium
| | - Jesse Vanbesien
- Department of Pediatrics, University Hospital Brussels, Brussel, Belgium
| | - Marieke den Brinker
- Department of Pediatrics Division of Pediatric Endocrinology and Diabetology, University Hospital Antwerp, Edegem, Belgium
| | - Sylvia Depoorter
- Department of Child Endocrinology, General Hospital Sint-Jan Bruges-Ostend, Bruges, Belgium
| | - Daniel Klink
- Department of Child Endocrinology, Queen Paola Children's Hospital, Antwerp, Belgium
| | - Martine Cools
- Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Ghent, Belgium.,Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental, Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | | |
Collapse
|
27
|
Madrigal MA, López M, Sánchez A, Cao MJ, Castro MJ, Jiménez JM. Type 1 Diabetes Mellitus in Pediatric Patients and Its Impact on Relationships in the Family Environment. Diabetes Metab Syndr Obes 2020; 13:4973-4980. [PMID: 33364801 PMCID: PMC7751600 DOI: 10.2147/dmso.s281949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/29/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of this study is to assess the impact of type 1 diabetes mellitus on family environment relationships, as well as the management and approach to this disease. PATIENTS AND METHODS One hundred one children, 52.47% male and 47.52% female, with an average age of 8.55 ± 4.01 years, diagnosis of type 1 diabetes mellitus. Quantitative cross-sectional descriptive study was conducted using the validated questionnaires "Modified Diabetes Quality of Life" and "Questionnaire for the assessment of psychological impact in parents/guardians of diabetic children". RESULTS Most of the children (70.3% versus 29.7%) identified diabetes as unpleasant or not fun. The ≤5-year-olds expressed that they felt concerned about the consequences of being diabetic (8.1% by age group), as opposed to the 10-year-olds who did not feel concerned (85.1% by age group), P <0.001. The family environment was affected in 98.1% (n=99) of the cases. CONCLUSION Self-care of type 1 diabetes mellitus in pediatric patients is a complex process that impacts the family environment and their relationship with their peers, especially for children under the age of 5. Fear, concern and insecurity were prevalent feelings in children suffering type 1 diabetes mellitus.
Collapse
Affiliation(s)
- Miguel Angel Madrigal
- Faculty of Nursing, Universidad de Valladolid, Valladolid, Spain
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - María López
- Faculty of Nursing, Universidad de Valladolid, Valladolid, Spain
- Correspondence: María LópezFaculty of Nursing, Universidad de Valladolid, Avda Ramón y Cajal, Nº 7, Valladolid, SpainTel +34 983184056 Email
| | - Alicia Sánchez
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - María José Cao
- Faculty of Nursing, Universidad de Valladolid, Valladolid, Spain
| | | | | |
Collapse
|
28
|
Jaser SS, Hamburger ER, Pagoto S, Williams R, Meyn A, Jones AC, Simmons JH. Communication and coping intervention for mothers of adolescents with type 1 diabetes: Rationale and trial design. Contemp Clin Trials 2019; 85:105844. [PMID: 31499228 DOI: 10.1016/j.cct.2019.105844] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/03/2019] [Accepted: 09/04/2019] [Indexed: 12/21/2022]
Abstract
Mothers of adolescents with type 1 diabetes (T1D) experience high rates of depressive symptoms and diabetes distress, which are established risk factors for deteriorating glycemic control, problems with adherence, increased depressive symptoms, and poor quality of life in adolescents. Given that adolescents are a high-risk population for suboptimal glycemic control, novel interventions to improve outcomes in adolescents with T1D are needed. Building on effective interventions to treat depression in adults, and our own pilot work in this population, we developed a cognitive behavioral intervention, Communication & Coping, to target maternal depressive symptoms and parenting behaviors. The randomized controlled trial compares the telephone and Facebook-delivered Communication & Coping intervention, which promotes the use of adaptive coping strategies and positive parenting practices, to a diabetes education control condition on diabetes outcomes and psychosocial outcomes in adolescents with T1D. This paper describes the study rationale, trial design, and methodology.
Collapse
|
29
|
Systematic Review of Father Involvement and Child Outcomes in Pediatric Chronic Illness Populations. J Clin Psychol Med Settings 2019; 27:89-106. [PMID: 31077009 DOI: 10.1007/s10880-019-09623-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The overall objective of this paper was to systematically review and synthesize the emerging literature investigating the role of father involvement in pediatric outcomes among chronic illness populations. This review sought to answer the following questions: (1) what measures are used to assess father involvement in pediatric chronic illness populations, and who is the respondent, and (2) how is father involvement associated with child psychosocial and health related outcomes in pediatric chronic illness populations? Databases were searched using a key word search strategy. Articles were screened according to exclusion criteria, resulting in 15 identified articles that included a pediatric illness population, and assessed both father involvement and a child outcome variable. Qualitative analysis revealed that several measures have been used to assess father involvement in pediatric chronic illness populations. As a whole, the majority of findings indicate that better outcomes are associated with more father involvement in illness and non-illness related activities, and higher father-child relationship quality. Contradictory findings may be due to the quality of the involvement being assessed, or the possibility that father's become more involved with illness tasks in response to their child's poorer health outcomes. Future research should include the development and use of psychometrically sound measures of father involvement and employ more diverse samples with rigorous methodology.
Collapse
|
30
|
Bekker CI, Deacon E, Segal D. Meaning in life experienced by parents of children living with diabetes. Health Psychol Open 2019; 6:2055102919832221. [PMID: 30858981 PMCID: PMC6402055 DOI: 10.1177/2055102919832221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
In this study, nine parents of children living with well-controlled diabetes participated in semi-structured interviews to explore how they make meaning of living with a child with diabetes. Creating a state of normalcy that incorporates the diabetes care plan, empowering their children to successful transition to independent care, positive relationships with their medical team as well as acquiring and sharing diabetes-related knowledge and skills add to the meaning in life of these parents. Health practitioners should facilitate conversations with parents to help them realise their motivation for adhering to the diabetes care plan.
Collapse
|
31
|
Schiaffini R, Carducci C, Cianfarani S, Mauti M, Nicolais G. Post-traumatic Stress Disorder in Children Affected by Type 1 Diabetes and Their Parents. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s42399-019-0049-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
32
|
Monzon A, McDonough R, Meltzer LJ, Patton SR. Sleep and type 1 diabetes in children and adolescents: Proposed theoretical model and clinical implications. Pediatr Diabetes 2019; 20:78-85. [PMID: 30447038 DOI: 10.1111/pedi.12797] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 10/17/2018] [Accepted: 10/23/2018] [Indexed: 01/01/2023] Open
Abstract
Youth with type 1 diabetes mellitus (T1D) experience more sleep disturbances and shorter sleep durations compared to their healthy peers. Researchers have now uncovered the negative mental health and physical health outcomes associated with poor sleep in youth with T1D. The field of T1D sleep research currently operates under the broad notion that sleep behaviors impact treatment adherence, which ultimately lead to worse long-term health outcomes. This model however does not explain how behavior influences T1D management and sleep outcomes on a day-to-day basis, leading to difficulties in providing tailored treatment recommendations. In this review, we present a theoretical framework that describes the recursive cycle between sleep behaviors, T1D outcomes, and symptoms of negative affect/stress over a 24-hour period. This model is guided by the sleep literature, showing a clear relationship between poor sleep and negative affect, and the T1D literature demonstrating a link between poor sleep and disease management for youth with T1D. Further, emerging literature indicates a need for additional parent sleep assessment considering that T1D management and fear of hypoglycemia negatively impact parent sleep behaviors. Recommendations are provided to move the field toward effective intervention studies and new areas of research to evaluate and modify the proposed model.
Collapse
Affiliation(s)
- Alexandra Monzon
- Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas
| | - Ryan McDonough
- Division of Endocrinology & Diabetes, Department of Pediatrics, Children's Mercy-Kansas City, Kansas City, Missouri
| | - Lisa J Meltzer
- Department of Pediatrics, National Jewish Health, Denver, Colorado
| | - Susana R Patton
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas
| |
Collapse
|
33
|
Prikken S, Oris L, Rassart J, Missotten LC, Weets I, Moons P, Goubert L, Luyckx K. Parental illness intrusiveness and youth glycaemic control in type 1 diabetes: intergenerational associations and processes. Psychol Health 2019; 34:438-455. [PMID: 30636450 DOI: 10.1080/08870446.2018.1538451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This study examined associations between the functioning of youth with type 1 diabetes and their parents, including parenting dimensions as intervening mechanisms. The study adds to the existing literature by focusing on (1) the concept of parental illness intrusiveness; (2) the (understudied) periods of adolescence and emerging adulthood; and (3) maternal and paternal functioning. DESIGN Questionnaires were completed by 317 patient-mother dyads and 277 patient-father dyads. All patients (aged 14-25) had type 1 diabetes. The hypothesised model was compared to an alternative model using structural equation modelling. MAIN OUTCOME MEASURES Youth reported on depressive symptoms and treatment adherence; Physicians provided HbA1c-values. Parents reported on illness intrusiveness, depressive symptoms, and their child's treatment adherence. Patients and parents reported on psychological control and overprotection. RESULTS The hypothesised path model had a good fit to the data. Parental illness intrusiveness was positively associated with depressive symptoms and both were positively related to overprotection and psychological control. Psychological control was positively related to patients' depressive symptoms and negatively to treatment adherence. Poorer treatment adherence was associated with worse HbA1c-values. CONCLUSION These findings underscore the relevance of parental illness intrusiveness and emphasise the importance of mothers' and fathers' roles throughout adolescence and emerging adulthood.
Collapse
Affiliation(s)
- Sofie Prikken
- a KU Leuven , Leuven , Belgium.,b Fonds Wetenschappelijk Onderzoek Vlaanderen , Brussels , Belgium
| | - Leen Oris
- a KU Leuven , Leuven , Belgium.,b Fonds Wetenschappelijk Onderzoek Vlaanderen , Brussels , Belgium
| | - Jessica Rassart
- a KU Leuven , Leuven , Belgium.,b Fonds Wetenschappelijk Onderzoek Vlaanderen , Brussels , Belgium
| | | | - Ilse Weets
- c Free University Brussels , Brussels , Belgium
| | - Philip Moons
- a KU Leuven , Leuven , Belgium.,d University of Gothenburg , Gothenburg , Sweden
| | | | | |
Collapse
|
34
|
Teasdale A, Limbers C. Avoidant coping moderates the relationship between paternal involvement in the child's type 1 diabetes (T1D) care and parenting stress. J Child Health Care 2018; 22:606-618. [PMID: 29606015 DOI: 10.1177/1367493518767068] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Fathers may experience greater parenting stress and anxiety when they are more involved in their child's type 1 diabetes (T1D) care. The present study evaluated whether seeking social support and avoidant coping strategies moderate the relationship between paternal involvement in the child's T1D care and parenting stress in an international sample. Two hundred forty-nine fathers of young children with T1D completed the Parenting Stress Index (PSI), Pediatric Inventory for Parents (PIP), Dads' Active Disease Support scale (DADS), COPE Inventory, Self-Care Inventory (SCI-R), and a demographic questionnaire online. Pearson's product moment correlations were computed, and multiple linear regression analysis was conducted with three separate models in which the PSI Child Domain, PIP Frequency, and PIP Difficulty scores represented different parenting stress outcomes. The interaction between use of denial coping and DADS Involvement was significantly correlated with general parenting stress (p < .05). There were no significant interactions between instrumental social support and DADS Involvement; however, use of instrumental social support coping was significantly correlated with difficulty of pediatric parenting stress (p < .05), DADS Involvement (p < .001), and SCI-R better adherence to the child diabetes treatment regimen (p < .001). Avoidant coping strategies are associated with more general parenting stress, especially when fathers are more involved in T1D management.
Collapse
Affiliation(s)
- Ashley Teasdale
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
| | - Christine Limbers
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
| |
Collapse
|
35
|
Olsson C, Björk M, Ringnér A. The Pediatric Inventory for Parents - Swedish Translation and Psychometric Testing. J Pediatr Nurs 2018; 42:e97-e102. [PMID: 29627285 DOI: 10.1016/j.pedn.2018.02.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 02/16/2018] [Accepted: 02/16/2018] [Indexed: 10/17/2022]
Abstract
UNLABELLED The Pediatric Inventory for Parents (PIP) measures parental stress related to caring for a child with an illness. However, no Swedish translation is available. PURPOSE This study reports a Swedish translation of the PIP and psychometric properties of the instrument. DESIGN AND METHODS This is a descriptive/methodological paper. The PIP was translated and culturally adapted to Swedish, and comprehensibility was tested. Data were collected twice from 48 parents of children with different illnesses, and initial psychometric properties of the instrument were examined. The IES-R (Impact of Event Scale-Revised) was used for concurrent validity. RESULTS The Swedish version of the PIP demonstrated good correlations with the IES-R, and temporal changes were similar. Endorsement frequencies and test-retest were also satisfactory. When comparing groups of parents, the parents of children with cancer were statistically significantly more distressed, both on total score and for emotional distress and role function. Discriminative validity was demonstrated by comparing parents of children with cancer with parents of children with other diseases. CONCLUSIONS The Swedish version of the PIP seems to be a valid and reliable instrument. However, as we used relatively small sample, for the future, we suggest further testing with larger samples. PRACTICE IMPLICATIONS Clinicians and researchers seeking to measure parental distress in chronic illness could use the Swedish version of the PIP.
Collapse
Affiliation(s)
- Cecilia Olsson
- Karlstad University, Department of Health Sciences, Karlstad, Sweden.
| | - Maria Björk
- Jönköping University, CHILD research group, Department of Nursing, School of Health and Welfare, Jönköping, Sweden.
| | - Anders Ringnér
- Umeå University, Department of Nursing, Umeå, Sweden; Umeå University Hospital, Department of Pediatrics, Umeå, Sweden.
| |
Collapse
|
36
|
Limbers CA, Teasdale A. Parenting Stress in Fathers of Children With Type 1 Diabetes. FAMILY & COMMUNITY HEALTH 2018; 41:117-122. [PMID: 29461360 DOI: 10.1097/fch.0000000000000185] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The purpose of the present study was to evaluate generic and pediatric parenting stress in an international sample of fathers of children with type 1 diabetes. Two-hundred forty-nine fathers of children ages 2 to 10 years with type 1 diabetes completed the Parenting Stress Index, Pediatric Inventory for Parents, Dads' Active Disease Support Scale (DADS), Self-Care Inventory, and a demographic/disease-related questionnaire online. More frequency of pediatric parenting stress was associated with greater general parenting stress (r = -0.25, P < .001), DADS Involvement (r = 0.18, P < .01). The present findings suggest that paternal involvement in management of the child's T1 can have meaningful implications for disease management outcomes.
Collapse
|
37
|
Berg CA, Butner J, Wiebe DJ, Lansing AH, Osborn P, King PS, Palmer DL, Butler JM. Developmental model of parent-child coordination for self-regulation across childhood and into emerging adulthood: Type 1 diabetes management as an example. DEVELOPMENTAL REVIEW 2017; 46:1-26. [DOI: 10.1016/j.dr.2017.09.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
38
|
Sand P, Blom MD, Forsander G, Lundin CS. Family dynamics when a child becomes chronically ill: Impact of type 1 diabetes onset in children and adolescents. NORDIC PSYCHOLOGY 2017. [DOI: 10.1080/19012276.2017.1362990] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Peter Sand
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Stora Nygatan 171/2, Göteborg 411 08, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Gun Forsander
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Stora Nygatan 171/2, Göteborg 411 08, Sweden
| | - Carina Sparud Lundin
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
39
|
Martinez-Perez P, Orozco-Beltran D, Carratalá-Munuera C, Pomares-Gomez F, Morisky D. Adherence to insulin therapeutic regims in patients with type 1 diabetes. A nationwide survey in brazil-Comment on Gomes et al. Diabetes Res Clin Pract 2017; 128:136-137. [PMID: 28238443 DOI: 10.1016/j.diabres.2017.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 01/24/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Pablo Martinez-Perez
- Catedra de Medicina de Familia, Clinical Medicine Department, Miguel Hernandez University, Carretera Nacional 332, Alicante-Valencia s/n, 03550 San Juan de Alicante, Spain.
| | - Domingo Orozco-Beltran
- Catedra de Medicina de Familia, Clinical Medicine Department, Miguel Hernandez University, Carretera Nacional 332, Alicante-Valencia s/n, 03550 San Juan de Alicante, Spain
| | - Concepción Carratalá-Munuera
- Catedra de Medicina de Familia, Clinical Medicine Department, Miguel Hernandez University, Carretera Nacional 332, Alicante-Valencia s/n, 03550 San Juan de Alicante, Spain
| | | | - Donald Morisky
- Department of Community Health Sciences, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, United States
| |
Collapse
|
40
|
Nieuwesteeg A, Hartman E, Emons W, van Bakel H, Aanstoot HJ, van Mil E, Pouwer F. Paediatric parenting stress in fathers and mothers of young children with Type 1 diabetes: a longitudinal study. Diabet Med 2017; 34:821-827. [PMID: 27973688 DOI: 10.1111/dme.13300] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 10/27/2016] [Accepted: 12/08/2016] [Indexed: 01/02/2023]
Abstract
AIM To compare levels of paediatric parenting stress in the fathers and mothers of young children with Type 1 diabetes and study the variation in this stress over time. METHODS One hundred and twelve parents (56 mothers and 56 fathers) of young children (0-7 years) with Type 1 diabetes participated in this study. They completed the Pediatric Inventory for Parents to assess paediatric parenting stress (frequency and difficulty scores on the Communication, Emotional Distress, Medical Care and Role Functioning subscales and Total Score); 44 mothers (79%) and 31 fathers (55%) completed the questionnaire again, 1 year later. Independent and paired sample t-tests were used to examine the differences between fathers and mothers and the changes over time. Cohen's d effect sizes were also calculated. RESULTS Mothers scored significantly higher than fathers on the stress subscales for Communication frequency and difficulty, Emotional Distress frequency and difficulty, Medical Care frequency and Total Score frequency and difficulty (d ranged from -0.44 to -0.56). Furthermore, fathers reported a decrease in Medical Care frequency (d = 0.10) and an increase in Emotional Distress difficulty (d = -0.32) and Total Score difficulty (d = -0.29), whereas mothers reported a decrease in Emotional Distress frequency, Medical Care frequency and Total Score frequency (d ranged from 0.31 to 0.66) over a 1-year period. CONCLUSIONS These results show that within families with a young child with Type 1 diabetes, the burden of care increases in fathers and decreases in mothers, suggesting that fathers assume more responsibility for care of their child with Type 1 diabetes as the child grows.
Collapse
Affiliation(s)
- A Nieuwesteeg
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - E Hartman
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - W Emons
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
| | - H van Bakel
- Department of Tranzo, Scientific Center for Care and Welfare, Tilburg University, Tilburg, The Netherlands
| | | | - E van Mil
- Kidz&Ko, Jeroen Bosch Hospital, Hertogenbosch, The Netherlands
| | - F Pouwer
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| |
Collapse
|
41
|
Family Impact and Infant Emotional Outcomes Following Diagnosis of Serious Liver Disease or Transplantation in Infancy. J Pediatr Gastroenterol Nutr 2017; 64:528-532. [PMID: 27673709 DOI: 10.1097/mpg.0000000000001404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES Research is lacking into the emotional effects on families of serious chronic illness in infants. We examined the effect of the diagnosis of serious liver disease in infants upon parent psychological symptoms and family functioning. We hypothesized that parent psychological symptoms, family functioning, and father engagement will predict infant emotional outcomes. METHODS Parents of infants recently diagnosed with serious liver disease completed validated questionnaires about parent stress, family function, impact of the illness on the family, and father engagement. The measures were repeated after 1 year, with the addition of the Child Behavior Checklist (CBCL). RESULTS Parents of 37 infants participated. Parent stress and family functioning scores were not elevated. Parent psychological symptoms, family function, and father engagement did not predict infant outcome. For mothers, infant diagnosis other than biliary atresia, number of outpatient visits, and impact of the illness on the family explained 32% of the variation in CBCL (P = 0.001). For fathers, socioeconomic status, infant diagnosis other than biliary atresia, whether the infant had had a transplant, and impact of the illness on the family explained 44% of the variation in CBCL (P < 0.001). CONCLUSIONS Parents and families appear to be resilient in coping with serious infant illness. Infant diagnosis other than biliary atresia and parental perceptions of high impact of the illness on the family are indicators of negative emotional outcomes for infants with serious liver disease. Psychosocial interventions for infants with chronic illness should target reducing the impact of illness on the family.
Collapse
|
42
|
Markowitz B, Parsons JA, Advani A. Diabetes in Emerging Adulthood: Transitions Lost in Translation. Can J Diabetes 2016; 41:1-5. [PMID: 27658766 DOI: 10.1016/j.jcjd.2016.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 05/03/2016] [Accepted: 06/07/2016] [Indexed: 12/25/2022]
Affiliation(s)
- Benjamin Markowitz
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Janet A Parsons
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Physical Therapy and the Rehabilitation Science Institute, University of Toronto, Toronto, Ontario, Canada
| | - Andrew Advani
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
| |
Collapse
|
43
|
Diabetes MILES Youth-Australia: methods and sample characteristics of a national survey of the psychological aspects of living with type 1 diabetes in Australian youth and their parents. BMC Psychol 2016; 4:42. [PMID: 27519408 PMCID: PMC4983064 DOI: 10.1186/s40359-016-0149-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 08/03/2016] [Indexed: 12/31/2022] Open
Abstract
Background Type 1 diabetes is a complex and demanding condition, which places a substantial behavioural and psychological burden on young people and their families. Around one-third of adolescents with type 1 diabetes need mental health support. Parents of a child with type 1 diabetes are also at increased risk of psychological distress. A better understanding of the motivators, behaviours and psychological well-being of young people with diabetes and their parents will inform improvement of resources for supporting self-management and reducing the burden of diabetes. The Diabetes MILES (Management and Impact for Long-term Empowerment and Success) Youth–Australia Study is the first large-scale, national survey of the impact of diabetes on the psychosocial outcomes of Australian adolescents with type 1 diabetes and their parents. Methods/design The survey was web-based to enable a large-scale, national survey to be undertaken. Recruitment involved multiple strategies: postal invitations; articles in consumer magazines; advertising in diabetes clinics; social media (e.g. Facebook, Twitter). Recruitment began in August 2014 and the survey was available online for approximately 8 weeks. A total of 781 young people (aged 10–19 years) with type 1 diabetes and 826 parents completed the survey. Both genders, all ages within the relevant range, and all Australian states and territories were represented, although compared to the general Australian population of youth with type 1 diabetes, respondents were from a relatively advantaged socioeconomic background. Discussion The online survey format was a successful and economical approach for engaging young people with type 1 diabetes and their parents. This rich quantitative and qualitative dataset focuses not only on diabetes management and healthcare access but also on important psychosocial factors (e.g. social support, general emotional well-being, and diabetes distress). Analysis of the Diabetes MILES Youth–Australia Study data is ongoing, and will provide further insights into the psychosocial problems facing young people with type 1 diabetes and their parents. These will inform future research and support services to meet the needs of young Australians with type 1 diabetes and their families. Electronic supplementary material The online version of this article (doi:10.1186/s40359-016-0149-9) contains supplementary material, which is available to authorized users.
Collapse
|
44
|
Ramchandani N, Maguire LL, Stern K, Quintos JB, Lee M, Sullivan-Bolyai S. PETS-D (parents education through simulation-diabetes): Parents' qualitative results. PATIENT EDUCATION AND COUNSELING 2016; 99:1362-7. [PMID: 27021779 PMCID: PMC4931973 DOI: 10.1016/j.pec.2016.03.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 03/12/2016] [Accepted: 03/18/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Parents who have a child newly diagnosed with type 1 diabetes (T1D) must quickly learn daily diabetes self-management. An RCT was conducted using human patient simulation (HPS) to enhance parents learning diabetes self-management with children with new-onset T1D. The purpose of this study was to describe parents' perspectives of using HPS to augment diabetes education. METHODS A qualitative descriptive design was used with open-ended in-depth interviews of parents (n=49) post-intervention. Qualitative directed content analysis was used. RESULTS The majority of parents were positive about learning with HPS. Although a few parents said the HPS was "hokey" or "creepy," most reported the visual and hands-on learning was realistic and very beneficial. Seeing a seizure increased their fear although they would have panicked if they had not had that learning experience, and it helped build their diabetes self-management confidence. Recommendations included teaching others with the HPS (grandparents, siblings, babysitters, and school nurses). CONCLUSION HPS-enhanced education is an acceptable and viable option that was generally well-received by parents of children with new-onset T1D. PRACTICE IMPLICATIONS The technique should be studied with parents of children with other chronic illnesses to see if the benefits found in this study are applicable to other settings.
Collapse
Affiliation(s)
| | | | - Kailyn Stern
- New York University College of Nursing, NY, NY, USA
| | | | - Mary Lee
- University of Massachusetts Worcester, Worcester, MA, USA
| | | |
Collapse
|
45
|
Pate T, Klemenčič S, Battelino T, Bratina N. Fear of hypoglycemia, anxiety, and subjective well-being in parents of children and adolescents with type 1 diabetes. J Health Psychol 2016; 24:209-218. [PMID: 27278280 DOI: 10.1177/1359105316650931] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study explored the association between parental fear of hypoglycemia, anxiety, and subjective well-being in parents of children and adolescents with type 1 diabetes. A total of 120 mothers and 79 fathers participated. Mothers' and fathers' fear of hypoglycemia was significantly associated with anxiety and negative affect as well as with worse glycemic control in child. Paired-samples t-test showed that mothers were more involved in diabetes management and reported more fear and anxiety compared to fathers, but they did not differ in worries about hypoglycemia. The findings suggest screening for fear of hypoglycemia and subjective well-being in all parents regardless of whether their child experienced severe hypoglycemia.
Collapse
Affiliation(s)
- Tanja Pate
- 1 University of Ljubljana, Slovenia.,2 Franciscan Family Institute, Slovenia
| | | | - Tadej Battelino
- 1 University of Ljubljana, Slovenia.,3 University Children's Hospital, Slovenia
| | | |
Collapse
|
46
|
Grover S, Bhadada S, Kate N, Sarkar S, Bhansali A, Avasthi A, Sharma S, Goel R. Coping and caregiving experience of parents of children and adolescents with type-1 diabetes: An exploratory study. Perspect Clin Res 2016; 7:32-9. [PMID: 26955574 PMCID: PMC4763515 DOI: 10.4103/2229-3485.173776] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aims: To assess the coping strategies and the relationship of coping with subjective burden and positive caregiving consequences as perceived by the caregivers of children and adolescents with Type-1 diabetes. Design: Cross-sectional assessment. Setting: Outpatient of Endocrinology Department. Participants: Forty-one parents of children and adolescents with Type-1 diabetes Main Outcome Measure: Ways of coping checklist (WCC), involvement evaluation questionnaire (IEQ) and scale for assessment of positive aspects of caregiving experience (scale for positive aspects of caregiving experience) to study the coping, burden and positive aspects of caregiving respectively. Results: On WCC, the highest score was obtained for seeking social support, followed by planful problem-solving. More frequent use of coping strategies of confrontation and escape-avoidance was associated with significantly higher score on the tension domain of IEQ. Those who more frequently used problem-solving and distancing had significantly higher scores on worrying-urging-I domain of IEQ. supervision domain of IEQ was associated with more frequent use of confrontation, self-control, social support, escape-avoidance and positive reappraisal. More frequent use of distancing and problem-solving were associated with lower caregiving personal gains. More frequent use of problem-solving was associated with higher caregiver satisfaction and lower scores in the domain of self-esteem and social aspects of caring. Conclusion: Caregivers of patients with Type-1 diabetes predominantly use adaptive coping strategies. Higher use of certain coping strategies is associated with negative and positive caregiving consequences.
Collapse
Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjay Bhadada
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Natasha Kate
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Siddharth Sarkar
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anil Bhansali
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajit Avasthi
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Sharma
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rashi Goel
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
47
|
Albanese-O’Neill A, Schatz DA, Bernhardt JM, Elder JH. Educational Needs and Technological Preferences of Fathers of Youth With Type 1 Diabetes. DIABETES EDUCATOR 2016; 42:209-19. [DOI: 10.1177/0145721716628649] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Purpose The purpose of this study was to identify the educational needs and technological preferences of fathers of youth aged 6 to 17 years with type 1 diabetes (T1DM). Methods Participants completed 2 surveys and 1 in-person semistructured interview. Survey data were collected via Qualtrics; interviews were recorded and transcribed. The quantitative data were analyzed with SPSS 22. Results Thirty fathers/stepfathers of youth 6 to 17 years old with T1DM participated in the study. Participants reported high levels of unmet diabetes-related educational needs, including needs in fundamental areas of diabetes management such as treatment of hyperglycemia, hypoglycemia, and calculating and adjusting insulin doses. A majority of participants identified educational needs in more nuanced aspects of diabetes management, indicating a need for more information about insulin pumps and continuous glucose monitors, managing diabetes at school, and finding help for diabetes challenges. All participants used smartphone technology, and most expressed interest in receiving diabetes education via mobile technology. Conclusions The findings contribute to our understanding of the educational needs of fathers of children with T1DM and provide preliminary support for the acceptability of delivering diabetes education via mobile technology. The incorporation of patient and caregiver perspectives into the development of mHealth diabetes education applications may increase engagement and improve health outcomes.
Collapse
Affiliation(s)
- Anastasia Albanese-O’Neill
- College of Nursing, University of Florida, Gainesville, Florida (Dr Albanese-O’Neill, Dr Elder)
- College of Medicine, University of Florida, Gainesville, Florida (Dr Schatz)
- Moody College of Communication, University of Texas at Austin, Austin, Texas (Dr Bernhardt)
| | - Desmond A. Schatz
- College of Nursing, University of Florida, Gainesville, Florida (Dr Albanese-O’Neill, Dr Elder)
- College of Medicine, University of Florida, Gainesville, Florida (Dr Schatz)
- Moody College of Communication, University of Texas at Austin, Austin, Texas (Dr Bernhardt)
| | - Jay M. Bernhardt
- College of Nursing, University of Florida, Gainesville, Florida (Dr Albanese-O’Neill, Dr Elder)
- College of Medicine, University of Florida, Gainesville, Florida (Dr Schatz)
- Moody College of Communication, University of Texas at Austin, Austin, Texas (Dr Bernhardt)
| | - Jennifer H. Elder
- College of Nursing, University of Florida, Gainesville, Florida (Dr Albanese-O’Neill, Dr Elder)
- College of Medicine, University of Florida, Gainesville, Florida (Dr Schatz)
- Moody College of Communication, University of Texas at Austin, Austin, Texas (Dr Bernhardt)
| |
Collapse
|
48
|
Herbert LJ, Monaghan M, Cogen F, Streisand R. The impact of parents' sleep quality and hypoglycemia worry on diabetes self-efficacy. Behav Sleep Med 2015; 13:308-23. [PMID: 24738994 PMCID: PMC4199924 DOI: 10.1080/15402002.2014.898303] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Parents of young children with type 1 diabetes (T1D) may experience poor sleep quality, possibly impacting their confidence in T1D management. This study investigated sleep characteristics among parents of children with T1D and relationships among parents' sleep quality, hypoglycemia worry, and diabetes self-efficacy. As part of baseline assessment for a randomized clinical trial (RCT) to promote parental management of T1D, 134 parents of children ≤ age 6 reported on demographics, parent sleep characteristics, hypoglycemia worry, and diabetes self-efficacy. Parents reported they slept less time than recommended by the National Sleep Foundation and endorsed greater global sleep problems than standardized norms of healthy adults; one third of parents reported their overall sleep quality was "fairly bad" or "very bad." Hypoglycemia worry and parents' sleep quality were both significantly related to diabetes self-efficacy, but parents' sleep quality did not mediate the relationship of hypoglycemia worry and diabetes self-efficacy. Many parents experience disrupted sleep that impacts their perceived ability to perform T1D management. Interventions designed to improve parental T1D self-efficacy should consider sleep and concerns about children's hypoglycemia.
Collapse
Affiliation(s)
| | - Maureen Monaghan
- Center for Translational Science, Children’s National Health System
| | - Fran Cogen
- Department of Endocrinology and Diabetes, Children’s National Health System
| | - Randi Streisand
- Center for Translational Science, Children’s National Health System
| |
Collapse
|
49
|
Jaser SS, Linsky R, Grey M. Coping and psychological distress in mothers of adolescents with type 1 diabetes. Matern Child Health J 2014; 18:101-108. [PMID: 23420308 DOI: 10.1007/s10995-013-1239-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The purpose of this study was to describe coping in mothers of adolescents with type 1 diabetes and to examine the association among mothers' diabetes-related stress and coping strategies and maternal psychological distress (e.g., symptoms of anxiety and depression), adolescent adjustment (e.g., symptoms of depression, quality of life), diabetes-related family conflict, and glycemic control. One hundred and eighteen mother-adolescent dyads completed measures of diabetes-related stress, coping, symptoms of anxiety and depression, quality of life, and family conflict. Data on glycemic control were collected from adolescents' medical charts. Single/divorced mothers and mothers of color were significantly more likely to use disengagement coping strategies (e.g., avoidance) than White and married/partnered mothers. Mothers' use of primary control coping (e.g., problem solving) and secondary control coping (e.g., acceptance) strategies was related to fewer symptoms of anxiety (r = - .51, -.39) and depression (r = - .32, -.37) and less family conflict (r = - .22, -.30, all p < .05). Mothers' use of disengagement coping strategies was related to greater symptoms of anxiety (r = .30) and depression (r = .27, both p < .01). Further, secondary control coping was found to mediate the relationship between diabetes-related stress and maternal symptoms of anxiety and depression. Maternal coping was not significantly associated with adolescent outcomes. The ways in which mothers of adolescents with type 1 diabetes cope with diabetes-related stress are associated with psychological distress and family conflict. By identifying and improving mothers' coping through screening and targeted interventions, we may have the potential to improve both maternal and adolescent outcomes.
Collapse
Affiliation(s)
- Sarah S Jaser
- School of Nursing, Yale University, New Haven, CT, USA.
- Department of Pediatrics, Vanderbilt University, DOT 11136, 2200 Children's Way, Nashville, TN, 37232, USA.
| | | | - Margaret Grey
- School of Nursing, Yale University, New Haven, CT, USA
| |
Collapse
|
50
|
Boman A, Povlsen L, Dahlborg-Lyckhage E, Hanas R, Borup IK. Fathers of Children With Type 1 Diabetes: Perceptions of a Father's Involvement From a Health Promotion Perspective. JOURNAL OF FAMILY NURSING 2014; 20:337-354. [PMID: 24948001 DOI: 10.1177/1074840714539190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study describes how fathers of children diagnosed with type 1 diabetes understand their involvement in their child's daily life from a health promotion perspective. Sixteen Swedish fathers of children living with type 1 diabetes were interviewed. Manifest and latent content analysis was used to identify two themes: the inner core of the father's general parental involvement and the additional involvement based on the child's diabetes. The former was underpinned by the fathers' prioritization of family life and the fathers being consciously involved in raising the child, and the latter by the fathers promoting and controlling the child's health and promoting and enabling the child's autonomy. The results highlight that the quality of the fathers' involvement is essential in the management of a child's chronic illness. It is important for pediatric diabetes health care professionals to assess the quality of fathers' involvement to promote the child's health.
Collapse
Affiliation(s)
- Ase Boman
- University West, Trollhättan, Sweden
| | - Lene Povlsen
- Nordic School of Public Health NHV, Gothenburg, Sweden
| | | | - Ragnar Hanas
- Norra Älvsborgs Länssjukhus Hospital Group, Uddevalla, Sweden
| | - Ina K Borup
- Nordic School of Public Health NHV, Gothenburg, Sweden
| |
Collapse
|