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Kawahara NE, Jacobson CJ, Bahjri KA, Whitley HP. National survey of educational impact on pharmacy learners by volunteering at camps for children with diabetes. CURRENTS IN PHARMACY TEACHING & LEARNING 2023; 15:S1877-1297(23)00071-0. [PMID: 37100729 DOI: 10.1016/j.cptl.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 02/16/2023] [Accepted: 04/16/2023] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Current literature on pharmacy students' and residents' experience attending camps for children with diabetes focuses on the experience at an individual campsite. The objective of this study was to examine the demographics and gains in understanding that pharmacy learners achieve when volunteering as medical staff at camps for children with type 1 diabetes (T1D). METHODS National listservs were used to identify pharmacists who precept pharmacy students and residents at diabetes camps. These self-identified pharmacists shared pre- and post-camp electronic surveys with their respective pharmacy learners. Statistical analysis was completed using SPSS Version 25 (IBM, Corp.). RESULTS Eighty-six pharmacy learners completed the pre-camp survey and 69 completed the post-camp survey. Most were Caucasian, in their fourth professional year, and participated in residential camps that lasted six and one-half days on average. Learners consistently engaged in patient care activities including: carbohydrate counting (87%), bolus insulin dose calculations (86%), treatment of hypo/hyperglycemic episodes (86%), blood glucose testing (83%), blood sugar trend evaluation (78%), basal insulin dosing calculations (74%), and insulin pump site changes (72%). Learners demonstrated statistically significant gains in every index measured with the exception of glucometer use. Eighty-seven percent indicated they learned how to appropriately manage T1D, 37% gained empathy for those living with T1D, and 13% learned how to work in a medical team. CONCLUSIONS Pharmacy learners who volunteered at diabetes camps experienced large gains in their understanding of concepts and devices, comfort with performing patient care tasks, and compassion for children and their families living with T1D.
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Affiliation(s)
- Nancy E Kawahara
- Pharmacy Practice, Loma Linda University School of Pharmacy, 24745 Stewart Street, Loma Linda, CA 92350, United States.
| | - Christopher J Jacobson
- Pharmacy Practice, Loma Linda University School of Pharmacy, 24745 Stewart Street, Loma Linda, CA 92350, United States.
| | - Khaled A Bahjri
- Pharmaceutical and Administrative Sciences, Loma Linda University School of Pharmacy, 24745 Stewart Street, Loma Linda, CA 92350, United States.
| | - Heather P Whitley
- Pharmacy Practice, Auburn University Harrison School of Pharmacy and Montgomery Family Medicine Residency Program, 4371 Narrow Lane Rd, Suite 100, Montgomery, AL 36113, United States.
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Lindholm Olinder A, DeAbreu M, Greene S, Haugstvedt A, Lange K, Majaliwa ES, Pais V, Pelicand J, Town M, Mahmud FH. ISPAD Clinical Practice Consensus Guidelines 2022: Diabetes education in children and adolescents. Pediatr Diabetes 2022; 23:1229-1242. [PMID: 36120721 PMCID: PMC10107631 DOI: 10.1111/pedi.13418] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 12/29/2022] Open
Affiliation(s)
- Anna Lindholm Olinder
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden.,Sachs' Children and Youths Hospital, Södersjukhuset, Stockholm, Sverige
| | - Matthew DeAbreu
- Parent and Advocate of Child with Type One Diabetes, Toronto, Ontario, Canada
| | | | - Anne Haugstvedt
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Karin Lange
- Medical Psychology Unit, Hannover Medical School, Hannover, Germany
| | - Edna S Majaliwa
- Department of Paediatrics and child health, Muhimbili National Hospital, Dar es Salaam, Tanzania.,Departement of peadiatrics and child health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Vanita Pais
- Department of Endocrinology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Julie Pelicand
- Pediatric Diabetology Unit, San Camilo Hospital, Medicine School, Universidad de Valparaiso, San Felipe, Chile.,Childhood, Adolescence & Diabetes, Toulouse Hospital, Toulouse, France
| | - Marissa Town
- Children with Diabetes and Department of Pediatric Endocrinology, Stanford University, California, USA
| | - Farid H Mahmud
- Division of Endocrinology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada
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3
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Papadakis JL, Shapiro JB, Evans M, Feldman MA, Weil LEG, Vesco AT, Thompson LG, Garza K, Weissberg-Benchell J. Psychometric properties of the diabetes skills checklist for adolescents with type 1 diabetes and their parents. Pediatr Diabetes 2021; 22:924-932. [PMID: 34173308 DOI: 10.1111/pedi.13241] [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] [Received: 05/26/2021] [Accepted: 06/14/2021] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Among adolescents with type 1 diabetes, research has found that their perception of their diabetes management is an important predictor of actual diabetes management. There is a need for measures that assess adolescents' perception of their ability to independently complete daily diabetes self-care tasks. The current study examined the psychometric properties of the Diabetes Skills Checklist Teen-Report (DSC-T) and DSC Parent of Teen-Report (DSC-PT), which assess perceived independence in diabetes self-care skills. RESEARCH DESIGN AND METHODS Data were from 1450 adolescents aged 12 to 18 years and their parents who participated in the Diabetes Camp Matters Study. Families completed the DSC as well as other questionnaires online assessing demographic and diabetes-related information, diabetes strengths, and diabetes-specific emotional distress. RESULTS Exploratory factor analysis revealed a 14-item DSC-T and 12-item DSC-PT, both with excellent internal consistency and concurrent validity. Both the DSC-T and DSC-PT were found to be positively correlated with diabetes strengths and negatively correlated with HbA1c, and the DSC-PT was significantly correlated with parent-reported diabetes distress. Adolescents who used insulin pumps and continuous glucose monitoring reported higher perceived independence in diabetes self-care skills compared to adolescents who used insulin pens/syringes or blood glucose meters. No differences were found based on demographic characteristics. CONCLUSIONS The DSC-T and DSC-PT have strong potential to be used during diabetes clinic visits to spark discussion regarding adolescents' self-care, which would allow for a more successful transfer of diabetes care from parent to adolescent, and eventually, the transition from pediatric to adult healthcare.
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Affiliation(s)
- Jaclyn Lennon Papadakis
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jenna B Shapiro
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Meredyth Evans
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Marissa A Feldman
- Child Development and Rehabilitation Center, Johns Hopkins All Children's Hospital, Saint Petersburg, Florida, USA
| | - Lindsey E G Weil
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Anthony T Vesco
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Laurie Gayes Thompson
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kimberly Garza
- Department of Anthropology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Jill Weissberg-Benchell
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Darukhanavala A, Puhr S, Dinunno K, Alfego D, Welsh J, Butler L, Magyar K. Association between attendance at an American diabetes camp and improvements in glycaemic control and treatment satisfaction. Endocrinol Diabetes Metab 2021; 4:e00254. [PMID: 34277978 PMCID: PMC8279631 DOI: 10.1002/edm2.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/24/2021] [Accepted: 03/27/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Few studies have evaluated glycaemic control using continuous glucose monitoring (CGM) in individuals before and after attendance at a diabetes camp or by comparing control groups at home to control groups at camp. Methods Youth (6–17 years) with T1D and receiving insulin therapy were enrolled at a week‐long diabetes camp. They participated in three clinic visits: at the start of a week at home, by initiating a Dexcom G6 CGM system; at the start of a week at camp, where the home week G6 was removed and a camp week G6 was inserted; and after camp, where the camp week G6 was removed. We administered Problem Areas in Diabetes (PAID) surveys at the second and third visits. Participants with <80% CGM data coverage or who did not complete all PAID surveys were excluded from analysis. We compared glycaemic control and PAID scores between the week at home and week at camp. Results Of 76 enrolled campers, 69 completed the study and 52 had results that qualified for analysis. The mean participant age was 12.5 ± 2.2 years. Camp was associated with significantly improved treatment satisfaction, time in desired glucose range and insulin sensitivity. Time in hyperglycaemia and basal insulin requirements decreased significantly. Conclusions Diabetes camp is associated with significant improvements in diabetes treatment satisfaction and glycaemic control compared to home care.
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Affiliation(s)
- Amy Darukhanavala
- Division of Pediatric Endocrinology UMass Medical Center Worcester MA USA
| | | | - Kyle Dinunno
- The Barton Center for Diabetes Education North Oxford MA USA
| | - David Alfego
- Division of Pediatric Endocrinology UMass Medical Center Worcester MA USA
| | | | - Lynn Butler
- The Barton Center for Diabetes Education North Oxford MA USA
| | - Kendra Magyar
- The Barton Center for Diabetes Education North Oxford MA USA
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Hasan I, Chowdhury ABMA, Haque MI, Patterson CC. Changes in glycated hemoglobin, diabetes knowledge, quality of life, and anxiety in children and adolescents with type 1 diabetes attending summer camps: A systematic review and meta-analysis. Pediatr Diabetes 2021; 22:124-131. [PMID: 33180368 DOI: 10.1111/pedi.13147] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/05/2020] [Accepted: 10/16/2020] [Indexed: 11/27/2022] Open
Abstract
Diabetes summer camps provide children and adolescents with type 1 diabetes opportunities to learn about the disease and its management in a supportive environment to help improve glycemic control, self-reliance, and quality of life. The objective of this quantitative review was to assess the advantages of attending summer camps and study any adverse psychological effects. Studies with a pre/post study design in children and adolescents attending summer camp were systematically reviewed. Five bibliographic databases were searched and relevant data extracted. Random effects meta-analyses were used to combine the individual study results to derive pooled estimates and meta-regression was used to explore between-study heterogeneity. Studies in the literature report short-term improvements in the glycemic control, diabetes knowledge (DK), quality of life (QOL) anxiety, diabetes self-management, and self-esteem. Thirty-three studies were identified, and those outcomes reported in five or more studies were included in meta-analyses. There were significant benefits with a pooled mean change for glycated hemoglobin (95% CI) of -0.59(-0.95,-0.23)% (-6.4[-10.4,-2.5]mmol/mol), and for standardized DK score of 1.99(1.28,2.70) but corresponding changes for QOL 0.17(-0.06,0.39) and for anxiety -0.32(-0.70, 0.06) were not significant. However, all outcomes showed considerable between-study heterogeneity little of which was explained by study characteristics. The findings suggest short-term benefits of camp on metabolic control, DK, QOL and anxiety in T1D children and adolescents, although the latter two were not statistically significant. Further research is warranted with more methodological rigor and longer-term follow-up to determine if there are long-term benefits associated with camp attendance.
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Affiliation(s)
- Istiaque Hasan
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Md Imdadul Haque
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh
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6
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Troncone A, Chianese A, Cascella C, Zanfardino A, Iafusco D. Psychological Outcomes in Children and Early Adolescents With Type 1 Diabetes Following Pediatric Diabetes Summer Camp: A 3-Month Follow-Up Study. Front Pediatr 2021; 9:650201. [PMID: 33777869 PMCID: PMC7987815 DOI: 10.3389/fped.2021.650201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/05/2021] [Indexed: 01/09/2023] Open
Abstract
Objective: The aim of this study was to assess general psychosocial adjustment to diabetes and perceived disease management among patients with type 1 diabetes (T1D) and their parents before and after patients' participation in a diabetes summer camp. Methods: In this follow-up study, 20 children and adolescents with T1D (eight boys; mean age = 11.01 ± 0.94 years; mean diabetes duration = 3.02 ± 2.27) attending a southern Italian diabetic center, along with their parents, were assessed prior to and 3 months after the youths participated in a 1 week camp-based intervention involving didactic and interactive child-centered education and recreational activities. Patients and their parents completed measures assessing patients' quality of life and strategies employed by patients to cope with pain. Patients also completed measures evaluating their diabetes psychosocial adjustment, diabetes self-efficacy management, and illness perception; also, their parents completed measures of caregivers' perceived diabetes burden and treatment satisfaction. Youths' glycated hemoglobin (HbA1c) and standardized body mass index (z-BMI) values were also assessed. Within-subjects repeated-measures analyses of variance evaluated pre- and post-camp changes. Results: Camp attendance showed no beneficial effects on glycemic control, as indicated by HbA1c values both before (7.02%) and after (7.28%) camp being lower than 7.5%. HbA1c values were found to have increased after camp (pre-camp = 7.02%, post-camp = 7.28%; p = 0.010), but since they still fell within an acceptable range, they did not reveal clinically relevant changes in glycemic control. No substantial significant improvement in psychosocial measures was observed in children or parents (all p > 0.05). According to the parents' evaluation, social support-seeking as a patient pain-coping strategy was slightly increased (p = 0.044) after attending the camp. Conclusions: This study does not provide empirical evidence of benefits of participating in a diabetes camp for either patients or their parents. These findings suggest that healthcare providers rethink such camps as an experience for youths with T1D that actively involves parents and that includes both youth- and parent-focused psychological interventions.
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Affiliation(s)
- Alda Troncone
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Antonietta Chianese
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Crescenzo Cascella
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Angela Zanfardino
- Department of the Woman, Child and General and Specialized Surgery, University of Campania "L. Vanvitelli", Naples, Italy
| | - Dario Iafusco
- Department of the Woman, Child and General and Specialized Surgery, University of Campania "L. Vanvitelli", Naples, Italy
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7
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Bitencourt N, Kramer J, Bermas BL, Solow EB, Wright T, Makris UE. Clinical Team Perspectives on the Psychosocial Aspects of Transition to Adult Care for Patients With Childhood-Onset Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken) 2020; 73:39-47. [PMID: 32976698 DOI: 10.1002/acr.24463] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/17/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The transition from pediatric to adult care for youth with childhood-onset systemic lupus erythematosus (SLE) is a vulnerable period. Adverse outcomes during this transition include gaps in care, unscheduled health care utilization, loss of insurance, and high disease activity. The objective of this study was to examine the clinical care teams' perspective on the psychosocial factors associated with transition outcomes, which are poorly understood in this population. METHODS We conducted in-depth interviews with clinical care team members who interact with childhood-onset SLE patients during transfer from pediatric to adult rheumatology. A semistructured interview guide was used to prompt participants' perspectives about the psychosocial factors associated with the transition process for patients with childhood-onset SLE. Audio recordings were transcribed and analyzed using the constant comparative method. We stopped conducting interviews once thematic saturation was achieved. RESULTS Thirteen in-depth interviews were conducted. Participants included pediatric rheumatologists (n = 4), adult rheumatologists from both academic and private practice settings (n = 4), nurses (n = 2), a nurse practitioner, a social worker, and a psychologist. We identified several themes deemed by clinical care teams as important during the transition, including the impact of the family, patient resilience and coping mechanisms, the role of mental health and emotional support, and the need for education, peer support, and social connectedness. CONCLUSION We identified several psychosocial themes that clinical team members believe impact the transition of patients with childhood-onset SLE into adult care. The role of parental modeling, youth resilience, mental health and emotional care, improved childhood-onset SLE education, and structured peer support and social connectedness are highlighted, which may be amenable to interventions.
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Affiliation(s)
| | - Justin Kramer
- University of Texas Southwestern Medical Center, Dallas
| | | | - E Blair Solow
- University of Texas Southwestern Medical Center, Dallas
| | - Tracey Wright
- University of Texas Southwestern Medical Center and Texas Scottish Rite Hospital for Children, Dallas
| | - Una E Makris
- University of Texas Southwestern Medical Center and Veterans Administration North Texas Health Care System, Dallas
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8
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Evans MA, Weil LEG, Shapiro JB, Anderson LM, Vesco AT, Rychlik K, Hilliard ME, Antisdel J, Weissberg-Benchell J. Psychometric Properties of the Parent and Child Problem Areas in Diabetes Measures. J Pediatr Psychol 2020; 44:703-713. [PMID: 30920628 DOI: 10.1093/jpepsy/jsz018] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/15/2019] [Accepted: 02/16/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Children with type 1 diabetes and their parents face daily self-care demands, leading to diabetes-specific emotional distress. A standardized measure of diabetes distress can guide clinical care and prevent negative outcomes. METHODS This study evaluated the psychometric properties of child- and parent-report measures of the Problem Areas in Diabetes Scale, adapted for children ages 8-12 (PAID-C) and their parents (P-PAID-C). Participants were from 42 diabetes camps in the United States. Children (N = 804; mean age = 10.3 ± 1.1) and parents (N = 968) completed measures of diabetes distress, diabetes-related strengths, and self-care skills. Half of the sample was used for exploratory factor analyses (EFA) with direct oblimin rotation and the other half for confirmatory factor analyses (CFAs). RESULTS For the PAID-C, EFA and CFAs supported an 11-item two-factor measure, Cronbach's α = .91, accounting for 54.6% of the variance. For the P-PAID-C, analyses resulted in a 16-item measure, Cronbach's α = .92, accounting for 51.9% of the variance. PAID-C and P-PAID-C scores were positively correlated with HbA1c (rchild = .08, p = .04; rparent = .18, p < .001), and negatively correlated with diabetes-related strengths (rchild = -.38, p < .001, rparent = -.29, p < .001) and parent report of child self-care skills (rparent = -.13, p < .001; rchild = -0.07, p = ns). CONCLUSIONS Initial psychometrics suggest that the PAID-C and P-PAID-C reliably and validly capture diabetes-specific emotional distress for children and their parents. Associations with glycemic control, self-care, and diabetes strengths demonstrate criterion validity. Both measures have potential applications for routine, clinic-based assessments of diabetes distress and may guide clinical decision-making.
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Affiliation(s)
- Meredyth A Evans
- Department of Child and Adolescent Psychiatry, Ann & Robert H. Lurie Children's Hospital of Chicago
| | - Lindsey E G Weil
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine
| | | | - Lindsay M Anderson
- Department of Child and Adolescent Psychiatry, Ann & Robert H. Lurie Children's Hospital of Chicago
| | - Anthony T Vesco
- Department of Child and Adolescent Psychiatry, Ann & Robert H. Lurie Children's Hospital of Chicago
| | - Karen Rychlik
- Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago
| | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital
| | - Jeanne Antisdel
- Department of Child and Adolescent Psychiatry, Ann & Robert H. Lurie Children's Hospital of Chicago
| | - Jill Weissberg-Benchell
- Department of Child and Adolescent Psychiatry, Ann & Robert H. Lurie Children's Hospital of Chicago
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Anarte MT, Carreira M, Leiva Gea A, Varela E, Mateo-Anarte M, López Siguero JP, Leiva Gea I. Diabetes Summer Camp in children and adolescents with type 1 diabetes: Effects on well-being and quality of life. ENDOCRINOL DIAB NUTR 2020; 67:326-332. [DOI: 10.1016/j.endinu.2019.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 07/26/2019] [Accepted: 08/16/2019] [Indexed: 01/09/2023]
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Lo HL, Adhikari S, White PC, Grishman EK, Gupta OT. Impact of insulin reduction on glycemic control in children attending a residential diabetes camp. Pediatr Diabetes 2019; 20:1094-1099. [PMID: 31456281 DOI: 10.1111/pedi.12912] [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: 05/03/2019] [Revised: 07/10/2019] [Accepted: 08/17/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND/OBJECTIVES Children attending diabetes camp are more active, increasing the risk of hypoglycemia. Decreasing initial insulin doses may reduce this risk. The objectives of our study were to compare glycemic control between campers receiving multiple daily injections (MDI) and continuous subcutaneous insulin infusion (CSII), and analyze the impact of decreasing basal insulin by 10%. METHODS We analyzed 849 camp sessions (599 children, 5-19 years old) from Camp Sweeney's 2016/2017 summers. Campers were separated into groups by year and insulin route (MDI_2016, MDI_2017, CSII_2016, and CSII_2017). The MDI_2016 group had initial basal insulin decreased 10%, while CSII_2016, MDI_2017, and CSII_2017 did not. Time spent in blood glucose ranges and area under the curve (AUC) were compared by year and insulin route using ANOVA. We also performed repeated measures ANOVA using campers who attended both years. RESULTS No significant differences in time spent in any glucose range could be attributed to the initial 10% basal decrease, including on paired analysis. MDI_2017 had more decreases to basal insulin than the other groups. CSII campers had higher AUC and more hyperglycemia than MDI campers. CONCLUSIONS Campers on MDI may benefit from decreasing basal insulin, either at the beginning of camp or during the first week. Future research is needed to optimize glycemic control in the camp setting.
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Affiliation(s)
- Huay-Lin Lo
- Department of Pediatrics, Division of Endocrinology and Diabetes, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Soumya Adhikari
- Department of Pediatrics, Division of Endocrinology and Diabetes, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Perrin C White
- Department of Pediatrics, Division of Endocrinology and Diabetes, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ellen K Grishman
- Department of Pediatrics, Division of Endocrinology and Diabetes, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Olga T Gupta
- Department of Pediatrics, Division of Endocrinology and Diabetes, University of Texas Southwestern Medical Center, Dallas, Texas
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11
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Shapiro JB, Vesco AT, Weil LEG, Evans MA, Hood KK, Weissberg-Benchell J. Psychometric Properties of the Problem Areas in Diabetes: Teen and Parent of Teen Versions. J Pediatr Psychol 2019; 43:561-571. [PMID: 29267939 DOI: 10.1093/jpepsy/jsx146] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 11/22/2017] [Indexed: 12/16/2022] Open
Abstract
Objective This study adds to the literature on the psychometric properties of the Problem Areas in Diabetes-Teen (PAID-T) and Parent (P-PAID-T) Versions. It also aims to shorten the measures of diabetes-specific distress, determine construct validity, and establish cutoff scores. Methods Data are from two independent studies (N = 1,265). Adolescent-caregiver dyads completed measures of emotional distress, diabetes strengths, hemoglobin A1c, blood glucose checks, and average blood glucose. Exploratory and confirmatory factor analyses assessed factor structures for each measure. Correlational analyses provided support for concurrent validity. Receiver-operating characteristic curves identified cutoff scores based on clinically meaningful groups identified with latent profile analysis. Results Analyses supported a 14-item PAID-T and a 15-item P-PAID-T, with preliminary cutoff scores ≥44 and ≥54, respectively. Measures were associated with emotional and health outcomes as hypothesized. Conclusions The PAID-T and P-PAID-T are valid, reliable, and useful measures of diabetes-specific distress for teenagers with type 1 diabetes and parents of teenagers.
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Affiliation(s)
| | - Anthony T Vesco
- Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago
| | | | - Meredyth A Evans
- Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago.,Northwestern University Feinberg School of Medicine, and
| | | | - Jill Weissberg-Benchell
- Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago.,Northwestern University Feinberg School of Medicine, and
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12
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Zimmerman K, Williams M, Arynchyna A, Rocque BG, Blount JP, Graham A, Hopson B. Program Evaluation of Camp V.I.P: Promoting Self-confidence and Independence for Patients with Spina Bifida. J Pediatr Nurs 2019; 47:30-35. [PMID: 31026678 DOI: 10.1016/j.pedn.2019.04.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/12/2019] [Accepted: 04/12/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Camp V.I·P (Victory, Independence, Possibilities) was established by the Spina Bifida Association of Alabama in 2012. The goal is to provide children with spina bifida (SB) and their families a traditional-style summer camp focusing on self-empowerment and fostering independence in medical self-management. DESIGN AND METHODS Part 1 of this study describes Camp V.I·P. structure. Part 2 describes an online survey to caregivers of campers gauging camp effectiveness and value and evaluating perceptions of confidence/independence and family connections. Camper characteristics were compared to the overall SB clinic population. RESULTS 63 children with SB, 81 siblings, and over 100 caregivers have attended camp. Campers are similar to the overall clinic population in race, gender, and ambulation status. At camp, there are significantly more children with myelomeningocele (versus other spinal dysraphism) and lumbar functional level (versus thoracic). Survey results show that confidence grew in 93% of campers, and 86% gained greater independence. Parents stated that they created lifelong friendships. The majority of caregivers (91%) indicated "certainty" that they would attend camp again. CONCLUSION Camp V.I·P is a family-centered environment that emphasizes respite, nurture, and the continuum between family and clinic. Our research shows that camp can be a useful tool to aid in independence, confidence, and social adaption. PRACTICE IMPLICATIONS Camp has become an integral part of our comprehensive care of children with SB and has been shown to reinforce what is taught through the clinic by creating trust between the care team and campers.
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Affiliation(s)
- Kathrin Zimmerman
- University of Alabama at Birmingham, Department of Neurosurgery, Section of Pediatric Neurosurgery, United States of America
| | - McKenna Williams
- University of Alabama at Birmingham, Department of Neurosurgery, Section of Pediatric Neurosurgery, United States of America
| | - Anastasia Arynchyna
- University of Alabama at Birmingham, Department of Neurosurgery, Section of Pediatric Neurosurgery, United States of America
| | - Brandon G Rocque
- University of Alabama at Birmingham, Department of Neurosurgery, Section of Pediatric Neurosurgery, United States of America
| | - Jeffrey P Blount
- University of Alabama at Birmingham, Department of Neurosurgery, Section of Pediatric Neurosurgery, United States of America
| | - Anna Graham
- University of Alabama at Birmingham, Department of Neurosurgery, Section of Pediatric Neurosurgery, United States of America
| | - Betsy Hopson
- University of Alabama at Birmingham, Department of Neurosurgery, Section of Pediatric Neurosurgery, United States of America; Children's of Alabama, United States of America.
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Weissberg-Benchell J, Vesco AT, Rychlik K. Diabetes camp still matters: Relationships with diabetes-specific distress, strengths, and self-care skills. Pediatr Diabetes 2019; 20:353-360. [PMID: 30793473 DOI: 10.1111/pedi.12836] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/10/2019] [Accepted: 02/11/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Prior studies suggest diabetes camps improve psychosocial well-being in youth with type 1 diabetes but these studies suffer from variable levels of rigor. The present study assessed associations between camp participation and diabetes distress, perceived independence in diabetes self-care, and diabetes strengths in a large sample of children, adolescents, and their parents across 44 camps in the United States. Analyses compared viewpoints of study participants, identified moderators of change, and assessed perceived benefits of camp participation. METHODS There were 2488 youth and 2563 parents consented for participation in the online survey. Participants reported diabetes distress and perceived independence in youth care, their new experiences and best parts of camp, and changes in behavior following camp. T-tests, regressions, Cohen's d, and relative frequencies were used as appropriate to assess baseline differences between reporters, pre-post outcome differences, and moderators of change. RESULTS Parents as compared to youth reported higher pre-camp distress and lower perception of youth independence in self-care. Youth experienced a statistically significant decrease in distress and increase in independence in self-care. Diabetes strengths did not change. Higher A1c prior to camp was associated with higher levels of distress across camp participation. Campers and their parents endorsed a high frequency of positive firsts, bests, and benefits of camp. CONCLUSIONS Data from a large sample youth with type 1 diabetes across multiple camps showed broad-based psychosocial benefits of camp participation.
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Affiliation(s)
- Jill Weissberg-Benchell
- Department of Psychiatry and Behavioral Health, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Anthony T Vesco
- Department of Psychiatry and Behavioral Health, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Karen Rychlik
- Stanley Manne Children's Research Institute, Biostatistics Research Core, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
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