The role of protective psychological factors, self-care behaviors, and HbA1c in young adults with type 1 diabetes

Adjustment experiences of adolescents living with well-controlled type 1 diabetes using closed-loop technology

Aim

This study aimed to obtain an in-depth understanding of the experiences of adolescents with well-controlled type 1 diabetes who were adjusting to closed-loop technology.

Method

Interpretative Phenomenological Analysis (IPA) was conducted. Five participants (aged 15-18) were recruited from the Centre for Diabetes and Endocrinology in Parktown, South Africa, to participate in semi-structured interviews about their experiences of adjusting to closed-loop technology.

Results

Five superordinate themes emerged (1): learning to trust the technology (2), making diabetes visible (3), building a relationship with diabetes (4), empowering support networks, and (5) transformative positive outcomes. The findings demonstrate that closed-loop technology positively impacts the adjustment to living with type 1 diabetes. However, as highlighted by all participants, the individual's engagement and management are crucial. Based on the adolescents' experiences, interventions should focus on psychological factors.

Self-Compassion in Adolescents and Young Adults With Inflammatory Bowel Disease: Relationship of Self-Compassion to Psychosocial and Physical Outcomes

BACKGROUND

Adolescents and young adults (AYAs) diagnosed with inflammatory bowel disease (IBD) are at an increased risk for poor physical and mental health due to the complexity of pediatric onset IBD and the unique developmental challenges of this period of life. Self-compassion is increasingly recognized as having an important role in explaining health outcomes and well-being across a range of populations. This study examines the relationship between self-compassion and psychosocial and physical health outcomes in AYAs with IBD.

METHODS

In this cross-sectional study, AYAs with IBD aged 15 to 25 years completed an online survey between February 2020 and October 2021. Questionnaires included the Self-Compassion Scale-Short Form, Patient-Reported Outcomes Measurement Information System (PROMIS) measures for psychosocial, physical and global health outcomes, and IBD disease activity indices.

RESULTS

AYAs with higher levels of self-compassion were found to have better psychosocial (ie, anxiety, depressive symptoms, psychological stress, physical stress, peer relationships), physical (ie, fatigue), and global health outcomes. Self-compassion was a significant independent predictor of anxiety (β = -5.80, P = < .001), depressive symptoms (β = -7.09, P = < .001), psychological stress (β = -4.66, P = < .001), physical stress (β = -3.19, P = < .001), peer relationships (β = 3.39, P = .003), fatigue (β = -2.05, P = .019), and improved global health (β = 5.15, P = < .001).

CONCLUSIONS

This study offers preliminary support for the importance of self-compassion in AYAs with IBD and demonstrates the need for further research in this area.

Identification of psychological constructs for a positive psychology intervention to assist with the adjustment to closed loop technology among adolescents living with type 1 diabetes

Aim

Adolescents have been identified as the group who struggle most with successful adjustment to closed loop technology. This study aims to identify the psychological constructs that should form part of a positive psychology intervention to assist with the adjustment to closed loop technology among adolescents living with type 1 diabetes.

Method

Qualitative document analysis was employed to integrate findings from two documents: a published ongoing intervention study and a recent phenomenological study by the authors. Reflexive thematic analysis was used to identify themes from the documents.

Findings

The following themes were identified as important psychological constructs that aid adjustment: the importance of knowledge and education; the process of positive adjustment to closed loop technology; a positive outlook; and building a relationship with diabetes.

Conclusion

Interventions are needed to assist adolescents in their adjustment to closed loop technology. The psychological constructs identified served as a starting point in designing an effective, evidence-based intervention grounded in data and theory. Knowledge and education, responsibility, identity, positive affect, gratitude, support, and trust are psychological constructs that need to be included in an intervention program.

Cross-Cultural Adaptation and Validation of the Revised Brief Diabetes Knowledge Test (DKT2) in Individuals With Type 2 Diabetes Mellitus and Their Caregivers

PURPOSE

The purpose of the study was to develop an Italian version of the Revised Brief Diabetes Knowledge Test (DKT2), providing a cultural and linguistic validation supported by psychometrics and hypotheses testing.

METHODS

This multimethods study was divided into 4 phases: (a) cultural-linguistic validation, with a translation and back-translation process; (b) confirmatory factor analysis (CFA) considering the original scale's structure (knowledge and insulin-specific knowledge); (c) criterion validity via hypotheses testing; and (d) cross-group measurement invariance. The internal consistency reliability was assessed by the Kuder-Richardson Formula 20 (KR-20) of the overall scale.

RESULTS

A total of 251 patients and 251 caregivers were enrolled. The CFA showed good goodness of fit for both patients and caregivers. The tested hypotheses supported criterion validity in both groups. Reliability was adequate: All KR-20 values in both groups and domains were higher than 0.60. The mean percentage of knowledge score on DKT2 was lower for patients than caregivers.

CONCLUSION

The DKT2 is a valid and reliable scale to assess overall knowledge of diabetes, considering its role in promoting appropriate self-care behaviors in patients with type 2 diabetes mellitus. The Italian version of DKT2 demonstrated reliability and validity, and it can be used by researchers and diabetes care and education specialists to assess a patient's or population's overall knowledge of diabetes.

The role of self-compassion in diabetes management: A rapid review

Aim

This study aimed to assemble and critically reflect on previously acquired insights from investigations that have already been conducted into the role of self-compassion in diabetes and its management.

Methods

This study implemented a rapid review approach to assess the pre-existing knowledge in a time-sensitive manner. A rapid review involves the synthesis of existing knowledge using a simplified systematic review process.

Results

A total of 16 articles were identified for this rapid review. The main findings from these articles included that self-compassion is associated with improved outcomes (psychologically and medically), self-compassion can be improved through interventions, and that many extraneous factors influence levels of self-compassion.

Conclusion

It is apparent that self-compassion plays a rather significant role in the management of diabetes, and that interventions aimed at developing self-compassion showed success in improving health-related outcomes. It is suggested that future research should build on the possibility of using positive psychology interventions to improve the quality of life of those living with diabetes, and work to better understand the influence of aspects such as gender and diabetes duration on self-compassion.

Instruments Measuring Self-Care in Children and Young Adults With Chronic Conditions: A Systematic Review

Children and young adults (CYAs) with chronic conditions need to engage in self-care to improve their quality of life. This study aimed to retrieve the literature on instruments to assess self-care in CYAs living with chronic conditions and evaluate the psychometric proprieties of the instruments retrieved. A systematic literature review was conducted on six databases to identify peer-reviewed papers that described or used an evaluation instrument of self-care in CYAs with chronic conditions. Twenty-three articles describing 11 instruments of self-care were identified. Five instruments (45.45%) were developed for specific diseases, while six (54.54%) for various chronic illnesses. Most of the instruments were focused on treatment adherence within self-care maintenance (i.e., behaviors to maintain illness stability), excluding the monitoring of clinical parameters or the management of exacerbations. This review provides an overview of available instruments that measure self-care in CYAs with chronic conditions, which health professionals could use for patient education.