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Shapiro JB, Garza KP, Feldman MA, Suhs MC, Ellis J, Terry A, Howard KR, Weissberg-Benchell J. Psychosocial Care for Youth with Type 1 Diabetes: Summary of Reviews to Inform Clinical Practice. Endocrinol Metab Clin North Am 2024; 53:107-122. [PMID: 38272590 DOI: 10.1016/j.ecl.2023.10.002] [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: 01/27/2024]
Abstract
The intensive demands of diabetes care can be difficult for youth with type 1 diabetes and their families to integrate into daily life. Standards of care in pediatric diabetes highlight the importance of evidence-based psychosocial interventions to optimize self-management behaviors and psychological well-being. The current review summarizes select systematic reviews and meta-analyses on evidence-based behavioral health interventions in pediatric diabetes. Interventions include strategies to strengthen youth psychosocial skills, improve family dynamics and caregiver mental health, enhance health and mental health equity, and address psychosocial factors related to diabetes technology use.
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Affiliation(s)
- Jenna B Shapiro
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA; Northwestern University Feinberg School of Medicine, Department of Psychiatry & Behavioral Sciences, 446 E Ontario Street, Chicago, IL, USA.
| | | | - Marissa A Feldman
- Johns Hopkins All Children's Hospital, Child Development and Rehabilitation Center, 880 Sixth Street South #170, Saint Petersburg, FL 33701, USA
| | - Madeleine C Suhs
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA
| | - Julia Ellis
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA
| | - Amanda Terry
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA; Northwestern University Feinberg School of Medicine, Department of Psychiatry & Behavioral Sciences, 446 E Ontario Street, Chicago, IL, USA
| | - Kelsey R Howard
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA; Northwestern University Feinberg School of Medicine, Department of Psychiatry & Behavioral Sciences, 446 E Ontario Street, Chicago, IL, USA
| | - Jill Weissberg-Benchell
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA; Northwestern University Feinberg School of Medicine, Department of Psychiatry & Behavioral Sciences, 446 E Ontario Street, Chicago, IL, USA
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de Wit M, Gajewska KA, Goethals ER, McDarby V, Zhao X, Hapunda G, Delamater AM, DiMeglio LA. ISPAD Clinical Practice Consensus Guidelines 2022: Psychological care of children, adolescents and young adults with diabetes. Pediatr Diabetes 2022; 23:1373-1389. [PMID: 36464988 PMCID: PMC10107478 DOI: 10.1111/pedi.13428] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Maartje de Wit
- Amsterdam UMC, Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam Public Health, Amsterdam, Netherlands
| | - Katarzyna A Gajewska
- Diabetes Ireland, Dublin, Ireland.,School of Public Health, University College Cork, Cork, Ireland
| | | | | | - Xiaolei Zhao
- The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Given Hapunda
- Department of Psychology, University of Zambia, Lusaka, Zambia
| | - Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Linda A DiMeglio
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA.,Department of Pediatrics, Division of Pediatric Endocrinology and Diabetology, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana, USA
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3
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Guha C, Khalid R, van Zwieten A, Francis A, Hawley CM, Jauré A, Teixeira-Pinto A, Mallard AR, Bernier-Jean A, Johnson DW, Hahn D, Reidlinger D, Pascoe EM, Ryan EG, Mackie F, McCarthy HJ, Craig JC, Varghese J, Kiriwandeniya C, Howard K, Larkins NG, Macauley L, Walker A, Howell M, Irving M, Caldwell PHY, Woodleigh R, Jesudason S, Carter SA, Kennedy SE, Alexander SI, McTaggart S, Wong G. Baseline characteristics of participants in the NAVKIDS 2 trial: a patient navigator program in children with chronic kidney disease. Pediatr Nephrol 2022; 38:1577-1590. [PMID: 36264432 PMCID: PMC9584266 DOI: 10.1007/s00467-022-05772-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 09/16/2022] [Accepted: 09/23/2022] [Indexed: 10/24/2022]
Abstract
BACKGROUND Children with chronic kidney disease (CKD) require multidisciplinary care to meet their complex healthcare needs. Patient navigators are trained non-medical personnel who assist patients and caregivers to overcome barriers to accessing health services through care coordination. This trial aims to determine the effectiveness of a patient navigator program in children with CKD. METHODS The NAVKIDS2 trial is a multi-center, waitlisted, randomized controlled trial of patient navigators in children with CKD conducted at five sites across Australia. Children (0-16 years) with CKD from low socioeconomic status rural or remote areas were randomized to an intervention group or a waitlisted control group (to receive intervention after 6 months). The study primary and secondary endpoints include the self-rated health (SRH) (primary), and utility-based quality of life, progression of kidney dysfunction of the child, SRH, and satisfaction with healthcare of the caregiver at 6 months post-randomization. RESULTS The trial completed recruitment in October 2021 with expected completion of follow-up by October 2022. There were 162 patients enrolled with 80 and 82 patients randomized to the immediate intervention and waitlisted groups, respectively. Fifty-eight (36%) participants were from regional/remote areas, with a median (IQR) age of 9.5 (5.0, 13.0) years, 46% were of European Australian ethnicity, and 65% were male. A total of 109 children (67%) had CKD stages 1-5, 42 (26%) were transplant recipients, and 11 (7%) were receiving dialysis. CONCLUSION The NAVKIDS2 trial is designed to evaluate the effectiveness of patient navigation in children with CKD from families experiencing socioeconomic disadvantage. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Chandana Guha
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Rabia Khalid
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Anita van Zwieten
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Anna Francis
- Child and Adolescent Renal Services, Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
| | - Carmel M Hawley
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia
- Translational Research Institute, Brisbane, QLD, Australia
| | - Allison Jauré
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Armando Teixeira-Pinto
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Alistair R Mallard
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Amelie Bernier-Jean
- CIUSSS du Nord-de-l'Île de Montréal, University of Montréal, Montreal, Canada
| | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia
- Translational Research Institute, Brisbane, QLD, Australia
| | - Deirdre Hahn
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
- Department of Nephrology, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Donna Reidlinger
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia
| | - Elaine M Pascoe
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia
| | - Elizabeth G Ryan
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia
- QCIF Facility for Advanced Bioinformatics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Fiona Mackie
- Department of Nephrology, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
| | - Hugh J McCarthy
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
- Department of Nephrology, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Julie Varghese
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia
| | - Charani Kiriwandeniya
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia
| | - Kirsten Howard
- Menzies Centre for Health Policy and Economics and Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Nicholas G Larkins
- Department of Nephrology, Perth Children's Hospital, Perth, WA, Australia
- School of Medicine, University of Western Australia, Perth, WA, Australia
| | | | - Amanda Walker
- Department of Nephrology, Royal Children's Hospital, Melbourne, VIC, Australia
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Martin Howell
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Michelle Irving
- Menzies Centre for Health Policy, The University of Sydney, Camperdown, Sydney, NSW, 2006, Australia
- Centre for Evidence and Implementation, 33 Lincoln Square South Carlton, Melbourne, VIC, 3053, Australia
| | - Patrina H Y Caldwell
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | | | - Shilpanjali Jesudason
- Central Northern Adelaide Renal and Transplantation Service (CNARTS), Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Simon A Carter
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
- Department of Nephrology, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Sean E Kennedy
- Department of Nephrology, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
- School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
| | - Stephen I Alexander
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Steven McTaggart
- Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
- The University of Queensland, Brisbane, QLD, Australia
| | - Germaine Wong
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.
- Department of Renal Medicine, Westmead Hospital, Sydney, NSW, Australia.
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Uhm JY, Kim MS. Online social support and collective empowerment: Serial mediation effect on self-efficacy among mothers of children with type 1 diabetes. J Adv Nurs 2022; 78:3225-3234. [PMID: 35451524 DOI: 10.1111/jan.15242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 12/15/2021] [Accepted: 03/23/2022] [Indexed: 12/01/2022]
Abstract
AIM To identify a serial multiple mediation effect of social support in online health communities and collective empowerment on the relationship between diabetes-related burden (DRB) and self-efficacy, among mothers using a continuous glucose monitoring device for children with type 1 diabetes (T1D). DESIGN A secondary analysis, cross-sectional, descriptive study. METHODS Data were obtained from 198 mothers of children with T1D via a web survey, from August to September 2020. Measures used were the Collective Empowerment in the Online Health Community Scale, a modified version of the Multidimensional Scale of Perceived Social Support, Problem Areas in Diabetes Survey-Parent Revised version and a modified version of the Maternal Self-efficacy for Diabetes Management Scale. Data were analysed using SPSS 25.0, and PROCESS MACRO for SPSS v3.5. RESULTS A serial multiple mediation model was used. The indirect effects of both social support in online health communities and collective empowerment were identified in the relationship between DRB and diabetes self-efficacy (DSE). However, there was no indirect effect of social support in online health communities on these relationships. CONCLUSION These findings suggest that online social support alone has a limited role in chronic disease management self-efficacy. Collective empowerment should be a strategic component in intervention development using online health communities to strengthen DSE in mothers of children with T1D. IMPACT This study provides novel insights into the functional mechanism of online health communities for T1D. Peer mentor coaching by parents of children with T1D effectively helps other children's parents with its recent diagnosis. The findings recognize a need for strategies enhancing collective empowerment among parents of children with T1D. Along with peer coaching, these strategies should strengthen knowledge of resources and methods to impact social change as well as resource mobilization for collective actions.
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Affiliation(s)
- Ju-Yeon Uhm
- Department of Nursing, Pukyong National University, Busan, South Korea
| | - Myoung Soo Kim
- Department of Nursing, Pukyong National University, Busan, South Korea
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Titoria R, Amed S, Tang TS. Peer Support Interventions on Digital Platforms for Children With Type 1 Diabetes and Their Caregivers. Diabetes Spectr 2022; 35:26-32. [PMID: 35308148 PMCID: PMC8914597 DOI: 10.2337/ds21-0081] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Peer support for children with type 1 diabetes and their caregivers has been recognized as a key component in diabetes management and mental health. In this era of digitization, support programs delivered via technology are growing rapidly, particularly with increased access to technology and social media. Although the development of different digital modalities for this purpose is in its early stages, five different types of digital platforms have been recognized: voice, text, website, video, and social media. This article discusses the significance of peer support and explores various digital peer support interventions in pediatric patients with type 1 diabetes (0-18 years of age) and their caregivers.
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Affiliation(s)
- Reena Titoria
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Corresponding author: Reena Titoria,
| | - Shazhan Amed
- BC Children’s Hospital Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tricia S. Tang
- Department of Medicine, Division of Endocrinology, University of British Columbia, Vancouver, British Columbia, Canada
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Sartore GM, Pourliakas A, Lagioia V. Peer support interventions for parents and carers of children with complex needs. Cochrane Database Syst Rev 2021; 12:CD010618. [PMID: 34923624 PMCID: PMC8684823 DOI: 10.1002/14651858.cd010618.pub2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Parents and family carers of children with complex needs experience a high level of pressure to meet children's needs while maintaining family functioning and, as a consequence, often experience reduced well-being and elevated psychological distress. Peer support interventions are intended to improve parent and carer well-being by enhancing the social support available to them. Support may be delivered via peer mentoring or through support groups (peer or facilitator led). Peer support interventions are widely available, but the potential benefits and risks of such interventions are not well established. OBJECTIVES To assess the effects of peer support interventions (compared to usual care or alternate interventions) on psychological and psychosocial outcomes, including adverse outcomes, for parents and other family carers of children with complex needs in any setting. SEARCH METHODS We searched the following resources. • Cochrane Central Register of Controlled Trials (CENTRAL; latest issue: April 2014), in the Cochrane Library. • MEDLINE (OvidSP) (1966 to 19 March 2014). • Embase (OvidSP) (1974 to 18 March 2014). • Journals@OVID (22 April 2014). • PsycINFO (OvidSP) (1887 to 19 March 2014). • BiblioMap (EPPI-Centre, Health Promotion Research database) (22 April 2014). • ProQuest Dissertations and Theses (26 May 2014). • metaRegister of Controlled Trials (13 May 2014). We conducted a search update of the following databases. • MEDLINE (OvidSP) (2013 to 20 February 2018) (search overlapped to 2013). • PsycINFO (ProQuest) (2013 to 20 February 2018). • Embase (Elsevier) (2013 to 21 February 2018). We handsearched the reference lists of included studies and four key journals (European Child and Adolescent Psychiatry: 31 March 2015; Journal of Autism and Developmental Disorders: 30 March 2015; Diabetes Educator: 7 April 2015; Journal of Intellectual Disability Research: 13 April 2015). We contacted key investigators and consulted key advocacy groups for advice on identifying unpublished data. We ran updated searches on 14 August 2019 and on 25 May 2021. Studies identified in these searches as eligible for full-text review are listed as "Studies awaiting classification" and will be assessed in a future update. SELECTION CRITERIA Randomised and cluster randomised controlled trials (RCTs and cluster RCTs) and quasi-RCTs were eligible for inclusion. Controlled before-and-after and interrupted time series studies were eligible for inclusion if they met criteria set by the Cochrane Effective Practice and Organisation of Care Review Group. The comparator could be usual care or an alternative intervention. The population eligible for inclusion consisted of parents and other family carers of children with any complex needs. We applied no restriction on setting. DATA COLLECTION AND ANALYSIS Inclusion decisions were made independently by two authors, with differences resolved by a third author. Extraction to data extraction templates was conducted independently by two authors and cross-checked. Risk of bias assessments were made independently by two authors and were reported according to Cochrane guidelines. All measures of treatment effect were continuous and were analysed in Review Manager version 5.3. GRADE assessments were undertaken independently by two review authors, with differences resolved by discussion. MAIN RESULTS We included 22 studies (21 RCTs, 1 quasi-RCT) of 2404 participants. Sixteen studies compared peer support to usual care; three studies compared peer support to an alternative intervention and to usual care but only data from the usual care arm contributed to results; and three studies compared peer support to an alternative intervention only. We judged risk of bias as moderate to high across all studies, particularly for selection, performance, and detection bias. Included studies contributed data to seven effect estimates compared to usual care: psychological distress (standardised mean difference (SMD) -0.10, 95% confidence interval (CI) -0.32 to 0.11; 8 studies, 864 participants), confidence and self-efficacy (SMD 0.04, 95% CI -0.14 to 0.21; 8 studies, 542 participants), perception of coping (SMD -0.08, 95% CI -0.38 to 0.21; 3 studies, 293 participants), quality of life and life satisfaction (SMD 0.03, 95% CI -0.32 to 0.38; 2 studies, 143 participants), family functioning (SMD 0.15, 95% CI -0.09 to 0.38; 4 studies, 272 participants), perceived social support (SMD 0.31, 95% CI -0.15 to 0.77; 4 studies, 191 participants), and confidence and skill in navigating medical services (SMD 0.05, 95% CI -0.17 to 0.28; 4 studies, 304 participants). In comparisons to alternative interventions, one pooled effect estimate was possible: psychological distress (SMD 0.2, 95% CI -0.38 to 0.79; 2 studies, 95 participants). No studies reported on adverse outcomes. All narratively synthesised data for psychological distress (compared to usual care - 2 studies), family functioning (compared to usual care - 1 study; compared to an alternative intervention - 1 study), perceived social support (compared to usual care - 2 studies), and self-efficacy (compared to alternative interventions - 1 study) were equivocal. Comparisons with usual care showed no difference between intervention and control groups (perceived social support), some effect over time for both groups but more effect for intervention (distress), or mixed effects for intervention (family function). Comparisons with alternative interventions showed no difference between the intervention of interest and the alternative. This may indicate similar effects to the intervention of interest or lack of effect of both, and we are uncertain which option is likely. We found no clear evidence of effects of peer support interventions on any parent outcome, for any comparator; however, the certainty of evidence for each outcome was low to very low, and true effects may differ substantially from those reported here. We found no evidence of adverse events such as mood contagion, negative group interactions, or worsened psychological health. Qualitative data suggest that parents and carers value peer support interventions and appreciate emotional support. AUTHORS' CONCLUSIONS Parents and carers of children with complex needs perceive peer support interventions as valuable, but this review found no evidence of either benefit or harm. Currently, there is uncertainty about the effects of peer support interventions for parents and carers of children with complex needs. However, given the overall low to very low certainty of available evidence, our estimates showing no effects of interventions may very well change with further research of higher quality.
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Affiliation(s)
| | - Anastasia Pourliakas
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia
| | - Vince Lagioia
- Parenting Research Centre, East Melbourne, Australia
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Tully C, Clary L, Monaghan M, Levy W, Hilliard ME, Streisand R. Implementation and Preliminary Feasibility of an Individualized, Supportive Approach to Behavioral Care for Parents of Young Children Newly Diagnosed With Type 1 Diabetes. COGNITIVE AND BEHAVIORAL PRACTICE 2021; 28:293-308. [PMID: 34025105 PMCID: PMC8136148 DOI: 10.1016/j.cbpra.2020.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
There are significant stressors related to parenting a young child with newly diagnosed type 1 diabetes (T1D). Despite these challenges, there are not yet clearly defined interventions to help promote psychological health and adherence for families with young children with T1D. First STEPS is a tailored stepped care design intervention to positively impact parents' emotional functioning and children's glycemic control in young children newly diagnosed with T1D. The First STEPS intervention is derived from a combination of Cognitive Behavioral Theory and Social Cognitive Theory to support family adjustment to T1D, promote parental mastery over T1D tasks, increase coping skills to manage stressors associated with T1D, and build on the strengths of families newly diagnosed with T1D to help them achieve positive health and wellbeing outcomes. We present details about the intervention and describe two pilot participants as case studies. Results indicated that the treatment and delivery model were acceptable to the pilot participants, as evidenced by treatment completion and satisfaction ratings. Future directions for this work include testing the efficacy of this new treatment in a randomized controlled trial.
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Affiliation(s)
- Carrie Tully
- Children's National Health System and George Washington University
| | - Lauren Clary
- Children's National Health System and George Washington University
| | - Maureen Monaghan
- Children's National Health System and George Washington University
| | - Wendy Levy
- Texas Children's Hospital and Baylor College of Medicine
| | | | - Randi Streisand
- Children's National Health System and George Washington University
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Marker AM, Monzon AD, Goggin K, Clements MA, Patton SR. Parent Perspectives on Educational and Psychosocial Intervention for Recent-Onset Type 1 Diabetes in Their School-Age Child: A Qualitative Study. Diabetes Spectr 2021; 34:166-174. [PMID: 34149257 PMCID: PMC8178719 DOI: 10.2337/ds20-0058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The recent-onset period of type 1 diabetes (T1D) in early school-age children should include comprehensive, parent-focused T1D education as well as family-centered resources and support to help with adjustment. Here, we present parent/caregiver perspectives on specific areas of concern during the recent-onset period of T1D and their preferred timing for different topics related to T1D education. METHODS Parents/caregivers of 5- to 9-year-old children with T1D completed a card-sorting task and qualitative interview to describe ongoing areas of concern and preferred educational topics during the first year after T1D diagnosis. RESULTS Thirteen parents/caregivers (aged 35.1 ± 6.9 years) of a child with T1D (aged 8.9 ± 0.8 years, 11.3 ± 7.0 months post-diagnosis) completed the card-sorting task, and 11 completed the qualitative interview. Parents/caregivers endorsed four preferred stages of education: basic education and T1D survival skills during month 1 post-diagnosis, application and practice of T1D skills from months 1-3, access to community supports to cope with anxiety and distress from months 3-6, and support to build autonomy and manage burnout beyond month 6 post-diagnosis. Parents/caregivers endorsed four main themes for ongoing concerns: anxiety, autonomy, distress, and support. CONCLUSION Parents endorsed four time points for education and psychosocial services within the first year of a T1D diagnosis. Parents/caregivers may benefit the most from psychosocial interventions 3-6 months post-diagnosis, once they have had sufficient time to develop basic T1D management skills. These findings support the need for regular parent psychosocial screening and access to scalable psychosocial interventions in the first year post-diagnosis of T1D.
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Affiliation(s)
| | | | - Kathy Goggin
- Children’s Mercy–Kansas City, Kansas City, MO
- University of Missouri Kansas City, Kansas City, MO
| | - Mark A. Clements
- Children’s Mercy–Kansas City, Kansas City, MO
- University of Missouri Kansas City, Kansas City, MO
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9
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Pals RAS, Coyne I, Skinner T, Grabowski D. A delicate balance between control and flexibility: Experiences of care and support among pre-teenage children with type 1 diabetes and their families. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:369-391. [PMID: 33338277 DOI: 10.1111/1467-9566.13223] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 09/20/2020] [Accepted: 11/03/2020] [Indexed: 06/12/2023]
Abstract
For children with type 1 diabetes, the period of adolescence is associated with higher blood glucose levels and increased psychological distress compared to other age groups. Focusing on pre-teens (9-12 years) with type 1 diabetes and their families has been suggested as key to understanding and reducing these challenges. The aim of this study was to explore: 1, how diabetes affects family life, 2, experiences of and needs for support and 3, how care responsibilities are negotiated among pre-teens with type 1 diabetes and their families. Data were obtained from four interactive workshops with pre-teens (n = 17), their parents (n = 26) and their siblings (n = 14). Dialogue tools, for example quotes and picture cards, were used to facilitate discussion and reflection concerning family life with type 1 diabetes. Data analysis resulted in three themes: 1, diabetes takes up 'a lot of space', 2, giving and receiving support and 3, balancing control and flexibility. While diabetes took up significant space in the families, family members protected each other from their respective frustrations. The findings point to the significance of considering all key family members and their interactions in diabetes interventions. This includes balancing control and flexibility, negotiating responsibilities and building trust.
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Affiliation(s)
- Regitze Anne Saurbrey Pals
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Imelda Coyne
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Timothy Skinner
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Department of Rural Health, La Trobe University, Bendigo, Victoria, Australia
- Department of Rural Health, The Australian Centre for Behavioural Research in Diabetes, Melbourne, Victoria, Australia
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Nieto-Eugenio I, Ventura-Puertos PE, Rich-Ruiz M. S.O.S! My Child is at School: A Hermeneutic of the Experience of Living a Chronic Disease in the School Environment. J Pediatr Nurs 2020; 53:e171-e178. [PMID: 32334897 DOI: 10.1016/j.pedn.2020.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 03/23/2020] [Accepted: 03/25/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE The purpose of the present study is to understand the experience of living a chronic disease in the school, from the perspective of the parents. DESIGN AND METHODS A Grounded Theory study was proposed with a sample of 14 affected families with children between three and eleven years old, all of them from the west and south of Spain. Information was collected using semi-structured surveys and the constant comparative method was used for the analysis. RESULTS Results are divided into three main themes: SOS! My child is at school, The Systems (don't) Answer and Families Answer. Parents live school enrolment in a state of constant alertness, characterized by distrust, worry, fear, anguish, and indignation. The responses to the problem given by the education and health systems are insufficient, uncoordinated and inefficient. Therefore, parents end up not expecting anything, they transmit the information, organize training sessions, and solve any occurring incident by themselves, often at the expense of quitting their jobs. CONCLUSION The presence of a school nurse would mean for these parents the integration between the education and health systems. PRACTICE IMPLICATIONS As findings highlight, more collaboration and sensitivity between the healthcare and educational system is needed, and the school nurse has been indicated as a crucial figure in this matter.
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Affiliation(s)
- Irene Nieto-Eugenio
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Hospital Universitario Reina Sofía (HURS). Avda. Menéndez Pidal s/n, Córdoba, Spain
| | - Pedro E Ventura-Puertos
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Hospital Universitario Reina Sofía (HURS). Avda. Menéndez Pidal s/n, Córdoba, Spain..
| | - Manuel Rich-Ruiz
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Hospital Universitario Reina Sofía (HURS). Avda. Menéndez Pidal s/n, Córdoba, Spain
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11
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Marker AM, Monzon AD, Nelson EL, Clements MA, Patton SR. An Intervention to Reduce Hypoglycemia Fear in Parents of Young Kids with Type 1 Diabetes Through Video-Based Telemedicine (REDCHiP): Trial Design, Feasibility, and Acceptability. Diabetes Technol Ther 2020; 22:25-33. [PMID: 31517512 PMCID: PMC6945796 DOI: 10.1089/dia.2019.0244] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background: Fear of hypoglycemia (FH) is common in parents of young children with type 1 diabetes (T1D) and problematically linked to maladaptive behaviors to avoid low blood glucose, parenting stress, and burnout. This study examined the feasibility and acceptability of a novel group-based telemedicine intervention to reduce FH in parents of young children with T1D. Materials and Methods: Forty-three families of a young child with T1D (1-6 years of age; diagnosed with T1D for at least 6 months) enrolled in the study and 36 completed the Reducing Emotional Distress for Childhood Hypoglycemia in Parents (REDCHiP) intervention. We assessed intervention feasibility with rates of attrition, intervention attendance, and fidelity to the treatment manual. We assessed acceptability with treatment satisfaction surveys and qualitative interviews (from a subset of completers; n = 10) about intervention acceptability, facilitators, and challenges. Results: Study attrition was 21%, including long-term follow-up (16% before or during the treatment phase). On average, parents attended 94% of intervention sessions and fidelity to the treatment manual was 89%. Intervention completers reported high satisfaction with the treatment groups (89% average satisfaction rating). Parent-reported positive influencers of the REDCHiP intervention were increased knowledge, fear awareness, coping strategies, confidence, behavioral parenting strategies, and support, whereas intervention challenges included feeling fearful or overwhelmed, family stress, lack of trust, and difficulty connecting with other group members. Conclusions: The REDCHiP intervention demonstrated initial feasibility and acceptability. Next steps include determining the intervention's impact on objective parent and child outcomes (e.g., glycemic control, parental FH, and parental stress/distress) as well as large-scale efficacy testing.
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Affiliation(s)
- Arwen M. Marker
- Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, Missouri
| | - Alexandra D. Monzon
- Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, Missouri
| | - Eve-Lynn Nelson
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, Missouri
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas
| | - Mark A. Clements
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, Missouri
- Division of Endocrinology and Diabetes, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri
| | - Susana R. Patton
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, Missouri
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas
- Address correspondence to: Susana R. Patton, PhD, ABPP, CDE, Center Director/Principal Research Scientist, CHDS-FL , Nemours Children's Clinic, 807 Children's Way, Jacksonville, FL 32207
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12
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Zhao X, Ai Z, Chen Y, Wang J, Zou S, Zheng S. The Effectiveness of Parenting Interventions on Psychosocial Adjustment in Parents of Children and Adolescents with Type 1 Diabetes: A Meta‐Analysis. Worldviews Evid Based Nurs 2019; 16:462-469. [PMID: 31647190 DOI: 10.1111/wvn.12399] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/09/2019] [Accepted: 05/20/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Xiaolei Zhao
- The Affiliated Hospital of Southwest Medical University Luzhou China
| | - Zhongping Ai
- The Affiliated Hospital of Southwest Medical University Luzhou China
| | - Yanhua Chen
- The Affiliated Hospital of Southwest Medical University Luzhou China
| | - Jiaxiang Wang
- The Affiliated Hospital of Southwest Medical University Luzhou China
| | - Shufang Zou
- The Affiliated Hospital of Southwest Medical University Luzhou China
| | - Silin Zheng
- The Affiliated Hospital of Southwest Medical University Luzhou China
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13
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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.
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14
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Berget C, Driscoll KA, Lagges A, Lange S, DiMeglio LA, Hannon TS, Woerner SE, Iturralde E, Barley RC, Hanes S, Hood KK, Buckingham BB. Optimizing the use of continuous glucose monitoring in young children with type 1 diabetes with an adaptive study design and multiple randomizations. Contemp Clin Trials 2019; 82:60-65. [PMID: 31129370 DOI: 10.1016/j.cct.2019.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 05/13/2019] [Accepted: 05/22/2019] [Indexed: 11/18/2022]
Abstract
Parents of young children with type 1 diabetes (T1D) experience unique, developmental challenges in managing their child's T1D, resulting in psychosocial distress. Only a small portion of young children reach glucose goals and adherence to diabetes devices that help improve T1D management have historically been low in this population. The purpose of this study is to test four interventions that couple developmentally tailored behavioral supports with education to optimize use of diabetes devices, improve glucose control, and reduce psychosocial distress for parents of young children with T1D. The study team designed four behavioral interventions, two aimed at improving glucose control and two aimed at optimizing use of diabetes devices. The goal of this paper is to describe the behavioral interventions developed for this study, including the results of a pilot test, and describe the methods and analysis plan to test this intervention strategy with ninety participants in a large-scale, randomized trial using a sequential multiple assignment randomization trial (SMART) design. A SMART design will permit a clinically relevant evaluation of the intervention strategy, as it allows multiple randomizations based on individualized assessments throughout the study instead of a fixed intervention dose seen in most traditional randomized controlled trials.
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Affiliation(s)
- Cari Berget
- University of Colorado Denver, School of Medicine, Barbara Davis Center for Childhood Diabetes, United States of America
| | - Kimberly A Driscoll
- University of Colorado Denver, School of Medicine, Barbara Davis Center for Childhood Diabetes, United States of America
| | - Ann Lagges
- Indiana University, School of Medicine, Clinical Psychiatry, United States of America
| | - Samantha Lange
- University of Colorado Denver, School of Medicine, Barbara Davis Center for Childhood Diabetes, United States of America
| | - Linda A DiMeglio
- Indiana University, School of Medicine, Pediatric Endocrinology/Diabetology, United States of America
| | - Tamara S Hannon
- Indiana University, School of Medicine, Pediatric Endocrinology/Diabetology, United States of America
| | - Stephanie E Woerner
- Indiana University, School of Medicine, Pediatric Endocrinology/Diabetology, United States of America
| | - Esti Iturralde
- Stanford University, School of Medicine, Pediatric Diabetes & Endocrinology, United States of America; Kaiser Permanente Norther California, Division of Research, United States of America
| | - Regan C Barley
- Stanford University, School of Medicine, Pediatric Diabetes & Endocrinology, United States of America
| | - Sarah Hanes
- Stanford University, School of Medicine, Pediatric Diabetes & Endocrinology, United States of America
| | - Korey K Hood
- Stanford University, School of Medicine, Pediatric Diabetes & Endocrinology, United States of America.
| | - Bruce B Buckingham
- Stanford University, School of Medicine, Pediatric Diabetes & Endocrinology, United States of America
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15
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Tully C, Mackey E, Aronow L, Monaghan M, Henderson C, Cogen F, Wang J, Streisand R. Parenting Intervention to Improve Nutrition and Physical Activity for Preschoolers with Type 1 Diabetes: A Feasibility Study. J Pediatr Health Care 2018; 32:548-556. [PMID: 29954648 PMCID: PMC6204310 DOI: 10.1016/j.pedhc.2018.04.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 04/25/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE This study reports the feasibility and acceptability of a healthy eating and physical-activity-focused behavioral intervention for parents of young children with type 1 diabetes (T1D). METHODS Ten parents of young children (age 2-5 years) with T1D enrolled. The intervention included six behavioral sessions (five by telephone), diabetes nursing consultation, parent coach contact, text messages, and a study website. Analyses explored feasibility, acceptability, and preliminary findings. RESULTS There was evidence of high acceptability (mean parent satisfaction = 1.11, very satisfied). Although most participants completed all of the assessments, there were some barriers to data collection devices. The number of participants within the American Diabetes Association recommended glycemic range doubled; there was no significant change in hemoglobin A1c, diet, or physical activity. CONCLUSION There was evidence of feasibility and acceptability and initial evidence of change in hypothesized directions. Minor changes were made for the larger randomized controlled trial.
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16
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Delamater AM, de Wit M, McDarby V, Malik JA, Hilliard ME, Northam E, Acerini CL. ISPAD Clinical Practice Consensus Guidelines 2018: Psychological care of children and adolescents with type 1 diabetes. Pediatr Diabetes 2018; 19 Suppl 27:237-249. [PMID: 30058247 DOI: 10.1111/pedi.12736] [Citation(s) in RCA: 157] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 07/16/2018] [Indexed: 01/09/2023] Open
MESH Headings
- Adaptation, Psychological/physiology
- Adolescent
- Burnout, Psychological/psychology
- Burnout, Psychological/therapy
- Child
- Consensus
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 1/psychology
- Diabetes Mellitus, Type 1/therapy
- Endocrinology/organization & administration
- Endocrinology/standards
- Humans
- International Cooperation
- Neurodevelopmental Disorders/therapy
- Pediatrics/organization & administration
- Pediatrics/standards
- Practice Patterns, Physicians'/standards
- Psychotherapy/methods
- Psychotherapy/standards
- Quality of Life/psychology
- Resilience, Psychological
- Societies, Medical/organization & administration
- Societies, Medical/standards
- Stress, Psychological/etiology
- Stress, Psychological/therapy
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Affiliation(s)
- Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida
| | - Maartje de Wit
- Department of Medical Psychology, EMGO Institute for Health & Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Vincent McDarby
- National Children's Research Centre and Our Lady's Children's Hospital, Dublin, Ireland
| | - Jamil A Malik
- Center of Excellence, National Institute of Psychology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | | | - Carlo L Acerini
- Department of Paediatrics, University of Cambridge, Cambridge, UK
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17
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Mirza M, Krischer A, Stolley M, Magaña S, Martin M. Review of parental activation interventions for parents of children with special health care needs. Child Care Health Dev 2018; 44:401-426. [PMID: 29484702 DOI: 10.1111/cch.12554] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/09/2017] [Accepted: 01/11/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND A large number of U.S. children are identified as having special health care needs (CSHCN). Despite parents' central role in managing their child's needs, many parents report difficulties in navigating service systems, finding information about their child's condition, and accessing health care and community resources. Therefore, there is a need for interventions that "activate" parents of children with special health care needs to increase their knowledge, skills, and confidence in managing, coordinating, and advocating for their child's needs. This study sought to review the existing literature and examine the effects of parent support interventions that focus on parental activation either in part or whole, on child, parent, or family outcomes. Specific aims included (a) summarizing the nature and content of interventions; (b) describing changes in relevant outcomes; (c) identifying limitations and making recommendations for future research. METHODS Following electronic databases were searched: MEDLINE, EMBASE, PsycINFO via ProQuest, PubMed, Cumulative Index to Nursing and Allied Health via EBSCO, Education Resources Information Center (ERIC) via ProQuest, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register), and Google Scholar. Twenty-two studies were selected, data were extracted, and quality was assessed using standardized procedures. RESULTS Five intervention categories were identified: parent-to-parent supports, psycho-educational groups, content-specific groups, community health worker model, and self-management-based interventions. Although most studies showed positive effects of the intervention, evidence was inconsistent for parental outcomes such as self-efficacy, confidence, strain, depression, and perceived social support. Evidence was more consistent in showing improvement in parent coping and in use of community-based services and resources. CONCLUSIONS There is a need to boost active ingredients of interventions that specifically target enhancing parent skill sets relevant to areas of self-efficacy, confidence, and empowerment. Future studies must also adapt intervention and study design to recruit socioeconomically vulnerable families.
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Affiliation(s)
- M Mirza
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - A Krischer
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - M Stolley
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - S Magaña
- Departments of Occupational Therapy and Disability and Human Development, University of Illinois at Chicago, Chicago, IL, USA
| | - M Martin
- Department of Pediatrics and Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
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18
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Tully C, Shneider C, Monaghan M, Hilliard ME, Streisand R. Peer Coaching Interventions for Parents of Children with Type 1 Diabetes. Curr Diab Rep 2017; 17:39. [PMID: 28434144 PMCID: PMC5630452 DOI: 10.1007/s11892-017-0870-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW Peer support is a promising model of providing psychosocial support to parents of children with type 1 diabetes. This review seeks to discuss the findings of the existing literature in peer coaching as it relates to parents and diabetes as well as to identify gaps in knowledge for future intervention development and implementation. RECENT FINDINGS Peer support programs vary widely with regard to recruitment, training, and delivery protocols. Across most programs, ongoing support and supervision are provided to peer coaches. Despite inconsistent effects on psychosocial and child health outcomes, parent coaching is consistently a highly acceptable and feasible intervention with parents of children with T1D. Current evidence supports use of parent coaching as part of a multicomponent intervention or program to increase patient satisfaction, but more research is needed to determine if it can stand alone as an active mechanism for behavior change. The use of peer coach interventions for parents of young children with diabetes is feasible to implement and highly acceptable. However, more research is needed to understand the enduring impact for target parents and peer coaches alike, as well as impact on child outcomes.
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Affiliation(s)
- Carrie Tully
- Center for Translational Science, Children's National Medical Center, 111 N. Michigan Avenue NW, Washington, DC, 20010, USA.
| | - Caitlin Shneider
- Center for Translational Science, Children's National Medical Center, 111 N. Michigan Avenue NW, Washington, DC, 20010, USA
| | - Maureen Monaghan
- Center for Translational Science, Children's National Medical Center, 111 N. Michigan Avenue NW, Washington, DC, 20010, USA
- School of Medicine & Health Sciences, George Washington University, 2300 Eye Street NW, Washington, DC, 20037, USA
| | - Marisa E Hilliard
- Baylor College of Medicine and Texas Children's Hospital, 1102 Bates Ave, Suite 940, Houston, TX, 77030, USA
| | - Randi Streisand
- Center for Translational Science, Children's National Medical Center, 111 N. Michigan Avenue NW, Washington, DC, 20010, USA
- School of Medicine & Health Sciences, George Washington University, 2300 Eye Street NW, Washington, DC, 20037, USA
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19
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Rodgers CC, Laing CM, Herring RA, Tena N, Leonardelli A, Hockenberry M, Hendricks-Ferguson V. Understanding Effective Delivery of Patient and Family Education in Pediatric Oncology A Systematic Review From the Children's Oncology Group [Formula: see text]. J Pediatr Oncol Nurs 2016; 33:432-446. [PMID: 27450361 PMCID: PMC5235950 DOI: 10.1177/1043454216659449] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A diagnosis of childhood cancer is a life-changing event for the entire family. Parents must not only deal with the cancer diagnosis but also acquire new knowledge and skills to care safely for their child at home. Best practices for delivery of patient/family education after a new diagnosis of childhood cancer are currently unknown. The purpose of this systematic review was to evaluate the existing body of evidence to determine the current state of knowledge regarding the delivery of education to newly diagnosed pediatric oncology patients and families. Eighty-three articles regarding educational methods, content, influencing factors, and interventions for newly diagnosed pediatric patients with cancer or other chronic illnesses were systematically identified, summarized, and appraised according to the Grading of Recommendations Assessment, Development, and Evaluation criteria. Based on the evidence, 10 recommendations for practice were identified. These recommendations address delivery methods, content, influencing factors, and educational interventions for parents and siblings. Transferring these recommendations into practice may enhance the quality of education delivered by health care providers and received by patients and families following a new diagnosis of childhood cancer.
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Affiliation(s)
| | | | | | - Nancy Tena
- University of Michigan Health System, Ann Arbor, MI, USA
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20
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Channon S, Lowes L, Gregory JW, Grey L, Sullivan-Bolyai S. Feasibility of Parent-to-Parent Support in Recently Diagnosed Childhood Diabetes: The PLUS Study. DIABETES EDUCATOR 2016; 42:462-9. [PMID: 27099255 PMCID: PMC4944180 DOI: 10.1177/0145721716644673] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose The purpose of this study was to develop and test the feasibility of a parent-to-parent support intervention for parents whose child has recently been diagnosed with type 1 diabetes in the United Kingdom. Methods The research team conducted a formative evaluation, working with parents to design an individual-level parent-to-parent support intervention. Issues of recruitment, uptake, attrition, pattern of contact, and intervention acceptability were assessed. Results A US program was adapted in collaboration with a parents’ advisory group. Of 19 parents nominated as potential mentors by their pediatric diabetes specialist nurses, 12 (63%) volunteered and 11 continued for the 12-month intervention period. Thirty-three children were diagnosed with diabetes in the study period, with 25 families eligible to participate as recipients of the intervention; 9 parents from 7 of those families participated, representing 28% of those eligible. Feedback from parents and clinic staff identified peer support as a welcome service. Lessons were learned about the nature of the supporting relationship (eg, proximity, connectedness, and managing endings) that will enhance the design of future peer support programs. Conclusions Parent-to-parent support in the context of newly diagnosed childhood diabetes in the United Kingdom is feasible to deliver, with good engagement of mentors and clinic staff. The program was acceptable to parents who chose to participate, although uptake by parents whose child had been recently diagnosed was lower than expected. The results merit further investigation, including exploration of parent preference in relation to peer support.
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Affiliation(s)
- Sue Channon
- South East Wales Trials Unit, Cardiff University, Cardiff, UK (Dr Channon)
| | - Lesley Lowes
- School of Health Care Sciences, Cardiff University, Cardiff, UK (Dr Lowes)
| | - John W Gregory
- School of Medicine, Cardiff University, Cardiff, UK (Dr Gregory)
| | - Laura Grey
- School of Psychology, Cardiff University, Cardiff, UK (Dr Grey)
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21
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Forsner M, Berggren J, Masaba J, Ekbladh A, Anna Lindholm AL. Parents’ experiences of caring for a child younger than two years of age treated with continuous subcutaneous insulin infusion. ACTA ACUST UNITED AC 2015. [DOI: 10.1002/edn.239] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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22
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Delamater AM, de Wit M, McDarby V, Malik J, Acerini CL. ISPAD Clinical Practice Consensus Guidelines 2014. Psychological care of children and adolescents with type 1 diabetes. Pediatr Diabetes 2014; 15 Suppl 20:232-44. [PMID: 25182317 DOI: 10.1111/pedi.12191] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Accepted: 06/17/2014] [Indexed: 02/06/2023] Open
Affiliation(s)
- Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
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23
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Rankin D, Harden J, Waugh N, Noyes K, Barnard KD, Lawton J. Parents' information and support needs when their child is diagnosed with type 1 diabetes: a qualitative study. Health Expect 2014; 19:580-91. [PMID: 25074412 PMCID: PMC5055234 DOI: 10.1111/hex.12244] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AIM AND OBJECTIVE The aim of this study was to describe and explore parents' information and support needs when their child is diagnosed with type 1 diabetes, including their views about the timing and chronology of current support provision. Our objective was to identify ways in which parents could be better supported in the future. DESIGN AND PARTICIPANTS Semi-structured interviews were conducted with 54 parents of children with type 1 diabetes in four paediatric diabetes clinics in Scotland. Data were analysed using an inductive, thematic approach. FINDINGS Parents described needing more reassurance after their child was diagnosed before being given complex information about diabetes management, so they would be better placed psychologically and emotionally to absorb this information. Parents also highlighted a need for more emotional and practical support from health professionals when they first began to implement diabetes regimens at home, tailored to their personal and domestic circumstances. However, some felt unable to ask for help or believed that health professionals were unable to offer empathetic support. Whilst some parents highlighted a need for support delivered by peer parents, others who had received peer support conveyed ambivalent views about the input and advice they had received. CONCLUSIONS Our findings suggest that professionals should consider the timing and chronology of support provision to ensure that parents' emotional and informational needs are addressed when their child is diagnosed and that practical advice and further emotional support are provided thereafter, which takes account of their day-to-day experiences of caring for their child.
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Affiliation(s)
- David Rankin
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Jeni Harden
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Norman Waugh
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | | | - Julia Lawton
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
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Revisiting a non-significant findings study: a parent mentor intervention trial as exemplar. Appl Nurs Res 2014; 27:213-8. [PMID: 24661347 DOI: 10.1016/j.apnr.2014.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 11/05/2013] [Accepted: 02/03/2014] [Indexed: 11/22/2022]
Abstract
The purpose of this paper is to describe an interactive process for revising a parent social support intervention study with non-significant quantitative findings but strong clinical significance. We will present the methodological challenges that were problematic in the original intervention that potentially contributed to the non-significant findings, and a revised plan of action for conducting a future parent social support intervention. Of note, we have reconsidered the theory used to frame the original study, the randomization process, the intervention clarity and fidelity plan, what measures would better capture the effect, and the development of a more robust analysis plan that considers intra-family correlation, mediation and moderation (mixed model analysis). We will present the revision for each of these methods supported by recent empirical literature. Although this process may not be appropriate for all non-significant interventions, it should be considered with any study that has clinical significance.
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25
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Abstract
The incidence of type 1 diabetes (T1D) in young children (age <6 years) is rising. Diabetes management guidelines offered by the American Diabetes Association and health care teams understandably place a high burden of responsibility on caregivers to check young children's blood glucose levels, administer insulin, and monitor diet and physical activity with the ultimate goal of maintaining tight glycemic control. Unfortunately, this tight control is needed during a vulnerable developmental period when behavior is unpredictable, T1D can be physiologically difficult to control, parenting stress can be elevated, and caregivers are strained by normal child caretaking routines. Despite the potentially different management needs, specific education and clinical services for managing diabetes in young children are rarely offered, and behavioral research with this young child age group has been limited in scope and quantity. Research findings pertinent to young children with T1D are reviewed, and potential clinical implications, as well as areas for future research, are discussed.
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Affiliation(s)
- Randi Streisand
- Center for Translational Science Children's National Medical Center 111 Michigan Ave NW Washington, DC 20010 (202) 476-2730 (phone); (202) 476-3966 (fax)
| | - Maureen Monaghan
- Center for Translational Science Children's National Medical Center 111 Michigan Ave NW Washington, DC 20010 (202) 476-4726 (phone); (202) 476-3966 (fax)
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Shilling V, Morris C, Thompson-Coon J, Ukoumunne O, Rogers M, Logan S. Peer support for parents of children with chronic disabling conditions: a systematic review of quantitative and qualitative studies. Dev Med Child Neurol 2013; 55:602-9. [PMID: 23421818 DOI: 10.1111/dmcn.12091] [Citation(s) in RCA: 153] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/20/2012] [Indexed: 11/28/2022]
Abstract
AIM To review the qualitative and quantitative evidence of the benefits of peer support for parents of children with disabling conditions in the context of health, well-being, impact on family, and economic and service implications. METHOD We comprehensively searched multiple databases. Eligible studies evaluated parent-to-parent support and reported on the psychological health and experience of giving or receiving support. There were no limits on the child's condition, study design, language, date, or setting. We sought to aggregate quantitative data; findings of qualitative studies were combined using thematic analysis. Qualitative and quantitative data were brought together in a narrative synthesis. RESULTS Seventeen papers were included: nine qualitative studies, seven quantitative studies, and one mixed-methods evaluation. Four themes were identified from qualitative studies: (1) shared social identity, (2) learning from the experiences of others, (3) personal growth, and (4) supporting others. Some quantitative studies reported a positive effect of peer support on psychological health and other outcomes; however, this was not consistently confirmed. It was not possible to aggregate data across studies. No costing data were identified. CONCLUSION Qualitative studies strongly suggest that parents perceive benefit from peer support programmes, an effect seen across different types of support and conditions. However, quantitative studies provide inconsistent evidence of positive effects. Further research should explore whether this dissonance is substantive or an artefact of how outcomes have been measured.
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Affiliation(s)
- Val Shilling
- Peninsula Cerebra Research Unit, University of Exeter Medical School, Exeter, UK
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Whittemore R, Jaser S, Chao A, Jang M, Grey M. Psychological experience of parents of children with type 1 diabetes: a systematic mixed-studies review. DIABETES EDUCATOR 2012; 38:562-79. [PMID: 22581804 DOI: 10.1177/0145721712445216] [Citation(s) in RCA: 247] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE The purpose of this review is to describe the prevalence of psychological distress in parents of children with type 1 diabetes (T1DM), the relationship between parental psychological distress and health outcomes, and parents' psychological experience of having a child with T1DM. Clinical and research implications are presented. METHOD A systematic mixed-studies review was undertaken to review the quantitative and qualitative research on the parental experience of having a child with T1DM. A total of 34 articles met the inclusion criteria and were included in the review. RESULTS The prevalence of parental psychological distress across all studies ranged from 10% to 74%, with an average of 33.5% of parents reporting distress at diagnosis and 19% of parents reporting distress 1 to 4 years after diagnosis. Parental psychological distress in parents of children with T1DM, regardless of how it was defined, was associated with higher child self-report of stress and depressive symptoms, more problematic child behavior, and lower child self-report of quality of life. Parental psychological distress also had negative effects on diabetes management. Themes of the qualitative synthesis indicated that parents perceived T1DM as a difficult diagnosis that contributed to significant family disruption. Adjustment occurred over time; however, ongoing stress was experienced. CONCLUSIONS Screening for psychological distress in parents of children with T1DM is indicated, and preventive interventions are needed.
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Affiliation(s)
| | - Sarah Jaser
- Yale School of Nursing, New Haven, Connecticut
| | - Ariana Chao
- Yale School of Nursing, New Haven, Connecticut
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Nicholas DB, Fellner KD, Frank M, Small M, Hetherington R, Slater R, Daneman D. Evaluation of an online education and support intervention for adolescents with diabetes. SOCIAL WORK IN HEALTH CARE 2012; 51:815-827. [PMID: 23078013 DOI: 10.1080/00981389.2012.699507] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The current study evaluated an online education and support website intervention for adolescents with Type 1 diabetes. Participants were enrolled in an 8-week, online program addressing diabetes-related issues for adolescents. The evaluation comprised an intervention trial in which participants were assigned to an intervention or control group, and pre- and post-intervention measures of social support were administered. Outcomes indicated interventional gains approaching significance in participants' quality of relationships with others external to their family. Post-intervention qualitative interviews with intervention group participants identified beneficial impacts of decreased isolation, knowledge gain, and normalization of experience. Findings suggest that online information and support is an important resource in augmenting clinical care. Implications and recommendations for clinical practice are discussed.
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Affiliation(s)
- David B Nicholas
- Faculty of Social Work, University of Calgary, Edmonton, Alberta, Canada.
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Abstract
Diabetes mellitus diagnosed during the first 2 years of life differs from the disease in older children regarding its causes, clinical characteristics, treatment options and needs in terms of education and psychosocial support. Over the past decade, new genetic causes of neonatal diabetes mellitus have been elucidated, including monogenic β-cell defects and chromosome 6q24 abnormalities. In patients with KCNJ11 or ABCC8 mutations and diabetes mellitus, oral sulfonylurea offers an easy and effective treatment option. Type 1 diabetes mellitus in infants is characterized by a more rapid disease onset, poorer residual β-cell function and lower rate of partial remission than in older children. Insulin therapy in infants with type 1 diabetes mellitus or other monogenic causes of diabetes mellitus is a challenge, and novel data highlight the value of continuous subcutaneous insulin infusion in this very young patient population. Infants are entirely dependent on caregivers for insulin therapy, nutrition and glucose monitoring, which emphasizes the need for appropriate education and psychosocial support of parents. To achieve optimal long-term metabolic control with low rates of acute and chronic complications, continuous and structured diabetes care should be provided by a multidisciplinary health-care team.
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Affiliation(s)
- Beate Karges
- Division of Endocrinology and Diabetes, RWTH Aachen University, Pauwelsstraße 30, D-52074 Aachen, Germany.
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Rearick EM, Sullivan-Bolyai S, Bova C, Knafl KA. Parents of Children Newly Diagnosed With Type 1 Diabetes: Experiences With Social Support and Family Management. DIABETES EDUCATOR 2011; 37:508-18. [DOI: 10.1177/0145721711412979] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose The purpose of this mixed-methods descriptive study with parents of children newly diagnosed with type 1 diabetes was to explore their experiences with peer social support following the Social Support to Empower Parents (STEP) intervention and the usefulness of the Family Management Measure (FaMM) in this population. Methods Parents who were in the experimental arm of STEP were recruited. Qualitative interviews were conducted (n = 21), and 11 parents completed the FaMM, a quantitative family-functioning measure. Qualitative content data analysis was conducted and compared to the descriptive measure analysis. Findings Three themes were identified: availability, practical tips, and common ground. Five FaMM subscales were reliable (α > .80) in this small sample. Conclusions The findings illustrate that the STEP intervention is helpful, providing the participants with emotional, affirmational, and informational social support. The use of the FaMM is a first step in assessing family management in families with children with type 1 diabetes.
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Sullivan-Bolyai S, Lee MM. Parent mentor perspectives on providing social support to empower parents. DIABETES EDUCATOR 2011; 37:35-43. [PMID: 21292621 DOI: 10.1177/0145721710392248] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To describe the experience of parent mentors providing a social support intervention to parents of children < 13 years old newly diagnosed with type 1 diabetes mellitus. METHODS Qualitative descriptive interviews were conducted with 6 parent mentors (all mothers) who provided social support to 34 mothers and 19 fathers of children newly diagnosed with type 1 diabetes mellitus over a 12-month period. The mentors were trained to provide informational, affirmational, and emotional social support through home visits, phone calls, and/or e-mail. Qualitative content analysis was used to identify themes guided by the Ireys social support framework. FINDINGS The parent mentors described support activities that could be categorized into the 3 types of support defined in the Ireys framework. The parent mentors provided informational support, such as tips for travel, school, parties and family get-togethers, camp resources, and how to advocate for the child. Affirmational support was provided by sharing stories and validating parents' feelings and experiences. Emotional support was provided by "being there" for the parents. No instances were described where parent mentors were pushed to give advice on medical management issues but were more so used for advice on growth and development, sleep, and healthy eating suggestions. Parent mentors also reported being empowered by the role by helping others. CONCLUSION Careful selection of parent mentors is a strategy for providing social support to parents of children newly diagnosed with type 1 diabetes mellitus, especially in day-to-day management areas that the health care professionals have not experienced.
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Affiliation(s)
- Susan Sullivan-Bolyai
- The University of Massachusetts, Worcester, Massachusetts (Sullivan-Bolyai),University of Massachusetts Diabetes and Endocrinology Research Center (DK32520) (Sullivan-Bolyai and Lee)
| | - Mary M Lee
- The Department of Pediatrics, UMass Medical School, Worcester, Massachusetts (Lee),University of Massachusetts Diabetes and Endocrinology Research Center (DK32520) (Sullivan-Bolyai and Lee)
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Still too little qualitative research to shed light on results from reviews of effectiveness trials: a case study of a Cochrane review on the use of lay health workers. Implement Sci 2011; 6:53. [PMID: 21619645 PMCID: PMC3117743 DOI: 10.1186/1748-5908-6-53] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Accepted: 05/27/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Qualitative research is used increasingly alongside trials of complex interventions to explore processes, contextual factors, or intervention characteristics that may have influenced trial outcomes. Qualitative research conducted alongside trials can also be used to shed light on the results of systematic reviews of effectiveness by looking for factors that can help explain heterogeneous results across trials. In a Cochrane review on the effects of using lay health workers on maternal and child health and infectious disease control, we identified 82 trials. These trials showed promising benefits but results were heterogeneous. OBJECTIVE To use qualitative studies conducted alongside these trials to explore factors and processes that might have influenced intervention outcomes. METHODS We attempted to identify qualitative research carried out alongside the trials by contacting trial authors, checking papers for references to qualitative research, searching Pubmed for related studies, and carrying out citation searches. For those qualitative studies that we included, we extracted information regarding study objective, data collection and analysis methods, and key themes and categories. RESULTS For 52 (63%) of the trials, we found no qualitative research that had been conducted alongside the trials. For 16 (20%) trials, some form of qualitative data collection had been done but was unavailable or had been done before the trial. For 14 (17%) trials, qualitative research had been done during or shortly after the trial, although descriptions of qualitative methods and results were often sparse. Most of these 14 studies aimed to elicit trial participants' perspectives and experiences of the intervention. A common theme was participants' appreciation of the lay health workers' shared circumstances, for instance with regard to social background or experience of the health condition. In six studies, researchers explored the experiences of the lay health workers themselves. Issues included the importance of regular supervision and health professionals' support or lack of support. CONCLUSIONS Qualitative studies carried out alongside trials of complex interventions could offer opportunities to authors of systematic reviews of effectiveness wishing to understand the heterogeneity of trial results. For interventions of lay health worker programmes at least, too few such studies exist at present for these opportunities to be realised.
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Grey M, Jaser SS, Whittemore R, Jeon S, Lindemann E. Coping skills training for parents of children with type 1 diabetes: 12-month outcomes. Nurs Res 2011; 60:173-81. [PMID: 21522034 PMCID: PMC3134246 DOI: 10.1097/nnr.0b013e3182159c8f] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although it is recognized that caring for a child with Type 1 diabetes (T1D) is stressful for parents, few interventions have been developed and tested for this population. OBJECTIVES The aim of this study was to compare a group educational intervention for parents of children with T1D to a coping skills training intervention. METHODS Parents of children with T1D were randomized to the group educational (n = 106) or coping skills training (n = 75) conditions. Parents completed measures of family conflict, responsibility for treatment, coping, and quality of life at baseline and at 3, 6, and 12 months postintervention. Clinical data (i.e., HbA1c) were collected from children's medical records preintervention and postintervention. RESULTS There were no significant treatment effects 12 months postintervention, but parents in both groups reported improved coping (p < .001), less responsibility for treatment management (p < .001), and improved quality of life (p = .005). While children's metabolic control worsened over time, mean values at 12 months were still within the recommended levels in this well-controlled sample (HbA1c <8%). DISCUSSION Group-based interventions for parents of children with T1D may lessen the impact of treatment management, improving coping and quality of life.
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Affiliation(s)
- Margaret Grey
- School of Nursing, Yale University, New Haven, Connecticut 06536, USA
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Parent advocates in children's mental health: program implementation processes and considerations. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2011; 37:468-83. [PMID: 20195743 DOI: 10.1007/s10488-010-0288-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Children's mental health service systems are increasingly utilizing peer support services to support families experiencing serious child mental illness. The literature provides few detailed accounts of such peer-based approaches. This study qualitatively examined the approaches and processes of "parent advocate" programs implemented in two Ohio counties for children served through publicly funded mental health services. Descriptions of each county's program, the background and roles of parent advocates, reasons families decline advocate services, and challenges to advocates' work with families are provided. Implications for the field in developing clear and effective administrative and practice structures for peer support services are discussed.
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Monaghan M, Hilliard ME, Cogen FR, Streisand R. Supporting parents of very young children with type 1 diabetes: results from a pilot study. PATIENT EDUCATION AND COUNSELING 2011; 82:271-4. [PMID: 20434293 PMCID: PMC2965294 DOI: 10.1016/j.pec.2010.04.007] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Revised: 03/17/2010] [Accepted: 04/02/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To assess initial efficacy and feasibility of a telephone-based supportive intervention for parents of young children with type 1 diabetes (T1D) designed to improve parental quality of life (QOL) through decreased parental stress, increased social support, and improved daily management of their child's diabetes. METHODS The research team developed a brief program based on social cognitive theory for parents of young children with T1D. Twenty-four parents (88% mothers) of young children with T1D (ages 2-5 years) participated in a pilot study of the program and completed psychosocial questionnaires and a program satisfaction survey. RESULTS Paired t-tests of pre- and post-intervention scores suggested a favorable within-group impact for the intervention group, as evidenced by decreased pediatric parenting stress and a trend for increased perceived social support. The program was well-received, with the majority of participants rating it as helpful and interesting. CONCLUSION Assisting parents with the unique challenges of diabetes management in young children through implementation of a structured intervention is promising. PRACTICE IMPLICATIONS A telephone-based intervention focused on child development, coping, and problem-solving skills has the potential to positively impact parents' QOL and may have implications for children's health.
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Affiliation(s)
- Maureen Monaghan
- Department of Psychology, Clinical Research Institute, Children's National Medical Center, Washington, DC 20010, USA.
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Lewin S, Munabi‐Babigumira S, Glenton C, Daniels K, Bosch‐Capblanch X, van Wyk BE, Odgaard‐Jensen J, Johansen M, Aja GN, Zwarenstein M, Scheel IB. Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases. Cochrane Database Syst Rev 2010; 2010:CD004015. [PMID: 20238326 PMCID: PMC6485809 DOI: 10.1002/14651858.cd004015.pub3] [Citation(s) in RCA: 528] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Lay health workers (LHWs) are widely used to provide care for a broad range of health issues. Little is known, however, about the effectiveness of LHW interventions. OBJECTIVES To assess the effects of LHW interventions in primary and community health care on maternal and child health and the management of infectious diseases. SEARCH STRATEGY For the current version of this review we searched The Cochrane Central Register of Controlled Trials (including citations uploaded from the EPOC and the CCRG registers) (The Cochrane Library 2009, Issue 1 Online) (searched 18 February 2009); MEDLINE, Ovid (1950 to February Week 1 2009) (searched 17 February 2009); MEDLINE In-Process & Other Non-Indexed Citations, Ovid (February 13 2009) (searched 17 February 2009); EMBASE, Ovid (1980 to 2009 Week 05) (searched 18 February 2009); AMED, Ovid (1985 to February 2009) (searched 19 February 2009); British Nursing Index and Archive, Ovid (1985 to February 2009) (searched 17 February 2009); CINAHL, Ebsco 1981 to present (searched 07 February 2010); POPLINE (searched 25 February 2009); WHOLIS (searched 16 April 2009); Science Citation Index and Social Sciences Citation Index (ISI Web of Science) (1975 to present) (searched 10 August 2006 and 10 February 2010). We also searched the reference lists of all included papers and relevant reviews, and contacted study authors and researchers in the field for additional papers. SELECTION CRITERIA Randomised controlled trials of any intervention delivered by LHWs (paid or voluntary) in primary or community health care and intended to improve maternal or child health or the management of infectious diseases. A 'lay health worker' was defined as any health worker carrying out functions related to healthcare delivery, trained in some way in the context of the intervention, and having no formal professional or paraprofessional certificate or tertiary education degree. There were no restrictions on care recipients. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data using a standard form and assessed risk of bias. Studies that compared broadly similar types of interventions were grouped together. Where feasible, the study results were combined and an overall estimate of effect obtained. MAIN RESULTS Eighty-two studies met the inclusion criteria. These showed considerable diversity in the targeted health issue and the aims, content, and outcomes of interventions. The majority were conducted in high income countries (n = 55) but many of these focused on low income and minority populations. The diversity of included studies limited meta-analysis to outcomes for four study groups. These analyses found evidence of moderate quality of the effectiveness of LHWs in promoting immunisation childhood uptake (RR 1.22, 95% CI 1.10 to 1.37; P = 0.0004); promoting initiation of breastfeeding (RR = 1.36, 95% CI 1.14 to 1.61; P < 0.00001), any breastfeeding (RR 1.24, 95% CI 1.10 to 1.39; P = 0.0004), and exclusive breastfeeding (RR 2.78, 95% CI 1.74 to 4.44; P <0.0001); and improving pulmonary TB cure rates (RR 1.22 (95% CI 1.13 to 1.31) P <0.0001), when compared to usual care. There was moderate quality evidence that LHW support had little or no effect on TB preventive treatment completion (RR 1.00, 95% CI 0.92 to 1.09; P = 0.99). There was also low quality evidence that LHWs may reduce child morbidity (RR 0.86, 95% CI 0.75 to 0.99; P = 0.03) and child (RR 0.75, 95% CI 0.55 to 1.03; P = 0.07) and neonatal (RR 0.76, 95% CI 0.57 to 1.02; P = 0.07) mortality, and increase the likelihood of seeking care for childhood illness (RR 1.33, 95% CI 0.86 to 2.05; P = 0.20). For other health issues, the evidence is insufficient to draw conclusions regarding effectiveness, or to enable the identification of specific LHW training or intervention strategies likely to be most effective. AUTHORS' CONCLUSIONS LHWs provide promising benefits in promoting immunisation uptake and breastfeeding, improving TB treatment outcomes, and reducing child morbidity and mortality when compared to usual care. For other health issues, evidence is insufficient to draw conclusions about the effects of LHWs.
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Affiliation(s)
- Simon Lewin
- Norwegian Knowledge Centre for the Health ServicesPreventive and International Health Care UnitBox 7004 St OlavsplassOsloNorwayN‐0130
| | - Susan Munabi‐Babigumira
- Norwegian Knowledge Centre for the Health ServicesPreventive and International Health Care UnitBox 7004 St OlavsplassOsloNorwayN‐0130
| | - Claire Glenton
- SINTEF Health ResearchDepartment of Global Health and WelfareP.O. Box 124 BlindernOsloNorwayN‐0314
| | - Karen Daniels
- Medical Research CouncilHealth Systems Research UnitPO Box 19070TygerbergSouth Africa7505
| | - Xavier Bosch‐Capblanch
- Swiss Tropical and Public Health InstituteSwiss Centre for International HealthSocinstrasse 57BaselSwitzerland4002
| | - Brian E van Wyk
- University of the Western CapeSchool of Public HealthModderdam RoadBellvilleSouth Africa7535
| | - Jan Odgaard‐Jensen
- Norwegian Knowledge Centre for the Health ServicesPO Box 7004, St. Olavs PlassOsloNorwayN‐0130
| | - Marit Johansen
- Norwegian Knowledge Centre for the Health ServicesPO Box 7004, St. Olavs PlassOsloNorwayN‐0130
| | - Godwin N Aja
- Babcock UniversityDepartment of Health SciencesIlishan‐RemoIkeja‐LagosSouth WestNigeriaPMB 21244
| | - Merrick Zwarenstein
- Sunnybrook Health Sciences CentreCombined Health Services Sciences2075 Bayview Ave., Room G1 06TorontoONCanadaM4N 3M5
| | - Inger B Scheel
- SINTEF Health ResearchDepartment of Global Health and WelfareP.O. Box 124 BlindernOsloNorwayN‐0314
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Sullivan-Bolyai S, Bova C, Leung K, Trudeau A, Lee M, Gruppuso P. Social Support to Empower Parents (STEP): an intervention for parents of young children newly diagnosed with type 1 diabetes. DIABETES EDUCATOR 2009; 36:88-97. [PMID: 20016058 DOI: 10.1177/0145721709352384] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this study was to test the efficacy of a social support intervention with parents of children <13 years old newly diagnosed with type 1 diabetes mellitus (T1DM). METHODS For this randomized, controlled clinical trial, 10 parent mentors of children diagnosed with T1DM >or=1 year and 60 parent participants were recruited from 2 pediatric diabetes centers. Mentors were trained to provide social support (home visits and phone calls) for 12 months to families in the experimental arm (32 mothers). Control group parents (28 mothers) received the phone number of an experienced parent (not trained to give social support) to call as needed. Findings Mothers in the experimental and control arms differed at baseline only in birth order of the child with T1DM. The 2 groups did not differ significantly at 3, 6, or 12 months in parent concern, confidence, worry, impact on the family, or perceived social support. Mothers in the experimental arm identified the parent mentor as someone they would seek for advice and issues regarding growth and development, sleep, eating habits, and identification of community agencies. Parent mentors consistently referred mothers to health care providers for advice on medications and treatments but helped them incorporate this advice into day-to-day management. CONCLUSION Mothers in the experimental arm valued the mentors' help in adjusting to the diagnosis, but this value was not measured by the study instruments. Focus group research is under way to clarify the concept of parent mentor social support and to develop a social support measurement tool.
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Affiliation(s)
- Susan Sullivan-Bolyai
- The Graduate School of Nursing, University of Massachusetts, Worcester (Ms Sullivan-Bolyai, Dr Bova, Ms Leung, Ms Trudeau, Dr Lee)
| | - Carol Bova
- The Graduate School of Nursing, University of Massachusetts, Worcester (Ms Sullivan-Bolyai, Dr Bova, Ms Leung, Ms Trudeau, Dr Lee)
| | - Katherine Leung
- The Graduate School of Nursing, University of Massachusetts, Worcester (Ms Sullivan-Bolyai, Dr Bova, Ms Leung, Ms Trudeau, Dr Lee)
| | - Allison Trudeau
- The Graduate School of Nursing, University of Massachusetts, Worcester (Ms Sullivan-Bolyai, Dr Bova, Ms Leung, Ms Trudeau, Dr Lee)
| | - Mary Lee
- The Graduate School of Nursing, University of Massachusetts, Worcester (Ms Sullivan-Bolyai, Dr Bova, Ms Leung, Ms Trudeau, Dr Lee)
| | - Philip Gruppuso
- Brown University School of Medicine, Providence, Rhode Island (Dr Gruppuso)
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Sullivan-Bolyai S. Familias Apoyadas: Latino families supporting each other for diabetes care. J Pediatr Nurs 2009; 24:495-505. [PMID: 19931147 DOI: 10.1016/j.pedn.2008.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2008] [Revised: 04/29/2008] [Accepted: 07/16/2008] [Indexed: 10/20/2022]
Abstract
This study was undertaken to improve the cultural and linguistic sensitivity of an established parent-mentor training curriculum for Latino parents of young children newly diagnosed with type 1 diabetes. The cultural sensitivity of curriculum components was determined by interviewing four Latino mothers raising five children (aged 7 to 12 years) with type 1 diabetes. The mothers recommended offering resources in English and Spanish, including access to bilingual taxi service, providing access to family diabetes education on child development and preparation of healthy traditional cultural foods, and training for babysitting children with diabetes. They also suggested offering after-school and weekend diabetes clinics to decrease interference with work and school activities.
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Affiliation(s)
- Susan Sullivan-Bolyai
- Graduate School of Nursing, University of Massachusetts, Worcester, Worcester, MA, USA.
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Affiliation(s)
- Alan M Delamater
- University of Miami, Department of Pediatrics, Miami, Florida, USA.
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Grey M, Whittemore R, Jaser S, Ambrosino J, Lindemann E, Liberti L, Northrup V, Dziura J. Effects of coping skills training in school-age children with type 1 diabetes. Res Nurs Health 2009; 32:405-18. [PMID: 19488997 DOI: 10.1002/nur.20336] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Children with type 1 diabetes are at risk for negative psychosocial and physiological outcomes, particularly as they enter adolescence. The purpose of this randomized trial (n = 82) was to determine the effects, mediators, and moderators of a coping skills training intervention (n = 53) for school-aged children compared to general diabetes education (n = 29). Both groups improved over time, reporting lower impact of diabetes, better coping with diabetes, better diabetes self-efficacy, fewer depressive symptoms, and less parental control. Treatment modality (pump vs. injections) moderated intervention efficacy on select outcomes. Findings suggest that group-based interventions may be beneficial for this age group.
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Affiliation(s)
- Margaret Grey
- Yale School of Nursing, 100 Church Street South, New Haven, CT 06536-0740, USA
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Abstract
The first two years after an infant's birth is a time of transition for mothers as changes in roles, responsibilities, expectations, and behaviors occur in response to the demands of caring for newborn infants and young children. Mothers play pivotal roles in overall child development and health and may benefit from nursing intervention that assists in the transition to motherhood. A review of the intervention literature related to the promotion of effective mothering was performed in order to examine the range of interventions and evidence of their usefulness for maternal-child and pediatric nursing practice. Five broad categories of interventions appropriate for nursing practice were identified through the literature review. Home visiting, skin-to-skin contact, individual, infant-focused education/counseling, and theory-based group intervention have a specific applicability for the promotion of mothering in particular populations of mothers. Based on the evidence, nurses can incorporate selected strategies into nursing care to promote effective mothering during the first years of a child's life.
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Affiliation(s)
- Marcia R Gardner
- Center for Health Disparities Research, School of Nursing, University of Pennsylvania, Pennsylvania, Philadelphia 19102, USA.
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Grey M. Coping and Psychosocial Adjustment in Mothers of Young Children with Type 1 Diabetes. CHILDRENS HEALTH CARE 2009; 38:91-106. [PMID: 19412355 DOI: 10.1080/02739610902813229] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This study examined symptoms of anxiety and depression in mothers of young children with type 1 diabetes (T1D) in relation to mothers' fears of hypoglycemia, perceptions of coping, and children's metabolic control. Sixty-seven mothers of children less than 8 years of age diagnosed with T1D completed self-report measures, and children's metabolic control was measured with glycosolated hemoglobin (HbA1c). Twenty-one percent of mothers reported clinically significant levels of symptoms of anxiety, and twenty-four percent reported clinically significant levels of depression. Lower income level and finding it more upsetting to cope with diabetes-related stress accounted for higher symptoms of anxiety and depression in mothers. Mothers' symptoms were not related to children's metabolic control. Recommendations are made for screening mothers and providing supportive interventions to alleviate their distress.
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Abstract
BACKGROUND Peer support telephone calls have been used for a wide range of health-related concerns. However, little is known about their effects. OBJECTIVES To assess the effects of peer support telephone calls in terms of physical (e.g. blood pressure), psychological (e.g. depressive symptoms), and behavioural health outcomes (e.g. uptake of mammography) and other outcomes. SEARCH STRATEGY We searched: The Cochrane Library databases (CENTRAL, DARE, CDSR) (issue 4 2007); MEDLINE (OVID) (January 1966 to December 2007); EMBASE (OVID) (January 1985 to December 2007); CINAHL (Athens) (January 1966 to December 2007), trials registers and reference lists of articles, with no language restrictions. SELECTION CRITERIA Randomised controlled trials of peer support interventions delivered by telephone call. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data. We present results narratively and in tabular format. Meta-analysis was not possible due to heterogeneity between studies. MAIN RESULTS We included seven studies involving 2492 participants.Peer support telephone calls were associated with an increase in mammography screening, with 49% of women in the intervention group and 34% of women in the control group receiving a mammogram since the start of the intervention (P </ = 0.001). In another study, peer telephone support calls were found to maintain mammography screening uptake for baseline adherent women (P = 0.029).Peer support telephone calls for post myocardial infarction patients were associated at six months with a change in diet in the intervention and usual care groups of 54% and 44% respectively (P = 0.03). In another study for post myocardial infarction patients there were no significant differences between groups for self-efficacy, health status and mental health outcomes.Peer support telephone calls were associated with greater continuation of breastfeeding in mothers at 3 months post partum (P = 0.01).Peer support telephone calls were associated with reduced depressive symptoms in mothers with postnatal depression (Edinburgh Postnatal Depression Scale (EPDS) > 12). The peer support intervention significantly decreased depressive symptomatology at the 4-week assessment (odds ratio (OR) 6.23 (95% confidence interval (CI) 1.15 to 33.77; P = 0.02)) and 8-week assessment (OR 6.23 (95% CI 1.40 to 27.84; P = 0.01). One study investigated the use of peer support for patients with poorly controlled diabetes. There were no significant differences between groups for self-efficacy, HbA1C, cholesterol level and body mass index. AUTHORS' CONCLUSIONS Whilst this review provides some evidence that peer support telephone calls can be effective for certain health-related concerns, few of the studies were of high quality and so results should be interpreted cautiously. There were many methodological limitations thus limiting the generalisability of findings. Overall, there is a need for further well designed randomised controlled studies to clarify the cost and clinical effectiveness of peer support telephone calls for improvement in health and health-related behaviour.
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Affiliation(s)
- Jeremy Dale
- Health Sciences Research Institute, Warwick Medical School, University of Warwick, Gibbet Hill campus, Coventry, Warwickshire, UK, CV4 7AL.
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Dashiff C, Morrison S, Rowe J. Fathers of children and adolescents with diabetes: what do we know? J Pediatr Nurs 2008; 23:101-19. [PMID: 18339336 DOI: 10.1016/j.pedn.2007.08.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2007] [Revised: 08/01/2007] [Accepted: 08/07/2007] [Indexed: 10/22/2022]
Abstract
Knowing how fathers contribute to child outcomes is critical in the clinical management of children who have type 1 diabetes. The purposes of this review were to synthesize what is known about the role of fathers and to determine directions for future research. Research studies that reported findings that encompassed fathers' perceptions, knowledge, coping and adjustment, and behavior in relation to their children with type 1 diabetes were reviewed. Research suggests that, although fathers are usually not the primary caregiver or manager of the routine day-to-day care, their contribution to the family through perceptions, knowledge, adjustment, and behavior may be associated with important disease management outcomes.
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Affiliation(s)
- Carol Dashiff
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL 35294-1210, USA.
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Affiliation(s)
- Alan M Delamater
- Department of Pediatrics, University of Miami, Miami, FL 33101, USA.
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Sullivan-Bolyai S, Bova C, Deatrick JA, Knafl K, Grey M, Leung K, Trudeau A. Barriers and strategies for recruiting study participants in clinical settings. West J Nurs Res 2007; 29:486-500. [PMID: 17538128 DOI: 10.1177/0193945907299658] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Recruiting participants for research studies is often a challenging task. Recruitment requires careful planning, collaboration, and flexibility on the part of researchers and health care providers at the recruitment sites. This article describes six major barriers to recruiting study participants as identified from a review of the literature and from the coauthors' research experiences. These barriers include challenges related to regulations of the Health Insurance Portabililty and Accountability Act (HIPAA), health care providers' work burden, providers' financial disincentives, competition, health care provider concerns regarding research, and provider protection of patients. Each barrier is described, and specific strategies are suggested based on the empirical literature. In some instances, the coauthors' experiences are also shared.
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Abstract
This article demonstrates that families can make a difference in diabetes outcomes and nurses can make a difference in how families organize and interact around the person with diabetes. Highlighted are key findings from the research on families and diabetes across different phases of the lifespan. Recommendations for general practice with families that might be adapted by nurses to different settings in which they care for families with diabetes are included.
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Affiliation(s)
- Irene Cole
- Department of Family Health Care Nursing, University of California San Francisco, CA 94143-0606, USA
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Abstract
BACKGROUND A systematic review of the literature in 2000 revealed numerous methodological shortcomings in education research, but in recent years progress has been made in the quantity and quality of psycho-educational intervention studies. SUMMARY OF CONTENTS This review focuses on diabetes education programmes developed for children, young people and their families in the past 5 years. A comprehensive review of the literature identified 27 articles describing the evaluation of 24 psycho-educational interventions. Data summary tables compare the key features of these, and comparisons are made between individual, group and family-based interventions. Effect sizes are calculated for nine of the randomized studies. Three research questions are posed: firstly has the recent literature addressed the problems highlighted in the previous review; secondly is there sufficient evidence to recommend adaptation of a particular programme; and, finally, what do we still need to do? CONCLUSIONS Progress in the quality and quantity of educational research has not resulted in improved effectiveness of interventions. There is still insufficient evidence to recommend adaptation of a particular educational programme and no programme that has been proven effective in randomized studies for those with poor glycaemic control. To develop a range of effective educational interventions, further research involving larger sample sizes with multicentre collaboration is required.
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Affiliation(s)
- H R Murphy
- Department of Diabetes and Endocrinology, Ipswich Hospital, Ipswich, UK.
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Sullivan-Bolyai S, Bova C, Harper D. Developing and refining interventions in persons with health disparities: the use of qualitative description. Nurs Outlook 2005; 53:127-33. [PMID: 15988449 DOI: 10.1016/j.outlook.2005.03.005] [Citation(s) in RCA: 321] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Eliminating health disparities by the year 2010 has become a clear priority for nursing and health sciences research. To date, much of the research has relied on traditional analytic methods to identify the disparities and develop clinical interventions. However, health disparities are typically embedded in complex, cultural and contextual issues. Interventions to improve access, quality and care among vulnerable populations need to be developed with these factors in mind. This article illustrates the benefits of using Qualitative Description as one method for assessing, developing and refining interventions with vulnerable populations. Qualitative Description study results have tremendous potential to translate directly to pressing health care situations and provide clear information about ways to improve care.
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Current literature in diabetes. Diabetes Metab Res Rev 2005; 21:297-308. [PMID: 15858786 DOI: 10.1002/dmrr.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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