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Harrington MP, Satherley RM, John M, O'Donnell N, Read R, Wakelin K, Jones CJ. Reliability and validity of a parent-reported screening tool for disordered eating in children and young people with type 1 diabetes. Diabet Med 2024; 41:e15256. [PMID: 37925592 DOI: 10.1111/dme.15256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/08/2023] [Accepted: 11/01/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND There is a high prevalence and complex overlap between type 1 diabetes (T1D) and disordered eating. However, screening for disordered eating in children and young people (CYP) with T1D is not routinely conducted, with reluctance reported by both professionals and parents. This study aimed to validate a parent-reported version of a validated disordered eating screening tool for CYP with T1D (the Diabetes Eating Problems Survey-Revised; DEPS-R). METHODS The existing DEPS-R was adapted for parental use. Eighty-nine parents of CYP with T1D aged 11-14 years completed the parent-reported DEPS-R and other questionnaires related to demographics, child eating behaviours and parental well-being. CYP of parents were invited to participate, with 51 CYP completing the validated CYP-reported DEPS-R for comparison. RESULTS The parent-reported DEPS-R demonstrated good internal consistency (Cronbach's α = 0.89). Moderate to good inter-rater reliability was found between the parent-reported DEPS-R and CYP-reported DEPS-R (ICC 0.746, 95% CI = 0.554-0.855, p < 0.001), indicating good convergent validity. Construct validity with hypothesised variables, including specific eating behaviours, diabetes-related distress, well-being, CYP BMI, gender and parental worry about CYP disordered eating, suggested validity of the measure. However, some hypothesised variables did not significantly correlate with the parent-reported DEPS-R as expected. CONCLUSIONS The parent-reported DEPS-R has demonstrated good reliability and validity, and it may provide clinical benefit by increasing screening and early detection of disordered eating in CYP with T1D. Whilst novel and providing stepped increase in our knowledge, these findings would benefit from further validation (e.g. in a larger sample and responsiveness).
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Affiliation(s)
- Megan P Harrington
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Rose-Marie Satherley
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Mary John
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
- Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Hove, UK
| | - Nicola O'Donnell
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Rebecca Read
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Katherine Wakelin
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Christina J Jones
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
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Kim-Dorner SJ, Saßmann H, Heidtmann B, Kapellen TM, Kordonouri O, Nettelrodt KM, Schweizer R, von Sengbusch S, Lange K. Using person reported outcomes: Psychometric properties of the German diabetes treatment satisfaction questionnaire (DTSQ) for teens and parents. Heliyon 2024; 10:e27614. [PMID: 38524562 PMCID: PMC10957384 DOI: 10.1016/j.heliyon.2024.e27614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 02/12/2024] [Accepted: 03/04/2024] [Indexed: 03/26/2024] Open
Abstract
Aims To examine psychometric properties including the factor structure of the German versions of the Diabetes Treatment Satisfaction Questionnaire for teens and parents (DTSQ-T/-P). Methods Linguistically validated questionnaires were completed by 363 adolescents with type 1 diabetes and 655 parent-caregivers in a multicenter study. Confirmatory factor analysis (CFA), reliability, and correlations were examined. Results CFA confirmed the 2-factor model of treatment satisfaction (TS) & perceived diabetes control (PDC) with an adjustment of removing the "medical support" item from the TS and examining it as a single item in this study. Cronbach's α of TS for DTSQ-T/-P was 0.82 & 0.83, respectively, and α of the two-item PDC factor was 0.70 & 0.60, respectively. The DTSQ scale scores positively correlated with time in range and inversely correlated with HbA1c. Scale scores of DTSQ-T/-P showed significantly positive relations to the KIDSCREEN-10 Index and negative associations with the Problem Areas in Diabetes (PAID). The TS of the parents was correlated with depressive symptoms measured in the Patient Health Questionnaire-9. Conclusions The DTSQ-T/-P produced psychometrically sound scores in measuring diabetes treatment satisfaction in German teens with type 1 diabetes and their parents. German DTSQ versions for teens and parents are recommended in research and clinical practice.
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Affiliation(s)
- Su-Jong Kim-Dorner
- Medical Psychology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Heike Saßmann
- Medical Psychology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Bettina Heidtmann
- Pediatric Endocrinology and Diabetes, Wilhelmstift Catholic Children's Hospital, Liliencronstr. 130, 22149, Hamburg, Germany
| | - Thomas M. Kapellen
- MEDIAN Children's Hospital “Am Nicolausholz”, Elly-Kutscher-Str.16, 06628, Naumburg, Germany
- Department of Pediatrics, University of Leipzig, Liebigstraße 20a, 04103, Leipzig, Germany
| | - Olga Kordonouri
- Diabetes Centre for Children and Adolescents, Children's Hospital AUF DER BULT, Janusz-Korczak-Allee 12, 30173, Hannover, Germany
| | | | - Roland Schweizer
- Pediatric Endocrinology and Diabetology, University Children's Hospital Tübingen, Hoppe-Seyler-Str. 1, 72076, Tübingen, Germany
| | - Simone von Sengbusch
- Clinic for Pediatric and Adolescent Medicine, University Medical Center Schleswig-Holstein, Lübeck Campus, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Karin Lange
- Medical Psychology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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Geddie H, Visekruna S, Lawrence S, Sherifali D, Bassilious E. Type 1 Diabetes in Ontario Schools: Policy and Practice. Can J Diabetes 2024:S1499-2671(24)00021-2. [PMID: 38262529 DOI: 10.1016/j.jcjd.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/02/2024] [Accepted: 01/12/2024] [Indexed: 01/25/2024]
Abstract
OBJECTIVES Type 1 diabetes (T1D) is a challenging chronic condition. Young children with T1D require daily support to manage their condition while at school. In 2018, Ontario established a provincial policy to ensure safe and equitable school participation for children with diabetes. Despite this, children and parents describe very different school experiences. In this qualitative study we describe the interpretation and implementation of school board policy related to the care of children with T1D from the perspective of school educators (principals/teachers). METHODS Policy documents were reviewed employing a qualitative descriptive research design using directed qualitative content analysis. Semistructured interviews were conducted with 13 teachers and principals from 10 publicly funded elementary schools across the Hamilton and Toronto District School Boards in 2021. RESULTS There are major differences in how policies regarding T1D are being implemented in schools. This includes how school staff are educated about T1D, and how they interpret and act on blood glucose information. Although educators often play an active role in supporting children, many face barriers, including competing priorities, fear, lack of information, and lack of support. Facilitators include effective communication/collaboration, actionable information, time, and a diabetes "champion." In some instances, access to nursing support could help to resolve barriers or create care gaps. CONCLUSIONS School board policy provides high-level guidance on how to support children with type 1 diabetes in school, but gaps remain. We provide specific recommendations regarding policy, staff education/training, roles and responsibilities, and future research.
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Affiliation(s)
- Hannah Geddie
- Division of Endocrinology, Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada.
| | - Sanja Visekruna
- School of Nursing, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada
| | - Sarah Lawrence
- Division of Endocrinology, Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, United States
| | - Diana Sherifali
- School of Nursing, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada
| | - Ereny Bassilious
- Division of Endocrinology, Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada
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Kobos E, Rojkowska S, Szewczyk A, Dziedzic B. Burden of care and a sense of loneliness in caregivers of children with type 1 diabetes. a cross-sectional study. Biopsychosoc Med 2023; 17:34. [PMID: 37803450 PMCID: PMC10559508 DOI: 10.1186/s13030-023-00291-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/24/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Treatment of type 1 diabetes is a process involving not only sick children, but also their caregivers. AIM To assess the burden of care and sense of loneliness in caregivers of children with type 1 diabetes. Also, an analysis was conducted of the connection between sociodemographic factors characterizing caregivers and the clinical factors characterizing sick children and between the burden of care and the sense of loneliness. MATERIALS AND METHODS The study included 125 caregivers of children with type 1 diabetes. In order to collect the research data, the Caregiver Burden Scale and the Revised UCLA Loneliness Scale were used. RESULTS In the research group, the total result in the caregiving burden scale was 2.14, which remains within the average burden level. Caregivers showed the highest burden level in the General Strain Subscale. The analysis showed that mothers experience a greater burden of care than fathers in the General Strain Subscale and that caregivers of younger children are more burdened with care within the Isolation and Disappointment Subscales. Moderate high degree of loneliness was shown in 4.8% of caregivers. A higher burden of care for caregivers of children with type 1 diabetes is accompanied by a higher sense of loneliness. CONCLUSIONS The results of this study may help healthcare professionals plan a holistic, family-centered care program that will take into account factors that increase the burden of care: younger age of the affected child, motherhood, caregiver unemployment, feelings of loneliness, lower education, caregiver unemployment, blood glucose meter measurements, and frequent night-time blood glucose measurements.
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Affiliation(s)
- Ewa Kobos
- Department of Development of Nursing, Social and Medical Sciences, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
- Polish Federation for Diabetes Education, Warsaw, Poland
| | | | - Alicja Szewczyk
- Polish Federation for Diabetes Education, Warsaw, Poland
- Children’s Memorial Health Institute, Warsaw, Poland
| | - Beata Dziedzic
- Department of Development of Nursing, Social and Medical Sciences, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
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Lopez-Doriga Ruiz P, Stene LC. Is socio-economic status associated with risk of childhood type 1 diabetes? Literature review. Diabet Med 2023; 40:e15182. [PMID: 37489698 DOI: 10.1111/dme.15182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 06/16/2023] [Accepted: 07/09/2023] [Indexed: 07/26/2023]
Abstract
AIMS Studies of social inequality and risk of developing type 1 diabetes are inconsistent. The present review aimed to comprehensively review relevant literature and describe what has been reported on socio-economic status or parental occupation and risk of type 1 diabetes in children. METHODS We searched for publications between 1 January 1970 and 30 November 2021. We focused on the most recent and/or informative publication in cases of multiple publications from the same data source and referred to these as primary studies. RESULTS Our search identified 69 publications with relevant data. We identified eight primary cohort studies with individual-level data, which we considered the highest quality of evidence. Furthermore, we identified 13 primary case-control studies and 14 semi-ecological studies with area-level socio-economic status variables which provided a weaker quality of evidence. Four of eight primary cohort studies contained data on maternal education, showing non-linear associations with type 1 diabetes that were not consistent across studies. There was no consistent pattern on the association of parental occupation and childhood-onset type 1 diabetes. CONCLUSIONS There is a need for more high-quality studies, but the existing literature does not suggest a major and consistent role of socio-economic status in the risk of type 1 diabetes.
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Affiliation(s)
- Paz Lopez-Doriga Ruiz
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Lars C Stene
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
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Yin MZ, Gu YY, Shu JT, Zhang B, Su M, Zhang LP, Jiang YH, Qin G. Cost-effectiveness of cytomegalovirus vaccination for females in China: A decision-analytical Markov study. Vaccine 2023; 41:5825-5833. [PMID: 37580210 DOI: 10.1016/j.vaccine.2023.08.011] [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] [Received: 04/23/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND The global burden of disease caused by congenital cytomegalovirus (CMV) infection is high. Previous modeling studies have suggested that CMV vaccination may be cost-effective in developed countries. Congenital CMV infection is more likely driven by maternal non-primary infection in China. We aimed to measure the effectiveness and cost-effectiveness of population-level CMV vaccination in Chinese females. METHODS A decision tree Markov model was developed to simulate potential CMV vaccination strategies in a multi-cohort setting, with a population size of 1,000,000 each for the infant, adolescent (10-year-old) and young adult (20-year-old) cohorts. The hypothetical vaccines were assumed to have 50% efficacy, 20 years of protection, 70% coverage, at a price of US$120/dose for base-case analysis. Costs and disability-adjusted life years (DALYs) were discounted by 3% per year and the vaccination would be considered cost-effective if an incremental cost-effectiveness ratio (ICER) was lower than 2021 Chinese per capita GDP (US$12,500). FINDINGS For the pre-infection (PRI) vaccine efficacy type, the adolescent strategy was the most cost-effective, with an ICER of US$12,213 (12,134 to 12,291) pre DALY averted, compared with the next best strategy (young adult strategy). For pre- and post-infection (P&PI) efficacy type, the young adult strategy was the most cost-effective as it was cost-saving. In one-way analysis varying the PRI vaccine price, the infant strategy, adolescent strategy and the young adult strategy would be a dominant strategy over others if the vaccine cost ≤US$60, US$61-121 and US$122-251 per dose respectively. In contrast, the young adult strategy continued to be the preferred strategy until the P&PI vaccine price exceeded US$226/dose. Our main results were robust under a wide variety of sensitivity analyses and scenario analyses. INTERPRETATION CMV vaccination for females would be cost-effective and even cost-saving in China. Our findings had public health implications for control of CMV diseases.
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Affiliation(s)
- Meng-Zhao Yin
- Department of Infectious Diseases, Affiliated Hospital of Nantong University, Nantong, JS, China
| | - Yuan-Yuan Gu
- Centre for the Health Economy, Macquarie University, Sydney, NSW, Australia
| | - Jun-Tao Shu
- Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, Nantong, JS, China
| | - Bin Zhang
- Department of Infectious Diseases, Affiliated Hospital of Nantong University, Nantong, JS, China
| | - Min Su
- Department of Obstetrics and Gynecology, Affiliated Hospital of Nantong University, Nantong, JS, China
| | - Lu-Ping Zhang
- Department of Otolaryngology, Affiliated Hospital of Nantong University, Nantong, JS, China.
| | - Yin-Hua Jiang
- Clinical Medicine Research Center, Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong, JS, China.
| | - Gang Qin
- Department of Infectious Diseases, Affiliated Hospital of Nantong University, Nantong, JS, China; Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, Nantong, JS, China.
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Gallegos E, Harmon KB, Lee G, Qi Y, Jewell VD. A Descriptive Study of the Quality of Life and Burden of Mothers of Children and Adolescents with Type 1 Diabetes. Occup Ther Health Care 2022; 37:296-312. [PMID: 35189069 DOI: 10.1080/07380577.2022.2038401] [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] [Indexed: 10/19/2022]
Abstract
The purpose of this cross-sectional survey was to examine the quality of life and level of burden experienced by mothers of children and adolescents with type 1 diabetes (n = 199). Data was collected using a sociodemographic questionnaire, the Zarit Burden Interview Scale (ZBIS), and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) instruments. A simple descriptive analysis was conducted, and the Pearson's correlation coefficient was utilized to determine the correlation among variables. Most respondents (68.9%) reported moderate to severe burden on the ZBIS. Across age groups, statistically significant, negative correlations were found between burden and physical health (r = -0.371, p < 0.001), social relationships (r = -0.389, p < 0.001), psychological health (r = -0.445, p < 0.001) and environment (r = -0.438, p < 0.001). Mothers of children and adolescents with type 1 diabetes reported an inverse relationship between burden and quality of life influenced by the occupation of caregiving. Occupational therapy practitioners can address strategies to reduce caregiver burden and improve mothers' quality of life.
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Affiliation(s)
- Erica Gallegos
- Occupational Therapy Department, Regis-Creighton University Pathway, Denver, CO, USA
| | - Kasey B Harmon
- Occupational Therapy Department, Regis-Creighton University Pathway, Denver, CO, USA
| | - Gilliane Lee
- Occupational Therapy Department, Regis-Creighton University Pathway, Denver, CO, USA
| | - Yongyue Qi
- Occupational Therapy Department, Creighton University, Omaha, NE, USA
| | - Vanessa D Jewell
- Occupational Therapy Department, Creighton University, Omaha, NE, USA
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9
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Saßmann H, Kim-Dorner SJ, Berndt V, Biester T, Dehn-Hindenberg A, Heidtmann B, Jorch N, Lilienthal E, Nellen-Hellmuth N, Neu A, Schaaf K, Ziegler R, Lange K. Understanding Daily, Emotional, and Physical Burdens and Needs of Parents Caring for Children with Type 1 Diabetes. J Diabetes Res 2022; 2022:9604115. [PMID: 36561282 PMCID: PMC9767735 DOI: 10.1155/2022/9604115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 11/07/2022] [Accepted: 11/12/2022] [Indexed: 12/15/2022] Open
Abstract
AIMS To investigate (1) daily, emotional, and physical caregiving burdens in parents of children with type 1 diabetes, (2) the sociodemographic and clinical predictors of three burdens, and (3) support measures that parents wish to receive. METHODS The study was a multicenter cross-sectional survey conducted in nine German pediatric diabetes centers. A questionnaire assessing three types of burdens and wishes for support was distributed to parents with a child with type 1 diabetes visiting one of the pediatric centers for a routine check-up. RESULTS Data from 1,107 parents (83% mothers) were analyzed. Parents reported significantly higher emotional burdens compared to daily and physical burdens (p < 0.0001). Mothers felt more burdened than fathers did. Parents of younger children reported higher daily and physical burdens compared to the parents of older children, and similarly, parents of technology users reported higher daily and physical burdens compared to the parents of nontechnology users. However, emotional burdens did not differ in both comparisons. Other demographic factors (i.e., parent's age, migration status, and single-parent family status) predicted high levels of daily or physical burdens, but only HbA1c level and the parent's gender (mother) predicted a high emotional burden. Independent of the level of burden, 78% of parents wanted additional diabetes training. CONCLUSION Despite parents reporting high emotional burdens in connection with diabetes care, HbA1c and the gender of the reporting parent were the only risk factors. As the child gets older, parents' daily and physical distress decrease but not the emotional burden. Diabetes training including regularly offered booster sessions as well as low-threshold interventions for mental health issues and practical self-care skills is recommended to provide continuous support for parents.
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Affiliation(s)
- Heike Saßmann
- Hannover Medical School, Medical Psychology, Hannover, Germany
| | | | - Verena Berndt
- Sana Hospital Group Berlin-Brandenburg, Social-Pediatric Centre Lichtenberg, Berlin, Germany
| | - Torben Biester
- Children's Hospital AUF DER BULT, Diabetes-Centre for Children and Adolescents, Hannover, Germany
| | | | | | - Norbert Jorch
- Bielefeld University, University Clinic for Pediatrics, Evang. Klinikum Bethel, Bielefeld, Germany
| | - Eggert Lilienthal
- University Clinic Ruhr-University Bochum, University Children's Hospital, Bochum, Germany
| | | | - Andreas Neu
- Eberhard Karls University Tübingen, Pediatric Endocrinology and Diabetes, Tübingen, Germany
| | - Katja Schaaf
- Elisabeth-Hospital-Essen, Pediatrics, Essen, Germany
| | - Ralph Ziegler
- Diabetes Clinic for Children and Adolescents Münster, Münster, Germany
| | - Karin Lange
- Hannover Medical School, Medical Psychology, Hannover, Germany
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Balcázar-Hernández L, Huerta-Martínez H, Garrido Magaña E, Nishimura-Meguro E, Jiménez Márquez A, Rivera-Hernández A. Burden in primary informal caregivers of children and adolescents with type 1 diabetes: Is it associated with depression, family dysfunction, and glycemic control? Front Endocrinol (Lausanne) 2022; 13:1089160. [PMID: 36743923 PMCID: PMC9892702 DOI: 10.3389/fendo.2022.1089160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/27/2022] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE The requirement of a chronic treatment and the increase in life expectancy in children with type 1 diabetes (T1D) leads to the possibility of caregiver burden. The aim of our study was to evaluate the burden in primary informal caregivers (PIC) of children and adolescents with type 1 diabetes and its association with depression, family dysfunction, and glycemic control. MATERIALS AND METHODS A retrospective study was performed in PIC of children and adolescents with T1D. Zarit Burden Interview Scale (ZBIS) was used to evaluate caregiver burden. Beck Depression Inventory (BDI-II) was used to evaluate depression in PIC, and the Family APGAR questionnaire was used to evaluate the family functionality. RESULTS A total of 100 PIC of children and adolescents with T1D were included. Caregiver burden was found in 33% of caregivers. The total score of the Zarit scale was 41 (34-49); 19% had mild caregiver burden, and 14% had severe caregiver burden. According to the BDI-II, 82% had minimal depression, 11% mild depression, 5% moderate depression, and 2% severe depression. Family function was good in 69%; 13% had moderate dysfunction, and 18% had severe dysfunction. A positive correlation between caregiver burden and BDI-II score (r = 0.84; p = 0.001) and the grade of depression (r = 0.87; p = 0.001) was found. A logistic regression model showed that BDI-II score was associated with caregiver burden (OR 1.14; 95% CI 1.061-1.23; p = 0.001). A BDI-II cut off of 9 or more had a sensibility and specificity of 58% and 28%, respectively, for caregiver burden [AUC 0.751 (0.64-0.85); p = 0.001]. A BDI-II score ≥9 was a predictor of caregiver burden (OR 3.4; 95% CI 1.4-8.1; p = 0.008). CONCLUSION Caregiver burden is present in more than one third of the PIC of patients with T1D and is associated with depression. A BDI-II score ≥9 is a predictor of caregiver burden which may be a point to take into account in the integral approach to the patient with T1D and his or her family nucleus.
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Affiliation(s)
- Lourdes Balcázar-Hernández
- Endocrinology Department, Hospital de Especialidades, Unidad Médica de Alta Especialidad (UMAE) Centro Médico Nacional Siglo XXI, Mexico City, Mexico
| | - Hebert Huerta-Martínez
- Pediatric Endocrinology Department, Hospital de Pediatría, Unidad Médica de Alta Especialidad Centro Médico Nacional Siglo XXI, Mexico City, Mexico
| | - Eulalia Garrido Magaña
- Pediatric Endocrinology Department, Hospital de Pediatría, Unidad Médica de Alta Especialidad Centro Médico Nacional Siglo XXI, Mexico City, Mexico
| | - Elisa Nishimura-Meguro
- Pediatric Endocrinology Department, Hospital de Pediatría, Unidad Médica de Alta Especialidad Centro Médico Nacional Siglo XXI, Mexico City, Mexico
| | - Abigail Jiménez Márquez
- Pediatric Endocrinology Department, Hospital de Pediatría, Unidad Médica de Alta Especialidad Centro Médico Nacional Siglo XXI, Mexico City, Mexico
| | - Aleida Rivera-Hernández
- Pediatric Endocrinology Department, Hospital de Pediatría, Unidad Médica de Alta Especialidad Centro Médico Nacional Siglo XXI, Mexico City, Mexico
- *Correspondence: Aleida Rivera-Hernández,
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