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Galtieri LR, Perez MN, Barakat LP. Quality of life of caregivers at the end of their child's pediatric cancer treatment: cancer-specific worry and material hardship. J Pediatr Psychol 2024; 49:348-355. [PMID: 38457310 DOI: 10.1093/jpepsy/jsae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/18/2024] [Accepted: 02/19/2024] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVE Emerging research suggests that completion of pediatric cancer treatment can be challenging for caregivers given shifting roles and responsibilities. Lower caregiver quality of life (QOL) has been associated with cancer-related variables, higher cancer caregiving strain, and more household material hardship during pediatric cancer treatment. Caregiver QOL at the end of treatment has not been fully investigated but has implications for child and family well-being. Using a psycho-oncology framework, this study aimed to understand the cumulative burden of household material hardship and cancer-related factors on caregiver QOL at the end of treatment. METHODS Caregivers (N = 143) of children (Mage=10.51 years) within 1 year of ending active cancer treatment completed self-report questionnaires assessing their QOL, cancer-specific worry, and material hardship (e.g., housing, insurance). Total months of active cancer treatment were extracted from the medical record. Hierarchical linear regression was used to test the relative effects of length of treatment, material hardship, and cancer-specific worry on caregiver QOL. RESULTS Cancer-specific worry was significantly associated with and accounted for significant variance in caregiver QOL, above and beyond the length of treatment and material hardship. Caregivers who endorsed more cancer-specific worry had poorer QOL. Material hardship was also significantly associated with caregivers' QOL, but length of treatment was not. CONCLUSIONS Caregivers with sufficient resources and less worry about cancer have higher QOL. Findings highlight the importance of end-of-treatment screening of caregivers' subjective cancer-specific worry in addition to material hardship, irrespective of their cancer-related stressors, for ongoing psychosocial support.
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Affiliation(s)
- Liana R Galtieri
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Megan N Perez
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Lamia P Barakat
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Hu X, Grosse SD, Han X, Marchak JG, Ji X. Mental Health Care Utilization Among Parents of Children With Cancer. JAMA Netw Open 2024; 7:e244531. [PMID: 38564218 PMCID: PMC10988353 DOI: 10.1001/jamanetworkopen.2024.4531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/05/2024] [Indexed: 04/04/2024] Open
Abstract
Importance Caring for children diagnosed with cancer may adversely affect the mental health (MH) of parents. Objective To characterize utilization of MH services among parents of children with vs without cancer using nationwide commercial claims data. Design, Setting, and Participants For this cross-sectional study, the Merative MarketScan Commercial Claims Database was used to identify continuously insured families of children treated for cancer (aged ≤21 years at diagnosis) during 2010 to 2018, compared with families who matched eligibility criteria but did not have a child with a cancer history. Parents were assessed from 18 months before to 12 months after their child's cancer diagnosis. Analyses were conducted from February 2022 to September 2023. Exposures Children's cancer diagnosis. Main Outcomes and Measures Outcomes included parents' MH-related visits during the first year following their child's cancer diagnosis. Logistic regressions compared outcomes between families of children with vs without cancer, adjusting for sociodemographic and clinical factors. Results This study included 4837 families of children with cancer (4210 mothers and 4016 fathers) and 24 185 families of children without cancer (21 444 mothers and 19 591 fathers) with continuous insurance enrollment. Most household leads were aged 35 to 54 years (3700 [76.5%] in families of children with cancer vs 17 812 [73.6%] in families of children without cancer) and resided in urban areas (4252 [87.9%] vs 21 156 [87.5%]). The probabilities of parents having anxiety-related visits (10.6% vs 7.0%), depression-related visits (8.4% vs 6.1%), and any MH-related visits (18.1% vs 13.3%) were higher in families of children with vs without cancer. Adjusted analyses showed absolute increases of 3.2 percentage points (95% CI, 2.3 to 4.0; 45.7% relative increase), 2.2 percentage points (95% CI, 1.4 to 3.0; 36.1% relative increase), and 4.2 percentage points (95% CI, 3.1 to 5.3; 31.3% relative increase) in the probabilities of 1 or both parents having anxiety-related visits, depression-related visits, and any MH-related visits, respectively, among families of children with vs without cancer. Such differences were greater in magnitude among mothers than fathers. Conclusions and Relevance In this cohort study of privately insured parents, those caring for children with cancer had a higher likelihood of utilizing MH care than other parents. These findings underline the importance of interventions toward targeted counseling and support to better meet MH care needs among parents and caregivers of children with cancer.
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Affiliation(s)
- Xin Hu
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville
| | - Scott D. Grosse
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Xuesong Han
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Jordan Gilleland Marchak
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
- Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, Georgia
| | - Xu Ji
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
- Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, Georgia
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Broadbridge E, Venetis MK, Devine KA, Lee LE, Banerjee SC, Greene K. Supporting the support person: Oncologists' roles in reducing support people's uncertainty and facilitating psychological adjustment. Psychooncology 2024; 33:e6313. [PMID: 38446532 PMCID: PMC11046424 DOI: 10.1002/pon.6313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/29/2024] [Accepted: 02/16/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE Support people of cancer patients are at significant risk for psychological distress. Additionally, cancer patients' well-being is reciprocally associated with support peoples' psychological well-being. Informed by Uncertainty in Illness Theory, this study tests whether support person psychological well-being is influenced by provider communication and uncertainty reduction. METHODS We tested a multiple mediation model to investigate how empathic communication facilitates psychological adjustment in support people of cancer patients and how this process is mediated by support peoples' illness uncertainty and caregiver burden. Support people of cancer patients (N = 121; including spouses, adult children, etc.) completed an online questionnaire about their perceptions of oncologists' empathy, uncertainty about the cancer patients' illness, perceived caregiving burden, and their psychological adjustment to diagnoses. RESULTS Path analysis revealed that (1) more perceived oncologist empathy was associated with less illness uncertainty, (2) more illness uncertainty was associated with worse psychological adjustment and more perceived caregiver burden, and (3) more burden was associated with worse adjustment (χ2 (2) = 1.19, p = 0.55; RMSEA < 0.01; CFI = 1.00; SRMR = 0.02). CONCLUSIONS Given the reciprocal nature of well-being between cancer patients and their support people, it is critical to understand and bolster support people's psychological well-being. Results demonstrated how empathic provider communication can support psychological well-being for support people of cancer patients. Additionally, this study offers theoretical contributions to understandings of illness uncertainty in caregiver populations.
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Affiliation(s)
| | - Maria K. Venetis
- Department of Communication, Rutgers University, New Brunswick, New Jersey, USA
| | - Katie A. Devine
- Division of Pediatric Hematology/Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Lauren E. Lee
- Department of Communication, Rutgers University, New Brunswick, New Jersey, USA
| | - Smita C. Banerjee
- Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kathryn Greene
- Department of Communication, Rutgers University, New Brunswick, New Jersey, USA
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Sisk BA, Newman AR, Chen D, Mack JW, Reeve BB. Designing and validating novel communication measures for pediatric, adolescent, and young adult oncology care and research: The PedCOM measures. Pediatr Blood Cancer 2023; 70:e30685. [PMID: 37740578 DOI: 10.1002/pbc.30685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/06/2023] [Accepted: 09/10/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND High-quality communication in pediatric and adolescent cancer is the standard of care. Yet, we lack pediatric-specific communication measures. We designed self-report and caregiver-report communication measures for use in pediatric oncology settings. METHODS We recruited adolescent and young adults (AYAs; 12-24 years) with cancer and parents of children and AYAs between 1 month post-diagnosis and 2 months after completing treatment. Participants completed measures including 58 questions addressing eight previously characterized communication functions. For each function, we conducted factor analysis, and assessed reliability and construct validity. Based on psychometric properties, we created final long-form (31 items) and short-form (eight items) communication measures (PedCOM) for both self- and caregiver-report. RESULTS Participants included 200 parents and 88 AYAs. The final 31-item and eight-item PedCOM measures for parents and AYAs demonstrated good unidimensional model fit. Each communication function (e.g., building relationships) demonstrated high reliability, coefficient alphas ranged from .83 to .93 for parents and .85 to .93 for AYAs. The overall 31-item and eight-item PedCOM measures also demonstrated high reliability (alphas >.9). For construct validity, PedCOM-Parent-31 and PedCOM-Parent-8 correlated positively with satisfaction with care, trust, emotional self-management, and decisional satisfaction, and negatively with anxiety and caregiver burden. PedCOM-AYA-31 and PedCOM-AYA-8 correlated positively with satisfaction with care, trust, emotional self-management, symptoms self-management, and decisional satisfaction, and negatively with anxiety. DISCUSSION We developed valid and reliable measures of communication functions for parents and AYAs with cancer. These measures can support organizations and stakeholder groups that are striving to improve the quality of cancer care.
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Affiliation(s)
- Bryan A Sisk
- Department of Pediatrics and Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Amy R Newman
- Marquette University, Milwaukee, Wisconsin, USA
- Children's Wisconsin, Milwaukee, Wisconsin, USA
| | - Dandan Chen
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jennifer W Mack
- Department of Pediatric Oncology and Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Bryce B Reeve
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
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Gorsky KG, Butala S, House M, Moon C, Calvetti S, Khando T, Kipke M, Lakshmanan A. Uncertainty and the NICU Experience: A Qualitative Evaluation of Family and Provider Perspectives. Children (Basel) 2023; 10:1745. [PMID: 38002836 PMCID: PMC10670907 DOI: 10.3390/children10111745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/13/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023]
Abstract
There is limited information regarding caregiver and provider perspectives on uncertainty across the continuum of the neonatal intensive care unit (NICU) experience. Open-ended semi-structured interviews were conducted with providers and English- and Spanish-speaking caregivers of infants with a history of admission to a quaternary safety-net NICU. Major themes were generated using inductive-deductive thematic analysis. Seventy-six individuals participated in the study: 47 caregivers and 29 providers. The median gestational age of the infants was 29 weeks and 85% were classified as having chronic complex disease per the Pediatric Medical Complexity Algorithm. Most providers were neonatologists (37%) and nurses (27%) and more than half had over ten years of experience. A conceptual model of caregiver uncertainty was developed and key domains included drivers of uncertainty and its impact, and factors influencing coping and adaptation. Our analysis found a positive association between caregiver information gathering, clinical continuity, support systems, maternal mental health supports, and witnessing a child's progress and the development of adjustment to chronic uncertainty. These results suggest key areas for intervention that can promote parental adaptation to the uncertainty inherent in the NICU experience.
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Affiliation(s)
- Katharine Griffin Gorsky
- Division of Neonatology, San Francisco School of Medicine, University of California, San Francisco, CA 94158, USA;
| | - Saloni Butala
- Fetal and Neonatal Medicine Institute, Division of Neonatal Medicine, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA; (S.B.); (M.H.)
- School of Medicine, WesternU College of Osteopathic Medicine of the Pacific, Pomona, CA 91766, USA
| | - Madison House
- Fetal and Neonatal Medicine Institute, Division of Neonatal Medicine, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA; (S.B.); (M.H.)
- School of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Chelsea Moon
- Fetal and Neonatal Medicine Institute, Division of Neonatal Medicine, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA; (S.B.); (M.H.)
- School of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Sam Calvetti
- Community Health Outcome Intervention Research, Children’s Hospital, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA;
| | - Tenzin Khando
- Life Course Intervention Research Network, University of California, Los Angeles, CA 94158, USA;
| | - Michele Kipke
- School of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Ashwini Lakshmanan
- Fetal and Neonatal Medicine Institute, Division of Neonatal Medicine, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA; (S.B.); (M.H.)
- Department of Health Systems Science, Bernard J. Tyson School of Medicine, Pasadena, CA 91101, USA
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Basile NL, Dattilo TM, DeLone AM, Kraft JD, Edwards CS, Buchanan CL, Cheng EY, Poppas DP, Wisniewski AB, Mullins LL. Parental Uncertainty Scale Factor Structure in Pediatric DSD With Ambiguous Genitalia. J Pediatr Psychol 2023; 48:386-395. [PMID: 36728708 PMCID: PMC10118853 DOI: 10.1093/jpepsy/jsad001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/12/2023] [Accepted: 01/14/2023] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Illness uncertainty is a salient experience for caregivers of children with disorders/differences of sex development (DSD) presenting with ambiguous genitalia; however, no validated measure of illness uncertainty exists for this unique population. Thus, the current study aimed to preliminarily identify the factor structure of the Parental Perception of Uncertainty Scale (PPUS) in caregivers of children with DSD presenting with ambiguous genitalia and examine the convergent validity of the PPUS. METHODS Participants included 115 caregivers (Mage = 32.12 years, SD = 6.54; 57% mothers) of children (<2-year-olds) diagnosed with DSD participating in a larger, longitudinal study. Caregivers completed the PPUS as well as self-report measures of anxious, depressive, and posttraumatic stress symptoms. An exploratory factor analysis was conducted. RESULTS Exploratory factor analysis results indicated that a 23-item 1-factor solution was the most parsimonious and theoretically sound factor structure (α = 0.92). Convergent validity analyses demonstrated further support for the use of the 23-item 1-factor solution over the original PPUS factor structure. CONCLUSION These results demonstrate the preliminary clinical and research utility of the PPUS with caregivers of children with DSD presenting with ambiguous genitalia. The PPUS may benefit from further refinement through qualitative research and item adaptation to capture uncertainties unique to DSD presenting with ambiguous genitalia. In addition, future research should replicate the proposed factor structure using confirmatory factor analysis with a separate, larger sample of caregivers of children with DSD to confirm the factor structure.
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Affiliation(s)
- Nathan L Basile
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Taylor M Dattilo
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Alexandra M DeLone
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Jacob D Kraft
- Department of Psychiatry, University of Michigan, USA
| | - Clayton S Edwards
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Cindy L Buchanan
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, USA
| | - Earl Y Cheng
- Department of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, USA
| | - Dix P Poppas
- Institute for Pediatric Urology, Komansky Children’s Hospital, New York Presbyterian Hospital-Weill Cornell Medicine, USA
| | - Amy B Wisniewski
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
| | - Larry L Mullins
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA
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Huang BS, Lin CY, Hung TM, Chung CF, Chang YL, Chen SC. Factors influencing family function in spousal caregivers of head and neck cancer patients within 6 months posttreatment. Support Care Cancer 2022. [PMID: 35606476 DOI: 10.1007/s00520-022-07158-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/16/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Spousal caregiving of head and neck cancer (HNC) patients challenges relationship quality and may negatively impact family function. Our purpose was to identify factors associated with family dysfunction in spousal caregivers (SCs) of HNC patients within the first 6 months after treatment. We explored whether patient or SC characteristics differ by level of family dysfunction. METHODS We conducted a cross-sectional study of HNC patient-SC dyads in Taiwan from July 2020 to January 2022 using patient-reported outcomes. Patients were assessed using a set of structured questionnaires to measure performance status, demographic and clinical characteristics, physical function, and social-emotional function. SCs were measured on their hardiness, coping styles, spousal relationship, quality of life, and family function. RESULTS Of the 132 dyads surveyed, 62.1% of SCs reported a functional family, 34.8% reported a moderately dysfunctional family, and 3.0% reported a highly dysfunctional family. Patient factors associated with family dysfunction (highly dysfunctional or moderately dysfunctional) included lower family annual income and worse social-emotional function. Associated SC factors were lower hardiness, less use of active coping, and worse spousal relationships. CONCLUSIONS Lower family annual income, less patient social-emotional function, less SC hardiness, less SC active coping, and worse SC perceived spousal relationship were associated with perceived family dysfunction. Providing patient-SC dyads with sufficient social resources and problem-solving training may help them positively cope with cancer and enhance family function.
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Hancock K, Barrera M, Prasad S, Desjardins L, Shama W, Alexander S, Szatmari P. A qualitative examination of the benefits and challenges of a psychosocial screening intervention in pediatric oncology: "Support comes to us". Pediatr Blood Cancer 2022; 69:e29578. [PMID: 35084106 DOI: 10.1002/pbc.29578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 12/30/2021] [Accepted: 01/01/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Pediatric cancer diagnosis and treatment can have detrimental mental health effects on parents (caregivers) and their children/adolescents (youth). Psychosocial screening and intervention have been recognized as standards of care in pediatric oncology. The most effective psychosocial interventions to support those in need post screening have not been determined. AIMS This qualitative study aimed to investigate the perceived benefits and challenges for caregiver and youth participants in the screening-intervention arm of an Enhanced Psychosocial Screening Intervention (EPSI) pilot study. METHODS EPSI consists of a psychosocial navigator (PSN) who shares screening results conducted near diagnosis (T1) and monthly for 1 year (T2) with treating teams and families. All 17 caregiver-youth dyads who had completed EPSI were invited to participate in a semi-structured interview. RESULTS Ten caregivers and nine youth participated. Identified themes were grouped into benefits and challenges of EPSI: feeling supported and cared for (support comes to us regularly, having someone to talk to); and feeling empowered through knowledge of resources and services were perceived as benefits. Caregivers were challenged by feeling overwhelmed, and youth by screening questions perceived as too repetitive. CONCLUSIONS Regular monthly contacts for a year by the PSN with screening results and recommendations were perceived as beneficial by youth newly diagnosed with cancer and their caregivers who participated in EPSI. Feeling that support came to them and they had someone to talk to was a critical component. While information about psychosocial resources was not always used right away, it did evoke feelings of being empowered.
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Affiliation(s)
- Kelly Hancock
- Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Maru Barrera
- Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Soni Prasad
- Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Leandra Desjardins
- Research Centre, Sainte-Justine University Health Center, Montreal, Quebec, Canada
| | - Wendy Shama
- Department of Social Work, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sarah Alexander
- Division of Haematology, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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O’Donnell NR, Satherley RM, John M, Cooke D, Hale LS, Stewart R, Jones CJ. Development and Theoretical Underpinnings of the PRIORITY Intervention: A Parenting Intervention to Prevent Disordered Eating in Children and Young People With Type 1 Diabetes. Front Clin Diabetes Healthc 2022; 3:822233. [PMID: 36992722 PMCID: PMC10012129 DOI: 10.3389/fcdhc.2022.822233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/21/2022] [Indexed: 11/13/2022]
Abstract
Children and young people (CYP) with type 1 diabetes (T1D) are twice as likely to develop disordered eating (T1DE) and clinical eating disorders than those without. This has significant implications for physical and mental health, with some eating disorders associated with repeated diabetic ketoacidosis and higher HbA1c levels, both of which are life threatening. There is currently limited psychological support for CYP and families with T1D but increasingly, policy and practice are suggesting disordered eating in T1D may be effectively prevented through psychological intervention. We describe the development and theoretical underpinnings of a preventative psychological intervention for parents of CYP aged 11-14, with T1D. The intervention was informed by psychological theory, notably the Information Motivation Behaviour Skills model and Behaviour Change Technique Taxonomy. The intervention was co-developed with an expert advisory group of clinicians, and families with T1D. The manualised intervention includes two online group workshops, and supplementary online materials. The intervention continues to evolve, and feasibility findings will inform how best to align the intervention with routine care in NHS diabetes teams. Early detection and intervention are crucial in preventing T1DE, and it is hoped that the current intervention can contribute to improving the psychological and physical wellbeing of young people and families managing T1D.
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Affiliation(s)
| | | | - Mary John
- School of Psychology, University of Surrey, Guildford, United Kingdom
- Research and Development Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Brighton & Hove, United Kingdom
| | - Debbie Cooke
- School of Health Sciences, University of Surrey, Guildford, United Kingdom
| | - Lucy S. Hale
- School of Psychology, University of Surrey, Guildford, United Kingdom
| | - Rose Stewart
- Wrexham Maelor Hospital, Betsi Cadwaladr University Health Board, Wrexham, United Kingdom
| | - Christina J. Jones
- School of Psychology, University of Surrey, Guildford, United Kingdom
- *Correspondence: Christina J. Jones,
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