Feasibility of a multidisciplinary pilot intervention for parent/caregiver diabetes distress

IF 3.2 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetic Medicine Pub Date : 2025-02-19 DOI:10.1111/dme.70006

E. H. Alkhatib, M. Segawa, A. Danner, H. Kasper, E. Frymark, S. Roberts, L. Clary, R. Streisand, S. Majidi

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引用次数: 0

Abstract

Aims

Caregiver diabetes distress (DD) consists of negative emotions about a child's T1D diagnosis and has been associated with increased child haemoglobin A1c and family conflict. The primary aim was to identify the feasibility and acceptability of a multidisciplinary pilot intervention for caregiver DD in a diverse academic pediatric diabetes centre. Another primary aim was to determine the percentage of local caregivers with DD. A secondary aim was to determine if the intervention affected caregiver DD. We also explored potential associations between caregiver DD and demographic and diabetes-related characteristics.

Methods

Individual interviews with five caregivers with DD (who did not participate in the intervention) were held pre-intervention, in order to gather qualitative, open-ended feedback on prepared educational materials. As a pilot feasibility study, we held 3 monthly, one-hour educational and support group virtual sessions per cohort (6–8 caregivers) on Nutrition, Fear of Hypoglycemia and Parent/Child Collaboration. Sessions were attended by an endocrinologist with leaders from other disciplines including dietician, diabetes educator and/or social worker. Target enrollment was 30 caregivers with DD (PAID-PR/Problem Areas in Diabetes—Parent Revised score of ≥56/100) of children 5–17 years old with T1D for ≥6 months. Data include demographic information, pre-/post- PAID-PR scores, caregivers' session satisfaction ratings and open-ended written feedback. We also examined data from 26 parents of children who did not have elevated scores on DD (the comparison group) and were not invited to attend the intervention sessions.

Results

Caregiver participants were 85% women, ages 42.5 ± 11.3 years; children's characteristics: 38% girls, ages 11.1 ± 2.1 years, 47.6% Black, 33.3% Caucasian, 9.5% Hispanic, 9.6% other, 43% public insurance, mean diabetes duration 4.3 ± 0.18 years and A1c 8.5 ± 0.7% (69.4 mmol/mol). Pre- and post-intervention PAID-PR scores improved from 68 to 51 (p < 0.05). This was sustained 3 months post-intervention with a mean PAID-PR of 42 (p < 0.05).

Conclusion

The pilot intervention was feasible, with two-thirds of caregivers attending ≥2 sessions. Reported DD improved over time. Limitations include a small initial sample. Future directions include expanding this study to a larger population and ultimately incorporating a similar support program into the clinical setting as part of routine outpatient diabetes care.

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多学科试点干预父母/照顾者糖尿病困扰的可行性。

目的：照顾者糖尿病困扰（DD）包括对儿童T1D诊断的负面情绪，并与儿童血红蛋白A1c升高和家庭冲突有关。主要目的是确定一个多学科试点干预的可行性和可接受性护理人员DD在一个多样化的学术儿科糖尿病中心。另一个主要目的是确定患有DD的当地护理人员的百分比。第二个目的是确定干预是否影响护理人员的DD。我们还探讨了护理人员DD与人口统计学和糖尿病相关特征之间的潜在关联。方法：在干预前对5名患有DD的照顾者（未参与干预）进行单独访谈，以收集对准备好的教育材料的定性、开放式反馈。作为一项试点可行性研究，我们每个队列（6-8名护理人员）举办了3个月、1小时的教育和支持小组虚拟会议，内容涉及营养、对低血糖的恐惧和亲子合作。会议由一位内分泌学家和其他学科的领导者参加，包括营养师、糖尿病教育者和/或社会工作者。目标入组为30名护理人员，5-17岁T1D儿童的DD (PAID-PR/Problem Areas in diabetes - parents Revised score≥56/100)≥6个月。数据包括人口统计信息、付费pr前/后得分、护理人员的会话满意度评级和开放式书面反馈。我们还检查了26位没有DD得分高的孩子的父母（对照组）的数据，他们没有被邀请参加干预会议。结果：照顾者85%为女性，年龄42.5±11.3岁；儿童特征：女孩38%，年龄11.1±2.1岁，黑人47.6%，白种人33.3%，西班牙裔9.5%，其他9.6%，公共保险43%，平均糖尿病病程4.3±0.18年，A1c 8.5±0.7% （69.4 mmol/mol）。干预前和干预后的PAID-PR评分从68分提高到51分。结论：试点干预是可行的，三分之二的护理人员参加≥2次治疗。报告的DD随着时间的推移而改善。局限性包括初始样本很小。未来的方向包括将这项研究扩展到更大的人群，并最终将类似的支持计划纳入临床环境，作为常规门诊糖尿病护理的一部分。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”