Katherine E. Wakelin, Rebecca K. Read, Ashely Y. Williams, Rachel R. Francois-Walcott, Nicola O'Donnell, Rose-Marie Satherley, Megan P. Harrington, Mary John, Christina J. Jones
{"title":"1型糖尿病儿童家庭心理干预对照顾者和儿童功能的影响：系统回顾和荟萃分析","authors":"Katherine E. Wakelin, Rebecca K. Read, Ashely Y. Williams, Rachel R. Francois-Walcott, Nicola O'Donnell, Rose-Marie Satherley, Megan P. Harrington, Mary John, Christina J. Jones","doi":"10.1111/1753-0407.70112","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Research suggests that the wellbeing of caregivers of children with Type 1 Diabetes can influence child health outcomes. Therefore, the aim was to conduct a systematic review and meta-analysis to estimate the effect of psychological interventions for families of children with Type 1 Diabetes on caregiver and child functioning.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A systematic search of the literature identified 58 randomized controlled trials (RCTs) that met inclusion. Study quality was assessed using the Cochrane Risk-of-Bias Tool.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Fifty-one trials had sufficient data to be included in the meta-analysis, analyzing nine variables (caregiver and child psychological distress, diabetes distress, family conflict and child quality of life (QoL), diabetes QoL and blood glucose) over three timepoints (post-intervention, short-term and long-term follow-up). Results from 10 (<i>n</i> = 550), three (<i>n</i> = 347) and 16 RCTs (<i>n</i> = 1631) respectively indicated that psychological interventions significantly reduced caregiver psychological distress post-intervention (SMD = −0.64, 95% CI = −1.15, −0.12), child psychological distress post-intervention (SMD = −0.34, 95% CI = −0.55, −0.31) and child blood glucose at short-term follow-up (SMD = −0.11, 95% CI = −0.21, −0.01), relative to controls.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Participants allocated to controls showed greater reductions in caregiver diabetes family conflict at short-and long-term follow−up than those assigned to psychological interventions. This was explained by significant baseline differences influencing a small number of studies. Studies were highly heterogenous regarding outcome measures, follow-ups, and interventions, with high concerns of bias often observed, reflecting the complexity of real−world clinical practice. Findings are promising. Appropriately powered RCTs with robust randomization are recommended to investigate the significance of effects, whilst considering dose response.</p>\n </section>\n </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 6","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70112","citationCount":"0","resultStr":"{\"title\":\"The Effectiveness of Psychological Interventions for Families of Children With Type 1 Diabetes on Caregiver and Child Functioning: A Systematic Review and Meta-Analysis\",\"authors\":\"Katherine E. Wakelin, Rebecca K. Read, Ashely Y. Williams, Rachel R. Francois-Walcott, Nicola O'Donnell, Rose-Marie Satherley, Megan P. Harrington, Mary John, Christina J. Jones\",\"doi\":\"10.1111/1753-0407.70112\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Research suggests that the wellbeing of caregivers of children with Type 1 Diabetes can influence child health outcomes. Therefore, the aim was to conduct a systematic review and meta-analysis to estimate the effect of psychological interventions for families of children with Type 1 Diabetes on caregiver and child functioning.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A systematic search of the literature identified 58 randomized controlled trials (RCTs) that met inclusion. 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Results from 10 (<i>n</i> = 550), three (<i>n</i> = 347) and 16 RCTs (<i>n</i> = 1631) respectively indicated that psychological interventions significantly reduced caregiver psychological distress post-intervention (SMD = −0.64, 95% CI = −1.15, −0.12), child psychological distress post-intervention (SMD = −0.34, 95% CI = −0.55, −0.31) and child blood glucose at short-term follow-up (SMD = −0.11, 95% CI = −0.21, −0.01), relative to controls.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Participants allocated to controls showed greater reductions in caregiver diabetes family conflict at short-and long-term follow−up than those assigned to psychological interventions. This was explained by significant baseline differences influencing a small number of studies. Studies were highly heterogenous regarding outcome measures, follow-ups, and interventions, with high concerns of bias often observed, reflecting the complexity of real−world clinical practice. 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The Effectiveness of Psychological Interventions for Families of Children With Type 1 Diabetes on Caregiver and Child Functioning: A Systematic Review and Meta-Analysis
Background
Research suggests that the wellbeing of caregivers of children with Type 1 Diabetes can influence child health outcomes. Therefore, the aim was to conduct a systematic review and meta-analysis to estimate the effect of psychological interventions for families of children with Type 1 Diabetes on caregiver and child functioning.
Methods
A systematic search of the literature identified 58 randomized controlled trials (RCTs) that met inclusion. Study quality was assessed using the Cochrane Risk-of-Bias Tool.
Results
Fifty-one trials had sufficient data to be included in the meta-analysis, analyzing nine variables (caregiver and child psychological distress, diabetes distress, family conflict and child quality of life (QoL), diabetes QoL and blood glucose) over three timepoints (post-intervention, short-term and long-term follow-up). Results from 10 (n = 550), three (n = 347) and 16 RCTs (n = 1631) respectively indicated that psychological interventions significantly reduced caregiver psychological distress post-intervention (SMD = −0.64, 95% CI = −1.15, −0.12), child psychological distress post-intervention (SMD = −0.34, 95% CI = −0.55, −0.31) and child blood glucose at short-term follow-up (SMD = −0.11, 95% CI = −0.21, −0.01), relative to controls.
Conclusions
Participants allocated to controls showed greater reductions in caregiver diabetes family conflict at short-and long-term follow−up than those assigned to psychological interventions. This was explained by significant baseline differences influencing a small number of studies. Studies were highly heterogenous regarding outcome measures, follow-ups, and interventions, with high concerns of bias often observed, reflecting the complexity of real−world clinical practice. Findings are promising. Appropriately powered RCTs with robust randomization are recommended to investigate the significance of effects, whilst considering dose response.
期刊介绍：
Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation.
The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.
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