Evaluating fear of hypoglycemia, pediatric parenting stress, and self-efficacy among parents of children with type 1 diabetes and their correlation with glycemic control

Abstract

Background: This study was designed to determine the level of fear of hypoglycemia (FoH), pediatric parenting stress and selfefficacy in parents of children with type 1 diabetes (T1D). Methods: In this cross-sectional study, 61 families of children with T1D who had been diagnosed for at least 6 months recruited from "Gabric Diabetes Education Association" in Tehran. Sixty mothers and 41 fathers of 61 children (26 girls, age: 6.0-12.7 years) were assessed using the Hypoglycemia Fear Survey-Parent (HFS-P), Pediatric Inventory for Parents (PIP) and Self-Efficacy for Diabetes Scale-Parent (SED-P) questionnaires. Pearson correlation analysis was used to compute the correlation between HFS-P, PIP and SEDP scores separately for mother and fathers. Results: Only 8.3% of children had controlled diabetes. Internal reliability of the Persian version of all questionnaires was good. FoH were higher for mothers. Mothers whose children had diabetes for less than two years had significantly lower mean HFS-Behavior subscale (HFS-B) scores than mothers whose children had diabetes for more than two years. There was a positive correlation between fathers’ mean HFS-B score and children’s total insulin dose per day. Parents' FoH score was positively correlated with increased pediatric parenting stress. Findings also showed considerable emotional distress in 51% of mothers and 29.7% of fathers. Frequency of selfmonitoring blood glucose tests (SMBG) correlated negatively with HbA1c. Conclusion: We concluded that parents with high levels of FoH and stress may benefit from diabetes education. Important implications for education are considering psychological adjustment, recognizing diabetes-related fear and stress in parents, encouraging fathers to become actively involved in the child’s diabetes management and emphasizing the importance of SMBG.

Characterizing Common Challenges Faced by Parental Caregivers of Children With Type 1 Diabetes Mellitus in Mainland China: A Qualitative Study

“…During the course of our interviews, it emerged that worry, anxiety, and sorrow were closely linked to uncertainty of disease progression. This observation is consistent with prior studies that have shown parental caregivers of children with T1DM experience a heightened level of disease uncertainty compared to caregivers of other chronic disease states, which can exert adverse effects on the health and psychological condition of the parental caregivers and the children they care for 26 . Thus, medical staff should pay particular attention to these potential effects in parental caregivers.…”

Characterising common challenges faced by parental caregivers of children with type 1 diabetes mellitus in mainland China: a qualitative study

“…This observation is consistent with prior studies that have shown parental caregivers of children with T1DM experience a heightened level of disease uncertainty compared with caregivers of other chronic states, which can exert adverse effects on the health and psychological condition of the parental caregivers and the children they care for. 26 Thus, medical staff should pay particular attention to these potential effects in early stages of the disease progression.…”

The impact of hypoglycaemia in children and adolescents with type 1 diabetes on parental quality of life and related outcomes: A systematic review

“…Six studies did not report parents' age. 24,[27][28][29][30][31] Nine of the 12 studies focused their analyses on parents and caregivers alone (reporting only demographic and clinical data from children), [9][10][11][23][24][25][26]30,31 while three studies reported results from both parents and children. [27][28][29] The mean ± SD age of children ranged from 5 ± 2 to 15 ± 2 years.…”

“…The occurrence or frequency of hypoglycaemia was proxy-reported by parents in 10 studies, [9][10][11]23,[25][26][27][28]30,31 and was obtained via clinical records in two studies. 24,29 The recall periods for hypoglycaemia episodes varied across studies, with the most common recall period being episodes in the past 12 months in five studies.…”

“…24,29 The recall periods for hypoglycaemia episodes varied across studies, with the most common recall period being episodes in the past 12 months in five studies. 9,10,25,28,29 One study had a recall period of 3 months, 23 and two studies had a six-month recall period. 11,27 Four studies did not report recall periods for hypoglycaemic episodes.…”