The Effectiveness of Parenting Interventions on Psychosocial Adjustment in Parents of Children and Adolescents with Type 1 Diabetes: A Meta‐Analysis

Abstract

Aims: Parenting interventions in this review refer to supportive parenting training provided for parents or primary caregivers of children and adolescents with type 1 diabetes mellitus (T1DM). The review aimed to synthesize evidence about parenting interventions in parents or caregivers of children and adolescents with T1DM, and to evaluate the effect of interventions in reducing parents' or caregivers' psychological distress, helping them share diabetes management responsibility, seek social support, and improve their quality of life.Methods: We searched PubMed, MEDLINE, EMBASE, CINAHL, Cochrane, and Web of Science from January 1978 to October 2018. Randomized controlled trials (RCTs) comparing an intervention group of parenting programs with a control group of usual care were included. The primary outcomes were stress, family responsibility and conflict, and social support. Secondary outcomes included other psychological index and quality of life. Pooled effect sizes of weighted mean difference (WMD) were calculated.Results: A total of 17 RCTs with 962 participants met the inclusion criteria. Findings of the meta-analysis showed parenting interventions could significantly reduce parents' depression (WMD = −5.78, 95% CI: −6.23 to −5.33, I 2 = 0%) and distress (WMD = −5.28, 95% CI: −10.31 to −.25, I 2 = 0%), and help them ask for positive social support (WMD = .83, 95% CI: .03 to 1.64, I 2 = 0%). No beneficial changes of other outcomes were found.Linking Evidence to Action: Parents of children and adolescents with T1DM need support from the multidisciplinary team in health care, especially in mental health, family management of childhood diabetes, and social support. Parenting interventions may help parents reduce psychological distress and depression and assist them to ask for social support. Future research should include well-designed RCTs with large samples, appropriate measures with clear definitions, objective assessment, and separation of effects on mothers and fathers.

ISPAD Clinical Practice Consensus Guidelines 2022: Psychological care of children, adolescents and young adults with diabetes

“…There is a substantial literature addressing psychosocial and behavioral interventions for the treatment of children and adolescents with T1D. Systematic reviews including meta‐analyses have shown the efficacy of various approaches 198–200 including family based interventions 38,201 . While methodological limitations have been noted, 198,202–205 it can generally be concluded that there is a solid evidence base for psychosocial and behavioral interventions 206 although the effects on glycemic outcomes are inconsistent 202 .…”

Quality of Life in Romanian Children with Type 1 Diabetes: A Cross-Sectional Survey Using an Interdisciplinary Healthcare Intervention

“…Even if the parent is the central pillar of the child's life, the adult's internal psycho-emotional resources that are aimed at managing the stressful life events in diabetes mellitus are not inexhaustible. Specialists often recommend parenting interventions [24] in order to trigger new coping mechanisms and good emotional control [25,26], so that the adult's psycho-emotional state does not affect the child's quality of life. In addition, the health status of the child with T1DM and the difficulties in controlling blood glucose levels can negatively influence the family climate, generating a snowballing effect on the child's psycho-emotional climate [27].…”

Interventions and strategies to improve social support for caregivers of children with chronic diseases: An umbrella review

“…One meta-analysis found that Parenting intervention was shown to be beneficial for parents of children with type 1 diabetes mellitus, Specifically, parenting interventions which include supportive parenting training or education programs could help parents of children with type 1 diabetes mellitus ask for positive social support (30).…”

“…However, the role of psychoeducational interventions on social support remains to be further explored, and extensive original research is still needed. Training or education could help increase the level of social support (30). Specifically, it focuses on helping parents of children with chronic diseases feel positively supported and providing them with practical parenting guidance, available information and resources.…”

“…Some systematic reviews have shown that connected health technologies are beneficial for providing psychosocial support for family caregivers affected by Pediatric cancer (28), and Early Family Intervention Program can increase perceived spousal emotional support for parents of children with appearanceaffecting health condition (29). Parenting intervention on psychosocial adjustment can also improve social support for parents of children with type 1 diabetes mellitus (30). However, evidence is fragmented.…”