1 型糖尿病患儿的社会心理因素和家庭的作用

Dhanya Soodhana Mohan, Vani Hn, R. K. Madegowda, Raghupathy Palany
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摘要

目的:1 型糖尿病(T1DM)的社会心理方面仍然是一个被忽视的领域,尤其是在印度儿童中。本研究计划对 T1DM 患儿的家庭支持、焦虑和抑郁症状进行评估和筛查,并评估这些社会心理因素在血糖控制中的作用。研究方法这项以问卷调查为基础的横断面观察性研究历时一年,共纳入了 70 名被诊断患有 T1DM 至少一年的 8-18 岁儿童。儿童和护理人员回答了预先验证的标准问卷,儿童每 3 个月接受一次 HbA1C 检测。推断性统计分析采用的方法包括信度分析、相关分析、χ2 检验和因子分析。结果显示单亲儿童的血糖控制较差(平均 HbA1C 14.4,p < 0.001)。此外,母亲接受过 10 年以上正规教育的儿童血糖控制较好。14名儿童(20%)患有中度至高度焦虑/抑郁症。家庭冲突与血糖控制之间的关系在父母和儿童的评分中均不显著。结论患有 T1DM 的儿童在诊断和管理方面承受着巨大的压力。许多家庭经历了严重的抑郁和焦虑,导致家庭冲突增加,对养育子女、子女的生活质量和血糖控制产生了负面影响。
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Psychosocial Factors and the Role of Family in Children with Type 1 Diabetes Mellitus
Purpose: The psychosocial aspects of type 1 diabetes mellitus (T1DM) are still a neglected area, especially among children in India. This study was planned to evaluate and screen the children with T1DM for family support, symptoms of anxiety and depression, and to assess the role of these psychosocial aspects in glycemic control. Methods: This cross-sectional observational questionnaire-based study conducted over a year included 70 children aged 8–18 years diagnosed with T1DM for at least a year. The child and caregiver answered pre-validated standard questionnaires and the children underwent HbA1C testing once every 3 months. The methods used for inferential statistical analysis were reliability analysis, correlation analysis, χ2 test, and factor analysis. Results: Poorer glycemic control was noted by children raised by single parents (mean HbA1C 14.4, p < 0.001). It was also noted that children whose mothers had formal education beyond 10th standard had better glycemic control. 14 children (20%) had anxiety/depression of medium to high severity. The relationship between family conflict and glycemic control was not significant in either the parent or the child scoring. Conclusion: Children with T1DM experience considerable stress related to the diagnosis and management. Many families experience significant depression and anxiety which leads to increase in family conflicts which have a negative effect on parenting, the child’s quality of life, and their glycemic control.
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