Rankin David, Harden Jeni, Waugh Norman, Noyes Kathryn, Barnard Katharine D, Stephen John, Robertson Kenneth J, Bath Louise, Robertson Linda, Lawton Julia
Centre for Population Health Sciences, School of Molecular, Genetic and Population Health Sciences, University of Edinburgh Medical School, Edinburgh, UK.
Pediatr Diabetes. 2014 Dec;15(8):591-8. doi: 10.1111/pedi.12124. Epub 2014 Feb 19.
The aim of this study was to explore from parents' perspectives the circumstances and events which led to their child being diagnosed with type 1 diabetes (T1D). The objective was to understand reasons for delays in seeking treatment and parents' emotional reactions to diagnosis so others can be better informed and supported in future.
In-depth interviews with 54 parents of children (aged ≤12 yr) with T1D were conducted. Data analysis used an inductive, thematic approach.
Parents described a 'prompt' and a 'delayed' pathway to their child being diagnosed. Parents who considered the diagnosis to be 'prompt' reported how they, or other people, had recognized their child had developed symptoms of T1D which resulted in a rapid presentation to health care professionals. In contrast, parents who perceived their child's diagnosis to be 'delayed' did not recognize signs of T1D and attributed their child's deteriorating health to other conditions, being out of routines and/or their stage of development. These parents often only sought medical help when symptoms became extreme. All parents were distressed by their child's diagnosis; however, parents in the 'delayed' pathway expressed unresolved feelings of guilt, particularly when their child was diagnosed with diabetic ketoacidosis.
Parents' and other people's knowledge about T1D can affect the duration between onset of their child's symptoms and diagnosis. Campaigns to raise awareness should ensure that parents are made aware of symptoms and that T1D can develop during childhood. Health care professionals could discuss with parents the events preceding their child's diagnosis to better determine their emotional support needs.
本研究旨在从家长的角度探究导致其孩子被诊断为1型糖尿病(T1D)的情况和事件。目的是了解寻求治疗延迟的原因以及家长对诊断的情绪反应,以便未来能让其他人得到更好的信息和支持。
对54名患有T1D的儿童(年龄≤12岁)的家长进行了深入访谈。数据分析采用归纳性的主题分析法。
家长们描述了孩子被诊断的“迅速”和“延迟”两种途径。认为诊断“迅速”的家长报告了他们或其他人如何识别出孩子出现了T1D症状,从而迅速就医。相比之下,认为孩子诊断“延迟”的家长没有识别出T1D的症状,将孩子健康状况的恶化归因于其他疾病、生活规律改变和/或孩子的发育阶段。这些家长通常在症状变得严重时才寻求医疗帮助。所有家长都因孩子的诊断而痛苦;然而,处于“延迟”途径的家长表达了未解决的内疚感,尤其是当他们的孩子被诊断为糖尿病酮症酸中毒时。
家长和其他人对T1D的了解会影响孩子症状出现到诊断之间的时间。提高认识的活动应确保家长了解症状,并且T1D可在儿童期发病。医疗保健专业人员可以与家长讨论孩子诊断前的事件,以更好地确定他们的情感支持需求。