Boogerd Emiel A, Damhuis Anouk M A, van Alfen-van der Velden Janiëlle A A E m, Steeghs Marley C C H, Noordam Cees, Verhaak Chris M, Vermaes Ignace P R
Children's Diabetes Center Nijmegen, Nijmegen, The Netherlands.
Department of Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.
J Clin Nurs. 2015 Aug;24(15-16):2143-51. doi: 10.1111/jocn.12789. Epub 2015 Mar 9.
To investigate the assessment of psychosocial problems in children with type 1 diabetes by means of clinical estimations made by nurses and paediatricians and by using standardised questionnaires.
Although children with type 1 diabetes and their parents show increased risk for psychosocial problems, standardised assessment of these problems lacks in diabetes care.
By comparing these different modes of assessment, using a cross-sectional design, information about the additional value of using standardised questionnaires is provided.
Participants were 110 children with type 1 diabetes (aged 4-16), their parents, and healthcare professionals. Children filled out the Strengths and Difficulties Questionnaire and the Paediatric Quality of Life Inventory, Diabetes Module. Parents filled out the Strengths and Difficulties Questionnaire parent-report and the Parenting Stress Index. Independently, nurses and paediatricians filled out a short questionnaire, which assessed their clinical estimations of the children's psychosocial problems and quality of life, and parents' levels of parenting stress. Reports of children and parents were compared to clinical estimations.
Children in our sample showed more psychosocial problems and lower health-related quality of life than their healthy peers. In approximately half of the children, dichotomous estimations by healthcare professionals and dichotomised reports by patients and parents were in agreement. In 10% of the children, no psychosocial problems were present according to professionals' estimations, although patients and parents-reported psychosocial problems. In 40%, psychosocial problems were present according to professionals' estimations, although parents and patients did not report psychosocial problems.
Children with type 1 diabetes show more psychosocial problems than healthy children. Professionals seem to tend towards overestimating psychosocial problems.
Extending the assessment of psychosocial problems with routine screening on patient-reported outcomes, using validated questionnaires, could be of additional value in tailoring care to the needs of the individual child and parents.
通过护士和儿科医生的临床评估以及使用标准化问卷，调查1型糖尿病患儿心理社会问题的评估情况。
尽管1型糖尿病患儿及其父母出现心理社会问题的风险增加，但在糖尿病护理中缺乏对这些问题的标准化评估。
采用横断面设计比较这些不同的评估方式，以提供关于使用标准化问卷的附加价值的信息。
参与者包括110名1型糖尿病患儿（4至16岁）、他们的父母以及医疗保健专业人员。患儿填写《长处与困难问卷》和《儿童生活质量量表，糖尿病模块》。父母填写《长处与困难问卷家长报告》和《养育压力指数》。护士和儿科医生独立填写一份简短问卷，评估他们对患儿心理社会问题和生活质量的临床评估以及父母的养育压力水平。将患儿和父母的报告与临床评估进行比较。
我们样本中的患儿比健康同龄人表现出更多的心理社会问题，且与健康相关的生活质量更低。在大约一半的患儿中，医疗保健专业人员的二分法评估与患者及父母的二分法报告一致。在10%的患儿中，根据专业人员的评估不存在心理社会问题，尽管患者和父母报告了心理社会问题。在40%的患儿中，根据专业人员的评估存在心理社会问题，尽管父母和患者未报告心理社会问题。
1型糖尿病患儿比健康儿童表现出更多的心理社会问题。专业人员似乎倾向于高估心理社会问题。
通过使用经过验证的问卷对患者报告的结果进行常规筛查来扩展心理社会问题的评估，可能在根据个体患儿及其父母的需求调整护理方面具有附加价值。
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