Nieuwesteeg Anke M, Hartman Esther E, Aanstoot Henk-Jan, van Bakel Hedwig J A, Emons Wilco H M, van Mil Edgar, Pouwer Frans
Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
Diabeter, 3011 TG, Rotterdam, The Netherlands.
Eur J Pediatr. 2016 Mar;175(3):329-38. doi: 10.1007/s00431-015-2631-4. Epub 2015 Oct 5.
To test whether parenting stress and the quality of parent-child interaction were associated with glycemic control and quality of life (QoL) in young children (0-7 years) with type 1 diabetes (T1DM), we videotaped 77 families with a young child with T1DM during mealtime (including glucose monitoring and insulin administration). Parent-child interactions were scored with a specifically designed instrument. Questionnaires assessed general and disease-related parenting stress and (diabetes-specific (DS)) QoL. HbA(1c) (glycemic control) was extracted from the medical records. Both general and disease-related parenting stress were associated with a lower (DS)QoL (r ranged from -0.39 to -0.70, p < 0.05), but not with HbA(1c) levels. Furthermore, with regard to the parent-child interaction, emotional involvement of parents (r = 0.23, p < 0.05) and expressed discomfort of the child (r = 0.23, p < 0.05) were related to suboptimal HbA(1c) levels. There was no clear pattern in the correlations between parent-child interaction and (DS)QoL.
The results support the notion that diabetes does not only affect the child with T1DM: T1DM is a family disease, as parenting factors (like stress and parent-child interactions) are associated with important child outcomes. Therefore, it is important for health-care providers to not only focus on the child with T1DM, but also on the family system.
为了测试育儿压力和亲子互动质量是否与1型糖尿病(T1DM)幼儿(0至7岁)的血糖控制及生活质量(QoL)相关,我们在进餐时间(包括血糖监测和胰岛素注射)对77个患有T1DM幼儿的家庭进行了录像。使用专门设计的工具对亲子互动进行评分。通过问卷评估一般和与疾病相关的育儿压力以及(糖尿病特异性(DS))生活质量。糖化血红蛋白(HbA1c)(血糖控制)数据从病历中提取。一般和与疾病相关的育儿压力均与较低的(DS)生活质量相关(r值范围为 -0.39至 -0.70,p < 0.05),但与HbA1c水平无关。此外,关于亲子互动,父母的情感投入(r = 0.23,p < 0.05)和孩子表现出的不适(r = 0.23,p < 0.05)与HbA1c水平未达最佳有关。亲子互动与(DS)生活质量之间的相关性没有明显模式。
结果支持这样一种观点,即糖尿病不仅影响患有T1DM的儿童:T1DM是一种家庭疾病,因为育儿因素(如压力和亲子互动)与儿童的重要结局相关。因此,医疗保健提供者不仅关注患有T1DM的儿童,还关注家庭系统非常重要。