Division of Endocrinology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas.
Children's Health Children's Medical Center, Dallas, Texas.
Pediatr Diabetes. 2018 Jun;19(4):761-768. doi: 10.1111/pedi.12624. Epub 2017 Dec 15.
Managing type 1 diabetes mellitus (T1DM) in preschool-aged children has unique challenges that can negatively impact glycemic control and parental coping.
To evaluate the impact of a camp-based multi-component intervention on glycated hemoglobin A1c (HbA1c) in young children with T1DM and psychosocial measures for their parents.
Two separate cohorts of 18 children (ages 3-5 years) and their families participated in a camp-based intervention that included didactic and interactive parent education, child-centered education and family-based recreational activities. In Camp 1.0, measures of HbA1c, parental fear of hypoglycemia, mealtime behaviors and quality of life (QOL) were compared before and after an initial session (I) and follow-up booster session (II) 6 months later. Based on these results, the intervention was consolidated into 1 session (Camp 2.0) and repeated with additional measures of parental stress and parental self-efficacy with diabetes management tasks.
Participants in Camp 2.0 exhibited a significant decrease in mean HbA1c level (-0.5%, P = .002) before and after camp. Mothers exhibited a significant improvement in diabetes-specific QOL (Camp 1.0/Session I and Camp 2.0) and reduction in stress as measured on the Pediatric Inventory for Parent (PIP) assessment (Camp 2.0). The booster session in Camp 1.0 showed no added benefit.
A family centered, camp-based multi-component intervention in young children with T1DM improved HbA1c and perceived QOL and stress in their mothers.
管理学龄前儿童 1 型糖尿病(T1DM)具有独特的挑战,可能会对血糖控制和父母应对能力产生负面影响。
评估基于营地的多组分干预对患有 T1DM 的幼儿糖化血红蛋白 A1c(HbA1c)和其父母心理社会措施的影响。
两个独立的队列,每组 18 名年龄在 3-5 岁的儿童及其家庭参加了基于营地的干预,包括家长教育的理论和互动式教育、以儿童为中心的教育和家庭为基础的娱乐活动。在营地 1.0 中,在初始会议(I)前后和 6 个月后的后续强化会议(II)比较了 HbA1c、父母对低血糖的恐惧、进餐行为和生活质量(QOL)的测量值。基于这些结果,干预措施被整合为 1 个会议(营地 2.0),并重复进行了父母压力和糖尿病管理任务自我效能的额外测量。
营地 2.0 的参与者在营地前后的平均 HbA1c 水平显著下降(-0.5%,P=0.002)。母亲的糖尿病特定 QOL(营地 1.0/会议 I 和营地 2.0)显著改善,儿童父母评估量表(PIP)上的压力(营地 2.0)显著降低。营地 1.0 的强化会议没有带来额外的益处。
在患有 T1DM 的幼儿中,以家庭为中心的基于营地的多组分干预措施可改善 HbA1c 和母亲感知的 QOL 和压力。