Troncone Alda, Chianese Antonietta, Cascella Crescenzo, Zanfardino Angela, Iafusco Dario
Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy.
Department of the Woman, Child and General and Specialized Surgery, University of Campania "L. Vanvitelli", Naples, Italy.
Front Pediatr. 2021 Mar 10;9:650201. doi: 10.3389/fped.2021.650201. eCollection 2021.
The aim of this study was to assess general psychosocial adjustment to diabetes and perceived disease management among patients with type 1 diabetes (T1D) and their parents before and after patients' participation in a diabetes summer camp. In this follow-up study, 20 children and adolescents with T1D (eight boys; mean age = 11.01 ± 0.94 years; mean diabetes duration = 3.02 ± 2.27) attending a southern Italian diabetic center, along with their parents, were assessed prior to and 3 months after the youths participated in a 1 week camp-based intervention involving didactic and interactive child-centered education and recreational activities. Patients and their parents completed measures assessing patients' quality of life and strategies employed by patients to cope with pain. Patients also completed measures evaluating their diabetes psychosocial adjustment, diabetes self-efficacy management, and illness perception; also, their parents completed measures of caregivers' perceived diabetes burden and treatment satisfaction. Youths' glycated hemoglobin (HbA1c) and standardized body mass index (z-BMI) values were also assessed. Within-subjects repeated-measures analyses of variance evaluated pre- and post-camp changes. Camp attendance showed no beneficial effects on glycemic control, as indicated by HbA1c values both before (7.02%) and after (7.28%) camp being lower than 7.5%. HbA1c values were found to have increased after camp (pre-camp = 7.02%, post-camp = 7.28%; = 0.010), but since they still fell within an acceptable range, they did not reveal clinically relevant changes in glycemic control. No substantial significant improvement in psychosocial measures was observed in children or parents (all > 0.05). According to the parents' evaluation, social support-seeking as a patient pain-coping strategy was slightly increased ( = 0.044) after attending the camp. This study does not provide empirical evidence of benefits of participating in a diabetes camp for either patients or their parents. These findings suggest that healthcare providers rethink such camps as an experience for youths with T1D that actively involves parents and that includes both youth- and parent-focused psychological interventions.
本研究旨在评估1型糖尿病（T1D）患者及其父母在患者参加糖尿病夏令营前后对糖尿病的总体心理社会适应情况以及对疾病管理的认知。在这项随访研究中，20名患有T1D的儿童和青少年（8名男孩；平均年龄 = 11.01 ± 0.94岁；平均糖尿病病程 = 3.02 ± 2.27）及其父母在青少年参加为期1周的以儿童为中心的教学和互动式教育及娱乐活动的营地干预之前和之后3个月，接受了评估。患者及其父母完成了评估患者生活质量以及患者应对疼痛所采用策略的测量。患者还完成了评估其糖尿病心理社会适应、糖尿病自我效能管理和疾病认知的测量；此外，他们的父母完成了照顾者对糖尿病负担的认知和治疗满意度的测量。还评估了青少年的糖化血红蛋白（HbA1c）和标准化体重指数（z-BMI）值。采用受试者内重复测量方差分析评估营前和营后的变化。正如HbA1c值所示，夏令营参与对血糖控制没有有益影响，营前（7.02%）和营后（7.28%）均低于7.5%。发现HbA1c值在营后有所增加（营前 = 7.02%，营后 = 7.28%；P = 0.010），但由于它们仍落在可接受范围内，因此未显示出血糖控制方面临床上相关的变化。在儿童或父母中未观察到心理社会测量指标有实质性的显著改善（所有P > 0.05）。根据父母的评估，参加夏令营后，作为患者疼痛应对策略的寻求社会支持略有增加（P = 0.044）。本研究没有为患者或其父母参加糖尿病夏令营的益处提供实证证据。这些发现表明，医疗保健提供者应重新思考此类夏令营，将其视为一项让T1D青少年积极参与且包括以青少年和父母为重点的心理干预的活动。
