Children's Hospital of Philadelphia.
Perelman School of Medicine at the University of Pennsylvania.
J Pediatr Psychol. 2021 Oct 18;46(10):1276-1285. doi: 10.1093/jpepsy/jsab068.
Continuous glucose monitoring (CGM) has become increasingly popular among youth with type 1 diabetes (T1D). Used with CGM, remote monitoring (RM) gives caregivers real-time access to patients' glucose values. Whereas RM may safeguard against hypo- and hyperglycemic events, little is known about how older children and adolescents, who are striving for independence, and their parents view the RM aspect of CGM. The goal of this study was to describe and explore parent and youth perceptions of RM.
Youth with T1D and their parents participated separately in semi-structured interviews 2 months after starting CGM. Questions focused on decisions to use and experiences with RM.
Analysis of 43 parents and 41 youth (13.79 years ± 2.82) interviews revealed four themes, with 10 subthemes. Seven subthemes emerged in parent and youth interviews, and three emerged exclusively in parent interviews. The overarching themes included the impact of RM on (1) peace-of-mind, (2) parental anxiety, (3) communication; and addressed (4) technological limitations that prevented some from using RM. Regardless of youth age, youth and parents found comfort in parental knowledge of glucose values and parental abilities to assist youth (e.g., giving reminders to eat). Whereas RM could lead to conflicts due to excessive communication (e.g., texting), conflicts could be resolved through iterative parent-youth conversations.
RM may facilitate youth independence by providing a way for them to stay connected to their support system while acquiring developmentally appropriate skills. However, families should have iterative discussions about boundaries to mitigate parental over-involvement.
连续血糖监测（CGM）在 1 型糖尿病（T1D）患儿中越来越受欢迎。与 CGM 一起使用的远程监测（RM）可让护理人员实时访问患者的血糖值。虽然 RM 可能有助于防止低血糖和高血糖事件，但对于正在努力独立的年龄较大的儿童和青少年及其父母如何看待 CGM 的 RM 方面，知之甚少。本研究的目的是描述和探讨父母和青少年对 RM 的看法。
T1D 患儿及其父母在开始 CGM 后 2 个月分别参加了半结构化访谈。问题集中在使用 RM 的决定和使用 RM 的经验上。
对 43 名父母和 41 名青少年（13.79 岁±2.82 岁）访谈的分析揭示了四个主题，包括 10 个子主题。7 个子主题出现在父母和青少年访谈中，3 个子主题仅出现在父母访谈中。总体主题包括 RM 对（1）安心、（2）父母焦虑、（3）沟通的影响；并涉及（4）阻止某些人使用 RM 的技术限制。无论青少年的年龄如何，青少年和父母都对父母了解血糖值的能力以及父母帮助青少年（例如，提醒他们进食）的能力感到放心。虽然 RM 可能会因过度沟通（例如，发短信）而导致冲突，但可以通过迭代的父母-青少年对话来解决冲突。
RM 通过为他们提供一种与支持系统保持联系的方式，同时培养与年龄相适应的技能，可能有助于青少年独立。然而，家庭应该就边界进行迭代讨论，以减轻父母的过度参与。
