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2019年冠状病毒病大流行期间的挑战:1型糖尿病儿童及其母亲的血糖控制和心理社会问题

Challenges During the Coronavirus Disease 2019 Pandemic: Diabetes Control and Psychosocial Issues in Children with Type 1 Diabetes Mellitus and Their Mothers.

作者信息

Canoruç Emet Dicle, Yeşil Ayşe Mete, Çelik Berna, Şencan Buse, Ünsal Yağmur, Gönç Nazlı, Özön Alev, Özmert Elif Nursel, Alikaşifoğlu Ayfer

机构信息

Division of Pediatric Endocrinology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Division of Developmental Pediatrics, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.

出版信息

Turk Arch Pediatr. 2023 Jul;58(4):418-424. doi: 10.5152/TurkArchPediatr.2023.23030.

Abstract

OBJECTIVE

Governments have enforced restrictions to prevent the spread of coronavirus dis- ease 2019, which has affected lifestyle and psychosocial well-being. The aim of this study is to examine the psychosocial dimensions of children with type 1 diabetes mellitus and lifestyle changes in the face of the pandemic.

MATERIALS AND METHODS

Sixty school-aged children with type 1 diabetes mellitus were included to evaluate socioeconomic status, lifestyle changes, and psychological state after a 3-month school closure, using a questionnaire as well as scales in children and mothers [Depression-Anx iety-Stress Scale (short-form), Revised Child Anxiety-Depression Scale (parent-version), The Perceived Stress Scale in Children] via a Google® Form. The effect of pre-pandemic glycemic control on lifestyle and factors affecting HbA1c change were also investigated.

RESULTS

The percentage of mothers having scale scores above the cutoff in terms of stress, anxiety, and depression were 18.3%, 23.3%, and 33.3%, respectively. Mother's and children's anxiety, depression, and stress scores were positively correlated. Employed mothers had higher depression scores. Paternal unemployment increased the anxiety of the mothers. Seventy-eight percent (n = 46) of the mothers thought that diabetes in their children increased the risk of coro- navirus disease 2019 infection, and children of these mothers had higher depression, anxiety, and stress scores(P = .01, P < .01, P < .01). The majority of participants were adversely affected by coronavirus disease 2019 in terms of daily routines and dietary compliance. Patients with poor-controlled type 1 diabetes mellitus deteriorated more in terms of diet compliance (P = .01).

CONCLUSION

Coronavirus disease 2019 affects the psychosocial dimensions in the family of chil- dren with type 1 diabetes mellitus. The psychosocial impact is reflected within the family and may affect diabetic control. Thus, it should be handled within the context of family. The provi- sion of proper information and guidance to parents may be crucial to alleviate the psychosocial burden on the family during the pandemic.

摘要

目的

各国政府已实施限制措施以防止2019冠状病毒病传播,这影响了人们的生活方式和心理社会幸福感。本研究旨在探讨1型糖尿病患儿的心理社会状况以及面对疫情时的生活方式变化。

材料与方法

纳入60名学龄期1型糖尿病患儿,通过谷歌表单使用问卷以及儿童和母亲的量表[抑郁-焦虑-压力量表(简版)、修订版儿童焦虑抑郁量表(家长版)、儿童感知压力量表]评估3个月学校关闭后的社会经济状况、生活方式变化和心理状态。还研究了疫情前血糖控制对生活方式的影响以及影响糖化血红蛋白变化的因素。

结果

母亲在压力、焦虑和抑郁方面量表得分高于临界值的比例分别为18.3%、23.3%和33.3%。母亲和儿童的焦虑、抑郁和压力得分呈正相关。有工作的母亲抑郁得分较高。父亲失业增加了母亲的焦虑。78%(n = 46)的母亲认为孩子患糖尿病增加了感染2019冠状病毒病的风险,这些母亲的孩子抑郁、焦虑和压力得分更高(P = .01,P < .01,P < .01)。大多数参与者在日常生活和饮食依从性方面受到2019冠状病毒病的不利影响。1型糖尿病控制不佳的患者在饮食依从性方面恶化更明显(P = .01)。

结论

2019冠状病毒病影响1型糖尿病患儿家庭的心理社会状况。心理社会影响在家庭内部得到体现,可能影响糖尿病控制。因此,应在家庭背景下加以应对。在疫情期间向家长提供适当的信息和指导对于减轻家庭的心理社会负担可能至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24af/10441149/af4a92fca4ce/tap-58-4-418_f001.jpg

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