Aalders Jori, Pouwer Frans, Hartman Esther, Nefs Giesje
Center of Research on Psychological Disorders and Somatic Diseases [CoRPS], Department of Medical and Clinical Psychology, Tilburg University, 5037 AB Tilburg, The Netherlands.
Department of Psychology, University of Southern Denmark, 5230 Odense, Denmark.
Healthcare (Basel). 2025 May 14;13(10):1143. doi: 10.3390/healthcare13101143.
: For families with a child with type 1 diabetes, it is often complex and challenging to decide how responsibilities for diabetes care should be divided between parents and children, and how and when these responsibilities should be transferred from parent to child. A smooth transfer of responsibilities is assumed to be key for optimal diabetes outcomes and a successful shift from paediatric to adult health care. However, a theoretical framework to conceptualise the division and transfer of diabetes care responsibilities that brings together the scattered literature regarding these topics is still lacking. : This narrative review synthesises insights from (a) prior quantitative and qualitative studies in the context of paediatric diabetes care, (b) prior reviews regarding the transfer of treatment responsibilities for families of children with a chronic condition, and (c) existing theoretical models in paediatrics, child development and parenting. : The division of responsibilities appears to be affected by a complex interaction between child, parent and context characteristics. These factors seem to change the division of diabetes care responsibilities by affecting (1) child/parental readiness to assume responsibility, (2) the alignment between the child's and the parent's readiness and (3) context support and demands. The "success" of the division and transfer of diabetes care responsibilities can be defined by biomedical, emotional, behavioural and parent-child interaction outcomes. : The presented conceptual framework can guide research and clinical practice in studying and evaluating the division and transfer of diabetes care responsibilities.
对于有1型糖尿病患儿的家庭而言，决定糖尿病护理责任应如何在父母与孩子之间划分，以及这些责任应如何、何时从父母转移给孩子，往往复杂且具有挑战性。责任的顺利转移被认为是实现最佳糖尿病治疗效果以及成功从儿科医疗向成人医疗过渡的关键。然而，目前仍缺乏一个理论框架，能够将关于这些主题的零散文献整合起来，对糖尿病护理责任的划分和转移进行概念化。
(a) 儿科糖尿病护理背景下先前的定量和定性研究；(b) 先前关于慢性病患儿家庭治疗责任转移的综述；(c) 儿科学、儿童发展和育儿领域现有的理论模型。
责任划分似乎受到儿童、父母和环境特征之间复杂相互作用的影响。这些因素似乎通过影响以下方面来改变糖尿病护理责任的划分：(1) 儿童/父母承担责任的准备程度；(2) 儿童与父母准备程度的一致性；(3) 环境支持和需求。糖尿病护理责任划分和转移的“成功”可以通过生物医学、情感、行为以及亲子互动结果来定义。
所提出的概念框架可为研究和评估糖尿病护理责任的划分与转移的研究及临床实践提供指导。
