Patton Susana R, Kahhan Nicole, Milkes Amy, McDonough Ryan J, Benson Matthew, Clements Mark Allen, Pierce Jessica S
Center for Healthcare Delivery Science, Nemours Children's Health System, Jacksonville, Florida, USA
Nemours Children's Health System, Jacksonville, Florida, USA.
BMJ Open Diabetes Res Care. 2025 Jun 1;13(3):e004964. doi: 10.1136/bmjdrc-2025-004964.
In a cohort of families of school-age children (8-12.99 years old) with type 1 diabetes, we examined the stability of parent and child diabetes-related distress (DRD) over 6 months and the associations between parent and child DRD and child glycated hemoglobin (HbA1c) over time.
We recruited families from two large pediatric hospital systems in the USA and used validated measures of parent (Parent Problem Areas in Diabetes-Child, PPAID-C) and child (Problem Areas in Diabetes-Child, PAID-C) DRD and children's HbA1c. We collected data at baseline and 6 months. We calculated minimal clinically important differences in PPAID-C and PAID-C to examine DRD stability and used a linear regression model to examine associations between PPAID-C and PAID-C scores and child HbA1c over time.
We recruited n=132 parent-child dyads (mean child age=10.23±1.5 years; 50% male, 86% non-Hispanic white). 60% of children and 55% of parents reported stable DRD levels, 20% of children and 14% of parents reported increasing DRD levels, and 20% of children and 31% of parents reported decreasing DRD levels from baseline to 6 months. In the regression model, child HbA1c and DRD scores at baseline significantly predicted child HbA1c 6 months later, β=0.013, t(157)=2.32, p=0.02.
Across 6 months, DRD remained stable or increased in 80% of school-aged children and 69% of parents. Only child HbA1c and DRD at baseline predicted higher child HbA1c 6 months later. Our results suggest it may be valuable to screen families of school-age children for DRD routinely and to develop treatments to help them reduce DRD.
在一组患有1型糖尿病的学龄儿童（8至12.99岁）家庭中，我们研究了父母和儿童糖尿病相关困扰（DRD）在6个月内的稳定性，以及父母和儿童DRD与儿童糖化血红蛋白（HbA1c）随时间的关联。
我们从美国两个大型儿科医院系统招募家庭，并使用经过验证的父母（糖尿病患儿家长问题领域，PPAID-C）和儿童（糖尿病患儿问题领域，PAID-C）DRD测量方法以及儿童的HbA1c。我们在基线和6个月时收集数据。我们计算了PPAID-C和PAID-C中最小临床重要差异以检查DRD稳定性，并使用线性回归模型检查PPAID-C和PAID-C分数与儿童HbA1c随时间的关联。
我们招募了n = 132对亲子二元组（儿童平均年龄 = 10.23±1.5岁；50%为男性，86%为非西班牙裔白人）。从基线到6个月，60%的儿童和55%的父母报告DRD水平稳定，20%的儿童和14%的父母报告DRD水平升高，20%的儿童和31%的父母报告DRD水平降低。在回归模型中，基线时儿童的HbA1c和DRD分数显著预测了6个月后的儿童HbA1c，β = 0.013，t(157)=2.32，p = 0.02。
在6个月期间，80%的学龄儿童和69%的父母的DRD保持稳定或增加。只有基线时儿童的HbA1c和DRD预测了6个月后更高的儿童HbA1c。我们的结果表明，定期筛查学龄儿童家庭的DRD并开发治疗方法以帮助他们降低DRD可能是有价值的。
