Purpose
This study examined the literature concerning the burdens of parents of preschool-aged children diagnosed with type 1 diabetes mellitus.
Methods
We employed an integrative review methodology based on Whittemore and Knafl's framework. The literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines across four electronic databases: PubMed, Web of Science, the Cumulative Index to Nursing Allied Health Literature (CINAHL), and PsycINFO. Ultimately, 18 articles were included in the review.
Results
The review yielded four themes: (1) parental burdens, (2) factors related to the burdens, (3) coping strategies, and (4) implications for clinical practice. Parents experienced psychological, physical, and social burdens due to the diabetes care of their children. Several factors influenced burdens, including child-related characteristics such as age, severity of diabetes, and hospitalization experience, as well as parental factors like family income, race, and residential area. Parents initially felt burdened when their child was diagnosed with type 1 diabetes, but over time, they often adapted to the situation through support and sharing of responsibilities. Parents desired education and interventions reflecting the unique characteristics of preschoolers.
Conclusion
This integrative literature review revealed that parents experience numerous burdens when their child is diagnosed with diabetes. Future research should focus on developing interventions to address parents' psychological difficulties, including tracking parental psychological changes over time. Tailored nursing interventions should also be provided to parents of preschool-aged children, as opposed to the more generic nursing interventions traditionally applied across all age groups of children in clinical settings.

Citations

• Distinguishing risk factors for depression and burnout in parents managing type 1 diabetes mellitus in children
  Sumbule Koksoy Vayisoglu, Ebru Koc, Emine Oncu
  Journal of Pediatric Nursing.2025; 80: 32.     CrossRef
• Factors affecting care burden and life satisfaction among parents of children with type 1 diabetes
  Tuğba Bilgehan, Ezgi Bağrıaçık, Münevver Sönmez
  Journal of Pediatric Nursing.2024; 77: e394.     CrossRef
• Preferences for Peer Support Amongst Families Engaged in Paediatric Screening Programmes: The Perspectives of Parents Involved in Screening for Type 1 Diabetes in Children Aged 3–13
  Ian Litchfield, Lauren M. Quinn, Felicity Boardman, Olga Boiko, Parth Narendran, Shivam Choundhary, Naga Setti, Veer Sheth, Sheila M. Greenfield
  Health Expectations.2024;[Epub]     CrossRef

PURPOSE
This comparative descriptive study was conducted to determine the effects of maternal employment on the maternal child-rearing attitude, child-rearing burden, and temperament and health related variables of their preschool children.
METHOD
Samples were recruited in child care centers in Seoul, Daejeon, and Suwon. 209 mothers with children age of three to six participated.
RESULT
Employed mothers showed more positive child-rearing attitude, but there was no significant difference in child-rearing burden, Also, maternal attitude and child-rearing burden were influenced by satisfaction on the employment state. Children's temperament subscales were not different in two groups. Breast feeding and compliance on vaccination were done better by unemployed mothers. However, home safety, experience of accident and hospitalization of children were not affected by maternal employment.
CONCLUSION
Maternal employment has positive influence in some aspects. This study provides basic data for parent counseling and anticipatory guidance for employed mothers.

PURPOSE
This study was conducted to test the reliability and validity of Family Burden Questionnaire.
METHOD
The subjects were 156 caregivers of children with acute or chronic disease. To test the reliability, internal consistency using Cronbach's alpha coefficient was analyzed, and factor analysis, known-group technique, and concurrent validity were utilized for validity test.
RESULT
Cronbach's alpha coefficient of the tool was .89. Six factors were identified and explained 58.7% of the total variance. Through analysis using known-group technique, the difference of family burden between acute and chronic disease groups was statistically significant(t= -4.09, p <.001). Correlations with mood state, other family burden score by Family Burden Interview Schedule, quality of life, and health symptoms were also relatively high and statistically significant.
CONCLUSION
Family Burden Questionnaire showed a relatively high validity and reliability to measure the burden of caregivers caring patients with various chronic conditions in Korea. For the further study, it may be reconsidered to identify the factor structure of the Family Burden Questionnaire with the various subjects from different age groups.

The purpose of the study was to develop and test the model for the quality of life in mothers of children with nephrotic syndrome. A hypothetical model was constructed on the basis of previous studies and a review of literature. The conceptual framework was built around ten constructs. Exogenous variables included in this model were mother's health, father's health, marital intimacy, mother's attitude on children, economic state, side effect of steroid, severity of illness and social support. Endogenous variables were mother's burden and quality of life. Empirical data for testing the hypothetical model were collected by using a self-report questionnaire from 152 mothers of children with nephrotic syndrom at the outpatient clinics and in the hospital. The data was collected from May, 1999 to August, 1999. Reliability of the seven instruments was tested with Cronbach's alpha which ranged from 0.71 - 0.92. For the data analysis, SPSS 8.0 WIN program and LISREL 8.20 WIN program were used for descriptive statistics and covariance structural analysis. The results of covariance structural analysis were as follow : 1.The hypothetical model showed a good fit with the empirical data.[x2 = .56, df = 3, p = .90(p > .05 ), GFI = .99, AGFI = .99, RMSR = .005.] 2. For the parsimony of model, a modified model was constructed by deleting 1 variable and excluding 2 paths according to the criteria of statistical significance and meaning. 3.The modified model also showed a good fit with the data[x2 = 2.83, df = 7, p = .90( p > .05 ), GFI = 1.00, AGFI = .97, RMSR = .011]. The result of the testing of the hypothesis were as follows : 1.Mother's health( gamma 21 = .26, t = 4.16), father's health( gamma 22 = .19, t = 2.92), marital intimacy( gamma 23 = .26, t = 4.13) and social support( gamma 28 = .12, t = 2.03) had a significant direct effect on the quality of life. 2. Mother's burden( beta 21 = -.20, t = -3.10) had a significant negative direct effect on the quality of life. 3. Mother's attitude on children( gamma 14 = -.34, t = .-4.57), mother's health( gamma 11 = -.22, t = -2.96) and side effect of steroid ( gamma 16 = -.23, t = .-2.69) had a significant direct negative effect on the burden. The result of this study showed that mother's health, marital intimacy, mother's burden, father's health, and social support had a significant direct effect on the quality of life. Mother's attitude on children, mother's health, and side effect of steroid had a significant direct effect on mother's burden. These six variables, mother's health, marital intimacy, father's health, social support, mother's attitude on children and side effect of steroid were identified as relatively important variables. The results of this study suggest, it needed to determine the nursing intervention will alleviate mother's burden and promote a greater quality of life in mothers of children with nephrotic syndrom.

The purpose of the descriptive correlation study was to examine relations among the hope, the burden and the family function in mothers caring for children with cancer. 145 mothers completed the three questionaires of the study divided into tree sections: a) The Hope Scale, b) The Burden Scale, c) FACES-lll. The collected data was analysed with t-test, ANOVA, Scheffe test and Pearson correlation coefficients. The results were as follows: 1) The average age of mothers of children with cancer was 35.6 years old and the ages between 30 to 39 were the most abundant. 57.3% of the mothers had an education level of below high school education and 66.0% had religion. The average age of the children was 8.6 years old. Ages between 1 to 7 were the most and 60.8% were diagnosed as leukemia. 2) Regarding the section of degree of burden, mothers of children with cancer marked 2.6 out of 5, and the degree of hope 3.2 out of 4. The result for family function came out to be 3.5 out of 5, an average of family cohesion of 3.9 and family adaptation of 3.1. 3) There were significantly less burden to the mothers who were living together with a spouse compared to the mothers who were not. Also mothers who replied that they preserved good health came out to be exposed to less burden compared to the mothers who did not. In analysing hope according to the general characteristics of mothers of children with cancer, mothers who were employed marked high in the degree of hope compared to unemployed mothers. Furthermore, the degree of family cohesion marked higher with mothers who had higher education of college graduate, mothers with religion and mothers with a monthly family income of over W3,000,000, compared to the group of mothers with lower education of high school graduate, non-religious or with a monthly family income of less than W1,000,000. 4) Excluding the fact that the group sorted with children diagnosed as leukemia marked a perceivably high score regarding family cohesion, compared to groups with other cancers, the degree of burden, hope and family cohesion did not show any noticeable difference according to characteristics of children with different cancers. 5) In the correlation of the hope, the burden and the family function regarding the mothers of children with cancer, the burden did not have any manifest relationship with hope or family function. However, the degree of hope and family function cohesion had a direct proportional relationship, as family cohesion marked higher when the degree of hope were high.

The purposes of this research were to add to the developing knowledge base about the burden and social support of grandmothers involved with caring grandchildren, and to examine whether a significant relationship exists between their burden and social support perceived by the grandmothers. A convenience sample of 102 grandmothers was recruited from five collective apartment areas at a small city in Korea. The criteria of selection of sample were that the grandmothers were raising their grandchildren under the age of 36 months for 3 months or longer at own or gandchildren's home. The instruments used were a 15-item multidemensional burden scale and a 8-item social support scale. Both scales were self report, five point Likert type scales. The higher the score, the higher the degree of burden and social support. Data was collected by two prepared research assistants visiting subjects' home from December 10, 1998 to March 20, 1999. The collected data were analysed using mean, t-test, one-way ANOVA, and Pearson's correlation coefficient computed by SPSS software. The results were as follows. 1. In the age distribution of grandmothers, the over half of subjects(58.8%) were under 60 years old. The majority(69.6%) of subjects were married at time of data collection. 79(77.5%) of the sample reported that their perceived health status was good or over. 2.The burden of the grandmothers was not scored high, and the item means on burden scale were ranged from 2.26 to 4.19 out of 5. 'Short of private time' (4.19) had the highest score, followed by 'fatigue' (3.92), 'short of rest' (3.75), and 'short of contact with friends and neighbors' (3.62). The lowest item was 'family doesn' t help me' (2.26), and followed by 'family doesn' t understand me' (2.33), 'angry with family' (2.43), and 'angry while caring for grandchild' (2.60). 3. There were significant relationships between the burden and present health status(p < .01), childcaring confidence(p < .01), and motive of caring(p < .01). 4. The score of social support, was ranging from 3.61 to 4.01 out of 5. 5. The relationship between burden and social support was found to be correlated negatively. The relationship was statistically significant( gamma = - .2833, p < .001). In conclusion, it was found that the burden was not high and burden of grandmothers caring grandchildren was correlated negatively to social support. Therefore, these results provide a basis for developing a nursing intervention to reduce the burden of grandmothers.

Today, more chronically ill and handicapped children are being cared for at home by a family member caregiver. The task of caring for a family member may feel burden that the caregiver has less time and money and more work. Family functioning and their burden have influence on coping and adaptation of families with chronically-ill children. This study attempted to identify the levels of burden and family functioning in families of children with cerebral palsy and to examine their relationships. The instruments were burden scale developed by Suh and Oh(1993), and a modified Feetham Family Functioning Survey based on Roberts and Feetham.(1982). The subjects were 98 parents of children, under 15 years, who have cerebral palsy and being treated and living in Pusan. Data were collected through a self-administered questionaire from April 26 to May 29. The collected data were tested using frequencies, percentiles, means, t-test, ANOVA, and Pearson correlation coefficient with SPSSWIN program. The results of this study were as follows ; 1. The mean rating scores of burden and family functioning were 2.79 +/- .51 and 4.12 +/- .69, respectively. 2. The relationships between general characteristics and burden were statistically significant difference : degree of children's handicap(F=6.333, P <.01). The relationships between general characteristics and family functioning were statistically significant differences : familial relation with the children(F=3.628, P <.05), caregiver's health status(F=4.359, P <.05), age of children (F=4.185, P <.05), and duration of treatment (F=6.802, P <.01). 3. In families of children with cerebral palsy, there was significantly negative correlation between the burden of parents and the performance of family functioning(r=-.230, P <.05). There were significantly negative correlations between the burden of parents and the satisfaction of family functioning (r=-.211, P <.05), and between the perceived importance and the satisfaction of family functioning(r=-.481, P <.01); however, there was a positive correlation between the performance and the perceived importance of family functioning(r=.425, P <.01). In conclusion, this study suggests that families of children with cerebral palsy need family-focused nursing interventions as supportive care for relieving their burden and for improving family functioning.

The purpose of this study was to identity the level of burden and quality of life of the subjects. The subjects of this study were 68 mothers of nephrotic syndrome patients who children hospitalized in 2 Pediatric wards of University Hospital in Seoul. The data were collected through a questionnaires and the period of the data collection was from August 1st to September 30th ,1998. The instruments for this study were Burden Measurement Instrument developed by Montgomery et. al (1985) and Quality of life scale designed by Ro, Yoo JA (1988). The statistical analysis was used by SPSS, t-test, ANOVA and Pearson correlation coefficient. The results of were as follows : 1. The level of burden showed a mean score 54.47 and the level quality of life, a mean score 140.20. 2. The level of burden differed according to s religion, pt's purpose of admission and perceived patient's condition by mothers. 3. The level of quality of life differed according to perceived pt's condition by mothers. 4. There was a negative correlation between burden and quality of life(r=-3.97, p<.001).

This study was designed to identity the degree of burden felt by mothers of children with nephrotic syndrome. Also, relations between the subject characteristics and burden were investigated to provide basis data for their family health and nursing intervention. The study subjects were composed of 70 mothers of nephrotic syndrome patients whose children were hospitalized in 2 Pediatric wards of University Hospital in Seoul and 1 in Pusan from Mar. 2nd, 1998 to May. 30th in the same year. The questionnaires were used which dealt with burden of mothers. the questionnaires for this study designed and used by researcher placed their basis in burden Measurement Instrument developed by Montgomery et. al(1985) and the reliability of the used instrument was .78. The data analysis was done by SPSS, t-test, ANOVA and Stepwise Multiple Regression. The results of were as follows. 1. Mean score of burden of subjects was 60.82(Maximum 86, standard deviation 1.244). 2. Of the mothers characteristics, the score of burden was high in case of no religion and low income. 3. Of the patients characteristics, the score of burden ranked as high in MCNS, doing oral therapy and injection therapy at the same time, and negative perceived patients' condition. 4. The degree of burden felt by mothers of children with nephrotic syndrome was significantly predicted by the level of pt's diagnosis(11%), pt's condition(8%), economic state(6%) and pt's sex(5%), respectively. In conclusion to above study, the researcher suggests that the development of instrument for measurement of burden is in much need. Relations between burden and social support should be studied to lessen burden of mothers of children with nephrotic syndrome.

It is important to asess the risk factors of parenting and provide early intervention for promotion of the maternal caretaking ability. The purpose of the study was to identify the maternal burden of caretaking, the supporting and the educational need for the caretaking activities of the mother of infant. Sixty three mothers of infants who visited the wellbaby clinic of S university hospital and one health center during the period of November 1st, to 30th in 1996 comprised the subjects of this study. Data were gathered through the instruments that were developed by researcher. Statistical analysis of this study was used ANOVA and Pearson correlation. The results were as follows : 1) The mean score of the maternal burden of caretaking was 22.06. The maternal burden of caretaking was significantly high in the mothers who had vaginal delivery compare with the mothers who had caeserean section and in the mothers who gave artificial feeding compare with the group of breast or mixed feeding. 2) The mean score of the support need for the caretaking activities was 30.69. The support need for the caretaking activities was significantly high in the mothers who had the second child, compare with the mothers who had first or third child. And the support need for the caretaking activities was significantly high in the mothers who had caretaking help compare with the mothers who had no caretaking help. The specific subjects of 'mother-infant interaction', 'immunization' and 'prevention of accident' on the support need for the caretaking activities were relatively high. 3) The mean score of the educational need of caretaking activities was 29.3. The educational need of caretaking activities was significantly high in the mother who had the second child compare with the mothers who had first or third child. And the educational need of caretaking activities was significantly high in the mothers who had caretaking help compare with the mothers who had no caretaking help. The specific subjects of 'mother-infant interaction', 'emergency care' and 'prevention of accident' on educational need of caretaking were relatively high. 4) The maternal burden of caretaking was not correlated with the support need or the educational need of caretaking activities. But the support need of caretaking activities was significantly correlated with the educational need of caretaking activities. 5) The support and educational need of caretaking activities were significantly high in the mothers who wanted home care for caretaking their infants. Through the study, it was found that there is considerable maternal burden of caretaking as well as the support and educational need on the caretaking activities in the mothers whose child is young. Therefore developing the systematic and effective program is needed to meet the mother's need. The results of this study will be useful resources to develop the program. On the other hand, it can be recommended that home health care will be one of the approach to support the mothers caretaking activities.