Purpose This pilot study aimed to assess the feasibility, preliminary efficacy, and effects of a mobile app healthcare coaching program developed based on self-regulation theory among youths with type 1 diabetes.
Methods A mixed-method design was utilized. Participants were randomly assigned into intervention (n=23, 12-week coaching program) or control groups (n=16, usual care). Pre- and post-intervention assessments included self-efficacy, diabetes management behavior, and health outcomes (quality of life, depression, and HbA1c). Quantitative data were analyzed with SPSS/WIN ver. 26.0. The narrative information from the participants in the healthcare coaching program underwent content analyzed.
Results The intervention group had significantly lower depression scores (t=2.57, p=.014) than the control group. No significant differences were observed in self-efficacy, diabetes management behavior, and health outcomes between the two groups. The average frequency of health behavior monitoring per week among the participants was 1.86±1.60. The qualitative findings indicated that participants perceived improved diabetes self-management with the intervention; however, challenges during vacations, dietary control difficulties, and a lack of disease awareness were identified.
Conclusion The healthcare coaching program improved psychological aspects for youth with type 1 diabetes. Further research is needed to develop and implement mobile app interventions aimed at enhancing compliance with diabetes management in pediatric and adolescent populations.
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.
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Purpose The purpose of this study was to investigate the effect of family-centered interventions on improving health outcomes in children and adolescents with type 1 diabetes mellitus (T1DM).
Methods A literature search was conducted according to the PRISMA guidelines, using six electronic databases: EMBASE, CINAHL, Medline, CENTRAL, Scopus, and Web of Science. The inclusion criteria encompassed studies with populations of children and adolescents (age <18 years) and at least one parent/caregiver, or only parents/caregivers if the children were very young, and studies that investigated the health outcomes of children and parents/caregivers diagnosed with T1DM.
Results From 2,746 published studies, only nine studies met the inclusion criteria. The key interventions were non-technology-based interventions (n=4), technology-based interventions (n=2), and combined technology- and non-technologybased interventions (n=3). The interventions had effects on glycated hemoglobin, adherence to diabetes management, diabetes self-management behaviors, and parentchild teamwork in diabetes management. Other essential effects were children's quality of life, children's problem-solving skills, parents' quality of life, and parents' coping and depression.
Conclusion Family-centered interventions can effectively improve health outcomes in children and adolescents with T1DM. In the future, family-centered interventions integrated with other approaches, theories, and models should be developed to achieve the best possible outcomes.
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Purpose The purpose of this study was to identify predictors of eating disorders in adolescents with type 1 diabetes, with the goal of providing data in support of nursing interventions to improve their health.
Methods A total of 136 adolescents aged 13-18 years with type 1 diabetes completed the Diabetes Eating Problem Survey-Revised, Rosenberg Self-Esteem Scale, and the Beck Depression Inventory-II, using structured self-reported questionnaires. The collected data were analyzed using the t-test, x2 test, and binominal logistic regression with SPSS version 23.0 for Windows.
Results The prevalence of eating disorders in adolescents with type 1 diabetes was 39%. Four significant predictors of eating disorders were identified; absence of body satisfaction (odds ratio [OR]=3.87, 95% confidence interval [CI]=1.55~9.65), depression (OR=2.87, 95% CI=1.13~7.28), female gender (OR=2.67, 95% CI=1.09~6.54), and glycosylated hemoglobin type A1c levels (OR=1.47, 95% CI=1.10~1.97).
Conclusion In order to prevent eating disorders among adolescents with type 1 diabetes, programs for managing adolescents’ depression and improving their body satisfaction should be developed. Futhermore, more attention should be directed towards programs aiming to prevent eating disorders in female adolescents.
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Purpose The purpose of this study was to investigate associations between self-management and diabetes knowledge, diabetesrelated attitudes, family support, and self-efficacy in adolescents with type 1 diabetes mellitus based on the information-motivation- behavior skills model.
Methods Data collection was conducted between March 18 and September 30, 2018. Patients (N=87) aged 12 to 19 years were recruited from the outpatient clinic of S children’s hospital and an online community for patient with type 1 diabetes mellitus. Data were analyzed using descriptive statistics, the independent t-test, one-way ANOVA, Pearsons correlation, and hierarchical multiple linear regression with SPSS IBM 23.0, with the two-tailed level of significance set at 0.05.
Results The mean score of self-management in adolescents with type 1 diabetes mellitus was 61.23±10.00 out of 80. The regression analysis showed that self-efficacy and family support significantly explained 56.9% of the variance in self-management (F=21.38, p<.001). Self-efficacy (β=.504, p<.001) and family support (β=.188, p<.001) were significant predictors of self-management.
Conclusion It is necessary to develop individual interventions to improve self-efficacy and family support for adolescents with type 1 diabetes mellitus to help them enhance their self-management.
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Purpose The purpose of this study was to describe the subjective happiness and satisfaction with life of children with type 1 diabetes and explore related factors.
Methods A descriptive cross-sectional study design was used and the study was conducted with children at a diabetes camp. Data were collected using a self-report questionnaire to explore positive and negative psychological factors. The questionnaire included Subjective Happiness Scale, Satisfaction with Life Scale, Perceived Stress Scale and the Center for Epidemiological Studies Depression Scale for Children (CES-DC), Multidimensional Scale of Perceived Social Support, and General Self-Efficacy Scale.
Results Data from 15 children were used for data analysis. The correlational analysis results showed that subjective happiness was positively correlated satisfaction with life, social support, and self-efficacy, and was negatively correlated with perceived stress. Satisfaction with life was positively correlated social support, and was negatively correlated with perceived stress.
Conclusion Results indicate that the positive psychology factors were closely related with social support and self-efficacy and may alleviate perceived stress and depressive feelings. Therefore, researchers and clinicians should include positive psychological factors in their health management model for children with chronic illness.
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Purpose The study purposes were to explore school nurses’ experience, perceived barriers, and education needs in diabetes management at school.
Methods This study was a cross sectional study and the study participants were recruited conveniently at continuing education seminars for school nurses at Incheon Metropolitan City.
Results Data for 101 school nurses were analyzed. The nurses were all women and their mean age was 46.9±9.3 years. About 66% of them had experience with children with diabetes at school. The school nurses reported that 74.6% of the students tested their blood glucose by themselves, the school clinic was the most common place for blood glucose tests (47.8%) and insulin injections (50.8%) and the nurses knew students’ diagnosis through the student health survey (58.2%). About half of the nurses (53.7%) reported that glucagon should be available at school and 49.2% were willing to inject glucagon when necessary. The most frequently reported barrier in diabetes management was role confusion (6.0±1.3) and the most common educational need was emergency responses (5.9±1.4).
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PURPOSE Study purposes were to exam effects of self-care education for children with type 1 diabetes on their diabetes management behaviors and to explore the relationship among diabetes management behaviors, knowledge, self-efficacy and clinical variables. METHODS This study was a one group quasi-experimental study. Study participants were children with type 1 diabetes and attended a four hour self-care education of a diabetes camp. Data were collected using structured questionnaires including Diabetes Management Behavior Scale (DMBS), Michigan Diabetes Research and Training Center's Brief Diabetes Knowledge Test and Self-Efficacy for Diabetes Self-Management. RESULTS The mean age of the participants was 12 (+/-2.3) years. After the education, their DMBS and knowledge improved, but the improvement was not statistically significant (t=1.758, p=.101; t=0.528, p=.606). Two areas of DMBS, daily prevention behaviors and modification of care plan, were associated with study variables. Daily prevention behaviors were associated with duration of diabetes (r=.653, p=.008), HbA1c (r=.563, p=.038) and having a complication (r=-2.788, p=.015). Modification of care plan was associated with age at diagnosis (r=-.552, p=.033). CONCLUSION Children with type 1 diabetes could improve some parts of their diabetes management behaviors even after a short diabetes camp.
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