Investigation of quality of life and family burden issues during insulin pump therapy in children with Type 1 diabetes mellitus-a large-scale multicentre pilot study
Investigation of quality of life and family burden issues during insulin pump therapy in children with Type 1 diabetes mellitus-a large-scale multicentre pilot study
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DOI：
10.1111/j.1464-5491.2009.02707.x
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发表时间：
2009-05-01
影响因子：
3.5
通讯作者：
Wagner, V. M.
中科院分区：
文献类型：
--
作者：
Mueller-Godeffroy, E.;Treichel, S.;Wagner, V. M.
为了研究1型糖尿病儿童持续皮下胰岛素输注（CSII）治疗的心理社会方面，并确定相关和敏感的措施，我们进行了一项多中心前瞻性的前/后研究，1型糖尿病儿童（53名女孩，64名男孩，年龄10.5 ± 3.7岁，平均值± SD）和他们的主要照顾者来自18个德国糖尿病中心。25名8-11岁的儿童和63名12-16岁的青少年及其父母，加上29名4-7岁儿童的父母，在过渡到CSII之前和过渡到CSII之后6个月完成了关于一般和糖尿病特异性生活质量（QOL）、一般父母压力、进餐时间行为、低血糖恐惧和家庭冲突的标准化问卷。在所有年龄组中，儿童糖尿病特异性QOL显著增加（P < 0.001），具有中等至大的效应量（4-7岁儿童：Cohen效应量= 1.3; 8-11岁：d = 0.9，12-16岁青少年：d = 0.6）。父母报告总体养育压力的频率（P < 0.01，d = 0.4-0.7）和难度（P < 0.01，d = 0.3-0.6）降低，对低血糖的担忧减少（P < 0.01，d = 0.4-0.6）。年龄较小的儿童（4-7岁）的父母报告营养管理问题减少（频率：P < 0.001，d = 1.1;难度：P < 0.05，d = 0.7）CSII可能具有实质性的心理社会益处。需要对照研究。
To investigate psychosocial aspects of continuous subcutaneous insulin infusion (CSII) therapy in children with Type 1 diabetes and to identify relevant and sensitive measures.We performed a multi-centre prospective pre-/post-study with children (53 girls, 64 boys, age 10.5 +/- 3.7 years, mean +/- sd) with Type 1 diabetes and their main carer from 18 German diabetic centres. Twenty-five children aged 8-11 years and 63 adolescents aged 12-16 years and their parents, plus 29 parents of children aged 4-7 years completed standardized questionnaires on generic and diabetes-specific quality of life (QOL), generic parenting stress, mealtime behaviour, fear of hypoglycaemia and family conflict immediately before and 6 months after transition to CSII.After transition to CSII, diabetes-specific QOL of children increased significantly (P < 0.001) in all age groups, with moderate to large effect sizes (children aged 4-7 years: Cohen's effect sized = 1.3; 8-11 years: d = 0.9, adolescents 12-16 years: d = 0.6). Parents reported reduced frequency (P < 0.01, d = 0.4-0.7) and difficulty (P < 0.01, d = 0.3-0.6) of overall parenting stress and decreased worries about hypoglycaemia (P < 0.01, d = 0.4-0.6). Parents of younger children (4-7 years) reported reduced problems with nutrition management (frequency: P < 0.001, d = 1.1; difficulty: P < 0.05, d = 0.7).CSII may have substantial psychosocial benefits. Controlled studies are needed.