"I Don't Want Them to Feel Different": A Mixed Methods Study of Parents' Beliefs and Dietary Management Strategies for Their Young Children with Type 1 Diabetes Mellitus.
"I Don't Want Them to Feel Different": A Mixed Methods Study of Parents' Beliefs and Dietary Management Strategies for Their Young Children with Type 1 Diabetes Mellitus.
复制标题
DOI：
10.1016/j.jand.2015.06.377
复制
发表时间：
2016-02
影响因子：
4.8
通讯作者：
Goggin K
中科院分区：
文献类型：
--
作者：
Patton SR;Clements MA;George K;Goggin K
许多患有1型糖尿病（T1 DM）的幼儿不吃健康的饮食;尽管有T1 DM教育，但为什么会发生这种情况仍然知之甚少。本研究描述了父母对幼儿T1 DM健康饮食的看法，并确定了与父母饮食管理相关的因素。进行了一项横断面、混合方法研究。父母完成了一份问卷调查，三天称重饮食记录，和一个半结构化的采访，他们的看法，健康饮食的T1 DM和他们的饮食管理做法。2012年2月至2013年4月期间，从美国中西部的儿科糖尿病诊所招募了23个家庭参加。符合条件的家庭中有1名1-6岁的T1 DM儿童，距诊断至少6个月，并且正在接受强化胰岛素治疗方案。平均分数和百分比是从饮食日记和父母问卷中计算出来的，而父母的访谈则被编码以确定共同的主题。结果表明，虽然父母可能认为他们知道什么是T1 DM的健康饮食，但他们并不总是给孩子提供健康的饮食。父母确定的健康饮食障碍包括：准备自制饭菜的时间有限，认为健康食品的成本较高，同龄人对儿童食物偏好的影响，以及挑食。家长们还讨论了不限制孩子饮食或让孩子“感觉不同”的愿望，许多家长说，这经常导致他们屈服于孩子对不太健康的食物选择的要求。患有T1 DM的幼儿的父母确定了所有父母都常见的健康饮食的几个障碍，例如时间限制，费用和儿童食物偏好。然而，独特的主题出现了，包括父母不希望限制孩子的饮食或让他们的孩子“感觉不同”。T1 DM教育的营养成分应包括心理和行为策略，以帮助父母管理这些独特的问题。
Many young children with type 1 diabetes (T1DM) do not consume a healthful diet; exactly why this occurs despite T1DM education remains poorly understood. This study describes parents’ perceptions of healthful eating for T1DM in young children and identifies factors related to parents’ dietary management. A cross-sectional, mixed-methods study was performed. Parents completed a questionnaire, three-day weighed diet record, and a semi-structured interview regarding their perceptions of healthful eating for T1DM and their dietary management practices. Twenty-three families, recruited from a Pediatric Diabetes Clinic in the Mid-Western United States between February 2012 and April 2013, participated. Eligible families had a child with T1DM who was 1-6 years old, at least six months from diagnosis, and was following an intensive insulin regimen. Mean scores and percentages were calculated from the diet diaries and parent questionnaires, while parents’ interviews were coded to identify common themes. Results showed that while parents may believe they know what constitutes a healthful diet for T1DM, they do not always feed their child a healthful diet. Parent-identified barriers to healthful eating included: limited time to prepare homemade meals, perceived higher costs of healthier foods, the influence of peers on children's food preferences, and picky eating. Parents also discussed a desire not to limit their child's diet or make their child “feel different”, which many parents said often led them to give into child's requests for less healthful food options. Parents of young children with T1DM identified several barriers to healthful eating that are common for all parents, such as time constraints, expense, and child food preferences. However, unique themes emerged including parents’ desire not to limit their child's diet or make their child “feel different.” Nutrition components of T1DM education should include psychological and behavioral strategies to help parents manage these unique concerns.