Societal Norms and Conditions and Their Influence on Daily Life in ChildrenWith Type 1 Diabetes in the West Bank in Palestine

Purpose: To explore the experiences of daily life in children with type 1 diabetes (T1D) and their parents living in the West Bank in Palestine. Design andMethods: A qualitative study using thematic interviewswas performed with 10 childrenwith T1D and their parents (n = 10). Content analysis was performed with the assistance of NVIVO 10. Results: The overall themewas facing the social reality of diabetes. Thiswas underpinned by two themes: stigmatization and social constraints. Facing the social reality of diabetes described children and their parents' everyday life attempts to place themselves within the context of the disease and social context. Children and their parents described how stigmatization and social constraints impacted their daily life as a result of fear of disclosing the disease, which could affect their social status. Conclusion: These findings highlighted how daily life in children with T1D and their parents was highly affected by cultural impacts, especially as stigma related to the illness affected social interactions of female and male children/ adolescents. Lack of knowledge andmisunderstandings about T1D in society lead to negative consequences like poorer management of diabetes, and this becomes mediated by gender. Practical Implications: The findings suggest health care providers need to be aware of the cultural and social impact of T1D on children's and parents' daily life in order to meet their needs and challenges by providing appropriate interventions, strategies and support.This research did not received any specific grant from funding agencies in the public, commercial, or not-for-profit sectors

Struggling and Overcoming Daily Life Barriers Among Children With Congenital Heart Disease and Their Parents in the West Bank, Palestine

Advances in early diagnosis, treatment, and postoperative care have resulted in increased survival rates among children with congenital heart disease (CHD). Research focus has shifted from survival to long-term follow-up, well-being, daily life experiences, and psychosocial consequences. This study explored the everyday experiences of children with CHD and of their parents living in the Palestinian West Bank. Interviews with nine children aged 8 to 18 years with CHD and nine parents were analyzed using content analysis. The overall theme that emerged was facing and managing challenges, consisting of four themes: sociocultural burden and finding comfort, physical and external limitations, self-perception and concerns about not standing out, and limitations in access to health care due to the political situation. To provide optimum care for children with CHD and their parents, health care providers and policy makers must understand the negative consequences associated with sociocultural conditions and beliefs about chronic illness.Acknowledgments We would like to thank all of the participants of this research. It was their willingness to share their experiences and insights that made this study possible. Funding The authors received no financial support for the research, authorship, and/or publication of this article

Self-Perceived Health Status and Sense of Coherence in Children With Type 1 Diabetes in the West Bank, Palestine

Introduction: Self-perceived health status and sense of coherence (SOC) are essential constructs for capturing health outcomes in children with type 1 diabetes (T1D). This study measured self-perceived health status and SOC in children with T1D and compared them with a healthy reference group in West Bank, Palestine. Methodology: One hundred children with T1D aged 8 to 18 years and 300 healthy children completed PedsQL 4.0 Generic Core Scales and SOC-13 in a crosssectional descriptive study. Results: All children reported acceptable self-perceived health status and low degree of SOC. In the diabetes group, high degree of SOC was associated with better self-perceived health status and more optimal metabolic control. Males in the diabetes group reported higher self-perceived health status than females. Discussion: The unstable political situation in Palestine may threaten SOC in children in general. Health professionals can monitor self-perceived health status and SOC to evaluate interventions aiming to improve glycemic control.We gratefully thank all the children for their participation and the nurses who assisted in data collection

Children living with type 1 diabetes and congenital heart disease in the West Bank, Palestine -Self-perceived health status, sense of coherence, and the daily life experiences of these children and theri parents

Chronic diseases such as type 1 diabetes (T1D) and congenital heart disease (CHD) are lifelong conditions, need regular treatment, self management, and health care follow-ups. Growing up with these conditions affects the children’s and their parents’ lives at various levels, because of the increased burden and responsibilities imposed on them. In addition, the particular socio-cultural conditions in the Palestinian West Bank can also be assumed to influence their daily life. The overall aim was to explore the experiences of daily life in children and adolescents with T1D and CHD and their parents living in the West Bank, Palestine, and to describe self-perceived health status and sense of coherence (SOC) in these children compared with a healthy reference group. In Study I and II, a qualitative descriptive design based on individual interviews was used to explore daily life experiences in children with T1D or CHD and their parents. In Study III and IV, a quantitative approach with a cross-sectional design was used to measure self-perceived health status and SOC in children with T1D or CHD and to compare them with a healthy reference group. PedsQLTM 4.0, Generic Core Scale was used to measure the self-perceived health status, whereas the SOC-13 scale was used for SOC. In Study I, children with T1D and their parents struggled to place themselves within the context of the disease and within their social context because of the impact of stigmatization and social constraints on their daily life. In Study II, children with CHD and their parents described how their daily life was influenced negatively by societal stereotyping, low access to specialized care due to the political situation, and the children’s perceptions of their illness. Although these factors affected almost every aspect of their lives, they referred to a reliance on God facilitating their acceptance of their fate and lives. In Study III, both children with T1D and a healthy reference group reported comparable self-perceived health status but low scores regarding SOC. In adolescents with T1D, a strong SOC was associated with better self-perceived health status and more optimal glycemic control. Boys with T1D reported higher self-perceived health status than girls. In Study IV, self-perceived health status was lower in children with CHD compared to a healthy reference group. SOC was low in both groups and no differences between the groups were found. Children with a mild CHD reported a better self-perceived health status, while children who had undergone heart surgery reported lower self-perceived health status. Furthermore, a stronger SOC was associated with higher self-perceived health status in adolescents with CHD. To provide optimum care for children with T1D and CHD and their parents, health care providers need to understand the negative consequences associated with sociocultural conditions and beliefs about chronic illness. Monitoring self-perceived health status and taking the role of SOC into consideration in children with T1D and CHD may form the basis for future health care interventions for these children