Families with pediatric type 1 diabetes : a comparison with the general population on child well-being, parental distress, and parenting behavior

Aims The aim of this study was to compare families with a child (2-12 years) with type 1 diabetes (T1D) to families which are not confronted with chronic illness, with regard to children's well-being, parental distress, and parenting behavior. In addition, differences were explored between families whose child has optimal vs suboptimal glycemic control. Methods Mothers, fathers, and children of 105 families with pediatric T1D completed questionnaires assessing child well-being, parental distress, and parenting. The control group consisted of 414 families without chronic illness. Results With regard to child well-being, children with T1D had more adjustment difficulties (as reported by mothers) and lower quality of life (QoL) (as reported by mothers and fathers), whereas children themselves (8-12 years) reported higher QoL compared to controls. In terms of parental distress, mothers, but not fathers, of children with T1D reported more stress, anxiety symptoms, and depressive symptoms than controls. With regard to parenting behavior, parent reports revealed less protectiveness in fathers and less autonomy support and responsiveness in both parents as compared to controls. No differences were found in parent-reported psychological control between parents of children with and without T1D, but children with T1D perceived lowered parental psychological control. Lastly, secondary analyses indicated that especially families with suboptimal child glycemic control showed more maternal distress and worse child well-being (according to parents). Conclusions Families confronted with pediatric T1D differ from families without chronic illness: childhood T1D impacts parental perceptions of child well-being and differentially affects mothers' and fathers' distress levels and behaviors

Advantages and disadvantages of an objective selection process for early intervention in employees at risk for sickness absence

<p>Abstract</p> <p>Background</p> <p>It is unclear if objective selection of employees, for an intervention to prevent sickness absence, is more effective than subjective 'personal enlistment'. We hypothesize that objectively selected employees are 'at risk' for sickness absence and eligible to participate in the intervention program.</p> <p>Methods</p> <p>The dispatch of 8603 screening instruments forms the starting point of the objective selection process. Different stages of this process, throughout which employees either dropped out or were excluded, were described and compared with the subjective selection process. Characteristics of ineligible and ultimately selected employees, for a randomized trial, were described and quantified using sickness absence data.</p> <p>Results</p> <p>Overall response rate on the screening instrument was 42.0%. Response bias was found for the parameters sex and age, but not for sickness absence. Sickness absence was higher in the 'at risk' (N = 212) group (42%) compared to the 'not at risk' (N = 2503) group (25%) (OR 2.17 CI 1.63–2.89; p = 0.000). The selection process ended with the successful inclusion of 151 eligible, i.e. 2% of the approached employees in the trial.</p> <p>Conclusion</p> <p>The study shows that objective selection of employees for early intervention is effective. Despite methodological and practical problems, selected employees are actually those at risk for sickness absence, who will probably benefit more from the intervention program than others.</p

Parental stress, anxiety and trait mindfulness : associations with parent–child mealtime interactions in children with type 1 diabetes

Introduction: This study examined how maternal and paternal stress, anxiety, and trait mindfulness, and child glycemic control are related to real-life parent–child interactions in families confronted with type 1 diabetes (T1D). Methods: Parents reported on trait mindfulness, illness-related parenting stress, general stress, and state anxiety. Parent–child mealtime interactions were videotaped and scored in 33 families (31 mothers and 20 fathers) of children with T1D (5–12y., mean HbA1c = 7.22%). Results: Parental stress and anxiety were related to more maladaptive and less adaptive parent–child interactions. For mothers, mindfulness was related to less observed discomfort of the child during injection. For fathers, more emotional involvement was related to better child glycemic control. Discussion: Results indicate that parental stress and anxiety may be risk factors for maladaptive parent–child interactions

Families with pediatric type 1 diabetes: A comparison with the general population on child well-being, parental distress, and parenting behavior

AIMS: The aim of this study was to compare families with a child (2-12 years) with type 1 diabetes (T1D) to families which are not confronted with chronic illness, with regard to children's well-being, parental distress, and parenting behavior. In addition, differences were explored between families whose child has optimal vs suboptimal glycemic control. METHODS: Mothers, fathers, and children of 105 families with pediatric T1D completed questionnaires assessing child well-being, parental distress, and parenting. The control group consisted of 414 families without chronic illness. RESULTS: With regard to child well-being, children with T1D had more adjustment difficulties (as reported by mothers) and lower quality of life (QoL) (as reported by mothers and fathers), whereas children themselves (8-12 years) reported higher QoL compared to controls. In terms of parental distress, mothers, but not fathers, of children with T1D reported more stress, anxiety symptoms, and depressive symptoms than controls. With regard to parenting behavior, parent reports revealed less protectiveness in fathers and less autonomy support and responsiveness in both parents as compared to controls. No differences were found in parent-reported psychological control between parents of children with and without T1D, but children with T1D perceived lowered parental psychological control. Lastly, secondary analyses indicated that especially families with suboptimal child glycemic control showed more maternal distress and worse child well-being (according to parents). CONCLUSIONS: Families confronted with pediatric T1D differ from families without chronic illness: childhood T1D impacts parental perceptions of child well-being and differentially affects mothers' and fathers' distress levels and behaviors.status: publishe