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改善 1 型糖尿病青少年的心理健康:冒险才有收获在线青少年和家长支持干预的随机对照试验方案。

Improving mental health of adolescents with Type 1 diabetes: protocol for a randomized controlled trial of the Nothing Ventured Nothing Gained online adolescent and parenting support intervention.

机构信息

Parenting Research Centre, 5/232 Victoria Pde, 3002, East Melbourne, Victoria, Australia.

出版信息

BMC Public Health. 2013 Dec 17;13:1185. doi: 10.1186/1471-2458-13-1185.

Abstract

BACKGROUND

Management of Type 1 diabetes comes with substantial personal and psychological demands particularly during adolescence, placing young people at significant risk for mental health problems. Supportive parenting can mitigate these risks, however the challenges associated with parenting a child with a chronic illness can interfere with a parent's capacity to parent effectively. Interventions that provide support for both the adolescent and their parents are needed to prevent mental health problems in adolescents; to support positive parent-adolescent relationships; and to empower young people to better self-manage their illness. This paper presents the research protocol for a study evaluating the efficacy of the Nothing Ventured Nothing Gained online adolescent and parenting intervention which aims to improve the mental health outcomes of adolescents with Type 1 diabetes.

METHOD/DESIGN: A randomized controlled trial using repeated measures with two arms (intervention and wait-list control) will be used to evaluate the efficacy and acceptability of the online intervention. Approximately 120 adolescents with Type 1 diabetes, aged 13-18 years and one of their parents/guardians will be recruited from pediatric diabetes clinics across Victoria, Australia. Participants will be randomized to receive the intervention immediately or to wait 6 months before accessing the intervention. Adolescent, parent and family outcomes will be assessed via self-report questionnaires at three time points (baseline, 6 weeks and 6 months). The primary outcome is improved adolescent mental health (depression and anxiety). Secondary outcomes include adolescent behavioral (diabetes self-management and risk taking behavior), psychosocial (diabetes relevant quality of life, parent reported child well-being, self-efficacy, resilience, and perceived illness benefits and burdens); metabolic (HbA1c) outcomes; parent psychosocial outcomes (negative affect and fatigue, self-efficacy, and parent experience of child illness); and family outcomes (parent and adolescent reported parent-adolescent communication, responsibility for diabetes care, diabetes related conflict). Process variables including recruitment, retention, intervention completion and intervention satisfaction will also be assessed.

DISCUSSION

The results of this study will provide valuable information about the efficacy, acceptability and therefore the viability of delivering online interventions to families affected by chronic illnesses such as Type 1 diabetes.

TRIAL REGISTRATION

Australian New Zealand clinical trials registry (ANZCTR); ACTRN12610000170022.

摘要

背景

1 型糖尿病的管理带来了巨大的个人和心理需求,尤其是在青少年时期,这使年轻人面临严重的心理健康问题风险。支持性的育儿可以减轻这些风险,但是育儿患有慢性疾病的孩子所带来的挑战会干扰父母有效地育儿的能力。需要为青少年及其父母提供支持,以预防青少年心理健康问题;支持积极的亲子关系;并赋予年轻人更好地自我管理疾病的能力。本文介绍了一项研究的研究方案,该研究评估了“Nothing Ventured Nothing Gained”在线青少年和育儿干预措施的功效,该干预措施旨在改善 1 型糖尿病青少年的心理健康结果。

方法/设计:将使用具有两个臂(干预组和等待名单对照组)的重复测量随机对照试验来评估在线干预的功效和可接受性。大约 120 名年龄在 13-18 岁之间的患有 1 型糖尿病的青少年及其父母/监护人将从澳大利亚维多利亚州的儿科糖尿病诊所招募。参与者将被随机分配立即接受干预或在 6 个月后才能访问干预。通过自我报告问卷在三个时间点(基线,6 周和 6 个月)评估青少年,父母和家庭的结果。主要结果是改善青少年的心理健康(抑郁和焦虑)。次要结果包括青少年行为(糖尿病自我管理和冒险行为),心理社会(糖尿病相关生活质量,父母报告的孩子幸福感,自我效能感,韧性以及感知的疾病益处和负担);代谢(HbA1c)结果;父母心理社会结果(负面情绪和疲劳,自我效能感以及父母对孩子疾病的体验);以及家庭结果(父母和青少年报告的父母与青少年之间的沟通,对糖尿病护理的责任,与糖尿病相关的冲突)。还将评估包括招募,保留,干预完成和干预满意度在内的过程变量。

讨论

该研究的结果将提供有关向受 1 型糖尿病等慢性疾病影响的家庭提供在线干预措施的功效,可接受性以及因此可行性的宝贵信息。

试验注册

澳大利亚和新西兰临床试验注册(ANZCTR);ACTRN12610000170022。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e10/3878581/b4e48100a6c9/1471-2458-13-1185-1.jpg

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