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基于群组的、视频为基础的远程医疗干预减少青少年 1 型糖尿病患儿父母糖尿病困扰的非随机试验

A Nonrandomized Pilot of a Group, Video-Based Telehealth Intervention to Reduce Diabetes Distress in Parents of Youth With Type 1 Diabetes Mellitus.

机构信息

Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas, United States.

Child Clinical Psychology Program, University of Kansas, Lawrence, Kansas, United States.

出版信息

Can J Diabetes. 2022 Apr;46(3):262-268. doi: 10.1016/j.jcjd.2021.10.007. Epub 2021 Nov 3.

Abstract

OBJECTIVES

Our aim in this study was to refine and pilot a video-based telehealth intervention to reduce diabetes distress, depressive symptoms and hypoglycemia fear in parents of school-age children with type 1 diabetes and to assess for changes in child glycated hemoglobin (A1C).

METHODS

We recruited 41 parents of children (5 to 12 years) to participate in a manualized, video-based telehealth intervention (Cognitive Adaptions to Reduce Emotional Stress [CARES]). Of these, 29 parents completed either a 12-week (n=13) or 8-week (n=16) version of CARES based on the timing of their recruitment. We assessed feasibility (i.e. attrition, attendance) and parent satisfaction with CARES. We used repeated-measures analysis of variance with parent group (8 vs 12 sessions) as a between-subject variable and time as a within-subject variable to measure change in our dependent variables.

RESULTS

Mostly mothers participated (97.3%). Parents' mean age was 39.65±6.84 years and children's mean age was 9.86±1.57 years at pretreatment. CARES had low attrition (20% to 25%) and good attendance (96% to 98%). Parents also reported high levels of treatment satisfaction (>85%). There were significant main effects for time for parent-reported diabetes distress and depressive symptoms at posttreatment and 3-month follow-up. There was a statistical trend suggesting a time × group interaction for parent depressive symptoms at posttreatment. There was a significant main effect for time for hypoglycemia fear at the 3-month follow-up but no change at posttreatment. There was no change in child A1C at posttreatment.

CONCLUSION

CARES showed high parent satisfaction, good feasibility and promising results for reducing diabetes distress in parents of school-age children with type 1 diabetes.

摘要

目的

本研究旨在改进并初步测试基于视频的远程医疗干预措施,以减轻学龄期 1 型糖尿病儿童父母的糖尿病困扰、抑郁症状和低血糖恐惧,并评估儿童糖化血红蛋白(HbA1c)的变化。

方法

我们招募了 41 名 5 至 12 岁儿童的父母参与一项基于手册的、基于视频的远程医疗干预(Cognitive Adaptions to Reduce Emotional Stress [CARES])。其中,根据招募时间,29 名父母完成了 12 周(n=13)或 8 周(n=16)的 CARES 版本。我们评估了 CARES 的可行性(即流失率、出勤率)和父母满意度。我们使用重复测量方差分析,以父母组(8 次与 12 次)作为组间变量,时间作为组内变量,来衡量我们的因变量的变化。

结果

大多数参与者为母亲(97.3%)。父母的平均年龄为 39.65±6.84 岁,孩子的平均年龄为 9.86±1.57 岁。CARES 的流失率低(20%至 25%),出勤率高(96%至 98%)。父母还报告了高度的治疗满意度(>85%)。在治疗后和 3 个月随访时,父母报告的糖尿病困扰和抑郁症状有显著的时间主效应。在治疗后,父母抑郁症状有统计学趋势的时间与组间交互作用。在 3 个月随访时,低血糖恐惧有显著的时间主效应,但在治疗后没有变化。治疗后儿童的 HbA1c 没有变化。

结论

CARES 显示出高的父母满意度、良好的可行性和有前途的结果,可以减轻学龄期 1 型糖尿病儿童父母的糖尿病困扰。

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