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- Sand, Peter, et al.
(författare)
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Family dynamics when a child becomes chronically ill: Impact of type 1 diabetes onset in children and adolescents
- 2018
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Ingår i: Nordic Psychology. - : Informa UK Limited. - 1901-2276 .- 1904-0016. ; 70:2, s. 97-114
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Tidskriftsartikel (refereegranskat)abstract
- © 2017 The Editors of Nordic Psychology The overall aim of the study was to explore the process of family dynamics when a child has been diagnosed with type one diabetes mellitus (T1DM). The study sample consisted of family members of 20 children with T1DM aged 3–17 years. Twenty-nine parents and seven siblings participated in nine focus group interviews. Five individual interviews were conducted. Focus group discussions and individual interviews were audiotaped, transcribed, and analyzed using a grounded theory methodology. The findings are outlined in the core category, the child’s sudden loss of health, and in three related categories: preconceptions, psychological reactions, and impact on family relationships. Preconceptions about T1DM played a critical role when trying to grasp and respond to the diagnosis. Most cohabiting mothers reported a psychological reaction of shock, which the separated mothers didn’t. Fathers paid more attention to the siblings and to the lifelong disease. Mothers of older children with T1DM were more concerned about the child’s future than the mothers of the younger children. In terms of family relationships, the psychological bond to a younger child was strengthened by the diagnosis, as manifested by increased control in social situations. Adolescent siblings showed a greater degree of empathy toward the child with T1DM, whereas preadolescents and preschool siblings tended to fall into rivalry with the child with T1DM. To conclude, in a clinical setting, this knowledge could help the diabetes team in supporting the families in their early process of adaption after the diabetes onset.
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| 2. |
- Sparud Lundin, Carina, 1964, et al.
(författare)
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Glycaemic control and diabetes care utilization in young adults with Type 1 diabetes.
- 2008
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Ingår i: Diabetic medicine : a journal of the British Diabetic Association. - : Wiley. - 1464-5491 .- 0742-3071. ; 25:8, s. 968-73
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To explore how glycaemic control in young adults is related to diabetes care utilization during the transition to adult diabetes care and if these variables differ between males and females. METHODS: This is a retrospective, longitudinal design following patients' records from age 18-24 years. Adolescents (n = 104) connected to one paediatric outpatient clinic and referred to six different adult clinics were included. Data were collected regarding gender, age at diagnosis and transfer, yearly glycated haemoglobin (HbA(1c)) and body mass index, severe hypoglycaemia and diabetic ketoacidosis, retinopathy and diabetes care utilization. RESULTS: HbA(1c) decreased over time in females (P = 0.004) but not in males. Less than 10% had HbA(1c) in the recommended range during the study period. The decrease in severe hypoglycaemia and diabetic ketoacidosis was not significant. The prevalence of background retinopathy increased from 5 to 29% during the study period (P < 0.001). Mean transfer age was 19.8 years. The youths visited the paediatric clinic more often than the adult clinic (P < 0.001) and females visited adult care more often than males (P = 0.04). There was a steady decrease in the number of visits/year over time (P < 0. 001). Poor glycaemic control was associated with more visits for both males and females (P = 0.005) in adult care. CONCLUSIONS: As there was no gender difference in the relation between HbA(1c) and the number of visits in adult diabetes care, the higher frequency of visits in adult care for females cannot be solely explained by their glycaemic control. Gender differences regarding diabetes care utilization should be further explored.
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