Quality of Life in Children with Type I Diabetes Mellitus (T1D) in Minia Governorate: Relationship with Mood and Family Attitudes

Abstract

Introduction: Children with T1D experience behavioral difficulties and lower social competency compared with healthy children. Quality of life is considered to be a significant indicator of disease prognosis. Aim:To evaluate the health related quality of life of children with T1D, and how much it could be affected by their mood and family attitudes and to study the relationship between these variables and the metabolic control of the diabetic children.Methods: 72 children with T1D were included and subjected to; history taking, clinical examination, application of Peds QL (Diabetes Module, Version 3), Childhood Depression inventory Scale (CDI),Parent Stress Index(PSI) questionnaire and HbA1c%. Another 72 children apparently healthy, non-diabetic, age and sex matched and siblings of the diabetic patients were included as a control group. They were subjected to Childhood Depression inventory Scale (CDI), Parent Stress Index (PSI) questionnaire.Results: Diabetic patients had significant higher CDI Score and total PSI score than the control group. There were significant positive fair correlations between the age, weight and BMI of diabetic children with the child PedsQL, the parent PedsQL and CDI total scores. Concerning glycemic control, there were significant positive fair correlations between CDI total score with frequency of DKA attacks and HbA1c%. Using the PSI domains, poorly controlled diabetic patients had significant higher parental distress, parent/child dysfunctional interactions and higher PSI total score compared to good controlled patients. Using CDI domains, poorly controlled diabetic patients had significantly more negative self-esteem than good controlled patients. There was a significant positive moderate relationship between CDI total score and PSI score. Finally, there were significant negative weak correlations between PSI score and PedsQL (child and parental) i.e. the higher the parental stress, the lower the quality of life of the diabetic child (reported by both child and parent).Conclusion: diabetic children, especially the poorly controlled ones, are significantly suffering from symptoms of depression which causing stress for their parents and this has significant impact on their quality of life and glycemic control.

Validation and Reliability of Healthcare Workers’ Knowledge, Attitude, and Practice Instrument for Uncomplicated Malaria by Rasch Measurement Model

“…The reduction in a large number of the items resulted in a slightly negative impact on the items' reliability. Similar observation was made with the separation values, although, all index values were within acceptable limits (Bond and Fox, 2015), which could be a proof that the measures have the ability to distinguish the items into two or more distinct groups, despite the low index values (Kook and Varni, 2008). The low separation index values of the items might partly be influenced by the sample size of the study population, although, it has been reported that small sample could be enough for validity analysis of instrument using Rasch measurement model (Bond and Fox, 2015), which was evident in the item reliability and separation index values for knowledge.…”

“…Mutatis mutandis, there were observed increment in persons' reliability measures to 0.64, 0.61, and 0.70 for KAP, respectively (Table 4) compared to those in the draft scale ( Table 2). The separation index values were also in the range of > 1, but < 2, which were indications of the levels of consistency in the respondent behavior, hence, it was an indication of the instruments' capability of differentiating between high and low-performance abilities of respondents (Kook and Varni, 2008;Bond and Fox, 2015). As a measure of consistency in behaviors, it implied that lapses made by the respondents were likely to affect the separation index value negatively, meaning that increasing sample size further might lead to a possible decrease in the index value (Bond and Fox, 2015).…”

The Relationship between Glycated Hemoglobin Levels and the Quality of Life among Type 1 Diabetes Mellitus in Children

“…However, when the Spearman correlation test was conducted, none of the functions and the quality of life were statistically had a significant correlation with HbA1C level (r = 0.264, p > 0.05). This is in line with the research conducted by Ali et al (Egypt) which states that the PedsQL domain shows no significant difference between children with good controls and poor controls T1DM (p > 0.05 for all domains) [21]. Consistent with previous research, Emmanouilidou (Greece) conducted a study on 89 children with T2DM also explained that there was no difference between HbA1C and the quality of life of children with T1DM [22].…”

Quality of Life and Glycemic Control in Saudi Children with Type 1 Diabetes at Different Developmental Age Groups

“…Literature has shown debating findings of either no significant correlations between the 2 or revealed a negative relationship, that is, achieving better glycemic control could be at the expense of reasonable QoL especially when tackling the task from parents' versus children's perspectives. 6,11,12 This study compared the QoL scores reported by Saudi children with T1D with the reports from their parents. It also shows the correlation between glycemic control and the total aggregate and domain-specific QoL scores reported by parents and children at different developmental age groups.…”