The Effect of Family-centered Care on Management of Blood Glucose Levels in Adolescents with Diabetes

Abstract

Background Responsibility for diabetes management tasks must shift from caregivers to adolescents as adolescents grow older. Also, family-centered care is a way to provide efficient care for them at home. This study aimed to identify the effect of family-centered care on management of blood glucose levels in adolescents with type 1 diabetes mellitus (T1DM). Methods This is a Pre-experimental study with a pre- and post-test design. The participants consisted of forty adolescents with T1DM, aged between 10-14 years, with their caregivers who were selected through simple random sampling from Hamadan Diabetes Research Center in Iran in 2013. The sample was divided into four similar groups. Educational sessions were conducted for each group for 30 to 40 minutes. Data collection tools were “Supervisory Behaviors of Caregiver” (SBC), “Management Behaviors of adolescents” (MBA) questionnaires, and the “Blood Glucose Levels Record Sheet”. Data were analyzed using SPSS 19 and based on descriptive statistics, Kolmogorov-Smirnov, paired t-test and Pearson coefficient. Results There was a significant difference between the subjects’ MBA and SBC mean scores before (110.17±26.6) and after (134.6±1.28) intervention in four domains: “blood glucose testing”, “insulin therapy”, “meal plan” and “physical activity” (P<0.001). There were significant differences between the mean levels of recorded blood glucose during a week before and after intervention and between the mean levels of Glycated Hemoglobin level (HbA1c) before (8.4±1.12) and three months after (7.78±1.2) it (P<0.001). Pearson coefficient showed a positive relationship between the supervisory behaviors of caregivers with management behaviors of adolescents before and after the intervention (P<0.001). Conclusion Empowering adolescents with T1DM and their caregivers in home-centered care could improve diabetic adolescents’ management of blood glucose levels and reduce their HbA1Clevels. Therefore, Family-centered care could provide for better regime adherence at home.

Psychoeducational interventions to improve adolescents’ medical management of diabetes: A comprehensive review

“…The majority of the studies evaluating the effects of a psychoeducational intervention on behaviour were underpowered, failed to control for the factor of development, had questionable dependent variables, and may not have used adequate control or comparison groups (Cheraghi et al, 2015;Heinrich et al, 2010). However, there are also many high-quality studies that provide strong evidence of the proof of concept for application to larger populations of adolescents with diabetes.…”

“…Failure to effectively monitor blood glucose levels, insulin delivery, diet, or physical activity can result in negative medical outcomes ranging from long-term effects such as vascular damage to acute issues such as diabetic ketoacidosis and hypoglycemia (Weissberg-Benchelle et al, 1995). Adolescence is also a challenging period for persons with diabetes because responsibilities for management shift from parent-directed to self-managed care (Cheraghi, Shamsaei, Mortazavi, & Moghimbeigi, 2015). Often the ability to self-manage is not mastered during this transition, placing adolescents at risk for medical complications and lower quality of life as they develop into adulthood (Anderson, Brackett, Ho, & Laffel, 1999;Corathers et al, 2015).…”

The Effect of Self-Care on Glycated Hemoglobin and Fasting Blood Sugar Levels on Adolescents with Diabetes

“…Several methods are used for training patients with diabetes, such as the follow-up care model (23), walking instruction (24), meal planning using the "MyPlate" method (6), counseling (25), family-centered care (26), aerobic and preparatory exercises (27), telephone follow-up by nurses, (28) and self-care training (29). The results of previous studies have shown that self-care levels differ among patients with diabetes.…”

Care demands of children with type 1 Diabetes Mellitus

“…3 Thus, studies have shown that the mothers of children with DM1 feel incompetent on the diagnosis and unprepared to deal with the complex situation of the disease, expressing feelings of anxiety, stress and social isolation. 3,7 Based on these assumptions, the importance of a multiprofessional approach in the care of children with DM1 and their family is emphasized, since understanding and evaluating their experience in the process of a disease like diabetes constitutes the foundation for health interventions, that is, family-centered care enhances home care. 7 Given these perspectives, the development of this study is motivated by the need to respond how families experience the demands of care required by a child with DM1.…”