Family dynamics when a child becomes chronically ill: Impact of type 1 diabetes onset in children and adolescents

Abstract

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.