Abstract
BackgroundTo assess initial efficacy and feasibility of a structured behavioural group training (DELFIN) for parents of children with diabetes type 1, in order to reduce parenting stress and to improve parenting skills.MethodsA randomized controlled study was conducted between July 2008 and September 2010, at a children’s hospital in Hannover with parents of children with type 1 diabetes (2–10 yrs) (intervention group n = 37; control group n = 28). Parenting skills, parents’ psychological burden, children’s behavioural difficulties and quality of metabolic control were assessed before, 3 months after and 12 months after participating in the training program.ResultsIn the intervention group parenting behaviour in conflict situations improved significantly after 3 months (Z = −3.28; p ≤ 0.001). It remained stable over 12 months (Z = −2.94; p ≤ 0.01). Depression and anxiety scores of parents decreased (Z = −1.93; p ≤ .05; Z = −2.02; p ≤ .05). Even though the outcome in the intervention group was more positive, the differences between both study arms failed to reach statistical significance. Unexpectedly parenting behaviour in the control group improved also (Z = −2.45; p ≤ .05). Anxiety as well as stress scores decreased in this group (Z = −2.02; p ≤ .05 and Z = −2.11; p ≤ .05). In both groups the initial metabolic control was good and without significant differences (A1c 7.2±0.8% vs. 7.1±0.4%; p > 0.5). It remained stable in the DELFIN group (A1c 7.1±0.8%; p > 0.5), but it increased slightly in controls (A1c 7.3±0.5%; Z = −2.79; p = .005).ConclusionsThis study has brought first evidence for the efficacy and feasibility of the program. A multicentre study with a larger sample is necessary to confirm these first results.
Highlights
To assess initial efficacy and feasibility of a structured behavioural group training (DELFIN) for parents of children with diabetes type 1, in order to reduce parenting stress and to improve parenting skills
Socio-demographic, metabolic and psychological status at study entry Families of the DELFIN group did not differ significantly from the controls according to age of parents, age of the index-child, number of siblings, gender of the indexchild, education level of mothers or insulin delivery modality (Table 1)
All children were on intensified insulin therapy
Summary
To assess initial efficacy and feasibility of a structured behavioural group training (DELFIN) for parents of children with diabetes type 1, in order to reduce parenting stress and to improve parenting skills. The therapy of children with type 1 diabetes has experienced tremendous improvements in the recent past [1,2,3,4,5]. In spite of the progress of the insulin therapy, its metabolic outcome is limited by family conflicts, family dysfunction and parenting problems, e. The specific parenting issues of parents with toddlers, pre- and elementary school children (temper tantrums, implementing prohibitions and rules, conflicts between siblings and the acquisition of skills) are exacerbated by the chronic disease [22]. Dealing with daily problems might become more complicated for the parents due to continuous requirements of the diabetes therapy and lack of social support
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