The relationship between parenting stress and parent-child interaction with health outcomes in the youngest patients with type 1 diabetes (0-7 years).

Abstract

To test whether parenting stress and the quality of parent–child interaction were associated with glycemic control and quality of life (QoL) in young children (0–7 years) with type 1 diabetes (T1DM), we videotaped 77 families with a young child with T1DM during mealtime (including glucose monitoring and insulin administration). Parent–child interactions were scored with a specifically designed instrument. Questionnaires assessed general and disease-related parenting stress and (diabetes-specific (DS)) QoL. HbA1c (glycemic control) was extracted from the medical records. Both general and disease-related parenting stress were associated with a lower (DS)QoL (r ranged from −0.39 to −0.70, p < 0.05), but not with HbA1c levels. Furthermore, with regard to the parent–child interaction, emotional involvement of parents (r = 0.23, p < 0.05) and expressed discomfort of the child (r = 0.23, p < 0.05) were related to suboptimal HbA1c levels. There was no clear pattern in the correlations between parent–child interaction and (DS)QoL.Conclusion: The results support the notion that diabetes does not only affect the child with T1DM: T1DM is a family disease, as parenting factors (like stress and parent–child interactions) are associated with important child outcomes. Therefore, it is important for health-care providers to not only focus on the child with T1DM, but also on the family system. What is Known: • The incidence of type 1 diabetes is rising, especially in the youngest age group. • Research examining the association between parenting factors (like stress and interaction with the child) and child outcomes (like glycemic control and quality of life) in this young patient group is scarce. What is New: • Higher levels of parental emotional involvement and more discomfort during disease-specific situations are both related with a less optimal glycemic control in young children with type 1 diabetes. • Higher levels of both general and disease-related parenting stress are associated with a lower general and diabetes-specific quality of life of young children with type 1 diabetes.