A Psychological Intervention for Mothers of Children with Type 1 Diabetes: Effects on Children's HbA1c Levels, Self-Management, Quality of Life, and Social Support

Document Type : Original Article (s)

Authors

1 Professor of Health Psychology, Behavioral Sciences Research Center, Isfahan University of Medical Science, Isfahan, Iran

2 Professor of Endocrinology & Metabolism, Endocrine and Metabolism Research Center, Isfahan University of Medical Science, Isfahan, Iran

3 Associate Professor of Health Psychology, Behavioral Sciences Research Center, Isfahan University of Medical Science, Isfahan, Iran

4 MSc of Health Psychology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Type 1 diabetes is the most common form of diabetes in children and adolescents. Its management requires active involvement from parents, particularly mothers. This study aimed to investigate the impact of psychological training for mothers on HbA1c, self-management, quality of life, and social support for children with diabetes.
Methods: This study was a randomized clinical trial with two groups: experimental and control. Forty-eight mothers of children with type 1 diabetes participated (24 in each group). The experimental group received psychological training over eight weekly sessions. Data were collected at three stages (pre-test, post-test, and three-month follow-up) and analyzed using repeated measures ANOVA and Mann-Whitney tests.
Findings: Psychoeducation had no significant impact on reducing HbA1c in the intervention group. Self-management scores significantly increased in the intervention group, and this increase remained higher than in the control group during the follow-up phase. Social support increased after the intervention, but this effect did not persist at the three-month follow-up. Quality of life scores showed no significant changes.
Conclusion: Psychoeducation provided to mothers of children with type 1 diabetes can be effective in improving their self-management and social support.

Highlights

Reza Bagherian Sararoudi: PubMed ,Google Scholar

Bijan Iraj: PubMed ,Google Scholar

Amrollah Ebrahimi:  PubMed ,Google Scholar 

Seyed Mahdi Mirpourian:  PubMed ,Google Scholar 

 

Keywords

Main Subjects


  1. Jeftha A, Roberts T, Kimmie-Dhansay F. The effect of periodontal disease on metabolic control in patients with diabetes mellitus in South Africa: Protocol for a Systematic Review. JMIR Res Protoc 2021; 10(7): e27471.
  2. Ghojazadeh M, Mobasseri M, Azar FP, Lotfi A. Prevalence and incidence of type 1 diabetes in the world: a systematic review and meta-analysis. Health Promot Perspect 2020; 10(2): 98–115.
  3. Ghazaiean M, Najafi B, Zamanfar D, Alipour MJ. Risk factors for suboptimal glycemic control in pediatrics with type 1 diabetes mellitus: a cross-sectional study. Sci Rep 2024; 14(1): 7492.
  4. Lin FY, Lee TY. Managing type 1 diabetes of a child: Parents' perspectives. Child Care Health Dev 2024; 50(2): e13238.
  5. Kazeminasab F, Ahmadinejad S. The effect of exercise training and diet, alone, on glycosylated hemoglobin (HbA1c) and fasting glucose in patients with type 1 diabetes: a meta-analysis systematic review [in Persian]. J Isfahan Med Sch 2023; 41(742): 988-1003.
  6. Chao G, Zhu Y, Chen L. Role and risk factors of glycosylated hemoglobin levels in early disease screening. J Diabetes Res 2021; 2021(1): 6626587.
  7. Committee ADAPP, Committee: ADAPP. 6. Glycemic targets: standards of medical care in diabetes—2022. Diabetes Care 2022; 45(Suppl-1): S83-S96.
  8. Akadri O, Akadri A. Lifestyle modification adherence among patients attending diabetes clinics in selected hospitals in Remo zone Ogun State, Nigeria: Lifestyle modification adherence. Babcock University Medical Journal 2021; 4(1): 23-32.
  9. Huang Y-M, Shiyanbola OO, Smith PD. Association of health literacy and medication self-efficacy with medication adherence and diabetes control. Patient Prefer Adherence 2018; 12: 793-802.
  10. Sanchez HM, Junior ALS, de Morais Sanchez EG, Silva JF, da Silva LA, Givigiez CR, et al. Quality of life and quality of sleep in health professionals working in critical areas. Rev Bras Med Trab 2024; 22(3): e20231190.
  11. Elian V, Popovici V, Ozon E-A, Musuc AM, Fița AC, Rusu E, et al. Current technologies for managing type 1 diabetes mellitus and their impact on quality of life—a narrative review. Life (Basel) 2023; 13(8): 1663.
  12. Nejati Safa A, Larijani B, Shariati B, Amini H, Rezagholizadeh A. Depression, quality of life and glycemic control in patients with diabetes. Journal of Diabetes and Metabolic Disorders 2007; 7(2): 195-204.
  13. Nohtani V, Peyman N. The role of social support on quality of life in breast cancer patients: a systematic review [in Persian]. J Isfahan Med Sch 2024; 42(761): 227-47.
  14. Hasan AA, Ismail A, Noor H. The influence of social support on self-care behavior among T2DM patients. SAGE Open Nurs 2024; 10: 23779608231219137.
  15. Alshammari M, Lee RLT, Stubbs M, Chan SW-C. Effectiveness of psychoeducation interventions for pregnant women with gestational diabetes mellitus: an integrative review. BMC Public Health 2024; 24(1): 2929.
  16. de Oliveira CT, Dias ACG. How can psychoeducation help in the treatment of mental disorders? Estudos de Psicologia (Campinas) 2023; 40: e190183.
  17. Luque B, Villaecija J, Castillo-Mayen R, Cuadrado E, Rubio S, Tabernero C. Psychoeducational interventions in children and adolescents with type-1 diabetes: A systematic review. Clinical and Health 2022; 33(1): 35-43.
  18. Theofilou P, Vlastos DD. The psychological burden of families with diabetic children: A literature review focusing on quality of life and stress. Children (Basel) 2023; 10(6): 937.
  19. Kichler JC, Kaugars AS. Kicking in Diabetes Support (KIDS) intervention effects: Parent reports of diabetes management. Clinical Practice in Pediatric Psychology 2021; 9(2): 135.
  20. Alqahtani YA, Shati AA, Alhawyan FS, Alhanshani AA, Al-Garni AM, Al-Qahtani SM, et al. Assessment of depression in children and adolescents with Type 1 diabetes mellitus: Impact and intervention strategies. Medicine (Baltimore) 2024; 103(29): e38868.
  21. Bergmame L, Shaw S. Clinical utility of psychoeducational interventions for youth with type 1 diabetes: a scoping review. Contin Educ 2021; 2(1): 76-108.
  22. Katz ML, Volkening LK, Butler DA, Anderson BJ, Laffel LM. Family‐based psychoeducation and care ambassador intervention to improve glycemic control in youth with type 1 diabetes: a randomized trial. Pediatr Diabetes 2014; 15(2): 142-50.
  23. Schmitt A, Gahr A, Hermanns N, Kulzer B, Huber J, Haak T. The Diabetes Self-Management Questionnaire (DSMQ): development and evaluation of an instrument to assess diabetes self-care activities associated with glycaemic control. Health Qual Life Outcomes 2013; 11: 138.
  24. Mirzaei H, Siavash M, Shahnazi H, Abasi MH, Eslami AA. Assessment of the psychometric properties of the Persian version of the diabetes self-management questionnaire (DSMQ) in patients with type 2 diabetes. J Diabetes Metab Disord 2022; 21(1): 123-31.
  25. Varni JW, Seid M, Kurtin PS. PedsQL™ 4.0: Reliability and validity of the Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales in healthy and patient populations. Med Care 2001; 39(8): 800-12.
  26. Mohamadian H, Akbari H, Gilasi H, Gharlipour Z, Moazami A, Aghajani M, et al. Validation of pediatric quality of life questionnaire (PedsQL) in Kashan city [in Persian]. J Ilam Univ Med Sci 2014; 22(3): 10-8.
  27. Malecki CK, Demaray MK, Elliott SN, Nolten PW. Child and adolescent social support scale. Psychology in the Schools; 1999.
  28. Aboutalei F, Khamesan A, Rastgoumoghadam M. The relationship between perceived social support with subjective well-being and academic achievement of female pre-university students [in Persian]. Educational Psychology 2018; 14(48): 147-68.
  29. İçel S, Özkan B. Effects of web-based education on HbA1c, quality of life and depression levels in adolescents with type 1 diabetes. J Psy Nurs 2024; 15(4): 410-9.
  30. Cockcroft EJ, Clarke R, Dias RP, Lloyd J, Mann RH, Narendran P, et al. Effectiveness of educational and psychoeducational self‐management interventions in children and adolescents with type 1 diabetes: a systematic review and meta‐analysis. Pediatr Diabetes 2024; 2024(1): 2921845.
  31. Hatzidimitriadou E, Manship S, Morris R, Thompson T, Moore J, Hulbert S, et al. Participant outcomes evaluation of the DWELL (Diabetes and WELLbeing) type 2 diabetes 12-week psychoeducational self-management programme across four European countries. medRxiv. 2025:2025.01. 13.25320460.
  32. Bronner MB, Peeters MA, Sattoe JN, van Staa A. The impact of type 1 diabetes on young adults’ health-related quality of life. Health Qual Life Outcomes 2020; 18(1): 137.