Education to Parents or Carers About Diabetics

 

 

 

Education to Parents or Carers About Diabetics
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Education to Parents or Carers About Diabetics
Background
Care for Diabetes is a crucial part of disease management for adults struggling with diabetes. Self-care is part of the management of diabetes and family members such as parents and other carers tend to play a significant role in managing the patient’s disease. Therefore, involving them in the self–care interventions positively impact and influence the outcomes of a diabetes patient. According to research conducted by Centres for Disease Control and Prevention, it showed that more than 29 million adults in the United States live with diabetes (Alamri & Bosua, 2018). In 2012, about 1.7 million adults were diagnosed with diabetes. Ideally, people with diabetes tend to be at a high risk of several complications such as premature death, diabetic retinopathy, cardiovascular diseases, neuropathy, amputations, and nephropathy (Alamri & Bosua, 2018). It is important to note that the management of diabetes can be complex for patients. Thus, they need to attend several physician visits every year and adhere to the different medications to control and manage their disease. Further, they are required to participate in several facets of self-care such as healthy eating, glucose monitoring, and exercise and engage in negotiating the barriers to management such as balancing work and life commitments and cost of care.
Diabetes self-management education (DSME) is a crucial aspect of care for all patients with diabetes (Alamri & Bosua, 2018). For example, adults living with type 2 diabetes can engage in self-care activities that are associated with improved control of glycaemic and can help prevent other diabetes-related complications (Commissariat et al, 2020). A lot of patients’ management of diabetes normally takes place in their social and family environments. Therefore, addressing and working with family environments for adults with diabetes is critical as that is the context through which the disease management happens. According to The Institute for Patient –and Family–Centred Care family members are defined as two or more persons who are related in different ways such as biologically, emotionally, and legally (Commissariat et al, 2020). Therefore carers can include the nuclear, kinship network, and extended members.
Offering diabetes education to only the individuals suffering from diabetes can limit their outcomes. Therefore, educating the parents and other carers as well will play a huge part in disease management Commissariat et al, 2020). Typically, family-based approaches, particularly to chronic disease management, tend to emphasize the context in which the disease takes place such as the family’s physical environment and the personal, educational, and relational needs of the family members and the patient (Kavookjian et al, 2022). To offer educational interventions to the parents and carers means empowering and equipping them to offer support to the patients with diabetes and help to establish healthy family attitudes and behaviors as well as promotion of self-management.
Some of the parent’s and carers’ interventions ought to place emphasis on communication skills and educate them on the positive ways to influence the patient health behaviors (Kavookjian et al, 2022). Usually, family members may feel overwhelmed and distressed by their loved one’s disease if they have limited knowledge regarding diabetes or do not know how to help and support their loved ones.
Purpose
The study aims to understand the impact of education on parents or carers about diabetics

Method

 

 

 

The search strategy used involved documenting the search activities and keeping a search diary s as to keep a track of effective search terms to assist other to reproduce the same steps to get the same results (Kristi Klee & Kathryn Ness, 2020). Besides, the search strategy involved the names of the sources searched and the provider accessed them through such as MEDLINE, CINAHL, Scopus or Psyinfo, and Lib quick search. The keywords used included diabetes, family interventions, and carer interventions (Kristi Klee & Kathryn Ness, 2020). The key terms used included education to parents or carers about diabetes also the search terms with and/or were removed in some search sites (Luo et al, 2021). It is important to note that some sources did not have many search results which is evidence of a gap in the literature and it confirms the importance of this research question (Luo et al, 2021). To focus on the research question, a search framework was employed and an example of a search framework employed was PICOT. For example, the Population, in this case, was people living with diabetes, and the intervention was an education to the parent and carers (Luo et al, 2021). The comparison between the lack of education for parents and carers of people with diabetes and the outcome would be the effective management of diabetes. Ideally, breaking down the issue into elements helped come out as an answerable research question.
A track of several factors is kept such as databases searched and the database provider such as MEDLINE, CINAHL, Scopus or Psyinfo and Lib quick search, the date the search was conducted, other resources searched such as citation searching, study registry, browsing contacts, and online sources (Nakhla et al, 2018). Full search strategy copy and pasted exactly as run., restrictions applied and the justification for their use, duplication processes as well as the software used, published search filters, the total number of records identified from each database and other information sources, search peer review process and acknowledgment of prior work (Nakhla et al, 2018). The quality assessment tool used was a table of selected literature that analyzed 10 articles and highlighted some of the key findings which included the qualities and the demographics of the selected articles. The quality appraisal tool helped to appraise the reliability, applicability, and importance of clinical evidence (Ng, et al, 2018). Ideally, it was a way of examining whether the study fully addresses a focused question, assessing whether the study used valid methods to address the question, whether the valid results of the study were important and whether the valid results apply to the population and patients.

Results
Article Authors Quality Appraisal Score Key Findings
Resilience outstrips the negative effect of caregiver burden on quality of life among parents of children with type 1 diabetes: An Application of Johnson–Neyman Analysis Luo, D., Gu, W., Bao, Y., Cai, X., Lu, Y., Li, R., … & Li, M. (2021). Resilience outstrips the negative effect of caregiver burden on quality of life among parents of children with type 1 diabetes: An Application of Johnson–Neyman Analysis. Journal of Clinical Nursing, 30(13-14), 1884-1892. Regular psychosocial assessment for parents of children with diabetes type in should be inculcated into clinical nursing practice. The study confirmed that resilience is a great intervention target for parents with a huge caregiver burden and unsatisfactory life quality.
“I’m essentially his pancreas”: Parent perceptions of diabetes burden and opportunities to reduce burden in the care of children <8 years old with type 1 diabetes Commissariat, P. V., Harrington, K. R., Whitehouse, A. L., Miller, K. M., Hilliard, M. E., Van Name, M., … & Laffel, L. M. (2020). “I’m essentially his pancreas”: Parent perceptions of diabetes burden and opportunities to reduce burden in the care of children< 8 years old with type 1 diabetes. Pediatric diabetes, 21(2), 377-383. In families that have children with type 1 diabetes the parental perceptions of the burden of dealing with diabetes tend to be common and can be mitigated by customized education programs that increase parent knowledge an strengthens parents confidence in themselves and boost their trust in secondary caregivers to manage diabetes.
Quality of Life and Psychological Burden of Parents of Children, Adolescents, and Young Adults with Type 1 Diabetes: A Cross-Sectional Study during the Lockdown Period of COVID-19 Rikos, N., Mpalaskas, A., Fragiadaki, M., Frantzeskaki, C., Kassotaki, A., & Linardakis, M. (2022). Quality of Life and Psychological Burden of Parents of Children, Adolescents, and Young Adults with Type 1 Diabetes: A Cross-Sectional Study during the Lockdown Period of COVID-19. Nursing Reports, 12(3), 564-573. The study revealed high level of parental anxiety for parents with children having Type 1 diabetes.
Experiences from Parents to Children with Diabetes Type 1. Rising Holmström, M., Häggström, M., & Söderberg, S. (2018). Experiences from Parents to Children with Diabetes Type 1. JSM Health Education Primary Health Care, 3(2). The findings of the study revealed that parents and carers of children with type 1 diabetes struggle with fear and looking for explanations thus the need to learn how to manage and control the illnesses. Therefore, they work with schools and consider it as an important source of education for understating the illness and the experiences of their children.
Risk of ketoacidosis in children at the time of diabetes mellitus diagnosis by primary caregiver status: a population-based retrospective cohort study Nakhla, M., Rahme, E., Simard, M., Larocque, I., Legault, L., & Li, P. (2018). Risk of ketoacidosis in children at the time of diabetes mellitus diagnosis by primary caregiver status: a population-based retrospective cohort study. Cmaj, 190(14), E416-E421. Children having a new diagnosis of diabetes should have a usual provider of care as a way of decreasing the risk of having ketoacidosis.
Perceptions of Diabetes Education Among East African Immigrant Parents Kristi Klee, D. N. P., Deann Atkins, B. S. N., & Kathryn Ness, M. D. (2020). Perceptions of diabetes education among East African immigrant parents. Pediatric Nursing, 46(3), 146-151. The information gathered during the interviews will be applied in home settings and in coming up with education programs for parents and carers of patients with diabetes.
Psychometric testing of the Family-Carer Diabetes Management Self-Efficacy Scale Wichit, N., Mnatzaganian, G., Courtney, M., Schulz, P., & Johnson, M. (2018). Psychometric testing of the family‐carer diabetes management self‐efficacy scale. Health & Social Care in the Community, 26(2), 214-223. The study showed that internal consistency of the family carer diabetes management self-efficacy scale is valid.
Continuous Glucose Monitoring in Children with Type 1 Diabetes Improves Well-Being, Alleviates Worry and Fear of Hypoglycaemia Ng, S. M., Moore, H. S., Clemente, M. F., Pintus, D., & Soni, A. (2019). Continuous glucose monitoring in children with type 1 diabetes improves well-being, alleviates worry and fear of hypoglycaemia. Diabetes technology & therapeutics, 21(3), 133-137. The findings showed that the use of continuous glucose monitoring did not indicate any significant improvement in glycaemic regulation after twelve months. However, the children and parental fear of hypoglycaemia were reduced after the CGM was used,
Using Online Phot Using Online Photo Sharing to Sharing to Support o Support Parents with T ends with Type One type One
Diabetic Children Alamri, H., Lederman, R., & Bosua, R. (2018). Using Online Photo Sharing to Support Parents with Type One Diabetic Children. The study showed that photos tend to create a storyline for parents experiences and they create an opportunity for them to express their negative and positive feelings regarding their experiences thus receiving the required support.
Impact of Diabetes Self-Management Education/Support on Self-Reported Quality of Life in Youth With Type 1 or Type 2 Diabetes Kavookjian, J., LaManna, J. B., Davidson, P., Davis, J. W., Fahim, S. M., McDaniel, C. C., … & Cox, C. (2022). Impact of Diabetes Self-Management Education/Support on Self-Reported Quality of Life in Youth With Type 1 or Type 2 Diabetes. The Science of Diabetes Self-Management and Care, 26350106221115450. The findings of the study reveal that to enhance the patient’s outcomes with diabetes, ongoing diabetes specific assessments out to be incorporated.

Discussion
Type 1 and 2 diabetes has become a common childhood disease and can be characterized by a deficiency in insulin. It is important to note that the condition requires years of management with insulin therapy to ensure that glucose is maintained at a near normal level to avoid any complications that may come as a result of not maintaining the right levels of glucose (Rikos et al, 2022). Research and studies show that patients with diabetes tend to have a twofold increased risk of morality than the other population. Diabetes in childhood is a challenging time as it is associated with less independent management and increases the risk of having acute recurrent hypoglycemia and diabetic ketoacidosis. It is important to note that effective control for patients with diabetes greatly depends on the parents and their involvement in managing the disease (Rikos et al, 2022). Essentially, parents and carers tend to assume the daily management activities of patients with diabetes. Also, they are required to take children often to clinics for regular check-ups. Diabetes is an illness that does not only affect the patient but the entire family.
Parents and carers tend to bear the burden through treatment and psychosocial challenges imposed by the illness. According to studies, caregiver burdens is as a result of the caregiving tasks on the caregiver’s economic resources, health, and social interactions (Rikos et al, 2022). On the other hand, there is a subjective burden which refers to a parent’s or caregiver’s negative attitude and appraisal of a situation. Typically, parents and carers have to participate in the complex management of diabetes patients such as injecting insulin as well as monitoring their sugar (Rikos et al, 2022). Also, they are expected to promote their children’s health attitudes and behavior such as supervising their exercise levels and imposing dietary restrictions. Therefore, the cost of treating diabetes patients and the need to provide informal care intensifies the economic burdens faced by the families. Other fears that are faced by these parents include fear of serious hypoglycemia as well as chronic complications and the guilt that comes from not offering the right care as well as anger regarding poor compliance (Rikos et al, 2022). As a way of boosting the resilience capacity of these parents, there is a need to ensure that they obtain the right education that will help them navigate the challenge of dealing with diabetes. The education will not only relieve the burden of poor compliance, but it will help them learn ways of coping and marinating a proper psychosocial function.
In 2018, in the United States, about two hundred thousand children and adolescents younger than 20 years old were diagnosed with diabetes (Rising Holmström & Söderberg, 2018). Diabetes has generally become an epidemic in all age groups and it costs the state large amounts of money every year. Research shows that lack of education has led to health disparities due to different population groups, and ethnic groups due to low health literacy which essentially means having the capacity to navigate the primary healthcare system and understand all the instructions, ask the right questions, and communicating the right concerns (Rising Holmström & Söderberg, 2018).. Evidently, low health literacy especially for parents and carers of patients with diabetes can adversely impact the patient’s and families’ understating of how to manage the needs of healthcare. Some of the factors that increase the risk of having a low health literacy include socioeconomic status, level of education, language, and ethnicity (Rising Holmström & Söderberg, 2018).. Normally, these difficulties tend to present problems in understating the care that needs to be given to the patients such as the medication dose, medical regimens as well as other management skills of the disease which eventually leads to poor health outcomes. Therefore, the articles emphasized the need to have education and health literacy for the parent and the carer as they have an impact on the patients’ health.
The findings in the articles have shown recognition of the role that family members play in increasing the efficacy of diabetes self-management interventions. Although, it is important to note that a majority of research showed that these family-based interventions have mainly targeted children suffering from diabetes (Wichit et al, 2018). However, the inclusion of close family members among adults with diabetes bolsters the psychosocial support and is not only beneficial to the patient but also to the carer as well. For example, having a family member in educational interventions has proven that the rates of smoking reduction and weight loss are achieved(Wichit et al, 2018) . According to a randomized controlled trial for chronic diseases, interventions that used a family-oriented approach for adults were beneficial as compared to the solely-patient interventions. Further, in a review of families and couples managing chronic health challenges, such as common neurological diseases, diabetes, cancer, and cardiovascular illnesses, family interventions heightened promise in assisting the patients and family members to manage the illness (Wichit et al, 2018). Among the adults living with diabetes, coming up with interventions that involve the household or family members of the patients with diabetes can be more effective than the usual care of improving diabetes-related knowledge and glycaemic control. Further, the research has shown that family support is closely associated with improved medication adherence and control of blood sugar.
Conclusion
Carefully designed studies have evaluated the benefits of having family-centered educational interventions in the self-management of diabetes for both the patient and the carer. Since families dealing with chronic diseases are affected in various ways, having the right education on the management of the disease will improve their knowledge base and will in return help in self-care and empower them with the ability to support their loved ones living with diabetes. Further, the family members benefit from the education as they reduce their psychological distress regarding their relative with diabetes and thus improving their health and being able to attend education programs. This way, these family members and carers will significantly reduce their likelihood of developing diabetes through having improved lifestyle behaviors.

References
Alamri, H., Lederman, R., & Bosua, R. (2018). Using Online Photo Sharing to Support Parents with Type One Diabetic Children.
Commissariat, P. V., Harrington, K. R., Whitehouse, A. L., Miller, K. M., Hilliard, M. E., Van Name, M., … & Laffel, L. M. (2020). “I’m essentially his pancreas”: Parent perceptions of diabetes burden and opportunities to reduce burden in the care of children< 8 years old with type 1 diabetes. Pediatric diabetes, 21(2), 377-383.
Kavookjian, J., LaManna, J. B., Davidson, P., Davis, J. W., Fahim, S. M., McDaniel, C. C., … & Cox, C. (2022). Impact of Diabetes Self-Management Education/Support on Self-Reported Quality of Life in Youth With Type 1 or Type 2 Diabetes. The Science of Diabetes Self-Management and Care, 26350106221115450.
Kristi Klee, D. N. P., Deann Atkins, B. S. N., & Kathryn Ness, M. D. (2020). Perceptions of diabetes education among East African immigrant parents. Pediatric Nursing, 46(3), 146-151.
Luo, D., Gu, W., Bao, Y., Cai, X., Lu, Y., Li, R., … & Li, M. (2021). Resilience outstrips the negative effect of caregiver burden on quality of life among parents of children with type 1 diabetes: An Application of Johnson–Neyman Analysis. Journal of Clinical Nursing, 30(13-14), 1884-1892.
Nakhla, M., Rahme, E., Simard, M., Larocque, I., Legault, L., & Li, P. (2018). Risk of ketoacidosis in children at the time of diabetes mellitus diagnosis by primary caregiver status: a population-based retrospective cohort study. Cmaj, 190(14), E416-E421.
Ng, S. M., Moore, H. S., Clemente, M. F., Pintus, D., & Soni, A. (2019). Continuous glucose monitoring in children with type 1 diabetes improves well-being, alleviates worry and fear of hypoglycemia. Diabetes technology & therapeutics, 21(3), 133-137.
Rikos, N., Mpalaskas, A., Fragiadaki, M., Frantzeskaki, C., Kassotaki, A., & Linardakis, M. (2022). Quality of Life and Psychological Burden of Parents of Children, Adolescents, and Young Adults with Type 1 Diabetes: A Cross-Sectional Study during the Lockdown Period of COVID-19. Nursing Reports, 12(3), 564-573
Rising Holmström, M., Häggström, M., & Söderberg, S. (2018). Experiences from Parents to Children with Diabetes Type 1. JSM Health Education Primary Health Care, 3(2).
Wichit, N., Mnatzaganian, G., Courtney, M., Schulz, P., & Johnson, M. (2018). Psychometric testing of the family‐carer diabetes management self‐efficacy scale. Health & Social Care in the Community, 26(2), 214-223.

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