Effects of Mothers’ Knowledge and Coping Strategies on the Glycemic Control of Their Diabetic Children in Egypt

Eman Mohamed Mahfouz, Nashwa Nabil Kamal, Eman Sameh Mohammed, Sara Ahmed Refaei Refaei

Abstract


Background: This study aimed to examine the relationship between mothers’ knowledge related to treatment management of type 1 diabetes (T1D), with perceptions of coping with diabetes‑related stress and to examine the relationship between children’s metabolic control and maternal coping. A cross‑sectional study was done among ninety‑two mothers of T1D children.

Methods: Data were collected using a structured questionnaire, Ways of coping questionnaire (WCQ), and Diabetes Knowledge questionnaire‑24 (DKQ‑24).

Results: The most important predictors of the total knowledge scores among mothers were father education (P < 0.0001), followed by child age and sex (P < 0.0001), while the most important coping scales affected by total knowledge scores was accepting responsibility (P = 0.01). There were positive correlation between HBA1C and escape‑avoidance and positive reappraisal coping scales (r = 0.24, P = 0.02 and r = 0.23, P = 0.02, respectively). Blood glucose level was the most important clinical characteristics affecting the use of seeking social support coping scale among mothers.

Conclusions: Parents with more knowledge of diabetes and with better education were able to cope more effective and maintain a better glycemic control of their diabetic children.

Keywords: Children, coping strategies, mothers, type 1 diabetes


Full Text:

PDF

References


Chiang JL, Kirkman MS, Laffel LM, Peters AL, Type 1 Diabetes

Sourcebook Authors. Type 1 diabetes through the life span:

A position statement of the American Diabetes Association.

Diabetes Care 2014;37:2034‑54.

Maahs DM, West NA, Lawrence JM, Mayer‑Davis EJ.

Epidemiology of type 1 diabetes. Endocrinol Metab Clin North

Am 2010;39:481‑97.

International Diabetes Federation. The IDF Diabetes Atlas. 5th ed.

Brussels: International Diabetes Federation; 2011. Available

from: http://www.idf.org/idf‑diabetes‑atlas‑fifth‑edition. [Last

accessed on 2013 Apr 23].

El‑Ziny MA, Salem NA, El‑Hawary AK, Chalaby NM,

Elsharkawy AA. Epidemiology of childhood type 1 diabetes

mellitus in Nile Delta, Northern Egypt – A retrospective study.

J Clin Res Pediatr Endocrinol 2014;6:9‑15.

Jaser SS, Whittemore R, Ambrosino JM, Lindemann E,

Grey M. Coping and psychosocial adjustment in mothers of

young children with type 1 diabetes. Children’s Health Care

;38:91‑106.

Hullmann SE, Wolfe‑Christensen C, Ryan JL, Fedele DA,

Rambo PL, Chaney JM, et al. Parental overprotection, perceived

child vulnerability, and parenting stress: A cross‑illness

comparison. J Clin Psychol Med Settings 2010;17:357‑65.

American Diabetes Association. Standards of medical care in

diabetes‑‑2007. Diabetes Care 2007;30 Suppl 1:S4‑41.

Grey M. Coping and psychosocial adjustment in mothers of young

children with type 1 diabetes. Child Health Care 2009;38:91‑106.

Cade WT. Diabetes‑related microvascular and macrovascular

diseases in the physical therapy setting. Phys Ther

;88:1322‑35.

Patterson C, Guariguata L, Dahlquist G, Soltész G, Ogle G,

Silink M, et al. Diabetes in the young – A global view and

worldwide estimates of numbers of children with type 1 diabetes.

Diabetes Res Clin Pract 2014;103:161‑75.

Tsiouli E, Alexopoulos EC, Stefanaki C, Darviri C, Chrousos GP.

Effects of diabetes‑related family stress on glycemic control in

young patients with type 1 diabetes: Systematic review. Can Fam

Physician 2013;59:143‑9.

Lewin AB, Storch EA, Silverstein JH, Baumeister AL,

Strawser MS, Geffken GR. Validation of the pediatric inventory

for parents in mothers of children with type 1 diabetes:

An examination of parenting stress, anxiety, and childhood

psychopathology. Fam Syst Health 2005;23:56‑65.

Halverson M, Yasuda P, Carpernter S, Kaiserman K. Unique

challenges for pediatric patients with diabetes. Diabetes Spectrum

;18:167‑73.

Sullivan‑Bolyai S, Deatrick J, Gruppuso P, Tamborlane W,

Grey M. Constant vigilance: Mothers’ work parenting young

children with type 1 diabetes. J Pediatr Nurs 2003;18:21‑9.

Mantzourani S, Darvyri E, Alexopoulos PP, Chrousos G.

Stress management in parents of children with diabetes type 1:

A randomized controlled trial. Psychology 2015;6:1040‑50.

Smith VC, Steelfisher GK, Salhi C, Shen LY. Coping with the

neonatal Intensive Care Unit experience: Parents’ strategies and

views of staff support. J Perinat Neonatal Nurs 2012;26:343‑52.

Jaser SS, Linsky R, Grey M. Coping and psychological distress

in mothers of adolescents with type 1 diabetes. Matern Child

Health J 2014;18:101‑8.

Jaser SS, Whittemore R, Ambrosino JM, Lindemann E, Grey M.

Mediators of depressive symptoms in children with type 1

diabetes and their mothers. J Pediatr Psychol 2008;33:509‑19.

Folkman S, Lazarus RS. Manual of Ways of Coping Questionnaire.

Palo Alto, CA: Consulting Psychologists Press; 1988.

Tennen H, Herzberger S. Ways of coping scale. Tests Critics

;3:687‑97.

Collins GS, Mughal S, Barnett AH, Fitzgerald J, Lloyd CE.

Modification and validation of the revised diabetes knowledge

scale. Diabet Med 2011;28:306‑10.

Villagomez E. Health Beliefs, Knowledge, and Metabolic Control

in Diabetic Mexican American Adults. MS Thesis. Houston, TX:

The University of Texas Health Science Center; 1989.

Bowes S, Lowes L, Warner J, Gregory JW. Chronic sorrow

in parents of children with type 1 diabetes. J Adv Nurs

;65:992‑1000.

McDonell MG, Rodgers ML, Short RA, Norell D, Pinter L,

Dyck DG. Clinician integrity in multiple family groups:

Psychometric properties and relationship with schizophrenia

client and caregiver outcomes. Cogn Ther Res 2007;6:785‑803.

Grover S, Bhadada S, Kate N, Sarkar S, Bhansali A, Avasthi A,

et al. Coping and caregiving experience of parents of children

and adolescents with type‑1 diabetes: An exploratory study.

Perspect Clin Res 2016;7:32‑9.

Mufunda E, Wikby K, Björn A, Hjelm K. Level and determinants

of diabetes knowledge in patients with diabetes in Zimbabwe:

A cross‑sectional study. Pan Afr Med J 2012;13:78.

Al‑Shookri A, Al‑Shukaily L, Hassan F, Al‑Sheraji S, Al‑Tobi S.

Effect of mothers nutritional knowledge and attitudes on Omani

children’s dietary intake. Oman Med J 2011;26:253‑7.

Aslam M, Kingdon G. Parental Education and Child Health –

Understanding the Pathways of Impact in Pakistan; 2010.

Available from: https://www.csae.ox.ac.uk/workingpapers/

pdfs/2010‑16text.pdf. [Last accessed on 2017 May 04].

Cruz DS, Collet N, Andrade EM, Nóbrega VM,

Nóbrega MM. Mothers of experiences in diabetic child. Esc Ann

Nery 2017;21:1‑8.

Dardas LA, Ahmad MM. Coping strategies as mediators and

moderators between stress and quality of life among parents of

children with autistic disorder. Stress Health 2015;31:5‑12.

Damião EB, Rossato LM, Fabri LR, Dias VC. Ways of coping

inventory: A theoretical framework. Rev Esc Enferm USP

;43:1199‑203.

Garland E, Gaylord S, Park J. The role of mindfulness in positive

reappraisal. Explore (NY) 2009;5:37‑44.

Azar R, Solomon CR. Coping strategies of parents facing child

diabetes mellitus. J Pediatr Nurs 2001;16:418‑28.

Bertolin DC, Pace AE, Kusumota L, Haas V. An association

between forms of coping and the socio‑demographic variables

of people on chronic hemodialysis. Rev Esc Enferm USP

;45:1070‑6.

Hara Y, Hisatomi M, Ito H, Nakao M, Tsuboi K, Ishihara Y,

et al. Effects of gender, age, family support, and treatment on

perceived stress and coping of patients with type 2 diabetes

mellitus. Biopsychosoc Med 2014;8:16.