E-coach for parents of teens with diabetes

BACKGROUND: Family functioning is important for the well-being and diabetes regulation of adolescents with type 1 diabetes. The relation between family atmosphere and glycemic control is complex. Adolescents' problems with the self management could easily initiate conflicts, but teenagers from non-supportive families are more at risk for regulation problems. If and how parents provide support proves to be a strong predictor of glycemic control as well as the quality of life of teenagers. Dealing with a teenager with diabetes in an appropriate way is often not easy and can put pressure on the family and the well-being of the parents.

AIM: Our aim is to develop an internet course for parents of teenagers with diabetes, the e-coach. This course will provide information and support on parenting by paying attention to the relationship with the teenager, partner and other family members. This study is funded by the Dutch Diabetes Research Foundation



BACKGROUND: ISPAD clinical practice consensus guidelines recommend that resources should be made available to include professionals with expertise in the mental and behavioral health of children and adolescents within the interdisciplinary diabetes healthcare team, including psychologists and social workers, with a goal to improve effective self-management and the psychosocial functioning of the whole family as a key objective of all pediatric diabetes care. Even with guidelines, a key foundation for securing comprehensive psychosocial care is the adequate use of valid, effective psychosocial evaluation methods. The study of de Wit et al. confirmed in a RCT that regular monitoring and discussion of health related quality of life improves the psychosocial well-being and satisfaction with care of adolescents with type 1 diabetes (de Wit et al. 2008). However, withdrawing the formal assessment of HRQoL resulted in the disappearance of those positive effects and a deterioration of glycaemic control (de Wit et al. 2009).

AIMS: DAWN MIND - Youth aims to promote and simplify the use of a psychosocial assessment as part of routine pediatric diabetes care in all involved countries and make these available for coordinated and routine application and research in interested countries. Using a stepped care approach, the assessment and discussion of the patient's psychosocial needs is the first step. It has been shown that respectfully discussing psychosocial issues with the patient (and parent) in it self is helpful and appreciated. If the outcomes of the assessment so indicate, actions can be taken, e.g. referral to a psychologist for further evaluation of a specific problem, possibly therapy.