BACKGROUND:Adolescents with Type 1 diabetes face significant challenges in achieving effective self-management and maintaining psychosocial well-being. Peer-based and participatory health education approaches, grounded in Social Learning Theory, may strengthen adolescents' motivation, confidence, and experiential learning in diabetes care. AIM:This study aimed to evaluate the effectiveness of a peer-based participatory health education program on psychosocial adaptation outcomes - self-efficacy, illness attitudes, and diabetes knowledge - and to explore its short-term effects on glycemic control among adolescents with Type 1 diabetes. METHODS:A parallel-group randomized controlled trial was conducted with 46 adolescents aged 13-18 years with suboptimal glycemic control (HbA1c > 7.5%), recruited from a tertiary pediatric endocrinology clinic. Participants were randomly allocated to an intervention group (n = 23) or a control group (n = 23). The intervention group received a seven-week peer-based experiential education program including group discussions, exercise activities, and a kitchen workshop, while the control group received routine individual education. Data were analyzed using appropriate parametric and non-parametric tests with a significance level of p < .05. RESULTS:Adolescents in the intervention group showed significantly higher posttest scores for self-efficacy, illness attitudes, and diabetes knowledge compared with the control group (p < .01). Within-group analyses demonstrated significant improvements in psychosocial outcomes among intervention participants, whereas no meaningful change was observed in the control group. Although HbA1c levels decreased slightly in both groups over the three-month follow-up period, the between-group difference was not statistically significant. CONCLUSION:Peer-based participatory health education improved psychosocial outcomes among adolescents with Type 1 diabetes. Incorporating peer interaction and experiential learning into diabetes education programs may strengthen psychosocial adaptation and support the foundations of effective self-management.
BACKGROUND:To enhance the quality of life for individuals with type 1 diabetes and mitigate the risks of complications, new methods for insulin delivery and glucose monitoring are being developed. The ability to monitor a child's glucose levels via a mobile phone can provide parents with a feeling of security, potentially leading to improved sleep quality. However, constant monitoring could lead to increased stress both for youths and parents. AIM:The aim of the study was to explore how youths with type 1 diabetes and their parents experienced using insulin pumps and continuous glucose monitoring devices (CGM) and the support from the diabetes team. Further, to explore their opinions about the glucose target HbA1c ≤ 48 mmol/mol (6.5%) and other glucose metabolic measurements. METHOD:Sixteen individual interviews were performed with eight youths with type 1 diabetes and their parents. Qualitative content analysis was done according to Graneheim and Lundman. RESULTS:The participants described increased satisfaction, security, strengthened independence and increased freedom. The parents described improved sleep at night leading to increased quality of life. The participants had not reflected so much over the change when the glucose target was lowered in 2017, but they found time in tight range to be more useful. They had a positive experience of healthcare with easy accessibility and continuity, and they described technical support as important. CONCLUSION:Insulin pumps and CGM facilitate everyday life for both youths and their parents, and the opportunity to follow their youth's glucose values does not seem to be a problem to neither youths nor parents. The lowering of the glucose target is not something that parents and youth had much concern about, and they consider the gluco-metabolic measurement time in tight range to be more useful.
BACKGROUND:Social phobia is prevalent in adolescence and may be shaped by early adversity and family context; Southeast Asian evidence remains limited. OBJECTIVES/AIMS/HYPOTHESES:This study aimed to examine whether childhood trauma, bullying experiences, and parental bonding predict adolescent social phobia. Demographic variables (age and gender) were also examined descriptively. We hypothesized that higher levels of trauma and bullying, as well as non-optimal parental bonding, would be associated with greater social phobia. DESIGN:Quantitative Exploratory. METHODS (SETTING, INCLUSION/EXCLUSION):We surveyed 252 students (aged 15-18) from a public senior high school in Yogyakarta, Indonesia. Inclusion: active enrollment and assent; parental consent for minors. Exclusion: current clinician-diagnosed psychiatric disorder under treatment. Instruments included the Childhood trauma was assessed using the 28-item Childhood Trauma Questionnaire - Short Form (CTQ-SF), Parental Bonding Instrument, Bullying Experience Scale, and Liebowitz Social Anxiety Scale - Self Report. Data were analyzed in SPSS using descriptive statistics and multiple linear regression (α = 0.05). RESULTS:Participants were mostly aged 16 years (40.5%) and female (61.1%). Trauma was commonly mild to moderate; non-optimal bonding was present in a sizable minority; bullying ranged from low to moderate for many. Social phobia was predominantly mild to moderate. Regression showed the model was significant (R = 0.652; R2 = 0.425; Adjusted R2 = 0.416; F (3,248) = 61.820, p < .001). Childhood trauma (B = 0.285, p < .001) and bullying (B = 0.312, p = .001) positively predicted social phobia, while optimal parental bonding was protective (B = -0.204, p = .002). CONCLUSIONS:Future research could explore the effectiveness of nurse-led screening, school based anti-bullying, and family psychoeducation interventions to minimize social phobia among adolescents. IMPACT STATEMENT:Childhood trauma, bullying, and parental bonding predict adolescent social phobia, highlighting the importance of family and school-based mental health interventions.
Children with complex medical care needs require extensive resources. Their families face significant challenges in coordinating care, managing insurance, and integrating various care plans, especially in areas without pediatric palliative care or complex care clinics. To address this gap, we developed a family-centered care coordination tool and evaluated stakeholder perceptions of its content and usability prior to electronic implementation. The tool was informed by a targeted literature review and iterative feedback from caregivers, primary care providers, and nurse coordinators. Stakeholders reviewed prototype templates and completed surveys with quantitative and qualitative items, analyzed using descriptive statistics and rapid thematic analysis. Caregivers and providers endorsed the tool's usefulness and anticipated benefits for care coordination. Key priorities included problem lists, medication details with doses, care-team contacts, and ease of updating. Feedback led to expanded medication and goal sections. Overall, stakeholders supported the tool's design and proposed electronic integration. A prospective pilot is planned to create an electronic prototype of the mobile application to assess usability, caregiver burden, and early clinical outcomes following implementation.
Holding children for procedures is often perceived as a routine, uncontested aspect of pediatric practice. There has been an increase in literature describing parents' experiences of holding their child and professionals reported practice. However, limited research has observed practice and explored what influences healthcare professionals' decisions to hold a child or to encourage parental holding. This study examined how and why healthcare professionals decide to initiate, continue, or stop holding a child during a procedure, and identified the factors that influence these decisions. A descriptive qualitative multi-method design was employed, incorporating semi-structured observations focused on verbal and nonverbal interactions, vignettes constructed from each observation, and semi-structured interviews with healthcare professionals. Purposeful sampling identified children under 10 years of age undergoing a procedure in a tertiary children's hospital in Northwest England. Data from the field notes and transcripts were analyzed thematically. Eight children (aged 1 month to 10 years) and their parents were observed, along with 12 healthcare professionals (doctors, nurses, healthcare assistants, and play specialists). Eleven professionals were interviewed in this study. The findings revealed a lack of explicit discussion or planning regarding the roles of professionals, parents, and children before the procedures. Two themes were identified which highlighted "healthcare professionals assumptions about parents' role" to comfort, distract, support and hold their child during a procedure, and "expectations about children's responses and behaviors during procedures," led professionals to expect that children who had been resistant previously and younger children would be distressed leading to holding being inevitable. This study provides the first in-depth exploration of healthcare professionals' decision-making about holding children based on observed practices. The findings demonstrate that unspoken assumptions and expectations influence procedural trajectories with implications for practice and training.
