ABSTRACT
This study formed part of a psychological survey of young people aged 10-17 years attending three Bristol diabetes clinics. The aim was to examine the characteristics of those who were admitted to hospital with unstable diabetes during the period between two assessments, and analyse how they differed from the rest. Ten young people were admitted to hospital during the study period. These 10 individuals had greater emotional difficulty with diabetes as measured by diabetes specific psychometric scales (median scale score: 19) compared to the 89 adolescents who were not readmitted (median scale score: 14) (p = 0.01). They did not differ in demographic characteristics or glycaemic control. Overall there was no relationship between psychological response to diabetes and glycaemic control as assessed by mean glycated haemoglobin. Five of those admitted presented with hyperglycaemia; they had greater emotional difficulty (median scale score: 31, p = 0.02) and a more negative attitude (median scale score: 22, p = 0.02) to diabetes than those presenting with hypoglycaemia (median scale scores: 16). Only those with hyperglycaemia differed from those who were not readmitted, having greater emotional difficulty (p = 0.002) and a more negative attitude (p = 0.01). The possibility of psychological difficulties with diabetes should be sought following an admission, particularly for hyperglycaemia.
Subject(s)
Adolescent, Hospitalized/psychology , Attitude to Health , Diabetes Mellitus, Type 1/psychology , Patient Admission/statistics & numerical data , Adolescent , Child , Diabetes Mellitus, Type 1/blood , Diabetes Mellitus, Type 1/drug therapy , England , Female , Glycated Hemoglobin/analysis , Humans , Male , Social ClassABSTRACT
We have developed a psychometric test to assess psychosocial adaptation to diabetes in young people aged from 10 to 17 years. This includes subscales which describe emotional difficulty with, and attitude to, diabetes. The content of the scales was drawn from unstructured discussions with 27 young people with diabetes. The scales were piloted on two further unselected groups of adolescents (n = 50, n = 99) to examine their reliability, validity, and acceptability. Highly significant correlations were found between the results of the scales and measures of psychosocial function (p less than 0.001), parents' perceptions. Performance on the scale also correlated with a number of behaviour variables and differentiated those who were reported to be restricted by their diabetes (p less than 0.005) and those who had had a previous psychiatric referral (p less than 0.05). The scales appear reliable within the constraints of the small population examined.
Subject(s)
Adaptation, Psychological , Diabetes Mellitus, Type 1/psychology , Social Adjustment , Adolescent , Age Factors , Child , Female , Humans , Male , Personality Inventory , Sex Factors , Social Class , Time FactorsABSTRACT
The diagnosis of diabetes mellitus implies a life-time regimented by insulin therapy, dietary manipulations and monitoring glycaemic control. There is also the ever present risk of ketosis and hypoglycaemia and as the child grows up there is an increasing awareness of the later complications of diabetes. This paper is concerned with the care of the child with diabetes from diagnosis, within the context of his home and school, with an emphasis on the emotional response of the child and his family.
