Psychosocial interventions for families of children with diabetes mellitus type 1

Parents may have difficulty balancing caring for their child with other demands and can experience increased stress, sadness, or family conflict. Psychosocial interventions for families of children with diabetes mellitus type 1 may include educational interventions, counselling, psychotherapy and contact with support groups.

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SBU Enquiry Service

Consists of structured literature searches to highlight studies that can address questions received by the SBU Enquiry Service from Swedish healthcare or social service providers. We assess the risk of bias in systematic reviews and when needed also quality and transferability of results in health economic studies. Relevant references are compiled by an SBU staff member, in consultation with an external expert when needed.

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Published: Report no: ut202001 Registration no: SBU 2019/691

Question

What systematic reviews are there on psychosocial interventions for families of children with diabetes mellitus type 1?

Identified literature

Table 1. Systematic reviews with low/medium risk of bias
CYP = Children and young people; GHb glycated haemoglobin = Glykosylerat haemoglobin; T1D = Diabetes type 1
1 HbA1c is a form om haemoglobin that is formed when haemoglobin reacts with blood sugar i.e. glucose.
Included studies Population/Intervention Outcome
Armour et al, 2004 [1]
19 randomized controlled trials Any person (<18 years) with Type 1 or 2 diabetes and any family member living in the home, including parent, spouse, sibling, aunt, uncle, or grandparent.
Family interventions were classified as either knowledge focused (e.g. of treatment and handling of diabetes-related symptoms and care, family knowledge sharing), behavioural (e.g. skills training [aiding with injections, glucose monitoring, foot care], health-seeking behaviours, physical activity, diet), or psychosocial (coping skills, family cohesion, conflict-resolution skills, self-efficacy of family or household members of people with diabetes, frequency of diabetes-related conflict, problem solving).		 Knowledge (e.g. of treatment and handling of diabetes-related symptoms and care, family knowledge sharing)
GHb glycated haemoglobin
Authors' conclusion:
“Evidence suggests that family interventions in family or household members of people with diabetes may be effective in improving diabetes-related knowledge and glycaemic control.”
Charalampopoulos 2017 [2]
Ten eligible trials of three educational and seven psycho-educational interventions Children and Young Persons up to 24 years with Type 1 Diabetes
Included interventions were targeting CYP, their families and/or health care professionals that aimed to improve management of diabetes in children.		 Glycaemic control measured by percentage of glycated haemoglobin (HbA1c)1; secondary outcomes psychosocial functioning, diabetes knowledge, adverse and other clinical outcomes.
Authors' conclusion:
“There is insufficient evidence to recommend the use of particular psycho-educational programme for CYP with T1D in the UK. Further trials with sufficient power and reporting”

References

  1. Armour, T. A., Norris, S. L., Jack, L., Jr., Zhang, X., & Fisher, L. (2005). The effectiveness of family interventions in people with diabetes mellitus: a systematic review. Diabetic medicine : a journal of the British Diabetic Association, 22(10), 1295-1305.
  2. Charalampopoulos, D., Hesketh, K. R., Amin, R., Paes, V. M., Viner, R. M., & Stephenson, T. (2017). Psycho-educational interventions for children and young people with Type 1 Diabetes in the UK: How effective are they? A systematic review and meta-analysis. PLoS ONE, 12(6), e0179685. doi:https://dx.doi.org/10.1371/journal.pone.017968.

Literature search

Embase via Embase 2019-11-22
Psychosocial treatment for children with diabetes type 1
The search result, usually found at the end of the documentation, forms the list of abstracts.; [MeSH] = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; [MeSH:NoExp] = Does not include terms found below this term in the MeSH hierarchy; [MAJR] = MeSH Major Topic; [TIAB] = Title or abstract; [TI] = Title; [AU] = Author; [TW] = Text Word; Systematic[SB] = Filter for retrieving systematic reviews; * = Truncation
Search terms Items found
Population:
1. Child/exp 2,799,670
2. infant/exp 1,105,361
3. (child* or infant* or baby or babies or toddler* or youth*):ti,ab 2,188,597
4. 1 OR 2 OR 3 3,451,584
Intervention:
5. Psychotherapy/exp 263,190
6. ‘Problem Solving’/exp 35,759
7. psychotherap*:ti,ab 61,786
8. ((cogniti* or famil* or behavio$r* or psych*) NEAR/3 (intervention* or treatment* or therap*)):ti,ab 198,799
9. counsel*:ti,ab 148,961
10. ((interpersonal OR play) NEAR/3 therap*):ti,ab 4,497
11. (problem* NEAR/3 solv*):ti,ab 60,365
12. 5 OR 6 OR 7 OR 8 OR 9 OR 10 OR 11 607,315
Outcome:
13. 'Diabetes Mellitus'/exp 957,807
14. diabet*:ti,ab,kw 925,058
15. (Diabet* NEAR/2 ’2’ NOT ((Diabet* NEAR/2 ’2’) AND ’1’)):ti 89,022
16. (13 OR 14) NOT 15 1,029,801
Study types:
17. [cochrane review]/lim OR [systematic review]/lim OR [meta analysis]/lim 324,604
18. ‘systematic review’/exp OR ‘meta analysis’/exp 314,278
19. ((systematic* NEAR/3 review*):ab,ti,kw) OR 'meta analy*':ab,ti OR metaanaly*:ab,ti,kw 335,439
20. 17 OR 18 OR 19 423,621
Combined sets:
21. 4 AND 12 AND 16 3,071
Final 20 AND 21 162

 

Medline via OVID 2019-11-22
Psychosocial treatment for children with diabetes type 1
The search result, usually found at the end of the documentation, forms the list of abstracts.; au = Author; MeSH = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; this term only = Does not include terms found below this term in the MeSH hierarchy; :ti = Title; :ab = Abstract; :kw = Keyword; * = Truncation; “ “ = Citation Marks; searches for an exact phrase; CDSR = Cochrane Database of Systematic Review; CENTRAL = Cochrane Central Register of Controlled Trials, “trials”; CRM = Method Studies; DARE = Database Abstracts of Reviews of Effects, “other reviews”; EED = Economic Evaluations; HTA = Health Technology Assessments
Search terms Items found
Population:
1. exp Child/ 1,862,955
2. exp Infant/ 1,114,471
3. (child* or infant* or baby or babies or toddler* or youth*).ti,ab. 1,692,878
4. 1 OR 2 OR 3 2,914,979
Intervention:
5. exp Psychotherapy/ 190,653
6. exp Problem Solving/ 24,794
7. psychotherap*.ti,ab. 40,680
8. ((cogniti* or famil* or behavio?r* or psych*) adj3 (intervention* or treatment* or therap*)).ti,ab. 138,384
9. counsel*.ti,ab. 103,527
10. ((interpersonal or play) adj3 therap*).ti,ab. 3,080
11. (problem* adj3 solv*).ti,ab. 49,060
12. 5 OR 6 OR 7 OR 8 OR 9 OR 10 OR 11 450,982
Outcome:
13. exp Diabetes Mellitus/ 412,305
14. diabet*.ti,ab,kw. 608,563
15. ((Diabet* adj2 "2") not ((Diabet* adj2 "2") and "1")).ti. 59,360
16. (13 OR 14) NOT 15 606,716
Study types:
17. exp "Systematic Review"/ or exp Meta-Analysis/ 176,225
18. ((systematic* adj3 review*) or meta analy* or metaanaly*).ti,ab. 261,606
19. 17 OR 18 283,085
Combined sets:
20. 4 AND 12 AND 16 1,604
Final 19 AND 20 105

 

Cochrane Library via Wiley 2019-11-22
Psychosocial treatment for children with diabetes type 1
/de = Term from the EMTREE controlled vocabulary; /exp = Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ti,ab = Title or abstract; * = Truncation; ’ ’ = Citation Marks; searches for an exact phrase
Search terms Items found
Population:
1. [mh child] 15,622
2. [mh infant] 1,203
3. (child* or infant* or baby or babies or toddler* or youth*):ti,ab 150,092
4. 1 OR 2 OR 3 153,872
Intervention:
5. [mh psychotherapy] 22,378
6. [mh "Problem Solving"] 1,500
7. psychotherap*:ti,ab 6,771
8. ((cogniti* or famil* or behavio$r* or psych*) NEAR/3 (intervention* or treatment* or therap*)):ti,ab 36,256
9. counsel*:ti,ab 18,014
10. ((interpersonal OR play) NEAR/3 therap*):ti,ab 579
11. (problem* NEAR/3 solv*):ti,ab 4,478
12. 5 OR 6 OR 7 OR 8 OR 9 OR 10 OR 11 71,040
Outcome:
13. [mh "Diabetes Mellitus"] 27,894
14. diabet*:ti,ab,kw 86,319
15. (Diabet* NEAR/2 "2" NOT ((Diabet* NEAR/2 "2") AND "1")):ti 19,308
16. (13 OR 14) NOT 15 67,195
Study types:
17. Cochrane Review  
Combined sets:
18. 4 AND 12 AND 16 425
Final 17 AND 18 14
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