Burden of care and a sense of loneliness in caregivers of children with type 1 diabetes. a cross-sectional study.

BACKGROUND: Treatment of type 1 diabetes is a process involving not only sick children, but also their caregivers. AIM: To assess the burden of care and sense of loneliness in caregivers of children with type 1 diabetes. Also, an analysis was conducted of the connection between sociodemographic factors characterizing caregivers and the clinical factors characterizing sick children and between the burden of care and the sense of loneliness. MATERIALS AND METHODS: The study included 125 caregivers of children with type 1 diabetes. In order to collect the research data, the Caregiver Burden Scale and the Revised UCLA Loneliness Scale were used. RESULTS: In the research group, the total result in the caregiving burden scale was 2.14, which remains within the average burden level. Caregivers showed the highest burden level in the General Strain Subscale. The analysis showed that mothers experience a greater burden of care than fathers in the General Strain Subscale and that caregivers of younger children are more burdened with care within the Isolation and Disappointment Subscales. Moderate high degree of loneliness was shown in 4.8% of caregivers. A higher burden of care for caregivers of children with type 1 diabetes is accompanied by a higher sense of loneliness. CONCLUSIONS: The results of this study may help healthcare professionals plan a holistic, family-centered care program that will take into account factors that increase the burden of care: younger age of the affected child, motherhood, caregiver unemployment, feelings of loneliness, lower education, caregiver unemployment, blood glucose meter measurements, and frequent night-time blood glucose measurements.

The impact of the COVID-19 pandemic on people with diabetes and diabetes services: A pan-European survey of diabetes specialist nurses undertaken by the Foundation of European Nurses in Diabetes survey consortium.

AIM: To describe diabetes nurses' perspectives on the impact of the COVID-19 pandemic on people with diabetes and diabetes services across Europe. METHODS: An online survey developed using a rapid Delphi method. The survey was translated into 17 different languages and disseminated electronically in 27 countries via national diabetes nurse networks. RESULTS: Survey responses from 1829 diabetes nurses were included in the analysis. The responses indicated that 28% (n = 504) and 48% (n = 873) of diabetes nurses felt the COVID-19 pandemic had impacted 'a lot' on the physical and psychological risks of people with diabetes, respectively. The following clinical problems were identified as having increased 'a lot': anxiety 82% (n = 1486); diabetes distress 65% (n = 1189); depression 49% (n = 893); acute hyperglycaemia 39% (n = 710) and foot complications 18% (n = 323). Forty-seven percent (n = 771) of respondents identified that the level of care provided to people with diabetes had declined either extremely or quite severely. Self-management support, diabetes education and psychological support were rated by diabetes nurse respondents as having declined extremely or quite severely during the COVID-19 pandemic by 31% (n = 499), 63% (n = 1,027) and 34% (n = 551), respectively. CONCLUSION: The findings show that diabetes nurses across Europe have seen significant increases in both physical and psychological problems in their patient populations during COVID-19. The data also show that clinical diabetes services have been significantly disrupted. As the COVID-19 situation continues, we need to adapt care systems with some urgency to minimise the impact of the pandemic on the diabetes population.

Factors associated with loneliness in patients with diabetes mellitus.

Aim: To (a) explore the prevalence of loneliness in patients with diabetes mellitus and (b) identify loneliness-related factors in the group of hospitalized patients with diabetes mellitus. Design: A cross-sectional study. Methods: The study included 248 patients with diabetes mellitus who were staying in six Polish hospitals. A questionnaire including sociodemographic and clinical data, and the Revised UCLA Loneliness Scale (R-UCLA), was used for research data collection. Data were collected from March 2019 to June 2019. Results: Patients with diabetes generally experience moderate loneliness, with almost one-fifth (16%) of patients experiencing intense loneliness. The patients scored a mean 9.94 out of a possible 20 in belongings and affiliation category and 20.14 out of a possible 40 in the intimate others category. Lower education, being single and the presence of chronic complications of diabetes mellitus were risk factors for increased loneliness.

Relationship between loneliness and blood glucose control in diabetes.

BACKGROUND: The data of the International Diabetes Federation show that about 463 million people have diabetes. Better understanding of psychosocial aspects of life with this disease has become one of healthcare priorities in this group of patients. The aim of this study was to assess the relationships between loneliness and blood glucose control in diabetic patients. METHODS: The study included 250 hospitalized patients with type 1 and 2 diabetes. The patients included in the study were those who had had diabetes for at least 1 year and received pharmacotherapy. Standardized Revised UCLA Loneliness Scale (R-UCLA) and an analysis of patient test results including 10 indicators of blood glucose control were used for data collection. Correlation analysis, i.e. Pearson's linear correlation coefficient (r, parametric method), was used for hypothesis verification. RESULTS: Less than one-fifth (16%) of the patients included in the study had higher loneliness index (based on the R-UCLA scale), and this loneliness index (total result) was significantly correlated with higher blood pressure. No significant correlations were demonstrated between loneliness and the other 9 indicators of blood glucose control. CONCLUSIONS: Systolic blood pressure was significantly correlated with loneliness in patients with diabetes. Further studies are needed to confirm these findings.

Actual and perceived knowledge of type 1 diabetes mellitus among school nurses.

BACKGROUND: In general, school nurses are aware that it is important to have knowledge of type 1 diabetes to give adequate care to children with the disease. Many studies assessing diabetes knowledge have found different deficits among nurses. To our knowledge, however, no study has assessed the knowledge of type 1 diabetes among school nurses. OBJECTIVE: To assess actual and perceived diabetes knowledge among school nurses. DESIGN: Cross-sectional studies. SETTINGS: Seventeen primary care facilities in Warsaw that employed school nurses. PARTICIPANTS: Two hundred and thirty school nurses. METHODS: With the Diabetes Knowledge Questionnaire (DKQ), we assessed actual diabetes knowledge. With the Self-Assessed Diabetes Knowledge (SADK), we assessed perceived diabetes knowledge. Both the DKQ and SADK assessed seven domains of diabetes knowledge: general diabetes knowledge; insulin and glucagon; insulin pumps; diabetes complications; nutrition; physical activity, stress, and comorbidities; and glycemia measurements. We related DKQ and SADK scores to each other and to sociodemographic and work-related factors. RESULTS: The rate of correct responses in the DKQ was 46.7%, with the lowest rate regarding knowledge of insulin pumps (36.5%), nutrition (37.4%), and insulin and glucagon (37.9%). Actual and perceived diabetes knowledge were moderately positively correlated (rho = 0.18, p =.009). In six of the seven knowledge domains examined, school nurses perceived their diabetes knowledge better compared with their actual knowledge. DKQ scores were higher in nurses with higher education (p = .024), those who had relatives or friends with diabetes (p = .032), and those who had prior diabetes training (p = .050). Interestingly, DKQ scores were higher among nurses with fewer years of experience (rho = - 0.18, p = .011). CONCLUSIONS: There is a need for additional diabetes training among nursing students and practicing nurses to provide safe and effective care for children with type 1 diabetes.