Stressors and Coping Patterns of NewlyVersus Old Diagnosed Children With Type1DiabetesMellitus: An Assessment Study

Abstract

Type1 diabetes is one of the most common chronic pediatric illnesses that requires extensive self-management with active involvement of both the child and his family in diabetes self-management. Diabetes self-management is complex and demands administration of insulin, carbohydrate counting, frequent blood glucose monitoring and treatment of events of hypo - and hyperglycemia. Diabetes self-management is the intensive, constant, complex and visible contribution to feelings of stress and social awkwardness in children, especially adolescents (Chao et al., 2016). Newly and old diagnosed children have physical, psychological and social stressors resulting from diagnosis and treatment of type1 diabetes and both of them sometimes can be able to cope with it. Aims of the study were to: 1- Assess the stressors and coping patterns of newly versus old diagnosed children with type1 diabetes. 2- Assess factors affecting stressors and coping patterns of newly versus old diagnosed children with type1diabetes.

Research questions: 1- What are the stressors and coping patterns of newly versus old diagnosed children with type1 diabetes? 2- What are the factors affecting stressors and coping patterns of newly versus old diagnosed children with type1diabetes? The subjects and methods of the current study were discussed under the following four designs: I. Technical design. II. Operational design. III. Administrative design. IV. Statistical design. I. Technical design: 1- Research design: A descriptive comparative research design was utilized in the current study. 2- Research settings This study was conducted at the diabetes outpatient clinics of children’s hospitals affiliated to Ain Shams and Tanta universities. 3- Research subjects: The study sample was composed of two hundred children suffering from type1 diabetes attending the previously mentioned settings regardless their characteristics. Selection of these children was based on the statistical annual follow up records of the diabetic children in diabetic outpatient clinics of children's hospitals affiliated to Ain shams (860) and Tanta (940) universities. They were classified into two groups: newly diagnosed children (57) who were diagnosed with type1 diabetes since less than 6 months' period and old diagnosed children (143) who were diagnosed with type1 diabetes since more than 6 months. Stressors of children aged between one and less than six years old were reported by their accompanied parents. 4- Tools of data collection: Data were collected through the following tools: I - A pre-designed questionnaire (Appendix II): It was designed in a simple Arabic language by the researcher after reviewing relevant literature and was revised by the thesis supervisors to suit the level of understanding of the studied children. The aim of the questionnaire was to assess children's knowledge about type1 diabetes, their stress, stressors, coping patterns and factors affecting stressors and coping patterns of newly versus old diagnosed children with type1 diabetes. It consisted of the following parts: Part 1: It was concerned with the characteristics of newly and old diagnosed children with type1diabetes (name, age, gender, child’s order, educational level, child's present health status, duration of illness and frequency of hospital admissions). Part 2: It was concerned with the factors that affected stressors and coping patterns of newly and old diagnosed children with type1diabetes (knowledge about type1 diabetes, onset of illness, presence of diabetes-related complications, follow up, insulin therapy, nutrition, exercise, BG monitoring and self-care practice). N.B.: The scoring system of ≥ 75% referred to satisfactory knowledge related to type1 diabetes and < 75% referred to unsatisfactory knowledge related to type1 diabetes.

Part 3: It was concerned with the physical, psychological and social stressors that affected newly and old diagnosed children with type1diabetes.