Date of Award

2010

Degree Type

Thesis

Degree Name

Bachelor of Science Honours

School

School of Psychology and Social Sciences

Faculty

Faculty of Computing, Health and Science

First Advisor

Dr Sonya Girdler

Second Advisor

Catherine Elliot

Third Advisor

Dr Elizabeth Davis

Fourth Advisor

Michael Owens

Abstract

Background: Research indicates an increased prevalence of psychiatric morbidity in adolescents with type 1 diabetes mellitus in comparison to their peers. As a result, psychosocial community-based services are sometimes available to those who are experiencing psychosocial problems. Several reviews have examined the effectiveness of psychosocial interventions for children/ adolescents living with type 1 diabetes mellitus, however the psychosocial outcomes of psychosocial interventions being conducted in the community specifically, have yet to be systematically reviewed. Objective: To systematically review the psychosocial outcomes of community-based psychosocial interventions for children and adolescents with type 1 diabetes mellitus and their families. Subjects: Participants in the studies were limited to children or adolescents (0-18 years) with type 1 diabetes mellitus, as well as family members of a child/ adolescent with T1DM. Participants were included if they were receiving psychosocial services in the community. Method: Electronic searches of four databases and manual searches of reference lists located relevant articles for this review. Articles which assessed the psychosocial outcomes of community-based psychosocial interventions used with children and adolescents with type 1 diabetes and their families were included. Data extraction and quality assessment was undertaken by two reviewers. Results: Eleven articles were eligible for inclusion. Interventions included an internet coping skills training program, parent mentoring and peer support, in-home behavioural family systems therapy, multisystemic therapy, motivational interviewing, and supportive telephone calls. Conclusions: Various community-based psychosocial interventions produce differing psychosocial outcomes for individuals with type 1 diabetes mellitus and for their families. Interventions varied in efficacy in relation to improving psychosocial outcomes in this population. Methodological shortcomings included small samples or uneven study groups, and lack of blinding of the investigators and participants. There is a need for future research with more robust methodology in order to understand the outcomes of community-based psychosocial interventions for children/adolescents with type 1 diabetes mellitus and their families. Background: Research indicates that children/adolescents with type 1 diabetes mellitus experience increased mental health issues in comparison to those in the general population. In response to this, a community mental health nurse working for the Department of Endocrinology at Princess Margaret Hospital for Children, Western Australia, provides a psychosocial service for families in which there is a child with type 1 diabetes mellitus, and who are experiencing mental health difficulties. Objective: To explore the experience of type 1 diabetes mellitus for children/adolescents and their families; and to describe and explore the role of the community mental health nurse for children/adolescents with type 1 diabetes mellitus and for their families. Subjects: Study participants were parents or caregivers of children/adolescents with type 1 diabetes mellitus, as well as their children with type 1 diabetes mellitus who were 12 years of age or older. Participants were recruited from the Department of Endocrinology at Princess Margaret Hospital and were invited to partake in the study if they had seen the community mental health nurse at least five times in the previous 12 months. Method: Mixed methods design. Two males (aged 15), two females (aged 13 and 16), and one or both of their parents participated in semi-structured interviews, and completed a battery of questionnaires. In families where children were less than 12 years of age, only the parent(s) were assessed. Results: Analysis of interviews revealed that the main themes were: type 1 diabetes mellitus has a significant emotional impact on the child, as well as their parents; type 1 diabetes mellitus has a major impact on the lifestyle of children living with the condition and their parents; and the community mental health nurse has a positive impact on families receiving the service. Conclusion: Community mental health nursing is a well-received intervention, which has shown to have a positive impact on the lives of children with type 1 diabetes mellitus and their families, who are experiencing mental health issues. Further research should be carried out on a larger sample and using a more robust methodology.

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