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Master Thesis

Implication et retentissement perçu du père et de la mère dans la prise en charge globale d’un enfant ou adolescent diabétique de type 1 âgé de moins de 18 ans à La Réunion

Abstract : Background: Type 1 diabetes (T1D) is a chronic disease whose incidence has been steadily increasing for several years. It is a compelling disease that upsets the daily lives of the parents as they are at the forefront of the daily care. The first objective of this study is to describe the involvement and perceived impact of fathers and mothers of children and adolescents with type 1 diabetes (CAT1D) under the age of 18 in Réunion Island. The second objective is to make comparisons between the responses of fathers and mothers and to carry out a comparative analysis between the HbA1c rates of the CAT1D and the parents' responses. Method: This is a descriptive and quantitative study carried out by phone interviews of parents of CAT1Ds treated in the Félix Guyon University Hospital, the GHOR and the CHOR. The questionnaire was closed-ended and covered different aspects of type 1 diabetes management (T1DM). The study included fathers and mothers (or maternal or paternal figures) of children under the age of 18 who had been diagnosed of T1D. Moreover, in this study the diagnosis of T1D must have been known for at least one year. The study excluded minor parents, protected adults, people who do not speak French and people who cannot answer the questionnaire for medical or legal reasons. We obtained the list of children and adolescents who are taken in charge in the 3 centers. We stratified the list by age (< 7 years, 7-12 years, ≥ 13 years) corresponding to different levels of autonomy. The data collection took place over the period from 6 July 2020 to 17 August 2020. 208 parents were contacted. We received 93 replies from mothers (including 4 refusals) and 89 replies from fathers (including 20 refusals). Results: The mother of the patient was the main contact person in 65 % of the medical records. We highlight that 60.8 % of the parents did not know their child's last HbA1c level with a significant difference between the mother and father group (49.4 % of mothers did not know their child's last HbA1c level versus 75.4 % of fathers, p- value 0.003). Concerning the management of the treatment, the mother is mainly involved in the daily care for the < 7 years old age stratum, with a progressive empowerment by the child between the second and third stratum (whatever the type of treatment: by insulin pump or multi-injections). Mothers declared that they prepare their children's meals "always in 100 % of cases" in a significantly higher proportion than fathers (respectively 55.1 % of mothers versus 20.3 % of fathers, p-value < 0.001). 79.1 % of the parents interviewed always share meals at home with the child without any significant difference between the father and mother group (83.1 % of mothers versus 73.9 % of fathers, p-value 0.075). Regarding the physical activity, mothers use insulin more frequently according to the glycemic variations linked to physical activity (58.4 % of mothers versus 36.2 % of fathers, p-value 0.006). As for consultations with diabetologists, pediatricians, general practitioners or during hospitalization, mothers are significantly more present than fathers. The analysis shows that the perceived impact of the disease is an ongoing concern equally for mothers and fathers. Besides, mothers feel significantly more involved than fathers in the management of diabetes [mothers: 9.1/10 (sd: 1.6) – fathers: 6.6/10 (sd: 2.6), p-value < 0.001]. Fathers report less self-confidence in the management of treatment than mothers [fathers: 7.420/10 (sd: 1.951) – mothers: 8.4/10 (sd: 1.5), p-value < 0,001]. 47.2 % of mothers and 24.6 % of fathers experience sleep issues even one year after the diagnosis of TD1 (p-value: 0.004). Conclusion: Mothers are most frequently the ones managing the care of their children’s diabetes mellitus. It would be interesting to carry out prospective studies on larger scales in order to offer means to help and support those families.
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Master Thesis
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Submitted on : Monday, February 1, 2021 - 7:38:00 AM
Last modification on : Wednesday, October 27, 2021 - 4:38:11 AM
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Julie Pougnet. Implication et retentissement perçu du père et de la mère dans la prise en charge globale d’un enfant ou adolescent diabétique de type 1 âgé de moins de 18 ans à La Réunion. Sciences du Vivant [q-bio]. 2020. ⟨dumas-03126676⟩



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