| BackgroundChildren’s health is always the focus of the society and the family.With the full implementation of the "Healthy China" strategy,it is urgent to pay attention to children’s chronic diseases.Parents should use reasonable health rules to regulate children’s behaviors,and relevant government departments and hospitals should strive to reduce the burden of children’s chronic diseases prevention and treatment,and find more favorable ways to help parents of children with chronic diseases,in order to realize family recovery.Type 1 diabetes is a major pediatric endocrine disease that endangers the health of children and adolescents.As a negative event that must be faced by families and children,it causes a heavy burden to the parents of children.However,if family members,especially parents,actively respond and cope with stressful situations,family function will recover in adversity,which will promote children’s health and improve their quality of life.ObjectiveTo understand the burden of parents and caregivers,sense of coherence,coping style,family resilience and influencing factors of children and adolescents with T1DM;To analyze the effects of caregivers’ burden,sense of coherence and coping style on family resilience;To explore the mediating effect of sense of coherence and coping style on caregivers’ burden and family resilience,in order to provide some theoretical basis for the formulation of intervention measures to improve the level of family resilience of parents of children with T1 DM.MethodsThe convenience sampling method was used to select 360 parents of children and adolescents with type 1 diabetes from several hospitals in Henan province as the research objects.The general information questionnaire,Zarit burden interview,Sense of Cohenence-13,Simplified coping style question naire and Family Resilience Assess ment Scale were used to investigate.SPSS 24.0 software was used for descriptive analysis,nonparametric test,Spearman correlation analysis,multiple linear regression analysis,etc.MPLUS7.0 software was used to build the structural equation model.Results1.The total score of the parents’ family resilience of children with T1 DM was(183.96±35.24).Children’s age,current blood glucose control,Primary caregivers,Parents’ age,marital status,occupational status,medical expenses and family monthly income were the main influencing factors of family resilience(P < 0.05).2.The score of parental caregiver burden in T1 DM children was(46.55±15.54).Age,Hb Alc,Course of disease,current blood glucose control,Primary caregivers,Parents’ age,educational level,marital status,family monthly income and medical expenses were the main influencing factors of caregiver burden score(P < 0.05).3.The score of parents’ sense of cohenence in children with T1 DM was(52.52±22.90).Being the only child,course of disease,current blood glucose control,Primary caregivers,marital status,occupational status,family monthly income and medical expenses are the main influencing factors(P < 0.05).4.The parents of T1 DM children scored(32.96±9.22)in positive coping style and(18.67±4.01)in negative coping style.Children’s age,current blood glucose control,course of disease,hospitalization times,parents’ age,educational level,marital status,family monthly income,medical expenses are the main factors that affect parents’ coping styles(P< 0.05).5.The results of multiple linear regression showed that sense of coherence(b=0.251,P=0.000),age of children(b=0.236,P=0.000),positive coping(b=0.176,P =0.000)were protective factors of family resilience of parents of children with T1 DM.Caregiver burden(b=3.106,P=0.000),and negative coping(b= 0.118,P=0.005),the current situation(poor)& good blood sugar control(b=0.126,P=0.000),Parents’ age(b = 0.076,P = 0.025),marital status(divorced or separated & married)(b=0.080,P=0.017),marital status(widowed married)&(b=0.113,P=0.001),the medical expense way(completely self-financed & health)(b=0.083,P=0.020)was a risk factor for the family resilience of the children’s parents.6.Sense of coherence and coping styles in children with their parents between the resilience of caregiver burden and family mediation effect analysis: Sense of coherence and positive coping played a partial mediating role in caregiver burden and family resilience.The estimated mediating effect was-0.023,95%CI of Bootstrap test(-0.044～-0.012).Negative coping played a partial mediating role in caregiver burden and family resilience,and the estimated mediating effect was-0.019,95%CI of Bootstrap test(-0.052～-0.011)。Conclusions1.The family resilience of the parents of children with T1 DM was above the medium level,and the burden of caregivers was at a moderate level.2.The burden of parents’ caregivers,psychological congruence and coping style are the important influencing factors of family resilience in children with T1 DM.Psychological congruence,positive coping and negative coping played a partial mediating role in the relationship between caregiver burden and family resilience. |
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