Quality Of Life And Its Influencing Factors In Children With Type 1 Diabetes Mellitus

Objective:This study aims to comprehensively explore the quality of life of children with Type 1 Diabetes Mellitus(T1DM),and further analyze the related factors affecting the quality of life,so as to provide a theoretical basis for better improving the quality of life of children.Methods:This study is divided into two parts,using parallel triangular cross-certification of mixed research design.1.The first part.The quantitative study adopted the cross-sectional design and the purpose sampling method,and 267 children aged 8-14 years old with T1DM admitted to the outpatient department of three hospitals in Liaocheng from March 2019 to April 2021 were selected as the research objects.The instruments included the Basic Information Questionnaire,Pediatric Quality of Life Inventory Measurement Models(PsdsQL 4.0).Data input and statistical description were completed by EpiData 3.1 software and SPSS 20.0 software.Qualitative research used descriptive qualitative research method.Twelve children with T1DM aged 8-14 years old who were treated in outpatient clinics of three hospitals in Liaocheng City from March 2019 to April 2021 were recruited.Data were collected in the form of semi-structured in-depth interviews with individuals.2.The second part.We used the same sample of the first part to collect further data.The quantitative research of this part additionally used instruments of the basic information questionnaire,the universal core scale of children’s quality of life,the Adaptation Partnership Growth Affection Resolve(APGAR),the Social Anxiety Scale for Children(SASC),and the Depression Self-rating Scale for Children(DSRS).EpiData 3.1 software and SPSS 20.0 software were used for data input and statistical description.Statistical methods include descriptive analysis,independent sample t test,one-way ANOVA,Pearson correlation analysis,multiple linear stepwise regression.Qualitative research adopted descriptive research method,and selected 12 T1DM children aged 8-14 from March 2019 to April 2021 in the outpatient of three hospitals in Liaocheng City as the research objects.Data were collected in the form of semi-structured in-depth interviews with individuals.Results:1.In the first part of the study,the quantitative study found that the total score of quality of life of T1DM children was(73.13±15.39),and the score in the physiological domain was(79.35 ± 16.60).The total score in the psychological domain was(71.06 ± 16.03).In the qualitative research part,the themes extracted by qualitative research are:(1)worrying physical condition;(2)high psychological pressure;(3)limited social activities;(4)learning and school life were affected;(5)decreased comfort.2.In the second part,quantitative studies showed that the influencing factors of quality of life in the physiological domain of T1DM children were family care(B=1.689,β=0.244,P<0.001),social anxiety(B=-0.732,β=-0.234,P<0.001),glycated hemoglobin(B=-3.323,β=-0.187,P=0.001),depression(B=-0.487,β=-0.182,P=0.001),gender(B=-4.347,β=-0.131,P=0.017).Regression model can explain 22.9%of the variance of physiological domain score.The influencing factors of quality of life in the psychological domain were social anxiety(B=-0.746,β=-0.247,P<0.001),family care(B=1.628,β=0.243,P<0.001),glycated hemoglobin(B=-2.572,β=-0.150,P=0.004),depression(B=-0.502,β=-0.194,P<0.001),frequency of blood glucose monitoring(B=11.245,β=0.193,P<0.001),gender(B=-4.383,β=-0.136,P=0.009),and stress events in the past half year(B=6.461,β=0.150,P=0.004).Regression model can explain 30.1%of the variance of psychological domain score.In the qualitative research,themes extracted by qualitative research are:(1)insufficient self-management ability;(2)severe stigma;(3)insufficient family support;(4)schools are unable to provide places for treatment.Conclusion:1.The quality of life of children with T1DM is poor in physiological and psychological domains.The quality of life of children with T1DM needs to be improved.2.Quantitative studies found that family care,social anxiety,glycosylated hemoglobin,depression and gender were the influencing factors in the physiological domain of quality of life in children with T1DM;social anxiety,family care,glycated hemoglobin,depression,frequency of blood glucose monitoring,gender,and stress events in the past half year are the influencing factors in the psychological domain of the quality of life of children with T1DM.Qualitative research found that insufficient self-management ability,severe stigma,insufficient family support and schools are unable to provide places for treatment were the influencing factors of quality of life in children with T1DM.