Effective interventions to improve quality of life for parents of young children living with type 1 diabetes : a systematic review

Abstract

Many studies have shown a link between parental distress and the effect thereof on the successful adherence of the diabetes care plan, as well as the impact thereof on the quality of life for all family members. In this study, the aim was to systematically review, synthesise and integrate evidence from literature pertaining to effective interventions that improve the quality of life for parents of young children living with type 1 diabetes. A comprehensive electronic search from 2000 to 2018 using electronic databases and citation tracking was used. The search identified 67 articles after ten duplicates and 7 review articles were removed. The reviews were cited in search of additional relevant articles of which 15 were identified. In total 82 articles were retrieved for further inclusion and exclusion procedures carried out by both reviewers, whereafter only eight (8) articles were included. After reading full-text articles, further inclusion and exclusion criteria pertaining to the quality of the articles and critical appraisals were considered with each study, and seven articles were identified for inclusion in this review. Data extraction was captured in a table format, including primary characteristics of each article. This systematic review yielded limited yet valuable findings in terms of interventions that improve parental and family wellbeing as well as overall quality of life, despite not reaching significant differences between experimental and control groups. The most effective methods of delivery are interventions that are based on group work or telephone-based programmes that strongly emphasise the component of support regardless of content, as parents often feel isolated when dealing with this life-threatening disease. Psycho-education, cognitive behavioural therapy and coping skills training programmes that were tailored to child developmental phases, were secondary findings pertaining to the effectiveness of interventions investigated in this review. Parents reported diabetes-specific and development-specific information as informative and relevant to their circumstances, as they feel incompetent and anxious at times. These findings hold promising ideas that can contribute to the future development of effective interventions. In order to promote healthy outcomes and improve the quality of life for the whole family living with children diagnosed with type 1 diabetes in South Africa, the limitations regarding sample size, diverse heterogenous groups as well as steps to increase rigour and specify more specific quality of life outcomes in this review, should be taken seriously when planning future research.