Med Bull Sisli Etfal Hosp. 2024; 58(2): 146-154 | DOI: 10.14744/SEMB.2024.21456

Evaluation of Quality of Life and Psychosocial Problems in Children with Type 1 Diabetes Mellitus

Elida Yuksel¹, Lida Bulbul², Semra Yilmaz³, Sami Hatipoglu⁴, Esra Deniz Papatya Cakir^5
1Department of Pediatrics, Acibadem Atakent Hospital, Istanbul, Türkiye
²Department of Pediatric Allergy and Immunology, University of Health Science Türkiye, Bagcilar Training and Research Hospital, Istanbul, Türkiye
³Department of Pediatric Psychiatry, Memorial Bahcelievler Hospital, Istanbul, Türkiye
⁴Department of Pediatrics, University of Health Science Türkiye, Bakirkoy Sadi Konuk Training and Research Hospital, Istanbul, Türkiye
⁵Department of Pediatric Endocrinology, University of Health Science Türkiye, Bakirkoy Sadi Konuk Training and Research Hospital, Istanbul, Türkiye

Objectives: To evaluate the frequency of psychosocial problems and the factors affecting the quality of life in children and adolescents aged between 8 and 18 years with type 1 diabetes mellitus (T1DM).
Methods: In the study, children and adolescents aged between 8 and 18 years who had been followed for at least 6 months for T1DM were evaluated (T1DM group), and compared with healthy children and adolescents who applied to the general pediatric outpatient clinic and did not have any chronic disease (control group). Data on disease follow-up of children and adolescents with T1DM were obtained from medical records. Sociodemographic characteristics of both groups were recorded in the study form. In addition, the Children's Depression Inventory (CDI), Screen for Child Anxiety Related Disorders (SCARED) and Children Quality of Life Questionnaire (KINDL: KINDerLebensqualitätsfragebogen) were applied to both groups. The scale scores of the T1DM group and the control group were compared. Factors affecting the scale scores of the T1DM group were evaluated.
Results: A total of 181 children or adolescents, 81 of whom were in the T1DM group and 100 in the control group, were evaluated for this study. The mean age was 13.1±2.4 years in the T1DM group and 12.4±2.1 years in the control group. The mean CDI, SCARED, and KINDL scores, respectively; it was 15.3±7.2, 23.6±11.9, and 53.5±13.7 in the T1DM group and 7.9±6.8, 14.7±13, 60±11.6 in the control group. There was a statistically significant difference between the two groups in terms of mean CDI, SCARED, and KINDL scores (all p values <0.001). As compliance with the diabetic diet decreased at home, there was a significant increase in the mean CDI score (p=0.005) and a significant decrease in the KINDL score (p=0.002). It was observed that KINDL score decreased significantly as compliance with the diabetic diet decreased outside the home (p=0.001).
Conclusion: Quality of life is lower, and levels of depression and anxiety are higher in children with T1DM compared to healthy children. Psychosocial support should be provided from the moment of diagnosis in order to improve the psychosocial problems and quality of life of children with T1DM.

Keywords: Anxiety, child, depression, quality of life, type 1 diabetes mellitus

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Tip 1 Diabetes Mellituslu Çocuklarda Yaþam Kalitesi ve Psikososyal Sorunlarýn Deðerlendirilmesi

Elida Yuksel¹, Lida Bulbul², Semra Yilmaz³, Sami Hatipoglu⁴, Esra Deniz Papatya Cakir^5
1Acýbadem Atakent Hastanesi, Çocuk Saðlýðý ve Hastalýklarý Kliniði, Ýstanbul
²Türkiye Saðlýk Bilimleri Üniversitesi, Baðcýlar Eðitim ve Araþtýrma Hastanesi, Pediatrik Alerji ve Ýmmünoloji Kliniði, Ýstanbul
³Memorial Bahçelievler Hastanesi, Çocuk Psikiyatrisi Kliniði, Ýstanbul
⁴Türkiye Saðlýk Bilimleri Üniversitesi, Bakýrköy Sadi Konuk Eðitim ve Araþtýrma Hastanesi, Çocuk Saðlýðý ve Hastalýklarý Kliniði, Ýstanbul
⁵Türkiye Saðlýk Bilimleri Üniversitesi, Bakýrköy Sadi Konuk Eðitim ve Araþtýrma Hastanesi, Pediatrik Endokrinoloji Kliniði, Ýstanbul

Amaç: Tip 1 diyabetli (T1DM) 8-18 yaþ arasý çocuk ve ergenlerde psikososyal sorunlarýn sýklýðýný ve yaþam kalitesini etkileyen faktörleri deðerlendirmek.
Gereç ve Yöntem: Çalýþmada, T1DM tanýsýyla en az 6 ay boyunca takip edilen 8-18 yaþ arasý çocuk ve ergenler deðerlendirilerek, saðlýklý çocuk ve ergenlerle karþýlaþtýrýldý. Her iki grubun hastalýk takibi ve sosyodemografik özelliklerine iliþkin veriler çalýþma formuna kaydedildi. Ayrýca her iki gruba da Çocuklarda Depresyon Envanteri (CDI), Çocuklarda Anksiyete Ýle Ýlgili Bozukluklar Taramasý (SCARED) ve Çocuklarda Yaþam Kalitesi Anketi (KINDL: KINDerLebensqualitätsfragebogen) uygulandý. T1DM grubu ile kontrol grubunun ölçek puanlarý karþýlaþtýrýldý.
Bulgular: Bu çalýþma için 81'i T1DM grubunda ve 100'ü kontrol grubunda olmak üzere toplam 181 çocuk veya ergen deðerlendirildi. Ortalama yaþ T1DM grubunda 13,1±2,4 yýl, kontrol grubunda ise 12,4±2,1 yýl idi. Ortalama CDI, SCARED ve KINDL puanlarý sýrasýyla; T1DM grubunda 15,3±7,2, 23,6±11,9, 53,5±13,7, kontrol grubunda ise 7,9±6,8, 14,7±13, 60±11,6 idi. Ýki grup arasýnda ortalama CDI, SCARED ve KINDL skorlarý açýsýndan istatistiksel olarak anlamlý fark vardý (tüm p deðerleri <0,001). Evde diyabet diyetine uyum azaldýkça ortalama CDI skorunda anlamlý artýþ (p=0,005), KINDL skorunda ise anlamlý düþüþ (p=0,002) görüldü. Ev dýþýnda diyabetik diyete uyum azaldýkça KINDL skorunun anlamlý düzeyde azaldýðý görüldü (p=0,001).
Sonuç: T1DM'li çocuklarda saðlýklý çocuklara göre yaþam kalitesi daha düþük, depresyon ve anksiyete düzeyleri daha yüksektir. Bu nedenle Tip 1DM'li çocuklara taný anýndan itibaren psikososyal destek saðlanmasý gerekmektedir. (SETB-2024-01-013)

Anahtar Kelimeler: Anksiyete, çocuk, depresyon, yaþam kalitesi, tip 1 diyabet

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