Relationship quality in parents of children with type 1 diabetes: Putting the “us” behind

Objective To examine relationship quality in parents of children with type 1 diabetes (T1D) and its associations with parental and child outcomes. Rationale Parents of children with T1D often experience high stress, which can affect their mental health and their child's health-related quality of life (HRQoL). Marital relationship satisfaction may influence both parental and child well-being, yet this link remains understudied in this population. Since relationship quality can be improved through brief interventions, understanding its role is crucial for supporting both parent and child well-being. Methods A cross-sectional survey was conducted at five pediatric diabetes centers in Germany. Parents completed the Quality of Marriage Index (QMI) to report their relationship quality. Associations with child glycemic outcomes and person-reported outcomes (parental diabetes burden, depression, and child health-related quality of life (HRQoL)) were examined. Results Parents of children with T1D (N = 587, 75.1% mothers) reported significantly lower relationship quality than a German population-based sample ( p < .001) and were nearly twice as likely to report relationship satisfaction below the cut-off (OR 1.97; 95% CI 1.56, 2.49). Relationship satisfaction was not associated with the children's HbA1c levels. However, parents with low relationship satisfaction reported higher emotional diabetes-distress related to negative feelings ( p = .001), chronic demands ( p < .001), personal regimen-specific demands ( p = .005), as well as elevated depressive symptoms ( p < .001). These parents also rated their children's HRQoL lower ( p < .001). In regression analyses, the burden associated with keeping up with chronic demands of diabetes and low relationship satisfaction were predictors of both parental depression and child HRQoL. Conclusions Parents of children with T1D often experience reduced relationship quality, even years after their child's diagnosis. Psychological support targeting highly burdened and depressed parents, including couple-based interventions, may alleviate parental distress and enhance both parental and child well-being.