Family support within psychosocial care of children with type 1 diabetes: impact on quality of life and treatment adherence

Background. Childhood and adolescent type 1 diabetes requires continuous medical monitoring, as well as long-term psychological, behavioural and social support. This is because daily treatment-related activities are substantially influenced by patterns of family interaction. The aim of this study was to provide a theoretical rationale for the importance of parental involvement. This involvement is in shaping emotional well-being, treatment-related behaviour and adaptation. These are among underage patients with impaired carbohydrate metabolism. Materials and methods. To this end, the study employed scientific evidence analysis and synthesis, comparative methods, systematisation, generalisation, and structural-logical modelling. These methods enabled the identification of the key ways in which family support influences the quality of life, treatment-related behaviour, and psychosocial adaptation of children with type 1 diabetes. Results. Constructive parental involvement was found to encompass emotional availability, coordinated responsibility, self-management assistance, autonomy support and conflict reduction. The most compelling evidence concerns the adverse role of diabetes-specific conflict. A systematic review of 20 studies found that 17 studies associated it with higher glycated haemoglobin levels. Seven studies found it to be associated with poorer self-management. A further seven studies found it to be associated with worse psychological outcomes. Intervention programmes were shown to have a positive effect on parental confidence, adolescent self-efficacy, communication and certain behavioural outcomes. However, their impact on metabolic control was inconsistent. It was shown that digital tools were only beneficial when combined with direct psychological support. Conclusions. The optimal approach is a model of flexible shared management. Adults remain involved in this model. They gradually transfer part of the responsibility to the child. This is in accordance with the child’s age, maturity and skills. These findings could inform the development of medical and psychological support programmes for families.