Burden in primary informal caregivers of children and adolescents with type 1 diabetes: Is it associated with depression, family dysfunction, and glycemic control?

ObjectiveThe requirement of a chronic treatment and the increase in life expectancy in children with type 1 diabetes (T1D) leads to the possibility of caregiver burden. The aim of our study was to evaluate the burden in primary informal caregivers (PIC) of children and adolescents with type 1 diabet...

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Main Authors: Lourdes Balcázar-Hernández, Hebert Huerta-Martínez, Eulalia Garrido Magaña, Elisa Nishimura-Meguro, Abigail Jiménez Márquez, Aleida Rivera-Hernández
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-01-01
Series:Frontiers in Endocrinology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2022.1089160/full
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author Lourdes Balcázar-Hernández
Hebert Huerta-Martínez
Eulalia Garrido Magaña
Elisa Nishimura-Meguro
Abigail Jiménez Márquez
Aleida Rivera-Hernández
author_facet Lourdes Balcázar-Hernández
Hebert Huerta-Martínez
Eulalia Garrido Magaña
Elisa Nishimura-Meguro
Abigail Jiménez Márquez
Aleida Rivera-Hernández
author_sort Lourdes Balcázar-Hernández
collection DOAJ
description ObjectiveThe requirement of a chronic treatment and the increase in life expectancy in children with type 1 diabetes (T1D) leads to the possibility of caregiver burden. The aim of our study was to evaluate the burden in primary informal caregivers (PIC) of children and adolescents with type 1 diabetes and its association with depression, family dysfunction, and glycemic control.Materials and methodsA retrospective study was performed in PIC of children and adolescents with T1D. Zarit Burden Interview Scale (ZBIS) was used to evaluate caregiver burden. Beck Depression Inventory (BDI-II) was used to evaluate depression in PIC, and the Family APGAR questionnaire was used to evaluate the family functionality.ResultsA total of 100 PIC of children and adolescents with T1D were included. Caregiver burden was found in 33% of caregivers. The total score of the Zarit scale was 41 (34–49); 19% had mild caregiver burden, and 14% had severe caregiver burden. According to the BDI-II, 82% had minimal depression, 11% mild depression, 5% moderate depression, and 2% severe depression. Family function was good in 69%; 13% had moderate dysfunction, and 18% had severe dysfunction. A positive correlation between caregiver burden and BDI-II score (r = 0.84; p = 0.001) and the grade of depression (r = 0.87; p = 0.001) was found. A logistic regression model showed that BDI-II score was associated with caregiver burden (OR 1.14; 95% CI 1.061–1.23; p = 0.001). A BDI-II cut off of 9 or more had a sensibility and specificity of 58% and 28%, respectively, for caregiver burden [AUC 0.751 (0.64–0.85); p = 0.001]. A BDI-II score ≥9 was a predictor of caregiver burden (OR 3.4; 95% CI 1.4–8.1; p = 0.008).ConclusionCaregiver burden is present in more than one third of the PIC of patients with T1D and is associated with depression. A BDI-II score ≥9 is a predictor of caregiver burden which may be a point to take into account in the integral approach to the patient with T1D and his or her family nucleus.
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spelling doaj.art-ba72c279f98d4026a29ee4a669e35ba82023-01-19T05:59:30ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-01-011310.3389/fendo.2022.10891601089160Burden in primary informal caregivers of children and adolescents with type 1 diabetes: Is it associated with depression, family dysfunction, and glycemic control?Lourdes Balcázar-Hernández0Hebert Huerta-Martínez1Eulalia Garrido Magaña2Elisa Nishimura-Meguro3Abigail Jiménez Márquez4Aleida Rivera-Hernández5Endocrinology Department, Hospital de Especialidades, Unidad Médica de Alta Especialidad (UMAE) Centro Médico Nacional Siglo XXI, Mexico City, MexicoPediatric Endocrinology Department, Hospital de Pediatría, Unidad Médica de Alta Especialidad Centro Médico Nacional Siglo XXI, Mexico City, MexicoPediatric Endocrinology Department, Hospital de Pediatría, Unidad Médica de Alta Especialidad Centro Médico Nacional Siglo XXI, Mexico City, MexicoPediatric Endocrinology Department, Hospital de Pediatría, Unidad Médica de Alta Especialidad Centro Médico Nacional Siglo XXI, Mexico City, MexicoPediatric Endocrinology Department, Hospital de Pediatría, Unidad Médica de Alta Especialidad Centro Médico Nacional Siglo XXI, Mexico City, MexicoPediatric Endocrinology Department, Hospital de Pediatría, Unidad Médica de Alta Especialidad Centro Médico Nacional Siglo XXI, Mexico City, MexicoObjectiveThe requirement of a chronic treatment and the increase in life expectancy in children with type 1 diabetes (T1D) leads to the possibility of caregiver burden. The aim of our study was to evaluate the burden in primary informal caregivers (PIC) of children and adolescents with type 1 diabetes and its association with depression, family dysfunction, and glycemic control.Materials and methodsA retrospective study was performed in PIC of children and adolescents with T1D. Zarit Burden Interview Scale (ZBIS) was used to evaluate caregiver burden. Beck Depression Inventory (BDI-II) was used to evaluate depression in PIC, and the Family APGAR questionnaire was used to evaluate the family functionality.ResultsA total of 100 PIC of children and adolescents with T1D were included. Caregiver burden was found in 33% of caregivers. The total score of the Zarit scale was 41 (34–49); 19% had mild caregiver burden, and 14% had severe caregiver burden. According to the BDI-II, 82% had minimal depression, 11% mild depression, 5% moderate depression, and 2% severe depression. Family function was good in 69%; 13% had moderate dysfunction, and 18% had severe dysfunction. A positive correlation between caregiver burden and BDI-II score (r = 0.84; p = 0.001) and the grade of depression (r = 0.87; p = 0.001) was found. A logistic regression model showed that BDI-II score was associated with caregiver burden (OR 1.14; 95% CI 1.061–1.23; p = 0.001). A BDI-II cut off of 9 or more had a sensibility and specificity of 58% and 28%, respectively, for caregiver burden [AUC 0.751 (0.64–0.85); p = 0.001]. A BDI-II score ≥9 was a predictor of caregiver burden (OR 3.4; 95% CI 1.4–8.1; p = 0.008).ConclusionCaregiver burden is present in more than one third of the PIC of patients with T1D and is associated with depression. A BDI-II score ≥9 is a predictor of caregiver burden which may be a point to take into account in the integral approach to the patient with T1D and his or her family nucleus.https://www.frontiersin.org/articles/10.3389/fendo.2022.1089160/fulltype 1 diabetes mellituscaregiver burdenprimary informal caregiversdepressionfamily dysfunction
spellingShingle Lourdes Balcázar-Hernández
Hebert Huerta-Martínez
Eulalia Garrido Magaña
Elisa Nishimura-Meguro
Abigail Jiménez Márquez
Aleida Rivera-Hernández
Burden in primary informal caregivers of children and adolescents with type 1 diabetes: Is it associated with depression, family dysfunction, and glycemic control?
Frontiers in Endocrinology
type 1 diabetes mellitus
caregiver burden
primary informal caregivers
depression
family dysfunction
title Burden in primary informal caregivers of children and adolescents with type 1 diabetes: Is it associated with depression, family dysfunction, and glycemic control?
title_full Burden in primary informal caregivers of children and adolescents with type 1 diabetes: Is it associated with depression, family dysfunction, and glycemic control?
title_fullStr Burden in primary informal caregivers of children and adolescents with type 1 diabetes: Is it associated with depression, family dysfunction, and glycemic control?
title_full_unstemmed Burden in primary informal caregivers of children and adolescents with type 1 diabetes: Is it associated with depression, family dysfunction, and glycemic control?
title_short Burden in primary informal caregivers of children and adolescents with type 1 diabetes: Is it associated with depression, family dysfunction, and glycemic control?
title_sort burden in primary informal caregivers of children and adolescents with type 1 diabetes is it associated with depression family dysfunction and glycemic control
topic type 1 diabetes mellitus
caregiver burden
primary informal caregivers
depression
family dysfunction
url https://www.frontiersin.org/articles/10.3389/fendo.2022.1089160/full
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