title: Psychological experience of parents of children with type 1 diabetes: a systematic mixed-studies review.
abstract: The purpose of this review is to describe the prevalence of psychological distress in parents of children with type 1 diabetes (T1DM), the relationship between parental psychological distress and health outcomes, and parents' psychological experience of having a child with T1DM. Clinical and research implications are presented.
  
  
  
  A systematic mixed-studies review was undertaken to review the quantitative and qualitative research on the parental experience of having a child with T1DM. A total of 34 articles met the inclusion criteria and were included in the review.
  
  
  
  The prevalence of parental psychological distress across all studies ranged from 10% to 74%, with an average of 33.5% of parents reporting distress at diagnosis and 19% of parents reporting distress 1 to 4 years after diagnosis. Parental psychological distress in parents of children with T1DM, regardless of how it was defined, was associated with higher child self-report of stress and depressive symptoms, more problematic child behavior, and lower child self-report of quality of life. Parental psychological distress also had negative effects on diabetes management. Themes of the qualitative synthesis indicated that parents perceived T1DM as a difficult diagnosis that contributed to significant family disruption. Adjustment occurred over time; however, ongoing stress was experienced.
  
  
  
  Screening for psychological distress in parents of children with T1DM is indicated, and preventive interventions are needed.
authors.affiliation: Yale School of Nursing, New Haven, Connecticut
authors.forename: Robin
authors.initials: R
authors.lastname: Whittemore
authors.affiliation: Yale School of Nursing, New Haven, Connecticut
authors.forename: Sarah
authors.initials: S
authors.lastname: Jaser
authors.affiliation: Yale School of Nursing, New Haven, Connecticut
authors.forename: Ariana
authors.initials: A
authors.lastname: Chao
authors.affiliation: Yale School of Nursing, New Haven, Connecticut
authors.forename: Myoungock
authors.initials: M
authors.lastname: Jang
authors.affiliation: Yale School of Nursing, New Haven, Connecticut
authors.forename: Margaret
authors.initials: M
authors.lastname: Grey
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008403:Mass Screening; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D036301:Qualitative Research; D012944:Social Support; D013315:Stress, Psychological / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D014481:United States / Q000453:epidemiology