title: Assessment of psychosocial problems in children with type 1 diabetes and their families: the added value of using standardised questionnaires in addition to clinical estimations of nurses and paediatricians.
abstract: OBJECTIVE
  To investigate the assessment of psychosocial problems in children with type 1 diabetes by means of clinical estimations made by nurses and paediatricians and by using standardised questionnaires.
  
  
  BACKGROUND
  Although children with type 1 diabetes and their parents show increased risk for psychosocial problems, standardised assessment of these problems lacks in diabetes care.
  
  
  METHODS
  By comparing these different modes of assessment, using a cross-sectional design, information about the additional value of using standardised questionnaires is provided.
  
  
  METHODS
  Participants were 110 children with type 1 diabetes (aged 4-16), their parents, and healthcare professionals. Children filled out the Strengths and Difficulties Questionnaire and the Paediatric Quality of Life Inventory, Diabetes Module. Parents filled out the Strengths and Difficulties Questionnaire parent-report and the Parenting Stress Index. Independently, nurses and paediatricians filled out a short questionnaire, which assessed their clinical estimations of the children's psychosocial problems and quality of life, and parents' levels of parenting stress. Reports of children and parents were compared to clinical estimations.
  
  
  RESULTS
  Children in our sample showed more psychosocial problems and lower health-related quality of life than their healthy peers. In approximately half of the children, dichotomous estimations by healthcare professionals and dichotomised reports by patients and parents were in agreement. In 10% of the children, no psychosocial problems were present according to professionals' estimations, although patients and parents-reported psychosocial problems. In 40%, psychosocial problems were present according to professionals' estimations, although parents and patients did not report psychosocial problems.
  
  
  CONCLUSIONS
  Children with type 1 diabetes show more psychosocial problems than healthy children. Professionals seem to tend towards overestimating psychosocial problems.
  
  
  CONCLUSIONS
  Extending the assessment of psychosocial problems with routine screening on patient-reported outcomes, using validated questionnaires, could be of additional value in tailoring care to the needs of the individual child and parents.
authors.affiliation: Children's Diabetes Center Nijmegen, Nijmegen, The Netherlands.|Department of Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Emiel A
authors.initials: EA
authors.lastname: Boogerd
authors.affiliation: Children's Diabetes Center Nijmegen, Nijmegen, The Netherlands.|Department of Paediatric Psychology, Tilburg University, Tilburg, The Netherlands.|Department of Psychology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
authors.forename: Anouk M A
authors.initials: AM
authors.lastname: Damhuis
authors.affiliation: Children's Diabetes Center Nijmegen, Nijmegen, The Netherlands.|Department of Paediatrics, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Janiëlle A A E m
authors.initials: JA
authors.lastname: van Alfen-van der Velden
authors.affiliation: Children's Diabetes Center Nijmegen, Nijmegen, The Netherlands.|Department of Psychology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
authors.forename: Marley C C H
authors.initials: MC
authors.lastname: Steeghs
authors.affiliation: Children's Diabetes Center Nijmegen, Nijmegen, The Netherlands.|Department of Paediatrics, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Cees
authors.initials: C
authors.lastname: Noordam
authors.affiliation: Department of Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Chris M
authors.initials: CM
authors.lastname: Verhaak
authors.affiliation: Department of Paediatric Psychology, Tilburg University, Tilburg, The Netherlands.|Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
authors.forename: Ignace P R
authors.initials: IP
authors.lastname: Vermaes
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000451:nursing / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009726:Nurses; D010290:Parents / Q000523:psychology*; D010371:Pediatric Nursing; D010372:Pediatrics; D010820:Physicians; D011788:Quality of Life; D018434:Sickness Impact Profile; D013315:Stress, Psychological; D011795:Surveys and Questionnaires / Q000592:standards
keywords: adolescent; child; diabetes mellitus type 1; parenting stress; psychosocial; quality of life; screening