Assessing fear of hypoglycaemia among parents of children with Type 1 Diabetes Mellitus

Abstract

Introduction: Hypoglycaemia is the most widespread acute side effect of insulin therapy in individuals with type 1 diabetes mellitus. Severe hypoglycaemia can cause loss of consciousness, seizures, accidents or physical injuries, and even death. Given these severe consequences, it is almost inevitable for patients or their caregivers not to develop fear of hypoglycaemia. Fear of hypoglycaemia in children and their parents has not, thus far, been measured at diabetic clinics in South Africa. Fear of hypoglycaemia among paediatric type 1 diabetes mellitus patients and their parents affects quality of life and adherence to diabetes management strategies. However, behavioural workshops can address and decrease such fears and therefore increase compliance with T1DM management programmes. An improved understanding of fear of hypoglycaemia should assist nurses running clinics to develop appropriate programmes to offer support. Aim of the study: To assess fear of hypoglycaemia among parents whose children have type 1 diabetes mellitus. Study objectives: The objectives of the study were: 1. To identify aspects suggestive of worry about hypoglycaemia among parents whose children have type 1 diabetes mellitus, and 2. To determine the behaviours adopted by parents to prevent hypoglycaemia among children with type 1 diabetes mellitus. Method: A descriptive and cross-sectional survey design was used to identify factors suggesting fear of hypoglycaemia among parents and the actions parents take to prevent hypoglycaemia. In this study the population comprises parents of type 1 diabetes mellitus children attending a specific diabetic outpatient’s clinic (N=140). The total population was used as a sample over a period of three months due to the limited population size. Fifteen (15) patients are pre-booked for clinic services every Monday from 08h00–13h00. vi Only parents or guardians of children aged 3 to 18 years, diagnosed with type 1 diabetes mellitus and on insulin therapy, were considered eligible for the study. Data collection: A self-administered Hypoglycaemia Fear Survey – Parent version (HFS-P) was used to collect data. Besides demographic data, the HFS-P’s data collection tool focuses on worry and avoidant behaviours, with a total of 25 questions scored using Likert Scales ranging from 0 (“never”) to 4 (“always”). The Worry subscale HFS-P (W) measures different anxiety-provoking aspects of hypoglycaemia. The Behaviour subscale HFS-P (B) measures behaviours used to avoid hypoglycaemia and its consequences. The demographic data collected concerned parents’ ages, genders, marital status, employment status and levels of education. Data analysis: Data was analysed using STATA version 13.1. Data analysis was divided into descriptive and inferential statistics. Results: Parents of type 1 diabetes mellitus children are more likely to experience fear of hypoglycaemia and to practise negative behaviours to avoid hypoglycaemia, which eventually impact negatively on glycaemic control. Nurses should be able to intervene and teach such parents how to manage type 1 diabetes mellitus correctly.