Burak BAYKARA, Aynur AKAY PEKCANLAR, Ece BÖBER, Özlem DOĞAN, Ayhan ABACI, Aylin ÖZBEK, Canem ERGİN

Tip 1 diyabetes mellitus tanılı çocuğu olan annelerin psikososyal özellikleri: Diyabetik kontrolle ilişki

Amaç: Bu çalışmada tip I diyabetes mellitus (T1DM) tanısı konan çocukların annelerinin depresyon ve anksiyete belirtilerinin araştırılması, bu annelerin çocuklarına karşı tutumları ve aile işlevselliklerinin belirlenmesi amaçlan- maktadır. Ek olarak, annelerin doldurduğu ölçek puanları ile metabolik kontrolün ilişkisi değerlendirilmektedir. Yöntem: Çalışmaya T1DM tanısı konan 50 çocuk ile 50 sağlıklı gönüllü ve anneleri alınmıştır. Tüm annelerden Beck Depresyon Ölçeği (BDÖ), Durumluk ve Sürekli Anksiyete Ölçeği (DSAÖ), Aile Hayatı ve Çocuk Yetiştirme Tutumu Ölçeği (AHÇYTÖ) ve Aile Değerlendirme Ölçeğini (ADÖ) doldurmaları istenmiştir. T1DM için metabolik kontrol HbA1c değeri ile değerlendirilmiştir. Sonuçlar: T1DM tanısı konan çocukların anneleri, kontrol grubu çocuklarının annelerine göre, AHÇYTÖ 'aşırı ebeveynlik tutumu' alt testinde istatistiksel olarak anlamlı düzeyde yüksek puanlar elde etmiştir. Bu sonuca göre T1DM'li çocuğu olan annelerin aşırı kontrolcü, endişeli ve aşırı istekte bulunan annebaba tutumu gösterdiği belirlenmiştir. Aile bireylerinin birbirleriyle olan ilişkisinin kalitesini değerlendiren ADÖ 'affektif bağlılık' alt testinde, diyabetik çocukların annelerinin istatistiksel olarak anlamlı yüksek puanlar aldığı saptanmıştır. T1DM'li çocukların ortalama HbA1c değerleri %8.93±1.81 (normal aralık: %5.7-14.8) olarak bulunmuştur. T1DM'li çocukların metabolik kontrolü ve çocukların annelerinin AHÇYTÖ 'demokratik tutum' alt ölçek puanları arasında istatistiksel olarak anlamlı negatif korelasyon saptanmıştır. Bu anne-lerin çocukları ile demokratik ve destekleyici bir ilişki kurabilmekte zorlandıkları gözlenmektedir. Buna ek olarak, T1DM hastalık süresi ile annelerin AHÇYTÖ 'otoriter tutum' alt ölçek puanlarının şiddeti arasında istatistiksel olarak anlamlı pozitif korelasyon saptanmıştır. Tartışma: Bu çalışma, T1DM'li çocukların annelerinde, T1DM hastalık sürecinin ve yetersiz metabolik kontrolün, özellikle annelik beceri-lerini ve aile ilişkilerini olumsuz etkilediğini göstermektedir. (Anadolu Psikiyatri Derg 2012; 13:39-45)

Psychosocial aspects of mothers of children with type 1 diabetes mellitus: the relationship with diabetic control

Objective: The aim of the study was to investigate the psychological profile of mothers of children with type I dia- betes mellitus (T1DM), their attitudes to their children and their family functioning. In addition, psychosocial pro- files of mothers were investigated in relation to putative effects on metabolic control. Methods: A series of 50 children with T1DM and 50 healthy controls and their mothers were involved in the study. Mothers completed Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Parental Attitude Research Instru-ment (PARI) and Family Assessment Device (FAD). Metabolic control was assessed by the HbA1c value. Results: The mothers of T1DM group had significantly higher scores of ‘attitude of over-parenting’ (over cont- rolling, anxious and over-demanding parental attitude) on PARI and higher scores on FAD affective each other when compared with mothers of the healthy controls. Mean HbA1c values of children with involvement subtest, which refers to quality of interest, concern, and investment that family members have for T1DM was 8.93±1.81% (range: 5.7- 14.8%). A statistically significant negative correlation was found between metabolic control and PARI ‘democratic attitude’ subscale of mothers of T1DM children. In addition, a statistically significant positive correlation was noticed between duration of T1DM and PARI ‘authoritarian attitude’ subscale of mothers which refers over- punishing and a rigid attitude in relationship. Discussion: This study demonstrated that, for mothers who have children with T1DM, disease itself and poor metabolic control may have an adverse effect on their lives and their family relationships. (Anatolian Journal of Psychiatry 2012; 13:39-45)

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