ESPE Abstracts (2018) 89 MTE8.1

Psychology of Childhood Diabetes: How to Motivate Children and Families with T1DM

Karin Lange

Hannover Medical School, Hannover, Germany

Type 1 diabetes in childhood is a family project challenging all members 24 h/365 days a year. Parents and children have to perform a multitude of self-management tasks responding to changes in activity, food, emotional well-being and physiology. In addition parents have to combine their role as loving carer with role of the responsible ‘diabetologist’ of their child. Personalized structured education and psychosocial support for all family members are the keys to successful management of diabetes and child’s age appropriate psychosocial development. Diabetes education is an interactive process that supports families to acquire and apply the necessary knowledge to develop confidence to manage their life with diabetes. Age-specific curricula are based on psycho-educational principles and combine practical education with problem solving tasks, goal setting, communication skills, motivational interviewing, family conflict resolution, support of self-efficacy and psychosocial adaptation. Lifelong diabetes management requires frequent qualified education at initial diagnosis and ongoing to support and motivate children and their care givers. During the workshop core elements of diabetes education and psychological advice will be discussed based on clinical cases: i) basic practical ‘survival skills’ and psychological support in the phase of diabetes diagnosis focusing on feelings of helplessness and guilt, development of feelings of security and self-efficacy as well as on positive coping among parents and children; all measures should follow common therapeutic goals and a shared holistic approach; ii) supporting positive emotional coping with unexpected glucose variation and improving patient confidence, self-efficacy and motivation during the first year with type 1 diabetes; iii) practical tools to support better coping with (un-)realistic fear of hypoglycemia and to reduce parents’ distress; iv) tools for effective use of CGM in children and their parents, e.g. worksheets on realistic expectations for adolescents and parents; discussion of parents’ and adolescents’ emotional reactions on alerts and unexpected glucose variation; cognitive behaviour techniques to prevent from overreaction on hypo alarms; step-by-step introduction of different alarms to prevent children, parents and other carer from overload; worksheets to support positive parent-adolescent cooperation (‘coaching contract’); v) Concerns, challenges and opportunities common to adolescents with diabetes, e.g. accepting the critical role of continued parental involvement and yet promoting independent, responsible self-management appropriate to the level of maturity and understanding, emotional and peer group conflicts, problem solving strategies for dealing with dietary indiscretions, illness, hypoglycemia, blood glucose fluctuation due to puberty, sports, smoking, alcohol, drugs, reproductive and sexual health and family planning.

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