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Bilgehan, Tuğba, Uludaşdemir, Dilek, Kızıler, Evrim, Kacar, Merve. (1404). The Mediating Role of Health Literacy in the Relationship between Care Burden and Health Perception among Caregivers of Children with Type 1 Diabetes: A Comparison Based on Continuous Glucose Monitoring System Usage. , 11(1), 30-46. doi: 10.22038/jhl.2025.88637.1793
Tuğba Bilgehan; Dilek Uludaşdemir; Evrim Kızıler; Merve Ertosun Kacar. "The Mediating Role of Health Literacy in the Relationship between Care Burden and Health Perception among Caregivers of Children with Type 1 Diabetes: A Comparison Based on Continuous Glucose Monitoring System Usage". , 11, 1, 1404, 30-46. doi: 10.22038/jhl.2025.88637.1793
Bilgehan, Tuğba, Uludaşdemir, Dilek, Kızıler, Evrim, Kacar, Merve. (1404). 'The Mediating Role of Health Literacy in the Relationship between Care Burden and Health Perception among Caregivers of Children with Type 1 Diabetes: A Comparison Based on Continuous Glucose Monitoring System Usage', , 11(1), pp. 30-46. doi: 10.22038/jhl.2025.88637.1793
Bilgehan, Tuğba, Uludaşdemir, Dilek, Kızıler, Evrim, Kacar, Merve. The Mediating Role of Health Literacy in the Relationship between Care Burden and Health Perception among Caregivers of Children with Type 1 Diabetes: A Comparison Based on Continuous Glucose Monitoring System Usage. , 1404; 11(1): 30-46. doi: 10.22038/jhl.2025.88637.1793

The Mediating Role of Health Literacy in the Relationship between Care Burden and Health Perception among Caregivers of Children with Type 1 Diabetes: A Comparison Based on Continuous Glucose Monitoring System Usage

Journal of Health Literacy
مقاله 2، دوره 11، شماره 1 - شماره پیاپی 40، فروردین 2026، صفحه 30-46    اصل مقاله (8.64 M)
نوع مقاله: Original Article
شناسه دیجیتال (DOI): 10.22038/jhl.2025.88637.1793
نویسندگان
Tuğba Bilgehan* 1؛ Dilek Uludaşdemir2؛ Evrim Kızıler2؛ Merve Ertosun Kacar3
1Ankara Yıldırım Beyazıt University, Faculty of Health Sciences, Department of Internal Medicine Nursing, Ankara, Türkiye.
2Ankara Yıldırım Beyazıt University, Faculty of Health Sciences, Depertment of Child Health and Disease Nursing, Ankara, Türkiye.
3Samsun Education and Research Hospital Maternity and Child Diseases Hospital Campus, Samsun, Türkiye.
چکیده
Background and Objective: Parents who assume the responsibility of caregiving for children diagnosed with Type 1 Diabetes Mellitus play a crucial role in effective diabetes management. This study aims to investigate the mediating role of health literacy in the relationship between health perception and caregiving burden among caregivers of children with Type 1 Diabetes Mellitus, separately for those using continuous glucose monitoring and those using self-monitoring of blood glucose.

Materials and Methods: This descriptive and cross-sectional study was conducted with 289 caregivers of children with Type 1 Diabetes Mellitus. The data were collected online between October 2024 and January 2025 using a sociodemographic data collection form, the Health Perception Scale, Zarit Caregiver Burden Scale, and the Short Form of the Health Literacy Scale. The data analysis was conducted using the SPSS 27 software and included descriptive statistics (frequency, percentage, mean, and standard deviation), Pearson correlation, regression analysis, and mediation testing. A significance level of p<0.05 was considered statistically significant.

Results: It was found that children using self-monitoring of blood glucose had higher HbA1c levels compared to those using continuous glucose monitoring. The findings indicated that health literacy played a mediating role in the relationship between caregiver burden and health perception among caregivers of children using continuous glucose monitoring, whereas no such effect was observed among caregivers of children using self-monitoring of blood glucose. Additionally, caregivers of children using continuous glucose monitoring reported lower caregiver burden and better glycemic control.

Conclusions: Health literacy was identified as a significant factor associated with reduced caregiver burden in the continuous glucose monitoring group. Interventions aimed at enhancing health literacy, particularly among caregivers of children using self-monitoring of blood glucose, may help promote more favorable outcomes in diabetes care.
کلیدواژه‌ها
Caregivers؛ Caregiver Burden؛ Diabetes Mellitus؛ Health Literacy؛ Type 1
مراجع
  1. Mayer-Davis EJ, Kahkoska AR, Jefferies C, Dabelea D, Balde N, Gong C, et al. ISPAD Clinical Practice Guidelines 2018: Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes. 2018;19(Suppl 27):7-19. https://doi.org/10.1111/pedi.12773 PMid:30226024 PMCid:PMC7521365
  2. Ogle GD, Wang F, Gregory GA, Maniam J. Estimates of type 1 diabetes in children and adults - 2022. IDF Atlas Reports [Internet]. Available from: www.diabetesatlas.org.
  3. International Diabetes Federation. IDF Diabetes Atlas [Internet]. Available from: https://diabetesatlas.org/data/en/indicators/18/. Accessed: 2025 Jan 10.
  4. Wood DL, Sawicki GS, Miller MD, Smotherman C, Lukens-Bull K, Livingood WC, et al. The Transition Readiness Assessment Questionnaire (TRAQ): its factor structure, reliability, and validity. Acad Pediatr. 2014;14(4):415-22.https://doi.org/10.1016/j.acap.2014.03.008 PMid:24976354
  5. Kobos E, Imiela J. Factors affecting the burden level of caregivers of children with type 1 diabetes. Appl Nurs Res. 2015;28(2):142-9. https://doi.org/10.1016/j.apnr.2014.09.008 PMid:25448058
  6. Adib-Hajbaghery M, Ahmadi B. Caregiver burden and related factors in caregivers of children and adolescents with chronic illnesses. Int J Community Based Nurs Midwifery. 2019;7(4):258-69. doi:10.30476/IJCBNM.2019.73893.0.
  7. Piran P, Khademi Z, Tayari N, Mansouri N. Care burden in children with chronic illnesses. Electron Physician. 2017;9(9):5380-7. https://doi.org/10.19082/5380 PMid:29038725 PMCid:PMC5633241
  8. Gallegos E, Harmon KB, Lee G, Qi Y, Jewell VD. A descriptive study on the quality of life and burden of mothers of children and adolescents with type 1 diabetes. Occup Ther Health Care. 2023;37(2):296-312. https://doi.org/10.1080/07380577.2022.2038401 PMid:35189069
  9. Efteli E, Khorshtd L. Comparison of health perceptions of students from two different departments. Ege Univ Nurs Fac J. 2016;32(2):1-10.
  10. Kaya ŞŞ, Kitiş Y. Elderly diabetes patients' health beliefs about care and treatment for diabetes. J Human Sci. 2018;15(1):51. https://doi.org/10.14687/jhs.v15i1.4903
  11. Küçük E, Yapar K. Health perception, health-related behaviors, and adherence to medication therapy in patients with type 2 diabetes: A study in Turkey's Black Sea region. Ege Univ Nurs Fac J. 2016;34(2):64-76.
  12. Christian BJ. Translational research- Pediatric nursing: Caring for children. J Pediatr Nurs. 2023;70:131-4. https://doi.org/10.1016/j.pedn.2023.04.004 PMid:37173069
  13. Diviani N, Zanini C, Jaks R, Brach M, Gemperli A, Rubinelli S. Information seeking behavior and perceived health literacy of family caregivers of persons living with a chronic condition. The case of spinal cord injury in Switzerland. Patient Educ Couns. 2020;103(8):1531-7. https://doi.org/10.1016/j.pec.2020.02.024 PMid:32098740
  14. McLarty R, Alloyce J, Chitema G, Msuya L. Glycemic control, associated factors, acute complications of Type 1 Diabetes Mellitus in children, adolescents and young adults in Tanzania. Endocrinol Diabetes Metab. 2021;4(2):e00200. https://doi.org/10.1002/edm2.200 PMid:33855206 PMCid:PMC8029575
  15. Martínez-Mesa J, González-Chica DA, Bastos JL, Bonamigo RR, Duquia RP. Sample size: how many participants do I need in my research? An Bras Dermatol. 2014;89(4):609-15. https://doi.org/10.1590/abd1806-4841.20143705 PMid:25054748 PMCid:PMC4148275
  16. Barutcu CD. Relationship between caregiver health literacy and caregiver burden. P R Health Sci J. 2019;38(3):138-43.
  17. Saßmann H, Kim-Dorner SJ, Berndt V, Biester T, Dehn-Hindenberg A, Heidtmann B, et al. Understanding daily, emotional, and physical burdens and needs of parents caring for children with type 1 diabetes. J Diabetes Res. 2022;2022:9604115. https://doi.org/10.1155/2022/9604115 PMid:36561282 PMCid:PMC9767735
  18. Yu J, Wang Y, Wang H, Li S, Zhou M, Xu J, et al. Association between eHealth literacy, diabetic behavior rating, and burden among caregivers of children with type 1 diabetes: Cross-sectional survey study. J Pediatr Nurs. 2023;73:1-6. https://doi.org/10.1016/j.pedn.2023.08.012 PMid:37597400
  19. Kobos E, Rojkowska S, Szewczyk A, Dziedzic B. Burden of care and a sense of loneliness in caregivers of children with type 1 diabetes: A cross-sectional study. BioPsychoSocial Med. 2023;17(1):34. https://doi.org/10.1186/s13030-023-00291-4 PMid:37803450 PMCid:PMC10559508
  20. Hölgyesi Á, Luczay A, Tóth-Heyn P, Muzslay E, Világos E, Szabó AJ, et al. The Impact of Parental Electronic Health Literacy on Disease Management and Outcomes in Pediatric Type 1 Diabetes Mellitus: Cross-Sectional Clinical Study. JMIR Pediatr Parent. 2024;7:e54807. https://doi.org/10.2196/54807 PMid:38506893 PMCid:PMC10993131
  21. Diamond JJ, Becker JA, Arenson CA, Chambers CV, Rosenthal MP. Development of a scale to measure adults' perceptions of health: preliminary findings. J Community Psychol. 2007;35(5):557-61. https://doi.org/10.1002/jcop.20164
  22. Kadıoğlu H, Yıldız A. Validity and reliability of the Turkish version of the Health Perception Scale. Turk Klin J Med Sci. 2012;32(1):47-53 https://doi.org/10.5336/medsci.2010-21761
  23. Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist. 1980;20(6):649-55. https://doi.org/10.1093/geront/20.6.649 PMid:7203086
  24. İnci FH, Erdem M. Validity and reliability of the Burden Interview and its adaptation to Turkish. Atatürk University School of Nursing Journal. 2008;11(4):85-95.
  25. Duong TV, Aringazina A, Kayupova G, Nurjanah, Pham TV, Pham KM, et al. Development and validation of a New Short-Form Health Literacy Instrument (HLS-SF12) for the general public in six Asian countries. HLRP. 2019;3(2):90-102. https://doi.org/10.3928/24748307-20190225-01 PMid:31294310 PMCid:PMC6607763
  26. Karahan Yılmaz S, Eskici G. Validity and reliability study of the Turkish form of the health literacy scale-short form and digital healthy diet literacy scale. İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi. 2021;6(3):19-25.
  27. R Core Team. R: A language and environment for statistical computing [Internet]. Vienna, Austria: R Foundation for Statistical Computing; 2023. Available from: https://www.R-project.org/.
  28. Lüdecke D. sjPlot: Data Visualization for Statistics in Social Science [Internet]. 2023. Available from: https://CRAN.R-project.org/package=sjPlot.
  29. Hayes AF. Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. 2nd ed. New York: Guilford Publications; 2017.
  30. Bilgehan T, Bağrıaçık E, Sönmez M. Factors affecting care burden and life satisfaction among parents of children with type 1 diabetes. J Pediatr Nurs. 2024;77:e394-e400. https://doi.org/10.1016/j.pedn.2024.05.002 PMid:38729898
  31. Azari S, Salehpour S. A Comparative Study of Two Glycemic Control Methods (SMBG vs. CGM) in Children and Adolescents Aged 4-18 with Type 1 Diabetes. Int J Pediatr. 2022;10(1):15331-9.
  32. Keklik D, Bayat M, Başdaş Ö. Care burden and quality of life in mothers of children with type 1 diabetes mellitus. Int J Diabetes Dev Ctries. 2020;40:431-5. https://doi.org/10.1007/s13410-020-00799-3
  33. Bilgehan T, Uludaşdemir D. Insomnia severity among caregivers of children with type 1 diabetes: A mixed method study. J Pediatr Nurs. 2024;77:e375-e384. https://doi.org/10.1016/j.pedn.2024.04.054 PMid:38724314
  34. Kimbell B, Lawton J, Boughton C, Hovorka R, Rankin D. Parents' experiences of caring for a young child with type 1 diabetes: A systematic review and synthesis of qualitative evidence. BMC Pediatr. 2021;21(1):160 https://doi.org/10.1186/s12887-021-02569-4
    PMid:33814007 PMCid:PMC8019496
  35. Costa V, Pereira B, Patton SR, Brandão T. Parental Psychosocial Variables and Glycemic Control in T1D Pediatric Age: A Systematic Review. Curr Diabetes Rep. 2025;25(1):1-14. https://doi.org/10.1007/s11892-024-01566-y PMid:39680256 PMCid:PMC11649725
  36. Batool SH, Safdar M, Eman S. Relationship between parents' health literacy and child health: systematic review. Library Hi Tech. 2022;42(1):131-48. https://doi.org/10.1108/LHT-11-2021-0398
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