Reducing stress and supporting positive relations in families of young children with type 1 diabetes: A randomized controlled study for evaluating the effects of the DELFIN parenting program

BACKGROUND To assess initial efficacy and feasibility of a structured behavioural group training (DELFIN) for parents of children with diabetes type 1, in order to reduce parenting stress and to improve parenting skills. METHODS A randomized controlled study was conducted between July 2008 and September 2010, at a children's hospital in Hannover with parents of children with type 1 diabetes (2-10 yrs) (intervention group n = 37; control group n = 28). Parenting skills, parents' psychological burden, children's behavioural difficulties and quality of metabolic control were assessed before, 3 months after and 12 months after participating in the training program. RESULTS In the intervention group parenting behaviour in conflict situations improved significantly after 3 months (Z = -3.28; p ≤ 0.001). It remained stable over 12 months (Z = -2.94; p ≤ 0.01). Depression and anxiety scores of parents decreased (Z = -1.93; p ≤ .05; Z = -2.02; p ≤ .05). Even though the outcome in the intervention group was more positive, the differences between both study arms failed to reach statistical significance. Unexpectedly parenting behaviour in the control group improved also (Z = -2.45; p ≤ .05). Anxiety as well as stress scores decreased in this group (Z = -2.02; p ≤ .05 and Z = -2.11; p ≤ .05). In both groups the initial metabolic control was good and without significant differences (A1c 7.2 ± 0.8% vs. 7.1 ± 0.4%; p > 0.5). It remained stable in the DELFIN group (A1c 7.1 ± 0.8%; p > 0.5), but it increased slightly in controls (A1c 7.3 ± 0.5%; Z = -2.79; p = .005). CONCLUSIONS This study has brought first evidence for the efficacy and feasibility of the program. A multicentre study with a larger sample is necessary to confirm these first results.