Impact of caregivers' psychological well-being on mental health and disease management in children with type 1 diabetes: A cross-sectional study using structural equation modeling.

BACKGROUND

Childhood type 1 diabetes poses substantial challenges for disease management and psychosocial well-being. Caregivers play a central role in diabetes care, and their psychological distress and caregiving burden may negatively influence children's mental health and illness-related outcomes. This study aimed to examine the associations between caregivers' psychological well-being and caregiving burden and the mental health and illness attitudes of children with type 1 diabetes.

METHODS

This cross-sectional study included 129 child-caregiver dyads (caregivers were all mothers) of children aged 10-18 years with type 1 diabetes who were followed at a pediatric endocrinology outpatient clinic in Turkey. Data were collected using validated questionnaires and analyzed using structural equation modeling.

RESULTS

Caregivers' depression, anxiety, stress, and caregiving burden were significantly associated with children's emotional, behavioral, and social difficulties (r = 0.51-0.77, p < 0.001). Structural equation modeling supported a sequential pathway in which caregiving burden predicted parental psychological distress, which in turn influenced children's illness attitudes and psychosocial outcomes (β = 0.52-0.66, p < 0.001).

CONCLUSION

Caregiver mental health plays a critical role in children's illness perception and psychosocial adjustment. Supporting caregivers may indirectly improve coping and psychosocial well-being in children with type 1 diabetes.

PRACTICE IMPLICATIONS: Pediatric and family nurses should incorporate caregiver psychological assessment and support into diabetes management. Family-centered interventions addressing caregiver distress and burden may enhance children's coping capacity, illness attitudes, and psychosocial well-being.