The Influence of Family Factors on the Quality of Life of Children With Diabetes Mellitus Type 1 in West Java, Indonesia: A Cross-Sectional Analytic Study

BACKGROUND: Diabetes is a chronic disease that has a negative impact on the quality of life of children. Family should be a support system to help optimize the quality of life of children with type 1 diabetes mellitus (T1DM).

PURPOSE: The study aims to analyze the influence of family conflict, number of children in the family, and depression in children on the quality of life of children with T1DM.

METHOD: The study employed a cross-sectional analytic design with a sample of 51 T1DM children with inclusion criteria being aged 4–18 years and currently undergoing outpatient care at the hospital. The measurement of quality of life used the KINDLR instrument, which consists of versions for children and parents. Depression was measured using the Children's Depression Inventory and diabetes-specific family conflict using the Revised Diabetes Family Conflict Scale. Multivariate analysis with multiple linear regression was performed to obtain a prediction model for the quality of life of children with T1DM.

RESULTS: The mean total scores of the quality of life for the children’s and parents’versionswere76.39 ± 13.27 and 78.64 ± 9.38, respectively. The mean score of diabetes-specific family conflictwas31.03 ± 9.28 with a min-max score of 19–50. Quality of life of children was not different between male and female (p = > .05). As many as 40% of the children experienced depression with ameanscoreof 8.28 ± 5.02. The quality of life of children for the parent-rated version had a positive correlation with the quality of life of children with r = .463 at p= .002. Depression was negatively correlated with the quality of life of children with r = -.287 at p =.025. Multivariate analysis shows interactionsbetweenfamily conflict and number of children in the family (p = .017) and depression (p = .050), both as the main factors affecting the quality of life of children.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Family conflict and the number of children in the family and depression in children were predictors of quality of life in children with T1DM. The results of the study have implications for the importance of nursing interventions in improving the ability of families of children with T1DM in handling diabetes-specific family conflict and efforts to prevent depression in children so that children can have better quality of life.