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Biomedical subjects

A L Snyder

Publications and source records attributed to A L Snyder.

15 recordsLinked to original sources
PubMed1998

Maternal fear of hypoglycemia in their children with insulin dependent diabetes mellitus.

A modified version of the Hypoglycemia Fear Survey (HFS) was used to measure fear of hypoglycemia among mothers of 46 pre-adolescent children with IDDM. Glycosylated hemoglobin (HbA1) levels were measured, and episodes of severe hypoglycemia over the previous year were recorded. The relationships between the child's age, disease duration, HbA1, history of hypoglycemia, and maternal distress concerning hypoglycemia and HFS-P scores were explored. Maternal HFS-P scores were also compared to those of 78 IDDM adults. There was no relationship between children's age, disease duration, number of severe hypoglycemic episodes and maternal HFS-P scores. However, mothers whose children had passed out with hypoglycemia had higher HFS-P scores. Correlations between mothers' responses concerning their children's history of hypoglycemia and HFS-P scores suggested that their degree of distress associated with events which occurred when their child was asleep, or in a social situation was related to their total HFS-P, and Behavior and Worry subscores. Mothers demonstrated significantly greater fear than did adult patients themselves. The HFS-P may be an appropriate instrument for examining the psychological impact of differing treatment regimens on families of children with IDDM.

Adult↗
PubMed1995

The Diabetes Control and Complications Trial: new challenges for the school nurse.

Results from the recently concluded Diabetes Control and Complications Trial confirm previously held beliefs regarding the relationships between hyperglycemia and the development of retinopathy, nephropathy, and neuropathy in insulin-dependent diabetes mellitus. Intensive therapy, now recommended for all patients 13 years and over, requires diabetes management throughout the school day and the active participation of the school nurse as a member of the child's health care team.

Child↗
PubMed1991

Accuracy of blood glucose estimation by children with IDDM and their parents.

OBJECTIVE: To evaluate the accuracy of blood glucose symptom recognition and subjective blood glucose estimation in insulin-dependent diabetic (IDDM) children and their parents. RESEARCH DESIGN AND METHODS: Blood glucose estimation questionnaires were completed 4 times/day at home during routine activities. A sequential sample of 19 families, who attended a pediatric diabetes clinic, with IDDM children less than 12 yr old and IDDM duration of greater than or equal to 9 mo comprised the study. RESULTS: Error grid analysis showed that both children and parents demonstrated poor accuracy, making clinically significant errors as frequently as clinically accurate estimates. The most common error was the failure to detect extreme blood glucose levels, with a significant tendency to underestimate hyperglycemia. Children often reported hypoglycemia when blood glucose was hyperglycemic. Confidence in the ability to estimate blood glucose was unrelated to measured accuracy. CONCLUSIONS: IDDM children and their parents demonstrated a higher rate of blood glucose estimation errors than IDDM adolescents and adults in previous studies. Even in families who use self-monitoring of blood glucose frequently, self-reported ability to recognize symptoms and estimate blood glucose should be viewed with caution. Families with IDDM children need more education about errors in symptom recognition and blood glucose estimation. They should also be encouraged to use self-monitoring of blood glucose before treating children's reported hypoglycemic symptoms whenever possible.

Adult↗
PubMed1989

Stress in parents of children with diabetes mellitus.

The level of stress experienced in the parenting role by mothers of 49 children with insulin-dependent diabetes mellitus (IDDM) and its relationship to glycemic control was examined with the parenting stress index (PSI). A subsample of the research group of 25 children with diabetes (less than or equal to 11 yr old) was compared with an age-matched control group (n = 21) drawn from the original study of the PSI on total stress, parent- and child-domain, and subdomain scale scores. The two groups differed on one child-domain subscale, whereby children with diabetes are perceived by their mothers as more demanding than healthy controls. Three parent-subscale differences existed between the two groups, with mothers of children with diabetes reporting less attachment to their children, less spousal support, and poorer health. Analysis of the diabetes sample demonstrated significant stress on several of the child- and parent-domain subscales in a large proportion of the sample. Stress, at levels greater than or equal to 70th percentile of the control group, existed on the child scales of acceptability, mood, demanding behavior, and reinforcement for 51% of children with diabetes. Elevations associated with stress in the parenting role were evident on the scales associated with parental attachment, depression, and competence for 33% of parents. No differences in the level of glycosylated hemoglobin (HbA1) existed between children whose mothers reported high levels of stress in themselves and their children and those whose mothers reported little stress. Hierarchal regression analysis demonstrated a significant relationship between the child stress scale of distractibility, the use of self-monitoring blood glucose assessment, and low levels of HbA1.

Adult↗
PubMed1985

Outpatient pediatric diabetes--I. Current practices.

A survey of pediatric diabetologists in the U.S. was made in an attempt to define current outpatient practices in diabetes subspecialty clinics. Survey questions addressed clinic organization, health care team members, content of histories and physical examinations, use of laboratory studies, patient education, therapeutic recommendations, self-management practices and screening procedures used to identify early diabetes-related complications. The results of the survey suggested similar clinic organization and operation in most settings; a high degree of reliance on glycosylated hemoglobin determinations; a preference for the use of NPH insulin; and a lack of credence given urinary glucose determinations. Additionally, screening tests for the development of complications are not performed with regularity.

Adolescent↗