Family Impact Module and Type 1 Diabetes

Introduction: The Pediatric Quality of Life Family Impact Module (FIM) measures different domains of family functioning. Its use in type 1 diabetes (T1D) has not been widely explored. The objective of this study is to assess if baseline demographics can predict the impact of T1D on family function as measured by FIM score.

Methods: Parents of children with T1D completed the FIM during a medical appointment. Parents also completed the Holmes and Rahe (H and R) questionnaire as a measure of stressful life events.

Results: The sample included 33 parents. The children (13 males), had a median age of 13.6 years (range: 5.7-20.7), median age at diagnosis of 7.9 years (range: 1-15), median diagnosis duration of 5 years (range: 1-16) and median A1c of 8.4% (range: 6.5-11.4). The median FIM total score was 73.3 (range: 16-100) and impact on function was strongly correlated with a higher H and R score (r= -0.44, p < 0.01 after excluding one outlier). Predictive characteristics were noted in some individual domains (univariate analysis, adjusting for H and R score): poorer outcomes in parent cognitive function (p=0.02) for those with a child with additional medical conditions, more communication challenges (p=0.003) for parents of males, and more worry (p=0.05) in parents with more than 1 child with T1D. Child’s gender, A1c, pump use, CGM use, age, age at diagnosis and disease duration were not significant predictors of total FIM score or FIM subscale scores.

Conclusion: Although sample size is small, our results suggest more impact in specific domains of function for families with the following: a child with more than one medical condition, a male child, and multiple children with T1D. This requires further study. While no demographic data predicted total FIM score, the score did correlate with stressful life events. It is important to screen families for stressful life events as well as level of function. Future study will also include a larger sample size and collection of data from a local healthy community sample.