The Mediating Role of Health Literacy in the Relationship between Care Burden and Health Perception among Caregivers of Children with Type 1 Diabetes: A Comparison Based on Continuous Glucose Monitoring System Usage

Articles in Press

Document Type : Original Article

Authors

1 Ankara Yıldırım Beyazıt University, Faculty of Health Sciences, Department of Internal Medicine Nursing, Ankara, Türkiye.

2 Ankara Yıldırım Beyazıt University, Faculty of Health Sciences, Depertment of Child Health and Disease Nursing, Ankara, Türkiye.

3 Samsun Education and Research Hospital Maternity and Child Diseases Hospital Campus, Samsun, Türkiye.

Abstract

Background and Objective: Parents who assume the responsibility of caregiving for children diagnosed with Type 1 Diabetes Mellitus play a crucial role in effective diabetes management. This study aims to investigate the mediating role of health literacy in the relationship between health perception and caregiving burden among caregivers of children with Type 1 Diabetes Mellitus, separately for those using continuous glucose monitoring and those using self-monitoring of blood glucose.

Materials and Methods: This descriptive and cross-sectional study was conducted with 289 caregivers of children with Type 1 Diabetes Mellitus. The data were collected online between October 2024 and January 2025 using a sociodemographic data collection form, the Health Perception Scale, Zarit Caregiver Burden Scale, and the Short Form of the Health Literacy Scale. The data analysis was conducted using the SPSS 27 software and included descriptive statistics (frequency, percentage, mean, and standard deviation), Pearson correlation, regression analysis, and mediation testing. A significance level of p<0.05 was considered statistically significant.

Results: It was found that children using self-monitoring of blood glucose had higher HbA1c levels compared to those using continuous glucose monitoring. The findings indicated that health literacy played a mediating role in the relationship between caregiver burden and health perception among caregivers of children using continuous glucose monitoring, whereas no such effect was observed among caregivers of children using self-monitoring of blood glucose. Additionally, caregivers of children using continuous glucose monitoring reported lower caregiver burden and better glycemic control.

Conclusions: Health literacy was identified as a significant factor associated with reduced caregiver burden in the continuous glucose monitoring group. Interventions aimed at enhancing health literacy, particularly among caregivers of children using self-monitoring of blood glucose, may help promote more favorable outcomes in diabetes care.

Keywords

Acknowledgements: We would like to express our sincere gratitude to the caregivers who participated in this study for their valuable time, dedication, and contributions to this research.


Availability of data and materials: The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.


Conflicts of interest: The authors declare that they have no conflicts of interest.


Consent for publication: Not applicable.


Ethics approval and consent to participate: Prior to data collection, ethical approval was obtained from the Ankara Yıldırım Beyazıt University Health Sciences Ethics Committee (Date: July 1, 2024, Meeting No: 06-803) and institutional permission was granted by the Black Sea Diabetes Association. During the data collection process, written and verbal informed consent was obtained from caregivers for participation in the study. Additionally, email permission was secured from the authors for the use of the scales in the research. The study was conducted in accordance with the principles of the Declaration of Helsinki.

 

Funding: No funding was received for this research.


Authors' Contribution: Conceptualization: TB, Data curation: TB, MK, Formal analysis: TB, DU, EK, Funding acquisition: None, Investigation: TB, DU, EK, Methodology: TB, Project administration: TB, Resources: TB, DU, EK, Software: TB, DU, EK, Supervision: TB, Validation: TB, Visualization: TB, Writing – original draft: TB, DU, EK.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Available Online from 25 August 2025

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