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Caregivers of children living with type 1 diabetes (T1D) face multiple challenges that significantly impact their mental health and quality of life. The well-being of caregivers directly affects the management of the child's condition. The Adhera Caring Digital Program (ACDP) is a comprehensive, digitally delivered program, designed to support family caregivers in enhancing self-management and well-being. This study aims to assess how the ACDP influences caregivers' mood, emotional well-being, and health-related quality of life within the context of T1D. This study aimed to evaluate the impact of ACDP on caregivers' psychological well-being and caregiving outcomes. This was a two-step, prospective, mixed methods study targeting caregivers of children living with T1D who were under the care of a pediatric endocrinologist at Miguel Servet Children's University Hospital in Zaragoza, Spain. In substudy 1 (SS1), qualitative and quantitative data were collected to optimize the ACDP. In substudy 2 (SS2), caregivers used the optimized ACDP for three months. Psychometric assessments were conducted at baseline and follow-up to evaluate positive mood states, general well-being, self-efficacy, and lifestyle behaviors. This paper focuses on SS2. Ninety caregivers participated in SS2. Positive affect significantly increased (P<.001), and negative affect decreased (P<.001) on the Positive and Negative Affect Schedule (PANAS). Depression, anxiety, and stress scores were reduced (P<.001) on the Depression, Anxiety and Stress Scale-21 Items (DASS-21). General well-being, measured by the Mental Health Continuum-Short Form (MHC-SF) and self-efficacy, assessed using General Self-Efficacy Scale (GSE), improved significantly (P<.001). Health-related quality of life (HrQoL) scores and Mediterranean Diet Quality Index scores increased modestly (P=.03, and P=.04, respectively). The ACDP intervention improved caregivers' psychological well-being and self-efficacy. These findings highlight the potential of digital solutions to support caregiver mental health and positively influence diabetes management. Future research should explore long-term outcomes and scalability.

Background Metabolic control and psychological management of paediatric type 1 diabetes mellitus (T1DM) can be challenging over time. Development of an instrument to assess the youth-reported burden could aid in preventing T1DM-associated diseases. Methods The aim of this study was to translate and validate the Spanish version of the Problem Area in Diabetes Survey–Pediatric version (PAID-Peds). A multicentre, cross-sectional translation and linguistic validation study was performed on a sample of 30 participants aged 8–17 years with a minimum 1-year history of T1DM diagnosed at the Miguel Servet University Hospital in Zaragoza (Aragon, Spain), Ramón y Cajal University Clinical Hospital in Madrid (Spain), and Sant Joan de Déu Hospital in Barcelona (Catalonia, Spain). The qualitative validation consisted of translation into Spanish and back-translation into English of the Paid-Peds survey and subsequent administration to the sample population. Data were gathered on parameters related to sociodemographic characteristics and metabolic control. Validity, feasibility, and test-retest reliability were evaluated. Internal consistency was determined using Cronbach’s alpha coefficient, test-retest reliability by means of interclass correlation, and paired samples using the Wilcoxon W-test. The study was approved by the ethics and research committees at each participating centre. Results The study assessed 30 children (46.7% female) with an average age of 13.33 ± 2.98 years; mean age at onset was 5.70 ± 3.62 years, and the mean disease duration was 7.63 ± 4.36 years. The mean score on the PAID-Peds survey was 42.88 ± 17.85. Cronbach’s alpha coefficient was 0.90. Test-retest reliability measured by interclass correlation coefficient was 0.8 (95% CI: 0.63–0.90). No significant differences in total scores were found between test and retest (Wilcoxon W-test: 289; p = 0.051). Conclusions The Spanish version of the PAID-Peds survey is a feasible, valid, and reliable instrument to assess the youth-perceived burden of T1DM.

Aim The metabolic and psychological management of paediatric type 1 diabetes mellitus (T1DM) can be challenging over time given that T1DM may cause a negative emotional burden and, consequently, result in poor metabolic control of the disease. The objectives of this study are to translate the Problem Area in Diabetes Survey–Pediatric version (PAID‐Peds) into Spanish, adapt it culturally and validate it. Design Multicenter cross sectional study. Methods 636 patients aged 8–17 years, diagnosed with T1DM, under treatment with insulin and follow‐up at the Miguel Servet University Hospital in Zaragoza (Aragón, Spain), the Ramón y Cajal University Clinical Hospital in Madrid (Spain) and at the Sant Joan de Déu Hospital in Barcelona (Catalonia, Spain) between 1 January 2023 and 31 December 2024 will be included. This study will consist of two phases: (1) Translation and cultural adaptation of the original PAID‐Peds® survey into Spanish following eight steps; (2) Validation of the Spanish version of the PAIS‐Peds® survey. The statistical analysis will be performed using Jamovi® 2.1.23. The reliability or internal consistency will be calculated using Cronbach's alpha index (considering an index higher than 0.8 to be good) and the test–retest will be evaluated using the intraclass correlation coefficient. For validity, confirmatory factor analysis will be calculated. This study has been approved by the ethics and research committees at each centre. Results The translation and validation into Spanish language of the Problem Area in Diabetes Survey‐Pediatric version will be feasible, valid and reliable to detecting the youth‐perceived burden of T1DM. Therapeutic education in diabetes—recommended by the WHO and the Diabetes Education Study Group—has shown encouraging results in glycaemia and psychosocial and behavioural factors in T1DM.

Background: Type 1 diabetes mellitus (T1DM) in pediatric patients often leads to emotional distress, impacting self-management. The PAID-Peds survey measures diabetes-related emotional burden but lacks a validated Spanish version. This study aimed to validate the Spanish PAID-Peds survey in children and adolescents with T1DM and correlate it with diabetic metabolic control parameters. Methods: A cross-sectional study was conducted from October 2022 to December 2023, recruiting 636 patients aged 8–17 years from three Spanish hospitals. Psychometric properties were assessed using Cronbach’s alpha for reliability and confirmatory factor analysis for construct validity. Associations between PAID-Peds scores and clinical measures, such as HbA1c, were examined. Results: The final sample consisted of 538 participants (84.59% response rate). The PAID-Peds survey showed high internal consistency (Cronbach’s alpha = 0.90). The confirmatory factor analysis indicated a satisfactory model fit (χ2 = 812.28, p < 0.001; RMSEA = 0.08). Weak correlations were found between PAID-Peds scores and HbA1c (r = 0.14, p < 0.001). Conclusions: The Spanish PAID-Peds survey is a reliable tool for assessing emotional burden in pediatric T1DM patients. Integrating it into clinical practice may improve early identification of emotional distress, aiding in better diabetes management. Further research should explore its application over time and in intervention studies.