Psychosocial-Spiritual Experiences and Outcomes in Parents of Children with Type 1 Diabetes Mellitus from the Middle East and North Africa Region: A Systematic Review

Background. Type 1 diabetes mellitus (T1DM) is prevalent in the Middle East and North Africa (MENA). Parents of children or young people (CYP) with T1D experience shock, devastation, guilt, and societal blame, which impact both physical and psychosocial-spiritual aspects of their lives. However, our knowledge of the breadth of these psychosocial-spiritual experiences and how they are assessed is limited. Aim. (1) To examine the diabetes-specific psychosocial experiences of parents of CYP with T1D in the MENA region; (2) to assess the person-reported outcome measures (PROMs) that measure the psychosocial-spiritual outcomes in this population; and (3) to assess their reliability and validity. Materials and Methods. A systematic review methodology was implemented using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Ovid MEDLINE, Embase, APA PsycINFO, CINAHL, and Global Health databases were searched for relevant articles. A narrative synthesis approach was used for data analysis. Results. Twenty-three studies were included. We identified four categories: (1) spiritual functioning, parents' ability to accept and cope with their CYP's condition, (2) psychological functioning, parents' emotional distress due to insufficient diabetes-related knowledge and skills, (3) social functioning, describing financial challenges, social support experiences, and cultural concerns faced by parents, and (4) physical functioning, parents' struggle with sleep deprivation. Our results revealed methodological and conceptual limitations of the current tools measuring these experiences. Some of the limitations of this review are (1) heterogeneity in the tools captured perhaps some but not all domains of the parents' psychosocial experiences, (2) only English studies were included, as no Arabic studies were found. Conclusion. Our studied population experiences psychosocial-spiritual distress by managing the condition of their CYP and needs culturally specific psychosocial-spiritual support. Further studies are needed to develop a new measure to specifically assess the psychosocial-spiritual outcomes of this population.