The effect of solution-focused social work intervention on the adaptation of families with children with type-1 diabetes to the disease

Type 1 diabetes is a chronic disease and is usually diagnosed in childhood. Management of the disease is complex and takes a lifetime. Especially in childhood, the inability of the child to manage diabetes on her/his own necessitates the active role of the family in the treatment process. Not only do Type 1 diabetes and its management affect the child but they also affect the family psychologically, socially and economically. This study, which aims to determine whether social work intervention with groups based on a solution-focused approach affects the adaptation of families with children with type 1 diabetes to the disease, was designed according to a convergent parallel design, which is a mixed research method in which quantitative and qualitative methods are used together. In the first stage of the study, a general screening was conducted with 377 parents in order to reach a general opinion about the perceived severity of the disease, family functionality and the effect of diabetes on the family among parents caring for a child with type 1 diabetes. The data collection tools of the first stage of the study are the Sociodemographic Information Form, the Diabetes Impact on the Family Scale (DAES), the Subjective Perceptions of the Disease Mother/Father Form (SPD-A/B) and the Family APGAR (FAP) Scale. When the general screening findings were evaluated, it was found that diabetes had the greatest negative impact on the family economically, the perceived severity of the disease by parents was quite high, and the level of satisfaction with family functionality was high. After describing the general situation of families with children with type 1 diabetes, the second phase of the research was started. In the second stage, a study based on a single-group pretest-posttest model was conducted. In this context, a total of 8 sessions were held once a week with eight parents within the scope of social service intervention in groups based on a solution-focused approach. At this stage, group sessions and Semi-Structured Interview Form were used as data collection tools in addition to the data collection tools used in the first part of the research. In order to analyze the quantitative data collected in the social work intervention with groups based on the solution-focused approach, Kruskall Wallis H test, Mann Whitney U test, Wilcoxon Signed Rank Test and Spearman Correlation analysis were used to examine the relationships between the scale scores. Qualitative data obtained from a total of 8 group sessions conducted within the scope of the research and the semi-structured interview form applied to determine the effectiveness of the intervention were deciphered. The obtained data were analyzed with the thematic analysis technique, which is among the qualitative data analysis techniques. According to the pretest-posttest measurements, the negative impact of diabetes on the family and the perceived severity of the disease differed positively in a statistically significant way in the parents in the experimental group. Additionally, parents' satisfaction with family functioning increased statistically significantly. As a result of the analysis of the qualitative data obtained during the group work sessions, 6 themes were reached: "purpose of participating in group work, miracle question, developing coping skills, exceptions, developing positive behavior and nightmare question". As a result of the analysis of the qualitative data obtained from the semi-structured interview form, 4 themes were reached: "the effect of group work on the family relationship, the effect on the parent's ability to cope with diabetes, the effect on the child's ability to cope with diabetes, and the effect on the parent/child relationship". As a result of thematic analyses, it was determined that the parents who participated in the group study developed solution-focused thinking and positive behavior development skills and experienced change and transformation in line with the purpose of the intervention, and it was concluded that these findings supported the quantitative findings. The findings revealed that social work intervention with groups based on a solution-focused approach was effective on the adaptation of families of children with type 1 diabetes to the disease. Key Words: Type 1 diabetes, Adaptation to illness, Solution focused approach, Solution focused therapy, Social work intervention with groups, Medical social work