[Needs of schoolchildren with type 1 diabetes in Extremadura: Family perceptions]

School Nurse-Parent Partnership in School Health Care for Children with Type 1 Diabetes: A Hybrid Method Concept Analysis

PURPOSE

To define school nurse-parent partnerships in school health care for children with type 1 diabetes (T1D) and determine its attributes using a hybrid model.

METHODS

This method involves a three-phase process: theoretical, fieldwork, and analytical. A literature review was conducted during the theoretical phase. A literature search of articles from January 1991 to February 2020 was conducted using relevant electronic databases. Eighty-three articles that met the inclusion criteria were completely read. Fieldwork data were collected through individual interviews from February to July 2019 in South Korea. In the fieldwork phase, interviews were conducted individually with 22 mothers of students with T1D and 20 school nurses recruited by purposeful sampling. Inductive content analysis was conducted. The findings from the theoretical phase were integrated with those from the fieldwork phase, and the final concept was derived.

RESULTS

School nurse-parent partnership in school health care for children with T1D has been defined as an interactive process of maintaining a balanced responsibility and providing tailored care to meet needs by establishing trusting relationships and communicating transparently and openly. This analysis yielded four attributes: trusting relationships, transparent and open communication, balanced responsibility, and providing tailored care to meet needs-this entails providing nursing actions by advocating for students and performing a negotiated role together or individually for student and family.

CONCLUSION

The findings of this study add to the importance of an attribute of balancing responsibility for partnership in school health care. The results show that this partnership could contribute to the development of a scale, theory, and nursing intervention in school health care for children with T1D.

School practice and preparedness in caring for children with type 1 diabetes: A Saudi nationwide cross-sectional study

AIM

We aimed to identify gaps in school care and support required for students with type 1 diabetes mellitus (T1DM) in Saudi Arabia.

METHODS

We performed a cross-sectional nationwide study using self-administered surveys that targeted teachers and parents of students with T1DM in Saudi Arabia from August to December 2019.

RESULTS

We collected surveys from 632 parents and 983 teachers. Responses were received from all 13 regions in Saudi Arabia, with the majority representing governmental schools. Results showed that 172 students (27.3%) had no available help at school to perform blood glucose measurement, 178 students (28.3%) were left with no hypoglycemia treatment, 374 students (59.6%) took their insulin dose for breakfast at home, and 40.0 (6.4%) students omitted insulin. Overall, school admission refusal was reported by 73 students (11.7%). Students with no available help to manage their hypoglycemia or to inject insulin at school had a higher hemoglobin A1c and poorer academic performance.

CONCLUSION

Our study revealed a significant gap between schools' local practices and international recommendations, which impacted students' safety, diabetes control, and school achievement. Our study findings will support the creation of the Saudi T1DM school practice guidelines necessary to improve the care of students with T1DM.

Barriers to and Facilitators of School Health Care for Students with Chronic Disease as Perceived by Their Parents: A Mixed Systematic Review

Understanding parental perspectives through mixed systematic reviews is imperative for developing effective school health care for children and adolescents with chronic disease. A mixed systematic review was conducted to explore barriers to and facilitators of school health care for students with chronic disease as perceived by their parents. Four databases (2010-2020) were searched, following which critical appraisals were conducted to determine the validity of the selected studies using the Mixed Method Appraisal Tool, version 2018. Twenty articles were synthesized using the convergent integrated approach from the Joanna Briggs Institute's mixed method systematic review methodology. We examined 20 articles regarding parents' perceived barriers and facilitators and found views across four levels: intrapersonal, interpersonal, institutional, and public and policy. Parents perceived more barriers than facilitators. Barriers on the institutional level were the most frequently reported of all levels of barriers. These results suggest that multi-level school health interventions could be a valuable resource to facilitate effective school guidelines and public policies for students with chronic diseases.

Predicting Quality of Life among Mothers in an Online Health Community for Children with Type 1 Diabetes

Quality of life of parents of children with chronic disease is important for disease self-management. This study aimed to identify predictors of quality of life among mothers of children with type 1 diabetes. A cross-sectional study was conducted. A total of 208 mothers of children with type 1 diabetes were recruited from an online health community. Online health community collective empowerment and social support, diabetes self-efficacy, diabetes-related burden, and quality of life were measured. A multiple regression analysis was conducted to determine predictive factors for quality of life. Multiple regression analysis showed that diabetes-related burden and the child’s age were predictors of quality of life, and total variance explained by the model was 64.1% using two factors. In mothers of younger children, it is important to reduce the diabetes-related burden. Factors that increase the diabetes-related burden should be identified, and strategies to reduce the diabetes-related burden must be established.

Teachers' Perspectives on Children With Type 1 Diabetes in German Kindergartens and Schools

The number of children with type 1 diabetes is rising, and these children must manage their diabetes during the day while in kindergarten or school. A total of 678 German kindergarten and school teachers (89% female) attended a structured training program for supporting children with type 1 diabetes in their diabetes management. The teachers completed questionnaires on their overall self-perception of their ability to handle diabetes and institutional factors supporting children with type 1 diabetes. Of these teachers, 251 who were currently working with a child with type 1 diabetes provided further insight into the experiences of children with diabetes in school and kindergarten. Teachers reported deficits in three areas: knowledge about diabetes and diabetes management, institutional support, and communication with parents and health professionals. On average, they gave themselves only fair ratings on both their knowledge about diabetes (3.60 ± 1.10 on a 5-point scale) and their ability to assist children with their diabetes management (3.67 ± 1.09). Whereas general information about supporting children with type 1 diabetes seemed to have been provided by almost half of the institutions (43%), specific school policies for sports (30%), extracurricular activities such as field trips (20%), or activities including sleepovers (16%) were rare. Poor communication between teachers, parents, and health professionals was reported. These deficits indicated by kindergarten and school teachers underline the importance of structured trainings and written policies on type 1 diabetes to improve the status of children with type 1 diabetes in school and kindergarten.