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Elizalde A, Hammer D, Su Y, Prasun MA. Increasing teachers' confidence during health emergencies: A hands-on quality improvement program led by the school nurse. J Pediatr Nurs 2024; 77:e263-e269. [PMID: 38679506 DOI: 10.1016/j.pedn.2024.04.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 05/01/2024]
Abstract
INTRODUCTION One in four school-age children has a chronic health condition, with approximately 6% of them having multiple chronic health conditions. These students are at an elevated risk of individual health emergencies during school hours. While teachers receive online training to assist in these emergencies, they lack practicing with rescue medications. METHODS We developed a Quality Improvement (QI) program that had a) a live presentation; b) a hands-on workshop to practice using rescue medications for allergies, asthma, seizures, and diabetes; c) fliers with first-aid guidelines; and d) a web-based reference toolkit. Teachers' confidence and knowledge were measured using the Learning Self-Efficacy Scale and a knowledge questionnaire with a pre- and post-intervention survey. We also assessed their clinical skills using the rescue medications. RESULTS 129 teachers took part in this QI program. We collected 95 pre- and 81 post-surveys, with 47 matched. We saw statistically significant increases in confidence, as well as in the individual cognitive, affective, and psychomotor domains. Teachers also increased their overall knowledge. Collaterally, other district-wide improvements developed. CONCLUSION This evidence-based, hands-on QI program provided teachers the opportunity to put into practice clinical skills, increasing their confidence to help students when experiencing an individual health emergency. Furthermore, changes beyond the primary goal of this QI program were implemented, highlighting the lead role of the registered nurse as the public health advocate. IMPLICATION TO PRACTICE Laypeople benefit from hands-on training to learn clinical skills. This program serves as a basis for improving health emergencies preparedness in schools.
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Affiliation(s)
- Analía Elizalde
- Illinois State University, Mennonite College of Nursing, Normal, IL, United States of America.
| | - Denise Hammer
- Illinois State University, Mennonite College of Nursing, Normal, IL, United States of America; Mennonite College of Nursing, Illinois State University, Edwards Hall, EDW 211, Normal, IL, United States of America.
| | - Yan Su
- College of Nursing & Health Sciences, University of Massachusetts, 285 Old Westport Road, Modular Unit #5 005, Dartmouth, MA 02747-2300, United States of America.
| | - Marilyn A Prasun
- Illinois State University, Mennonite College of Nursing, Normal, IL, United States of America; Mennonite College of Nursing, Illinois State University, Edwards Hall, EDW 111B, Normal, IL, United States of America.
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Bassi M, Scalas M, Spacco G, Perasso V, Franzone D, Strati MF, Dufour F, Lionetti B, Rizza F, Parodi S, d’Annunzio G, Minuto N. Management of Type 1 Diabetes in a school setting: effectiveness of an online training program for school staff. Front Public Health 2024; 11:1228975. [PMID: 38239792 PMCID: PMC10794362 DOI: 10.3389/fpubh.2023.1228975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 12/04/2023] [Indexed: 01/22/2024] Open
Abstract
Background and aims Since Type 1 Diabetes (T1D) onset usually occurs at a young age, a relevant number of affected people attend school for most of their time; it is necessary that school personnel receive appropriate education and training. We aimed to evaluate the effectiveness of the online training program offered by IRCCS Istituto Giannina Gaslini during and after COVID-19 pandemic. Methods The Institute's Diabetes team offered an online training program to school staff of the Region during COVID-19 pandemic. A validated questionnaire was proposed to all the schools in which training meetings were held in the previous 2 years (2020-2021 and 2021-2022). The questionnaire consisted of four sections: Section 1 (Socio-demographical data), Section 2 (Theoretical knowledge on T1D), Section 3 (Confidence in handling T1D), and Section 4 (Practical skills and Glucagon Administration). To evaluate the effectiveness of the online training program, the answers between participants (Group A) and non-participants (Group B) were then compared. Results 225 subjects from 19 schools participated in the survey. People who participated to the training (Group A, n = 53) demonstrated better T1D theoretical knowledge compared to non-participants (Group B, n = 154; p < 0.001). Group A revealed to feel more confident in the management of children with T1D during scholastic (p = 0.006) and extra-scholastic activities (p = 0.01), in supporting the children in the administration of insulin (p < 0.001) and in recognizing hypoglycaemia (p = 0.006). Moreover, results confirmed good levels of confidence among scholastic personnel who participated in the training of administration of glucagon in case of severe hypoglycaemia. Conclusion School staff who took part in the online training program on management of T1D showed better theoretical knowledge and better confidence in the management of daily needs and possible emergencies of students with T1D. It appears essential to offer educational programs on T1D for school staff by implementing the use of technological tools to reach a wider population. Moreover, it is advisable to offer a more practical approach, involving educational nurses.
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Affiliation(s)
- Marta Bassi
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Marta Scalas
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Giordano Spacco
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Viola Perasso
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Daniele Franzone
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Marina Francesca Strati
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Francesca Dufour
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Barbara Lionetti
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Francesca Rizza
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Stefano Parodi
- Epidemiology and Biostatistics Unit, Scientific Directorate, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Giuseppe d’Annunzio
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Nicola Minuto
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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3
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March CA, Hill A, Kazmerski TM, Siminerio L, Switzer G, Miller E, Libman I. School Nurse Confidence with Diabetes Devices in Relation to Diabetes Knowledge and Prior Training: A Study of Convergent Validity. Pediatr Diabetes 2023; 2023:2162900. [PMID: 37929232 PMCID: PMC10624001 DOI: 10.1155/2023/2162900] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Objective The Diabetes Device Confidence Scale (DDCS) is a new scale designed to evaluate school nurse confidence with diabetes devices. We hypothesized that DDCS score would be associated with related constructs of school nurse diabetes knowledge, experience, and training. Research Design and Methods In a cross-sectional study, we co-administered the DDCS and Diabetes Knowledge Test 2 (DKT2) questionnaires to school nurses in Pennsylvania. We summarized DDCS scores (range 1-5) descriptively. We evaluated the relationship between DKT2 percent score and DDCS mean score with the Spearman correlation coefficient. Simple linear regression examined school nurse characteristics as predictors of DDCS score. Results A total of 271 completed surveys were received. Mean DDCS score was 3.16±0.94, indicating moderate confidence with devices overall. School nurses frequently reported low confidence in items representing specific skills, including suspending insulin delivery (40%), giving a manual bolus (42%), knowing when to calibrate a continuous glucose monitor (48%), changing an insulin pump site (54%), and setting a temporary basal rate (58%). Mean DKT2 score was 89.5±0.1%, which was weakly but not significantly correlated with DDCS score (r=0.12, p=0.06). Formal device training (p<0.001), assisting ≥5 students with diabetes devices in the past 5 years (p<0.01), and a student caseload between 1000-1500 students (p<0.001) were associated with higher mean DDCS score. Conclusions DDCS score is related to prior training and experience, providing evidence for the scale's convergent validity. The DDCS may be a useful tool for assessing school nurse readiness to use devices and identify areas to enhance knowledge and practical skills.
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Affiliation(s)
- Christine A March
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA
- Division of Pediatric Endocrinology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Amber Hill
- University of Pittsburgh School of Medicine, Pittsburgh, PA
- Department of Pediatrics, Michigan Medicine, Ann Arbor, MI
| | - Traci M Kazmerski
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Linda Siminerio
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Galen Switzer
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA
| | - Elizabeth Miller
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA
| | - Ingrid Libman
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA
- Division of Pediatric Endocrinology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
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Uhm JY, Choi MY. School Nurse-Parent Partnership in School Health Care for Children with Type 1 Diabetes: A Hybrid Method Concept Analysis. Asian Nurs Res (Korean Soc Nurs Sci) 2022; 16:282-291. [PMID: 36375806 DOI: 10.1016/j.anr.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Ju-Yeon Uhm
- Department of Nursing, Pukyong National University, Republic of Korea
| | - Mi-Young Choi
- Department of Nursing Science, Chungbuk National University, Republic of Korea.
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Lawrence SE, Albanese-O'Neill A, Besançon S, Black T, Bratina N, Chaney D, Cogen FR, Cummings EA, Moreau E, Pierce JS, Richmond E, Mahmud FH. ISPAD Clinical Practice Consensus Guidelines 2022: Management and support of children and adolescents with diabetes in school. Pediatr Diabetes 2022; 23:1478-1495. [PMID: 36537526 DOI: 10.1111/pedi.13432] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 10/08/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Sarah E Lawrence
- Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | | | | | - Taryn Black
- Strategy Division, Diabetes Australia, Brisbane, Queensland, Australia
| | - Nataša Bratina
- Department of Endocrinology, Diabetes and Metabolism, UMC, University Children's Hospital, Ljubljana, Slovenia
| | - David Chaney
- Local Impact, Operations Directorate, Diabetes UK, London, UK
| | - Fran R Cogen
- Division of Endocrinology and Diabetes, Children's National Hospital, Washington, DC, USA
| | - Elizabeth A Cummings
- Department of Pediatrics, Dalhousie University, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Elizabeth Moreau
- Department of Communications & Knowledge Translation, Canadian Paediatric Society, Ottawa, Ontario, Canada
| | - Jessica S Pierce
- Center for Healthcare Delivery Science, Nemours Children's Health, Orlando, Florida, USA
| | - Erick Richmond
- Department of Pediatrics, National Children's Hospital, San José, Costa Rica
| | - Farid H Mahmud
- Department of Pediatrics, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada
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Demirtaş A, Aykanat Girgin B, Güven A, Kırmızıbekmez H. Psychometric Properties of the Turkish Version of the Diabetes Strengths and Resilience Measure for Adolescents with Type 1 Diabetes. J Clin Res Pediatr Endocrinol 2022; 14:324-333. [PMID: 35633640 PMCID: PMC9422910 DOI: 10.4274/jcrpe.galenos.2022.2022-2-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/23/2022] [Indexed: 12/01/2022] Open
Abstract
Objective Resilience in diabetes refers to the capacity overcome diabetes-related challenges to achieve favorable psychosocial and health outcomes. Despite the known benefits of resilience in adolescents with type 1 diabetes mellitus (T1DM), there tends to be more emphasis on risk factors in research and practice. This study evaluated the psychometric properties of the Diabetes Strengths and Resilience Measure for Adolescents with Type 1 Diabetes (DSTAR-Teen) in Turkey. Methods This descriptive, methodological study was conducted between October 2020 and May 2021. The Turkish DSTAR-Teen was administered to 120 adolescents with T1DM, and the data were evaluated using Cronbach’s alpha coefficients, factor analyses, test-retest correlation, and item-total score correlations. Results The Turkish DSTAR-Teen has 12 items in two factors that explained 50.64% of the total variance. Confirmatory factor analysis revealed goodness-of-fit and comparative fit indices of 0.92 and 0.95, respectively. The total Cronbach’s alpha value of the scale was 0.85. Item-total score correlations ranged from 0.49 to 0.74 (p<0.001). Conclusion Our analyses showed that the Turkish DSTAR-Teen is a valid and reliable instrument in Turkish adolescents with T1DM. The Turkish DSTAR-Teen can be used to evaluate strengths and resilience associated with diabetes management in adolescents with T1DM in Turkey.
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Affiliation(s)
- Aslı Demirtaş
- Zeynep Kamil Maternity and Children Diseases Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Burcu Aykanat Girgin
- University of Health Sciences Turkey, Hamidiye Faculty of Nursing, Department of Pediatric Nursing, İstanbul, Turkey
| | - Ayla Güven
- Zeynep Kamil Maternity and Children Diseases Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Heves Kırmızıbekmez
- İstanbul Ümraniye Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
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7
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Gardener L, Desha L, Bourke-Taylor H, Ziviani J. Responsibility sharing for adolescents with type 1 diabetes: A scoping review. Chronic Illn 2022; 18:6-21. [PMID: 32998528 DOI: 10.1177/1742395320959406] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The term 'Responsibility Sharing', albeit poorly defined, has emerged from the diabetes literature, to describe a distinct mechanism for comprehensively managing the characteristic shift in responsibility that underpins the transition to self-management for adolescents. METHODS A scoping review, following the PRISMA-ScR guidelines, distilled the literature from seven databases to answer the questions: What is responsibility sharing? Who are the key stakeholders? What factors affect responsibility transaction? What are its recognized outcomes? How is responsibility shared? RESULTS Responsibility sharing is a transactional arrangement between youth and their caregiver/s that functions to repeatedly and flexibly apply ownership to the management of diabetes care tasks, across the course of adolescence. In the main, responsibility sharing was associated with better metabolic and/or psychosocial outcomes. Effective responsibility sharing was seen as being responsive to adolescent capacity and driven by autonomy supportive, sustained communication patterns that enable mutually agreeable responsibility assumption by all stakeholders. CONCLUSION Different perspectives on responsibility sharing for adolescents with Type 1 diabetes, and the lack of a universal definition, have led to discordance within the literature about its operationalization and measurement. This paper proposes a definition of responsibility sharing for future researchers to apply.
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Affiliation(s)
- Lisa Gardener
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Laura Desha
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Helen Bourke-Taylor
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University - Peninsula Campus, Frankston, Australia
| | - Jenny Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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8
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An R, Li D, Cole M, Park K, Lyon AR, White NH. Implementation of School Diabetes Care in the United States: A Scoping Review. J Sch Nurs 2022; 38:61-73. [PMID: 34184953 PMCID: PMC9924139 DOI: 10.1177/10598405211026328] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Diabetes management at school demands close collaboration of multiple stakeholders, including students with diabetes and parents, school nurses, teachers/staff, and local health care providers. This scoping review identified and synthesized evidence concerning factors that contributed to the quality and effectiveness of diabetes care implementation in U.S. K-12 schools. Forty-six studies met the eligibility criteria and were included. Five common factors emerged surrounding training and experiences, communications, parent engagement, resource allocations, and school environment. Complex interactions between multiple stakeholders jointly determined the quality of school diabetes care. A conceptual model was established to elucidate the complex interactions between multiple stakeholders and the relevant facilitators and barriers. Future research should improve sample representativeness, contrast school diabetes care practices to the national guidelines, and assess the impact of the social, economic, and political environment at federal, state, local/district levels on school diabetes care implementation.
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Affiliation(s)
- Ruopeng An
- Brown School, 7548Washington University, St. Louis, MO, USA
| | - Danyi Li
- Brown School, 7548Washington University, St. Louis, MO, USA
| | - Marjorie Cole
- Missouri Department of Health & Senior Services, Jefferson City, MO, USA
| | | | - Aaron R Lyon
- Department of Psychiatry and Behavioral Sciences, 7284University of Washington, Seattle, WA, USA
| | - Neil H White
- School of Medicine, Washington University, St. Louis, MO, USA
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March CA, Oyetoro R, Adams J, Rodriguez H, Albanese-O'Neill A. School Nurse Perspectives on Do-It-Yourself Automated Pancreas Systems in the School Setting. Diabetes Technol Ther 2021; 23:705-709. [PMID: 33900843 DOI: 10.1089/dia.2021.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Do-it-yourself (DIY) artificial pancreas systems (APSs) are gaining popularity among children with type 1 diabetes. Little is known about how school systems provide care for children who use DIY APSs, and available guidance for schools is limited. This study explored school staff perspectives on DIY APSs through a national survey of school nurses about their current practices, beliefs, and attitudes toward DIY APSs. Although one-quarter (23%) of school nurses reported experience with DIY APSs in school, nearly half (46%) had no prior knowledge of this new technology. The majority (82%) reported that children should be allowed to use DIY APSs in school, although there was less consensus about school nurse responsibilities with these devices. Qualitative responses added context regarding potential barriers, including the need for more informed guidelines and training and fears of liability. Future development of school guidelines for DIY APSs is necessary and should incorporate stakeholder perspectives.
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Affiliation(s)
- Christine A March
- Division of Pediatric Endocrinology and Diabetes, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rebecca Oyetoro
- Department of Pediatrics, University of Florida, Gainesville, Florida, USA
| | - Janey Adams
- Department of Pediatrics, University of Florida, Gainesville, Florida, USA
| | - Henry Rodriguez
- USF Diabetes and Endocrinology Center, University of South Florida, Tampa, Florida, USA
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Rising Holmström M, Söderberg S. The lived experiences of young people living with type 1 diabetes: A hermeneutic study. Nurs Open 2021; 9:2878-2886. [PMID: 34291593 PMCID: PMC9584464 DOI: 10.1002/nop2.995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/25/2021] [Accepted: 07/10/2021] [Indexed: 01/24/2023] Open
Abstract
Aims The aim of this hermeneutic study was to explore and elucidate the lived experiences of young people living with type 1 diabetes in terms of their everyday life and school in Sweden. Design A qualitative interview study with a hermeneutic approach inspired by Gadamer's thinking. Methods Interviews were conducted with a purposive sample of seven girls and three boys with type 1 diabetes between January and September 2017 and analysed with a hermeneutic method. Results Young peoples' everyday lives were transformed and re‐organized by their illness and they parodically live a double‐edged everyday life. To support young people's healthcare personnel, headmasters and teachers must understand this double‐edged situation.
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Affiliation(s)
| | - Siv Söderberg
- Department of Nursing Science, Mid Sweden University, Sundsvall, Sweden
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11
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Ribeiro LB, Pieper CM, Frederico GA, Gamba MA, Rosa ADS. A relação entre a mulher com diabetes e o seu corpo: o risco da diabulimia. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023] Open
Abstract
Resumo Objetivo compreender a relação que as mulheres com diabulimia têm com o corpo. Método pesquisa qualitativa, desenvolvida com o Método da História Oral Temática, com quatro mulheres entre 18 e 30 anos que autorreferiram diabulimia. Resultados a relação das mulheres com o seu corpo foi pautada pela pressão social de magreza feminina que distorce a autoimagem, gera insatisfação com o corpo e a diminuição da autoestima. A perda de peso é proporcionalmente associada ao aumento da aceitação social e justifica a utilização de métodos deletérios à saúde como a diminuição da dose ou a suspensão do uso de insulina. As narradoras demonstraram conhecer os riscos, mas admitiram repeti-la em determinados contextos. Considerações finais e implicações para a prática o desejo que as mulheres com Diabetes Mellitus têm de perder peso precisa ser incorporado às estratégias de cuidado com a atenção dos profissionais da saúde à subjetividade, atuando para reconhecer e prevenir os transtornos alimentares em mulheres com diabetes e minimizar a adoção de ações prejudiciais à saúde.
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Affiliation(s)
| | - Claudia Maurício Pieper
- Pontifícia Universidade Católica do Rio de Janeiro, Brasil; Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, Brasil
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Ayar D, Gürkan KP, Bektas M, Böber E, Abaci A. Psychometric properties of a Turkish version of the Collaborative Parent Involvement Scale for youths with type 1 diabetes. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-00868-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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March CA, Nanni M, Kazmerski TM, Siminerio LM, Miller E, Libman IM. Modern diabetes devices in the school setting: Perspectives from school nurses. Pediatr Diabetes 2020; 21:832-840. [PMID: 32249474 PMCID: PMC7682111 DOI: 10.1111/pedi.13015] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 03/25/2020] [Accepted: 03/31/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To explore the experiences, practices, and attitudes of school nurses related to modern diabetes devices (insulin pumps, continuous glucose monitors, and hybrid-closed loop systems). RESEARCH DESIGN AND METHODS Semistructured interviews were conducted with 40 public school nurses caring for children in elementary and middle schools. Developed with stakeholder input, the interview questions explored experiences working with devices and communicating with the health care system. Deidentified transcripts were analyzed through an iterative process of coding to identify major themes. RESULTS School nurses reported a range of educational backgrounds (58% undergraduate, 42% graduate), geographic settings (20% urban, 55% suburban, 25% rural), and years of experience (20% <5 years, 38%, 5-15 years, 42% >15 years). Four major themes emerged: (a) As devices become more common, school nurses must quickly develop new knowledge and skills yet have inconsistent training opportunities; (b) Enthusiasm for devices is tempered by concerns about implementation due to poor planning prior to the school year and potential disruptions by remote monitors; (c) Barriers exist to integrating devices into schools, including school/classroom policies, liability/privacy concerns, and variable staff engagement; and (d) Collaboration between school nurses and providers is limited; better communication may benefit children with diabetes. CONCLUSIONS Devices are increasingly used by school-aged children. School nurses appreciate device potential but share structural and individual-level challenges. Guiding policy is needed as the technology progressively becomes standard of care. Enhanced training and collaboration with diabetes providers may help to optimize school-based management for children in the modern era.
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Affiliation(s)
- Christine A. March
- Division of Pediatric Endocrinology and Diabetes, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michelle Nanni
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Traci M. Kazmerski
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Linda M. Siminerio
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ingrid M. Libman
- Division of Pediatric Endocrinology and Diabetes, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
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Madrigal MA, López M, Sánchez A, Cao MJ, Castro MJ, Jiménez JM. Type 1 Diabetes Mellitus in Pediatric Patients and Its Impact on Relationships in the Family Environment. Diabetes Metab Syndr Obes 2020; 13:4973-4980. [PMID: 33364801 PMCID: PMC7751600 DOI: 10.2147/dmso.s281949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/29/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of this study is to assess the impact of type 1 diabetes mellitus on family environment relationships, as well as the management and approach to this disease. PATIENTS AND METHODS One hundred one children, 52.47% male and 47.52% female, with an average age of 8.55 ± 4.01 years, diagnosis of type 1 diabetes mellitus. Quantitative cross-sectional descriptive study was conducted using the validated questionnaires "Modified Diabetes Quality of Life" and "Questionnaire for the assessment of psychological impact in parents/guardians of diabetic children". RESULTS Most of the children (70.3% versus 29.7%) identified diabetes as unpleasant or not fun. The ≤5-year-olds expressed that they felt concerned about the consequences of being diabetic (8.1% by age group), as opposed to the 10-year-olds who did not feel concerned (85.1% by age group), P <0.001. The family environment was affected in 98.1% (n=99) of the cases. CONCLUSION Self-care of type 1 diabetes mellitus in pediatric patients is a complex process that impacts the family environment and their relationship with their peers, especially for children under the age of 5. Fear, concern and insecurity were prevalent feelings in children suffering type 1 diabetes mellitus.
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Affiliation(s)
- Miguel Angel Madrigal
- Faculty of Nursing, Universidad de Valladolid, Valladolid, Spain
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - María López
- Faculty of Nursing, Universidad de Valladolid, Valladolid, Spain
- Correspondence: María LópezFaculty of Nursing, Universidad de Valladolid, Avda Ramón y Cajal, Nº 7, Valladolid, SpainTel +34 983184056 Email
| | - Alicia Sánchez
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - María José Cao
- Faculty of Nursing, Universidad de Valladolid, Valladolid, Spain
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Shimasaki S, Brunner Nii P, Davis L, Bishop E, Berget C, Perreault C, Thomas JFF. A School Nurse Application of the ECHO Model. J Sch Nurs 2019; 37:306-315. [PMID: 31303104 DOI: 10.1177/1059840519861748] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Type I diabetes (T1D) is one of the most common childhood diseases and Type 2 diabetes (T2D) is increasing at alarming rates. Given that children spend a great percentage of their time in school, this setting is a critical environment for models of care that lead to better management of this and other health conditions. The School Nurses Managing Diabetes Care ECHO was offered to Colorado school nurses to build their capacity in providing evidence-based management of T1D. The purpose of this effort was to (1) determine whether or not the model could be used as a tool of collaboration and dissemination for school nurses across Colorado and (2) assess the effectiveness of the "School Nurses Managing Diabetes Care" ECHO learning series. Post-series survey results demonstrated a 25% increase in self-efficacy ratings, moving learners from "average among my peers" toward "competent." Additionally, all respondents planned to make one or more practice changes to improve care for students with T1D. Expanding the use of the ECHO model to implement intensive management of children and youth with T1D is critically important as rates of this and other chronic conditions continue to increase.
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Affiliation(s)
- Suzuho Shimasaki
- ECHO Colorado, Aurora, CO, USA.,Colorado School of Public Health, Aurora, CO, USA
| | | | - Lisa Davis
- Children's Hospital Colorado, Aurora, CO, USA
| | - Erin Bishop
- ECHO Colorado, Aurora, CO, USA.,Colorado School of Public Health, Aurora, CO, USA
| | - Cari Berget
- Barbara Davis Center for Diabetes, University of Colorado, Boulder, CO, USA
| | | | - John F Fred Thomas
- ECHO Colorado, Aurora, CO, USA.,Colorado School of Public Health, Aurora, CO, USA.,Children's Hospital Colorado, Aurora, CO, USA.,School of Medicine, University of Colorado, Aurora, CO, USA
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