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Owusu BA, Ofori-Boateng P, Forbes A, Doku DT. Knowledge of young people living with type 1 diabetes and their caregivers about its management. Nurs Open 2023; 10:2426-2438. [PMID: 36448367 PMCID: PMC10006669 DOI: 10.1002/nop2.1498] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 09/23/2022] [Accepted: 11/15/2022] [Indexed: 12/05/2022] Open
Abstract
AIMS AND OBJECTIVE We sought to investigate knowledge and skills of type 1 diabetes (T1D) management among young people living with the disease and their caregivers. Our aim is to provide baseline evidence to inform T1D self-management education for young people living with the disease and their caregivers. BACKGROUND Both local and international guidelines recommend ongoing T1D self-management education for people living with the disease. This is because T1D often develops among young people who rarely have the competencies to adequately manage their condition. However, the extent to which young people living with T1D and their caregivers can self-manage this chronic disease in a low-resource country like Ghana is unknown. METHODS Using a phenomenological study design, semi-structured interviews were conducted with 28 young people living with type 1 diabetes, 12 caregivers and 6 healthcare providers in southern Ghana. Data were collected at homes, hospitals and support group centres of participants via face-to-face interviews, photovoice and video-conferencing. The data were analysed thematically using QSR NVivo 11. RESULTS The young people living with T1D and their caregivers demonstrated knowledge and skills in the self-monitoring of blood glucose, and the treatment of hyperglycaemia. Areas of more marginal or lack of knowledge were concerning carbohydrate counting, severe hypoglycaemia and the management of intercurrent illnesses. Young persons living with T1D and their caregivers received their management information from healthcare and non-healthcare providers. Access to diabetes self-management education influenced T1D management knowledge and practices. CONCLUSION Young people living with type 1 diabetes and their caregivers possessed limited scope of knowledge on type 1 diabetes self-management. Multiple sources of T1D knowledge were found, some of which may not be helpful to patients. The knowledge gaps identified compromises transitional independence and self-management capacity. RELEVANCE TO CLINICAL PRACTICE It is important for clinicians and organizations that provide T1D education to provide diabetes self-management education also on managing hypoglycaemia, carbohydrate counting and managing T1D during intercurrent life events among young people living with T1D. NO PATIENT OR PUBLIC CONTRIBUTION Patients and their caregivers were interviewed as research participants. They did not conceptualize, analyse, interpret or prepare the manuscript.
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Affiliation(s)
| | - Prince Ofori-Boateng
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.,Cape Coast Teaching Hospital, Central Region, Cape Coast, Ghana
| | - Angus Forbes
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, London, UK
| | - David Teye Doku
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
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Sparapani VDC, Fels S, Kamal N, Ortiz La Banca R, Nascimento LC. A Video Game for Brazilian T1D Children about Knowledge of Disease and Self-care: A Methodological Study. J Diabetes Sci Technol 2022; 16:1444-1450. [PMID: 34044626 PMCID: PMC9631520 DOI: 10.1177/19322968211017555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Video games are interactive technologies able to support children in health promotion, behavior changes, and chronic disease self-management. The use of health behavior change determinants in video game design can increase its effectiveness. This study describes the process of designing a video game for Brazilian children with T1D clarifying the use of health behavior change determinants that may influence self-management behaviors. METHODS This was a methodological study based on health behavior change theories and the user-centered design approach. The results of a qualitative study conducted with children aged 7 to 12 years identified learning needs about knowledge on diabetes and self-care tasks which contribute to inappropriate behaviors. A Behavioral Diagnosis presented health behavior change determinants, capable of influencing children's learning needs and behaviors, that were considered to design The Heroes of Diabetes-the power of knowledge. RESULTS The results presented the process of designing 4 mini games with its description and theory foundation to reach children's lack of understanding about T1D, insulin's role, SMBG requirements, food groups and physical activity's role in glycemic control. Knowledge, goal settings, extrinsic and intrinsic motivation determinants were related with video games design features. CONCLUSIONS The findings support the use of health behavior change determinants into video game design as a guide to achieve children learning needs and that might influence self-management behaviors.
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Affiliation(s)
- Valéria de Cássia Sparapani
- Department of Nursing, Santa Catarina
Federal University, Florianopolis, SC, Brazil
- Valéria de Cássia Sparapani, PhD, RN,
Department of Nursing, Campus Universitário. Trindade, CEP 88040-970.
Florianópolis, SC 88040-900, Brazil.
| | - Sidney Fels
- Electrical and Computer Engineering,
University of British Columbia, Vancouver, BC, USA
| | - Noreen Kamal
- Department of Industrial Engineering,
Dalhousie University, Halifax, NS, Canada
| | - Rebecca Ortiz La Banca
- Section on Clinical, Behavioral and
Outcomes Research, Joslin Diabetes Center, Harvard Medical School, Boston, MA,
USA
| | - Lucila Castanheira Nascimento
- Department of Maternal-Infant and
Public Health Nursing, Ribeirao Preto College of Nursing, University of Sao Paulo,
WHO Collaborating Center for Nursing Research Development, SP, Brazil
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Neyra Marklund I, Rullander AC, Lindberg K, Ringnér A. Initial Education for Families with Children Diagnosed with Type 1 Diabetes: Consensus from Experts in a Delphi Study. Compr Child Adolesc Nurs 2022. [DOI: 10.1080/24694193.2022.2033351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Isabel Neyra Marklund
- Department of Nursing and Clinical Department of Paediatrics, Umeå University, Umeå, Sweden
| | - Anna-Clara Rullander
- Department of Nursing and Clinical Department of Paediatrics, Umeå University, Umeå, Sweden
| | - Karolina Lindberg
- Department of Nursing and Clinical Department of Paediatrics, Umeå University, Umeå, Sweden
| | - Anders Ringnér
- Department of Nursing and Clinical Department of Paediatrics, Umeå University, Umeå, Sweden
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Abstract
BACKGROUND Type 1 diabetes mellitus is the most common endocrine disease during infancy and adolescence. Diabetes causes serious coping problems during adolescence because of the need for continuous observation and because of diabetes-related complications. Thus, adolescents must adapt to and effectively manage their diabetes. PURPOSE This study was designed to determine the perceived barriers to home care in adolescents with Type 1 diabetes using the Health Promotion Model. METHODS Eighteen adolescents were selected from the qualified patients who applied to a diabetes polyclinic at a training and research hospital in western Turkey. Interview questions were created based on the Health Promotion Model. A phenomenological analysis of the data was conducted using the content analysis method. RESULTS The barriers that participants identified as negatively impacting their ability to manage their disease effectively were categorized into the three themes of "negative feelings about having diabetes," "personal barriers," and "environmental barriers." The barriers identified included school, friends, family, fear of complications, lack of information, and personal characteristics, among others. CONCLUSIONS/IMPLICATIONS FOR PRACTICE This qualitative study enables us to understand what patients feel because the participants explained their difficulties in managing their disease and in maintaining metabolic control. The findings provide an understanding of the subjective experiences of adolescent patients with diabetes. The findings of this study are intended to be helpful in restructuring training in clinics, raising diabetes awareness among teachers and students, socializing diabetic adolescents, and providing family-centered education.
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Dubovi I, Levy ST, Levy M, Zuckerman Levin N, Dagan E. Glycemic control in adolescents with type 1 diabetes: Are computerized simulations effective learning tools? Pediatr Diabetes 2020; 21:328-338. [PMID: 31885114 DOI: 10.1111/pedi.12974] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/21/2019] [Accepted: 12/16/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Type 1 diabetes mellitus (T1DM) in adolescent patients is often characterized by poor glycemic control. This study aimed at exploring the contribution of learning with computerized simulations to support: (a) mechanistic understanding of the biochemical processes related to diabetes; (b) diabetes self-management knowledge; and (c) glycemic control. We hypothesized that learning with such simulations might support adolescents in gaining a better understanding of the biochemical processes related to glucose regulation, and consequently improve their glycemic control. METHODS A prospective case-control study was conducted in 12- to 18-year-old adolescents with T1DM (n = 85) who were routinely treated at an outpatient diabetes clinic. While the control group (n = 45) received the routine face-to-face follow-up, the intervention group (n = 40) learned in addition with computerized simulations that were embedded in pedagogically supportive activities. Participants in both groups completed a set of questionnaires regarding sociodemographic characteristics, diabetes mechanistic reasoning and diabetes self-management. Clinical data and serum glycated hemoglobin (HbA1c) levels were gathered from medical records. All the data was collected at recruitment and 3 months later. RESULTS Analysis revealed improvement HbA1c levels in the intervention group (8.7% ± 1.7%) vs the controls (9.6% ± 1.6%) after 3 months (P < .05). Regression analysis showed that levels of diabetes mechanistic understanding and diabetes self-management knowledge, in addition to sociodemographic parameters, accounted for 31% of the HbA1c variance (P < .001). CONCLUSION These results suggest that learning with computerized simulations about biochemical processes can improve adolescents' adherence to medical recommendations and result in improved glycemic control. Implementing scientific learning into the hospital educational setting is discussed.
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Affiliation(s)
- Ilana Dubovi
- Nursing Department, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Sharona T Levy
- Department of Learning, Instruction and Teaching, University of Haifa, Haifa, Israel
| | - Milana Levy
- Pediatric Diabetes Clinic, Institute of Diabetes, Endocrinology and Metabolism, Rambam Health Care Campus, Haifa, Israel
| | - Nehama Zuckerman Levin
- Pediatric Diabetes Clinic, Institute of Diabetes, Endocrinology and Metabolism, Rambam Health Care Campus, Haifa, Israel.,Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Efrat Dagan
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel
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Dagan E, Dubovi I, Levy M, Zuckerman Levin N, Levy ST. Adherence to diabetes care: Knowledge of biochemical processes has a high impact on glycaemic control among adolescents with type 1 diabetes. J Adv Nurs 2019; 75:2701-2709. [PMID: 31197864 DOI: 10.1111/jan.14098] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 03/15/2019] [Accepted: 04/03/2019] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the impact of patients' understanding of biochemical processes involved in glucose regulation (causal-biochemical knowledge) and of diabetes self-management knowledge on adherence to treatment recommendations among adolescents with type 1 diabetes mellitus. DESIGN A cross-sectional study. METHODS Adolescents with type 1 diabetes mellitus, aged 12-18 years and able to read and write in Hebrew or in Arabic were eligible. Participants were recruited between August 2016 - January 2018 during routine visits to the Paediatric Diabetes Clinic; informed consent was obtained as customary. Patients completed sociodemographic, clinical and type 1 diabetes mellitus self-management and biochemical knowledge questionnaires. Adherence to treatment was assessed by patients' serum HbA1c levels, collected from medical records. RESULTS Ninety-seven patients participated in the study. Mean HbA1c levels were 9.2% (1.9%) and only 24 (24.7%) patients met the recommended HbA1c ≤ 7.5%. Lower HbA1c levels were strongly associated with higher family income, older age at diagnosis and with better type 1 diabetes mellitus self-management and causal-biochemical knowledge. A regression model showed that causal-biochemical knowledge contributed to the variance in HbA1c levels. Furthermore, causal-biochemical knowledge, but not self-management knowledge, was found to mediate the negative relationship between low family income and high HbA1c levels. CONCLUSIONS Causal-biochemical knowledge is a valuable component for the adherence to diabetes care and glycaemic control. IMPACT Our study suggests that causal knowledge is a valuable component that should be included in nursing and healthcare educational programmes for adolescents with type 1 diabetes mellitus.
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Affiliation(s)
- Efrat Dagan
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel
| | - Ilana Dubovi
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel.,Department of Education, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Milana Levy
- Pediatric Diabetes Clinic, Institute of Diabetes, Endocrinology and Metabolism, Rambam Health Care Campus, Haifa, Israel
| | - Nehama Zuckerman Levin
- Pediatric Diabetes Clinic, Institute of Diabetes, Endocrinology and Metabolism, Rambam Health Care Campus, Haifa, Israel.,Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Sharona T Levy
- Faculty of Education, University of Haifa, Haifa, Israel
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Kaneto LA, Damião EBC, Verissimo MDLÓR, Rossato LM, Toriyama ATM, Szylit R. Educational Workshop using games improves self-monitoring of blood glucose among children. Rev Lat Am Enfermagem 2018; 26:e3039. [PMID: 30379242 PMCID: PMC6206829 DOI: 10.1590/1518-8345.2400.3039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 05/27/2018] [Indexed: 11/22/2022] Open
Abstract
Objective: to evaluate the effectiveness of an educational workshop using games to
improve self-monitoring of blood glucose techniques for school children with
type 1 diabetes. Method: a quasi-experimental study was conducted with school children who attended
two outpatient clinics of a university hospital. Data were collected by
systematic observation of the self-monitoring of blood glucose (SMBG)
technique before and after the intervention. Data analysis consisted of
verifying changes while performing the technique, using pre- and
post-intervention compliance rates using statistical tests. The sample
consisted of 33 children. Each child participated in one session; 17
educational workshops were conducted in total. Results: we found an increased frequency of SMBG, changing lancets, rotation of
puncture sites, as well as calibration and periodic checking of date and
time of the glucose meter. Comparisons pre- and post-intervention showed
that the average number of steps in accordance with the SMBG technique
increased from 5.30 to 6.58, whereas the steps “Changing the lancet of the
lancing device”, “Pressing the puncture site” and “Disposing of materials
used in a needlestick container” showed statistically significant
differences. Conclusion: the educational workshop was effective, as it improved children’s performance
of the SBMG technique.
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Affiliation(s)
| | | | | | | | | | - Regina Szylit
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brazil
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Rankin D, Harden J, Barnard K, Bath L, Noyes K, Stephen J, Lawton J. Barriers and facilitators to taking on diabetes self-management tasks in pre-adolescent children with type 1 diabetes: a qualitative study. BMC Endocr Disord 2018; 18:71. [PMID: 30316299 PMCID: PMC6186043 DOI: 10.1186/s12902-018-0302-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 10/03/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND When children with type 1 diabetes approach adolescence, they are encouraged to become more involved in diabetes self-management. This study explored the challenges pre-adolescent children encounter when self-managing diabetes and the factors which motivate and enable them to take on new diabetes-related tasks. A key objective was to inform the support offered to pre-adolescent children. METHODS In-depth interviews using age-appropriate questioning with 24 children (aged 9-12 years) with type 1 diabetes. Data were analysed using an inductive, thematic approach. RESULTS Children reported several barriers to taking on self-management tasks. As well as seeking respite from managing diabetes, children described relying on their parents to: perform the complex maths involved in working out carbohydrate content in food; calculate insulin doses if they did not use a bolus advisor; and administer injections or insert a cannula in hard-to-reach locations. Children described being motivated to take on diabetes tasks in order to: minimise the pain experienced when others administered injections; alleviate the burden on their parents; and participate independently in activities with their peers. Several also discussed being motivated to take on diabetes-management responsibilities when they started secondary school. Children described being enabled to take on new responsibilities by using strategies which limited the need to perform complex maths. These included using labels on food packaging to determine carbohydrate contents, or choosing foods with carbohydrate values they could remember. Many children discussed using bolus advisors with pre-programmed ratios and entering carbohydrate on food labels or values provided by their parents to calculate insulin doses. Several also described using mobile phones to seek advice about carbohydrate contents in food. CONCLUSIONS Our findings highlight several barriers which deter children from taking on diabetes self-management tasks, motivators which encourage them to take on new responsibilities, and strategies and technologies which enable them to become more autonomous. To limit the need to perform complex maths, children may benefit from using bolus advisors provided they receive regular review from healthcare professionals to determine and adjust pre-programmed insulin-to-carbohydrate ratios. Education and support should be age-specific to reflect children's changing involvement in self-managing diabetes.
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Affiliation(s)
- David Rankin
- The Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG UK
| | - Jeni Harden
- The Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG UK
| | - Katharine Barnard
- BHR Ltd, 42 Kilmiston Drive, Portchester, Fareham, Hants, PO16 8EG and Faculty of Health & Social Science, Bournemouth University, Royal London House, Bournemouth, BH1 3LT UK
| | - Louise Bath
- Royal Hospital for Sick Children, Sciennes Road, Edinburgh, EH9 1LF UK
| | - Kathryn Noyes
- Royal Hospital for Sick Children, Sciennes Road, Edinburgh, EH9 1LF UK
| | - John Stephen
- Child Health Department, Borders General Hospital, Melrose, TD6 9BS UK
| | - Julia Lawton
- The Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG UK
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Biernatzki L, Kuske S, Genz J, Ritschel M, Stephan A, Bächle C, Droste S, Grobosch S, Ernstmann N, Chernyak N, Icks A. Information needs in people with diabetes mellitus: a systematic review. Syst Rev 2018; 7:27. [PMID: 29444711 PMCID: PMC5813383 DOI: 10.1186/s13643-018-0690-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 01/17/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The purpose of this study was to identify and analyse currently available knowledge on information needs of people with diabetes mellitus, also considering possible differences between subgroups and associated factors. METHODS Twelve databases including MEDLINE, EMBASE and the Cochrane Library were searched up until June 2015. Publications that addressed self-reported information needs of people with diabetes mellitus were included. Each study was assessed by using critical appraisal tools, e.g. from the UK National Institute for Health and Care Excellence. Extraction and content analysis were performed systematically. RESULTS In total, 1993 publications were identified and 26 were finally included. Nine main categories of information needs were identified, including 'treatment-process', 'course of disease', 'abnormalities of glucose metabolism' and 'diabetes through the life cycle'. Differences between patient subgroups, such as type of diabetes or age, were sparsely analysed. Some studies analysed associations between information needs and factors such as participation preferences or information seeking. They found, for example, that information needs on social support or life tasks were associated with information seeking in Internet forums. CONCLUSION Information needs in people with diabetes mellitus, appear to be high, yet poorly investigated. Research is needed regarding differences between diverse diabetes populations, including gender aspects or changes in information needs during the disease course. SYSTEMATIC REVIEW REGISTRATION The review protocol has been registered at Prospero ( CRD42015029610 ).
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Affiliation(s)
- Lisa Biernatzki
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Silke Kuske
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research, at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
| | - Jutta Genz
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research, at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
| | - Michaela Ritschel
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research, at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
| | - Astrid Stephan
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Christina Bächle
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research, at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
| | - Sigrid Droste
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Sandra Grobosch
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research, at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
| | - Nicole Ernstmann
- Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Nadja Chernyak
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research, at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
| | - Andrea Icks
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research, at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
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Pacheco APF, van de Sande-Lee S, Sandoval RDCB, Batista S, Marques JLB. Effects of a structured education program on glycemic control in type 1 diabetes. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2017; 61:534-541. [PMID: 28724054 PMCID: PMC10522068 DOI: 10.1590/2359-3997000000278] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 02/13/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Diabetes mellitus is associated with significant morbidity and mortality, and education is known to play a key role in managing this disease. This study addresses the effects of a structured education program (SEP) on self-care in subjects with type 1 diabetes mellitus (T1DM). The aim was to evaluate the effect of a SEP on glycemic control, knowledge, and skills associated with diabetes care in subjects with T1DM. SUBJECTS AND METHODS A total of 47 adults with T1DM were followed up for 20 months (32 participated in the SEP and 15 served as a control group). The SEP consisted of workshops, individualized care, 24-hour distant support, and a questionnaire assessing knowledge of diabetes care. Glycosylated hemoglobin (HbA1c) levels were measured before and after the SEP implementation. RESULTS Compared with pre-SEP levels, the mean HbA1c levels decreased by approximately 20% (21 mmol/mol) at 1 year, with a further 11% reduction (10 mmol/mol) observed 8 months later (p < 0.001). Knowledge about diabetes care increased by 37% between the pre-SEP and post-SEP questionnaires (p < 0.005). CONCLUSION Relevant improvements occurred after SEP activities. The sustained decrease in HbA1c levels and the overall increase in knowledge and confidence regarding diabetes care reinforce the importance, necessity, and positive outcomes of a SEP intervention in T1DM.
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Affiliation(s)
- Ana Paula F. Pacheco
- Centro de Ciências da SaúdeUniversidade Federal de Santa CatarinaFlorianópolisSCBrasilPrograma de Pós-Graduação em Ciências Médicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brasil
| | - Simone van de Sande-Lee
- Hospital UniversitárioUFSCFlorianópolisSCBrasilHospital Universitário, UFSC, Florianópolis, SC, Brasil
| | | | - Sônia Batista
- Hospital UniversitárioUFSCFlorianópolisSCBrasilHospital Universitário, UFSC, Florianópolis, SC, Brasil
| | - Jefferson L. B. Marques
- Centro de Ciências da SaúdeUniversidade Federal de Santa CatarinaFlorianópolisSCBrasilPrograma de Pós-Graduação em Ciências Médicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brasil
- Instituto de Engenharia BiomédicaDepartamento de Engenharia Elétrica e EletrônicaUFSCFlorianópolisSCBrasilInstituto de Engenharia Biomédica, Departamento de Engenharia Elétrica e Eletrônica, UFSC, Campus Universitário – Trindade, Florianópolis, SC, Brasil
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11
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Rising Holmström M, Häggström M, Audulv Å, Junehag L, Coyne I, Söderberg S. To integrate and manage diabetes in school: Youth’s experiences of living with Type 1 diabetes in relation to school – a qualitative study. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/20573316.2017.1375599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Marie Häggström
- Department of Nursing Science, Mid Sweden University, SE-851 70 Sundsvall, Sweden
| | - Åsa Audulv
- Department of Nursing Science, Mid Sweden University, SE-851 70 Sundsvall, Sweden
| | - Lena Junehag
- Department of Nursing Science, Mid Sweden University Sundsvall, SE-83125 Östersund, Sweden
| | - Imelda Coyne
- School of Nursing & Midwifery, Trinity College Dublin, 24 D’Olier street, Dublin 2, Ireland
| | - Siv Söderberg
- Department of Nursing Science, Mid Sweden University Sundsvall, SE-83125 Östersund, Sweden
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12
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Rankin D, Harden J, Jepson R, Lawton J. Children's experiences of managing Type 1 diabetes in everyday life: a thematic synthesis of qualitative studies. Diabet Med 2017; 34:1050-1060. [PMID: 28391607 DOI: 10.1111/dme.13362] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/05/2017] [Indexed: 12/18/2022]
Abstract
AIMS To explore the everyday experiences of children (aged ≤ 12 years) with Type 1 diabetes to identify factors that help or hinder diabetes self-management practices. METHODS Eight databases (Embase, Medline, CINAHL, Web of Science, PsychInfo, ASSIA, ERIC and ProQuest Dissertations) were searched in 2016 to identify qualitative studies exploring children's views about self-managing diabetes. Data were extracted, coded and analysed using thematic synthesis. RESULTS Eighteen studies from five countries were included in the review. Synthesis of studies' findings resulted in the identification of three overarching analytical themes. The first theme, 'Understandings of diabetes and involvement in self-management', outlines ways in which children understand diabetes and develop self-management responsibilities. The second theme, 'Disruption to life and getting on with it', reports children's frustrations at disruptions to everyday life when managing diabetes, and how attempts to appear normal to family and friends affect self-management practices. The third theme, 'Friends' support', describes how friends' reactions and responses to diabetes affect children's ability to appear normal and willingness to disclose information about diabetes, and support provided by 'informed friends', or peers with diabetes. CONCLUSIONS Although the synthesis has identified how children's everyday life experiences inform ways in which they undertake diabetes self-management, it was not possible to determine new ways to provide support. To help children optimise their glycaemic control, further work should be undertaken to identify their need for support and which takes into account the potential ways in which parents, friends and peers can offer assistance.
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Affiliation(s)
- D Rankin
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - J Harden
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - R Jepson
- The Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, UK
| | - J Lawton
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
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Abstract
Adults who have lived much of their life with type 1 diabetes have learned lessons that can benefit health care providers (HCPs), families, and young people who live with the condition. This study was undertaken to gain a better understanding of the challenges of growing up and living with type 1 diabetes from adults who have experienced those challenges and to recommend strategies for parents, caregivers, and HCPs who work with children or adolescents with type 1 diabetes. Thirty-five adults with type 1 diabetes participated in this qualitative study consisting of two in-depth interviews with each participant. Six themes emerged: 1) It's not who you are. 2) Don't let it limit you. 3) Get involved in diabetes support groups. 4) It's going to be OK. 5) Teach them; don't scare them. 6) Don't single kids out. Through hindsight and the more mature perspective of adulthood, study participants were able to share valuable insights that could inform the efforts of those who work with or care for younger people with type 1 diabetes.
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Affiliation(s)
| | - Tina Dyches
- Department of Counseling Psychology and Special Education, Brigham Young University, Provo, UT
| | - Susanne Olsen Roper
- College of Family, Home, and Social Sciences, Brigham Young University, Provo, UT
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Sparapani VDC, Fels S, Nascimento LC. The Value of Children's Voices for a Video Game Development in the Context of Type 1 Diabetes: Focus Group Study. JMIR Diabetes 2017; 2:e17. [PMID: 30291061 PMCID: PMC6238838 DOI: 10.2196/diabetes.7652] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 07/04/2017] [Accepted: 07/04/2017] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Children with type 1 diabetes mellitus (T1DM) face daily challenges performing self-care tasks, controlling symptoms, and dealing with psychosocial issues. The use of video games to improve health is a successful support for persons with chronic diseases, promoting adequate self-management through simulations of real life. Involving future users in the development of games is essential to generating innovative, creative, and effective programs. OBJECTIVE Our goal is to identify what children with T1DM need to know about their disease and their self-care tasks as well as their preferences in video games. METHODS Children with T1DM provided input about their learning needs, self-care tasks, and preferences in video games. Three categories were identified through qualitative content analysis: dealing with emotions and knowledge, practical skills and awareness, and game preferences. RESULTS Children expressed concerns about the difficulties of self-care, lack of knowledge about diabetes, and lack of awareness about the consequences of behaviors related to self-care, which contribute to inappropriate behaviors and significantly impact self-management of their disease. They expressed enthusiasm for a video game for children with diabetes that considered their needs and preferences. CONCLUSIONS Findings support the potential benefits when children's input is considered in game design. Consideration of customer needs and preferences is a powerful resource in the development of video games with enhanced learning experience.
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Affiliation(s)
- Valéria de Cássia Sparapani
- Ribeirao Preto College of Nursing, World Health Organization Collaborating Centre for Nursing Research Development, Department of Maternal-Infant and Public Health Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | - Sidney Fels
- Electrical and Computer Engineering, Department of Electrical and Computer Engineering, The University of British Columbia, Vancouver, BC, Canada
| | - Lucila Castanheira Nascimento
- Ribeirao Preto College of Nursing, World Health Organization Collaborating Centre for Nursing Research Development, Department of Maternal-Infant and Public Health Nursing, University of São Paulo, Ribeirão Preto, Brazil
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15
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Lindberg B, Söderberg S. Standing on their own feet: Experiences of young people living with Type 1 diabetes when entering adulthood — A qualitative study. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/20573316.2016.1170406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Birgitta Lindberg
- Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Siv Söderberg
- Department of Nursing Sciences, Mid Sweden University, Campus, Östersund, Sweden
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16
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Koller D, Khan N, Barrett S. Pediatric perspectives on diabetes self-care: a process of achieving acceptance. QUALITATIVE HEALTH RESEARCH 2015; 25:264-75. [PMID: 25267509 DOI: 10.1177/1049732314551057] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We conducted this qualitative study to explore children's and adolescents' perspectives about diabetes self-care, their knowledge of diabetes, and their emotions associated with having the disease. Drawing on the new sociological approach that acknowledges children's competence in discussing complex issues that concern them, we conducted individual interviews with a cross-sectional sample of 48 patients between the ages of 5 and 18 years. We recruited participants from a diabetes outpatient clinic within a large pediatric hospital in one of Canada's major urban centers. In this article, we present data from the following major themes: self-care, knowledge, and emotions. Through an in-depth analysis of these integrated themes, we offer validation that emotional support, along with disease education, provides supportive conditions for engaging in self-care and a process of acceptance.
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Affiliation(s)
| | - Noshin Khan
- Ryerson University, Toronto, Ontario, Canada
| | - Shaun Barrett
- The Hospital for Sick Children, Toronto, Ontario, Canada
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17
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Ekra EMR, Korsvold T, Gjengedal E. Characteristics of being hospitalized as a child with a new diagnosis of type 1 diabetes: a phenomenological study of children's past and present experiences. BMC Nurs 2015; 14:4. [PMID: 25606024 PMCID: PMC4299564 DOI: 10.1186/s12912-014-0051-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 12/22/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Our understanding of children and childhood has changed over the last few decades, which may have an impact on children's conditions in hospitals. Children's rights have been strengthened by the "Convention on the Rights of the Child" and ward regulations. The aim of this Norwegian study was to identify potential characteristics of children's lived experience of being hospitalized diagnosed with type 1 diabetes today and from a retrospective view in the period 1950-1980, despite the many obvious external changes. METHODS This study presents a further analysis of data from two previous phenomenological studies. The first had a retrospective perspective, and the second assumed a contemporary perspective. Twelve adults and nine children who had been hospitalized for newly diagnosed type 1 diabetes at the age of approximately 6-12 years old participated. The adults relayed narratives from their childhood memories through interviews, and the study with the children was designed as a combination of observations, in-depth interviews, and photographs. A hermeneutic phenomenological method was used in the analysis. RESULTS The analysis revealed a meaning structure that described a tension between vulnerability and agency in the experiences of being hospitalized as a child, both past and present. The experiences may further be characterized as alienation versus recognition and as passivity versus activity, relating to both the hospital environment and the illness. CONCLUSIONS To a greater extent than ever, children today tend to experience themselves as active and competent individuals who can manage their own illness. Previously, children seemed to experience themselves as more vulnerable and less competent in relationship to their environment and illness. Presently, as before, children appear to desire involvement in their illness; however, at the same time, they prefer to share responsibility with or hand over responsibility to adults. However, living with diabetes was and remains demanding, and it affects children's lifeworld. Balancing the children's vulnerability and agency seems to be the best way to care for children in hospitals. In this article, we thus argue for a lifeworld-led approach when caring for hospitalized children, paying attention to both their vulnerability and agency.
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Affiliation(s)
- Else Mari Ruberg Ekra
- />Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, Bergen, N-5018 Norway
- />Department of Health and Nursing Sciences, Faculty of Health and Sport Sciences, University of Agder, Jon Lilletuns vei 9, Grimstad, N-4898 Norway
| | - Tora Korsvold
- />Queen Maud University College of Early Childhood Education, Thrond Nergaards veg 7, Trondheim, N-7044 Norway
| | - Eva Gjengedal
- />Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, Bergen, N-5018 Norway
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18
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Noyes JP, Lowes L, Whitaker R, Allen D, Carter C, Edwards RT, Rycroft-Malone J, Sharp J, Edwards D, Spencer LH, Sylvestre Y, Yeo ST, Gregory JW. Developing and evaluating a child-centred intervention for diabetes medicine management using mixed methods and a multicentre randomised controlled trial. HEALTH SERVICES AND DELIVERY RESEARCH 2014. [DOI: 10.3310/hsdr02080] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
AimTo develop and evaluate an individually tailored age-appropriate diabetes diary and information pack for children and young people aged 6–18 years with type 1 diabetes to support decision-making and self-care with a specific focus on insulin management and blood glucose monitoring, compared with available resources in routine clinical practice.DesignFour-stage study following the Medical Research Council framework for designing and evaluating complex interventions. Stage 1: context – brief review of reviews and mixed-method systematic review; updating of database of children’s diabetes information; children’s diabetes information quality assessment and diabetes guideline analysis; and critical discourse analysis. Stage 2: intervention development – working with expert clinical advisory group; contextual qualitative interviews and focus groups with children and young people to ascertain their information preferences and self-care practices; ongoing consultation with children; development of intervention programme theory. Stage 3: randomised controlled trial (RCT) to evaluate the diabetes diaries and information packs in routine practice. Stage 4: process evaluation.FindingsThe RCT achieved 100% recruitment, was adequately powered and showed that the Evidence into Practice Information Counts (EPIC) packs and diabetes diaries were no more effective than receiving diabetes information in an ad hoc way. The cost per unit of producing the EPIC packs and diabetes diaries was low. Compared with treatment as usual information, the EPIC packs fulfilled all NHS policy imperatives that children and young people should receive high-quality, accurate and age-appropriate information about their condition, self-management and wider lifestyle and well-being issues. Diabetes guidelines recommend the use of a daily diabetes diary and EPIC diaries fill a gap in current provision. Irrespective of allocation, children and young people had a range of recorded glycated haemoglobin (HbA1c) levels, which showed that as a group their diabetes self-management would generally need to improve to achieve the HbA1clevels recommended in National Institute for Health and Care Excellence guidance. The process evaluation showed that promotion of the EPIC packs and diaries by diabetes professionals at randomisation did not happen as intended; the dominant ‘normalisation’ theory underpinning children’s diabetes information may be counterproductive; risk and long-term complications did not feature highly in children’s diabetes information; and children and young people engaged in risky behaviour and appeared not to care, and most did not use a diabetes diary or did not use the information to titrate their insulin as intended.LimitationsRecruitment of ‘hard to reach’ children and young people living away from their families was not successful. The findings are therefore more relevant to diabetes management within a family context.ConclusionsThe findings indicate a need to rethink context and the hierarchical relationships between children, young people, parents and diabetes professionals with regard to ‘partnership and participation’ in diabetes decision-making, self-care and self-management. Additional research, implementation strategies and service redesign are needed to translate available information into optimal self-management knowledge and subsequent optimal diabetes self-management action, including to better understand the disconnection between children’s diabetes texts and context; develop age-appropriate Apps/e-records for recording blood glucose measurements and insulin management; develop interventions to reduce risk-taking behaviour by children and young people in relation to their diabetes management; reconsider what could work to optimise children’s self-management of diabetes; understand how best to reorganise current diabetes services for children to optimise child-centred delivery of children’s diabetes information.Study registrationCurrent Controlled Trials ISRCTN17551624.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Jane P Noyes
- Centre for Health-Related Research, Bangor University, Bangor, UK
| | - Lesley Lowes
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Rhiannon Whitaker
- North Wales Organisation for Randomised Trials in Health (NWORTH), Bangor University, Bangor, UK
| | - Davina Allen
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Cynthia Carter
- Cardiff School of Journalism, Media and Cultural Studies, Cardiff University, Cardiff, UK
| | - Rhiannon T Edwards
- Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK
| | | | - Janice Sharp
- Media Resources Centre, University Hospital of Wales, Cardiff, UK
| | - Deborah Edwards
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | | | - Yvonne Sylvestre
- North Wales Organisation for Randomised Trials in Health (NWORTH), Bangor University, Bangor, UK
| | - Seow Tien Yeo
- Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK
| | - John W Gregory
- Department of Child Health, Wales School of Medicine, Cardiff University, Cardiff, UK
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Jaacks LM, Bell RA, Dabelea D, D'Agostino RB, Dolan LM, Imperatore G, Klingensmith G, Lawrence JM, Saydah S, Yi-Frazier J, Mayer-Davis EJ. Diabetes self-management education patterns in a US population-based cohort of youth with type 1 diabetes. THE DIABETES EDUCATOR 2014; 40:29-39. [PMID: 24248833 PMCID: PMC4076934 DOI: 10.1177/0145721713512156] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this study is to describe (1) the receipt of diabetes self-management education (DSME) in a large, diverse cohort of US youth with type 1 diabetes (T1DM), (2) the segregation of self-reported DSME variables into domains, and (3) the demographic and clinical characteristics of youth who receive DSME. METHODS Data are from the US population-based cohort SEARCH for Diabetes in Youth. A cross-sectional analysis was employed using data from 1273 youth <20 years of age at the time of diagnosis of T1DM. Clusters of 19 self-reported DSME variables were derived using factor analysis, and their associations with demographic and clinical characteristics were evaluated using polytomous logistic regression. RESULTS Nearly all participants reported receiving DSME content consistent with "survival skills" (eg, target blood glucose and what to do for low or high blood glucose), yet gaps in continuing education were identified (eg, fewer than half of the participants reported receiving specific medical nutrition therapy recommendations). Five DSME clusters were explored: receipt of specific MNT recommendations, receipt of diabetes information resources, receipt of clinic visit information, receipt of specific diabetes information, and met with educator or nutritionist. Factor scores were significantly associated with demographic and clinical characteristics, including race/ethnicity, socioeconomic status, and diabetes self-management practices. CONCLUSIONS Health care providers should work together to address reported gaps in DSME to improve patient care.
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Affiliation(s)
- Lindsay M Jaacks
- the Department of Nutrition, University of North Carolina, Chapel Hill, NC (Ms Jaacks, Dr Mayer-Davis)
| | - Ronny A Bell
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (Dr Bell)
| | - Dana Dabelea
- Department of Pediatrics and Barbara Davis Center, University of Colorado, Denver, CO (Dr Dabelea, Dr Klingensmith)
| | - Ralph B D'Agostino
- Department of Biostatistics, Wake Forest School of Medicine, Winston-Salem, NC (Dr D’Agostino)
| | - Lawrence M Dolan
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH (Dr Dolan)
| | | | - Georgeanna Klingensmith
- Department of Pediatrics and Barbara Davis Center, University of Colorado, Denver, CO (Dr Dabelea, Dr Klingensmith)
| | - Jean M Lawrence
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA (Dr Lawrence)
| | - Sharon Saydah
- Centers for Disease Control and Prevention, Atlanta, GA (Dr Imperatore, Dr Saydah)
| | | | - Elizabeth J Mayer-Davis
- the Department of Nutrition, University of North Carolina, Chapel Hill, NC (Ms Jaacks, Dr Mayer-Davis)
- Department of Medicine, University of North Carolina, Chapel Hill, NC (Dr Mayer-Davis)
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Ekim A, Ocakci AF. Perceptions of parents and children regarding asthma management responsibilities. J SPEC PEDIATR NURS 2013; 18:289-96. [PMID: 24094124 DOI: 10.1111/jspn.12037] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Revised: 04/28/2013] [Accepted: 04/29/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to examine perceptions of children and parents regarding shared responsibilities for asthma management. DESIGN AND METHODS The study included 72 children with asthma who were between the ages of 7 and 12 years and their parents. Asthma management responsibilities were assessed by the "Asthma Responsibility Questionnaire." RESULTS Disagreements occurred between parents and children on assuming responsibility. Children reported higher asthma management responsibility scores than reported by parents for them. PRACTICE IMPLICATIONS It is important that nurses provide education and counseling to both children and their families to ensure that children take responsibility for disease management.
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Affiliation(s)
- Ayfer Ekim
- Department of Pediatric Nursing, Faculty of Health Sciences, Marmara University, Turkey
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21
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Blanson Henkemans OA, Bierman BPB, Janssen J, Neerincx MA, Looije R, van der Bosch H, van der Giessen JAM. Using a robot to personalise health education for children with diabetes type 1: a pilot study. PATIENT EDUCATION AND COUNSELING 2013; 92:174-181. [PMID: 23684366 DOI: 10.1016/j.pec.2013.04.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 04/09/2013] [Accepted: 04/18/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Assess the effects of personalised robot behaviours on the enjoyment and motivation of children (8-12) with diabetes, and on their acquisition of health knowledge, in educational play. METHODS Children (N=5) played diabetes quizzes against a personal or neutral robot on three occasions: once at the clinic, twice at home. The personal robot asked them about their names, sports and favourite colours, referred to these data during the interaction, and engaged in small talk. Fun, motivation and diabetes knowledge was measured. Child-robot interaction was observed. RESULTS Children said the robot and quiz were fun, but this appreciation declined over time. With the personal robot, the children looked more at the robot and spoke more. The children mimicked the robot. Finally, an increase in knowledge about diabetes was observed. CONCLUSION The study provides strong indication for how a personal robot can help children to improve health literacy in an enjoyable way. Children mimic the robot. When the robot is personal, they follow suit. Our results are positive and establish a good foundation for further development and testing in a larger study. PRACTICE IMPLICATIONS Using a robot in health care could contribute to self-management in children and help them to cope with their illness.
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Freeborn D, Dyches T, Roper SO, Mandleco B. Identifying challenges of living with type 1 diabetes: child and youth perspectives. J Clin Nurs 2013; 22:1890-8. [DOI: 10.1111/jocn.12046] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Donna Freeborn
- College of Nursing; Brigham Young University; Provo UT USA
| | - Tina Dyches
- Department of Counseling Psychology and Special Education; Brigham Young University; Provo UT USA
| | - Susanne O Roper
- College of Family, Home, and Social Sciences; Brigham Young University; Provo UT USA
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Kelo M, Eriksson E, Eriksson I. Perceptions of patient education during hospital visit - described by school-age children with a chronic illness and their parents. Scand J Caring Sci 2012; 27:894-904. [DOI: 10.1111/scs.12001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 09/16/2012] [Indexed: 10/27/2022]
Affiliation(s)
- Marjatta Kelo
- Faculty of Health Care and Nursing; Helsinki Metropolia University of Applied Sciences; Helsinki Finland
| | - Elina Eriksson
- Department of Nursing Science; University of Turku; Turku Finland
| | - Ilse Eriksson
- Department of Education; Faculty of Behavioural Sciences; University of Helsinki; Helsinki Finland
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Scholes C, Mandleco B, Roper S, Dearing K, Dyches T, Freeborn D. A qualitative study of young people's perspectives of living with type 1 diabetes: do perceptions vary by levels of metabolic control? J Adv Nurs 2012; 69:1235-47. [DOI: 10.1111/j.1365-2648.2012.06111.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2012] [Indexed: 11/29/2022]
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Rankin D, Heller S, Lawton J. Understanding information and education gaps among people with type 1 diabetes: a qualitative investigation. PATIENT EDUCATION AND COUNSELING 2011; 83:87-91. [PMID: 20570079 DOI: 10.1016/j.pec.2010.04.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2009] [Revised: 03/16/2010] [Accepted: 04/28/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVE Many patients with type 1 diabetes struggle to self-manage this chronic disease, often because they have a poor knowledge and understanding of the condition. However, little attention has been paid to examining the reasons for this poor knowledge/understanding. To inform future educational interventions, we explored patients' accounts of the education and information they had received since diagnosis, and the reasons behind gaps in their diabetes knowledge. METHODS Semi-structured interviews were conducted with 30 type 1 diabetes patients enrolled on a structured education programme in the UK. Data were analysed using an inductive, thematic approach. RESULTS Patients' accounts illustrated a number of knowledge deficits which were influenced by various lifecourse events. Reasons for deficits included: diagnosis at a young age and assumption of decision-making responsibility by parents; lack of engagement with information when feeling well; transitions in care; inconsistency in information provision; and, lack of awareness that knowledge was poor or incomplete. CONCLUSION Patients' knowledge deficits can arise for different reasons, at different points in the lifecourse, and may change over time. PRACTICE IMPLICATIONS The delivery of individualised education should take account of the origins of patients' knowledge gaps and be provided on a regular and on-going basis.
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Affiliation(s)
- David Rankin
- Centre for Population Health Sciences, School of Clinical Science and Community Health, University of Edinburgh, UK.
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