Problems experienced in preschool and primary school children with type 1 diabetes mellitus regarding disease management at school
Öz
Aim: Children diagnosed with Type 1 diabetes mellitus (T1DM) need supervision in diabetes self-care,and the conditions at school, where they spend a significant part of the day, affect the disease
management. The aim of this study is to reveal the problems encountered by preschool and primaryschool children diagnosed with T1DM regarding disease management at school.
Materials and Methods: At this descriptive, cross-sectional study, 50 patients diagnosed with T1DM who were between ages 5-10 were included in the study. The questionnaire pertaining to diabetesmanagement at school was developed by their searcher with respect to the literature, and subsequently file doubt by the patient and/or their parents via Google questionnaire. The dataobtained were analyzed by descriptive statistical methods.
Results: The patients had diabetes for a mean duration of 5.39±2.56 years. Of all cases, 94% weregoing to public school. Health care rooms were not present in 78% of the schools, 92% did not have
nurses/health-care personnel. Of the participants, 86% were consuming a main meal at school, but themajority of them were bringing their meals from home or going home to eat. The most common problem with nutrition was the consumption of foods that were not suitable for the patient’s diet at school. At school, blood glucose levels were not being measured in 6% of the children. During their time at school, the rate of experiencing hypoglycemia was 40% in children, with the hypoglycemia intervention being most commonly conducted by the teacher (55%). In 77.5% of the children who werereceiving insulin at school, the administration was being performed by the mother or father. The mostcommonly experienced problems regarding insulin treatment at school was the lack of a persontrained in administering insulin, and a suitable room for application. The patients’ participation rate forphysical education was 98%. While most of the teachers and school administration treated the children with a positive attitude, 18% of the children were exposed to the negative attitude of theirpeers.
Conclusion: Preschool or primary school children diagnosed with T1DM have difficulties in nutrition, blood glucose measurement and insulin administration at school. Most schools do not have healthcare rooms and/or health-care staff. Since there are no people experienced in administering insulin tothis population at school, this is usually done by parents.
Anahtar Kelimeler
: Type 1 diabetes mellitus children school diabetes management.
Kaynakça
- Wodrich DL, Hasan K, Parent KB. Type 1 diabetes mellitus and school: a review. Pediatric diabetes 2011; 12 (1): 63-70.
- Atkinson MA, Eisenbarth GS, Michels AW. Type 1 diabetes. The Lancet 2014; 383 (9911): 69-82.
- Yeşilkaya E, Cinaz P, Andıran N, Bideci A, Hatun Ş, Sarı E, Türker T, Akgül Ö, Saldır M, H Kılıçaslan H, Açıkel C, Craig ME. First report on the nation wide incidence and prevalence of Type 1 diabetes among children in Turkey. Diabetic Medicine 2017; 34 (3): 405-10.
- American Diabetes Association. 13. Children and adolescents: standards of medical care in diabetes—2021. Diabetes care 2021; 44 (1):180-99.
- Bundak R. Ergenlik çağında diyabet yönetimi. Türk Pediatri Arşivi 2011; 46 (11): 79-81.
- Chiang JL, Maahs DM, Garvey KC, Hood KK, Laffel LM, Weinzimer SA, Schatz D. Type 1 diabetes in children and adolescents: a position statement by the American Diabetes Association. Diabetes care 2018; 41 (9): 2026-44.
- Silverstein J, Klingensmith G, Copeland K, Plotnick L, Kaufman F, Laffel L… & Clark N. Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes care 2005; 28 (1): 186-212.
- Glaab LA, Brown R & Daneman D. School attendance in children with type 1 diabetes. Diabetic Medicine 2005; 22 (4): 421-6.
- Särnblad S, Berg L, Detlofsson I, Jönsson Å & Forsander G. Diabetes management in Swedish schools: a national survey of attitudes of parents, children, and diabetes teams. Pediatric diabetes 2014; 15 (8): 550-6.
- Driscoll KA, Volkening LK, Haro H, Ocean G, Wang Y, Jackson CC,…&Siminerio LM. Are children with type 1 diabetes safe at school? Examining parent perceptions. Pediatric diabetes 2015; 16 (8): 613-20.
- Jackson CC, Albanese-O’Neill A, Butler KL, Chiang JL, Deeb LC, Hathaway K,... &Siminerio LM. Diabetes care in the school setting: a position statement of the American Diabetes Association. Diabetes care 2015; 38 (10): 1958-63.
- Lange K, Jackson C & Deeb L. Diabetes care in schools–the disturbing facts. Pediatric diabetes 2009; 10(13): 28-36.
- American Diabetes Association. Diabetes care in the school and daycare setting. Diabetes care 2010; 33 (1): 70-4.
- Canadian Diabetes Association Clinical Practice Guidelines Expert Committee; Helen Jones H, Berard LD, MacNeill G, Whitham D, Yu C. Can J Diabetes. 2013 Apr; 37 Suppl 1: S26-30. doi: 10.1016/j.jcjd.2013.01.015. Epub 2013 Mar 26.
- American Diabetes Association; Diabetes Care in the School and Day Care Setting. Diabetes Care 2012; 35 (1): 76–80.
- Hatun Ş, Mutlu GY, Gökçe T, Avcı Ö, Yardım N, Aycan Z & Darendeliler F. Care and Support of Children with Type 1 Diabetes at School: The Turkish Experience. Journal of Clinical Research in Pediatric Endocrinology 2021; 13 (4): 370-4.
- Tarı S & Kitiş Y. Tip 1 Diyabetli Çocukların Okulda Diyabet Yönetimiyle İlgili Yaşadıkları Güçlükler. Ege Üniversitesi Hemşirelik Fakültesi Dergisi 2016; 32 (2): 44-60.
- Haliloglu B, Akesen E, Atay Z, Guran T, Bereket A & Turan S. Diabetes related problems and diabetic controls among the school children with type 1 diabetes mellitus living in Istanbul. Pediatr Diabetes 2012; 13: 27-8.
- Türkiye Diyabet Programı 2015-2020. TC Sağlık Bakanlığı. Türkiye halk sağlığı kurumu. 2. Basım: Ekim 2014, Ankara.
- Davis EA, Keating B, Byrne GC, Russell M & Jones TW. Hypoglycemia: incidence and clinical predictors in a large population-based sample of children and adolescents with IDDM. Diabetes care 1997; 20 (1): 22-5.
- Johnson SR, Cooper MN, Davis EA &Jones TW. Hypoglycaemia, fear of hypoglycaemia and quality of life in children with Type 1 diabetes and their parents. Diabetic medicine 2013; 30 (9): 1126-31.
- Pate T, Klemenčič S, Battelino T & Bratina N. Fear of hypoglycemia, anxiety, and subjective well-being in parents of children and adolescents with type 1 diabetes. Journal of Health Psychology 2019; 24 (2): 209-18.
- Bratina N, Forsander G, Annan F, Wysocki T, Pierce J, Calliari LE,. &Acerini CL. Management and support of children and adolescents with type 1 diabetes in school. Pediatr Diabetes 2018; 19 (27): 287-301.
- Gökçe T, Sakarya S, Muradoğlu S, Mutlu GY, Can E, Cemhan K,... & Hatun Ş. An evaluation of the knowledge and attitudes of school staff related to diabetes care at school: The 10th year of the “diabetes program at school” in Turkey. Pediatric Diabetes 2021; 22 (2): 233-40.
- Miculis CP, Mascarenhas LP, Boguszewski M&Campos WD. Physical activity in children with type 1 diabetes. Jornal de pediatria 2010; 86 (4): 271-8.
- Amillategui B, Mora E, Calle JR &Giralt P. Special needs of children with type 1 diabetes at primary school: perceptions from parents, children, and teachers. Pediatric diabetes 2009; 10 (1): 67-73
Ana sınıfında veya ilkokulda okuyan tip 1 diabetes mellitus tanılı çocukların okulda hastalık yönetimi ile ilgili yaşadıkları sorunlar
Öz
Amaç: Tip 1 diabetes mellitus (T1DM) tanılı çocuklar diyabet öz bakımında gözetime ihtiyaç duymaktadırlar ve günün önemli bir kısmını geçirdikleri okuldaki koşullar hastalık yönetimini
etkilemektedir. Bu çalışmanın amacı, T1DM tanılı ana sınıfı ve ilkokul çağındaki çocukların okulda hastalık yönetimi ile ilgili karşılaştıkları sorunları ortaya koymaktır.
Gereç ve Yöntem: Bu kesitsel çalışmaya T1DM tanılı 5-10 yaş aralığındaki 50 hasta dahil edildi. Literatür doğrultusunda araştırmacı tarafından geliştirilen okulda diyabet yönetimiyle ilgili anket,
Google anket formu aracılığıyla hasta ve/veya ebeveynleri tarafından dolduruldu. Elde edilen veriler tanımlayıcı istatistiksel yöntemlerle analiz edildi.
Bulgular: Hastaların ortalama diyabet süreleri 5,39±2,56 yıldı. Olguların %94’ü devlet okuluna gidiyordu. Okulların %78’inde sağlık bakım odası, %92’sinde hemşire/sağlık personeli yoktu. Olguların %86’sı okulda ana öğün alıyordu, ancak bunların büyük çoğunluğu öğününü evden getiriyor veya eve gidip yiyordu. Beslenme ile ilgili en sık sorun okulda diyete uygun olmayan gıdaların tüketilmesiydi. Çocukların %6’sında okulda kan şekeri ölçümü yapılmıyordu. Okulda hipoglisemi yaşamış olanların sıklığı %40 olup en sık müdahale eden kişi öğretmendi (%55). Okulda insülin uygulanan çocukların %77,5’inde uygulamayı anne veya baba yapıyordu. İnsülin uygulamada yaşanan en sık sorunlar okulda uygulayabilecek kişinin ve uygun ortamın olmaması idi. Beden eğitimine katılım %98’di. Çocuklar öğretmen ve okul yönetiminden yüksek oranda olumlu yaklaşım görürken, %18 çocuk,arkadaşlarının olumsuz yaklaşımına maruz kalmaktaydı.
Sonuç: T1DM tanılı çocuklar okulda beslenme, kan şekeri ölçümü ve insülin uygulama konularında zorluklar yaşamaktadırlar. Okullarda sağlık bakım odası ve/veya sağlık personeli çoğunlukla
bulunmamaktadır. Okulda insülin uygulama konusunda deneyimli kişi olmaması nedeniyle bunu genellikle ebeveynler yapmaktadır.
Anahtar Kelimeler
Kaynakça
- Wodrich DL, Hasan K, Parent KB. Type 1 diabetes mellitus and school: a review. Pediatric diabetes 2011; 12 (1): 63-70.
- Atkinson MA, Eisenbarth GS, Michels AW. Type 1 diabetes. The Lancet 2014; 383 (9911): 69-82.
- Yeşilkaya E, Cinaz P, Andıran N, Bideci A, Hatun Ş, Sarı E, Türker T, Akgül Ö, Saldır M, H Kılıçaslan H, Açıkel C, Craig ME. First report on the nation wide incidence and prevalence of Type 1 diabetes among children in Turkey. Diabetic Medicine 2017; 34 (3): 405-10.
- American Diabetes Association. 13. Children and adolescents: standards of medical care in diabetes—2021. Diabetes care 2021; 44 (1):180-99.
- Bundak R. Ergenlik çağında diyabet yönetimi. Türk Pediatri Arşivi 2011; 46 (11): 79-81.
- Chiang JL, Maahs DM, Garvey KC, Hood KK, Laffel LM, Weinzimer SA, Schatz D. Type 1 diabetes in children and adolescents: a position statement by the American Diabetes Association. Diabetes care 2018; 41 (9): 2026-44.
- Silverstein J, Klingensmith G, Copeland K, Plotnick L, Kaufman F, Laffel L… & Clark N. Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes care 2005; 28 (1): 186-212.
- Glaab LA, Brown R & Daneman D. School attendance in children with type 1 diabetes. Diabetic Medicine 2005; 22 (4): 421-6.
- Särnblad S, Berg L, Detlofsson I, Jönsson Å & Forsander G. Diabetes management in Swedish schools: a national survey of attitudes of parents, children, and diabetes teams. Pediatric diabetes 2014; 15 (8): 550-6.
- Driscoll KA, Volkening LK, Haro H, Ocean G, Wang Y, Jackson CC,…&Siminerio LM. Are children with type 1 diabetes safe at school? Examining parent perceptions. Pediatric diabetes 2015; 16 (8): 613-20.
- Jackson CC, Albanese-O’Neill A, Butler KL, Chiang JL, Deeb LC, Hathaway K,... &Siminerio LM. Diabetes care in the school setting: a position statement of the American Diabetes Association. Diabetes care 2015; 38 (10): 1958-63.
- Lange K, Jackson C & Deeb L. Diabetes care in schools–the disturbing facts. Pediatric diabetes 2009; 10(13): 28-36.
- American Diabetes Association. Diabetes care in the school and daycare setting. Diabetes care 2010; 33 (1): 70-4.
- Canadian Diabetes Association Clinical Practice Guidelines Expert Committee; Helen Jones H, Berard LD, MacNeill G, Whitham D, Yu C. Can J Diabetes. 2013 Apr; 37 Suppl 1: S26-30. doi: 10.1016/j.jcjd.2013.01.015. Epub 2013 Mar 26.
- American Diabetes Association; Diabetes Care in the School and Day Care Setting. Diabetes Care 2012; 35 (1): 76–80.
- Hatun Ş, Mutlu GY, Gökçe T, Avcı Ö, Yardım N, Aycan Z & Darendeliler F. Care and Support of Children with Type 1 Diabetes at School: The Turkish Experience. Journal of Clinical Research in Pediatric Endocrinology 2021; 13 (4): 370-4.
- Tarı S & Kitiş Y. Tip 1 Diyabetli Çocukların Okulda Diyabet Yönetimiyle İlgili Yaşadıkları Güçlükler. Ege Üniversitesi Hemşirelik Fakültesi Dergisi 2016; 32 (2): 44-60.
- Haliloglu B, Akesen E, Atay Z, Guran T, Bereket A & Turan S. Diabetes related problems and diabetic controls among the school children with type 1 diabetes mellitus living in Istanbul. Pediatr Diabetes 2012; 13: 27-8.
- Türkiye Diyabet Programı 2015-2020. TC Sağlık Bakanlığı. Türkiye halk sağlığı kurumu. 2. Basım: Ekim 2014, Ankara.
- Davis EA, Keating B, Byrne GC, Russell M & Jones TW. Hypoglycemia: incidence and clinical predictors in a large population-based sample of children and adolescents with IDDM. Diabetes care 1997; 20 (1): 22-5.
- Johnson SR, Cooper MN, Davis EA &Jones TW. Hypoglycaemia, fear of hypoglycaemia and quality of life in children with Type 1 diabetes and their parents. Diabetic medicine 2013; 30 (9): 1126-31.
- Pate T, Klemenčič S, Battelino T & Bratina N. Fear of hypoglycemia, anxiety, and subjective well-being in parents of children and adolescents with type 1 diabetes. Journal of Health Psychology 2019; 24 (2): 209-18.
- Bratina N, Forsander G, Annan F, Wysocki T, Pierce J, Calliari LE,. &Acerini CL. Management and support of children and adolescents with type 1 diabetes in school. Pediatr Diabetes 2018; 19 (27): 287-301.
- Gökçe T, Sakarya S, Muradoğlu S, Mutlu GY, Can E, Cemhan K,... & Hatun Ş. An evaluation of the knowledge and attitudes of school staff related to diabetes care at school: The 10th year of the “diabetes program at school” in Turkey. Pediatric Diabetes 2021; 22 (2): 233-40.
- Miculis CP, Mascarenhas LP, Boguszewski M&Campos WD. Physical activity in children with type 1 diabetes. Jornal de pediatria 2010; 86 (4): 271-8.
- Amillategui B, Mora E, Calle JR &Giralt P. Special needs of children with type 1 diabetes at primary school: perceptions from parents, children, and teachers. Pediatric diabetes 2009; 10 (1): 67-73
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 15 Mart 2023 |
| Gönderilme Tarihi | 10 Mart 2022 |
| Yayımlandığı Sayı | Yıl 2023Cilt: 62 Sayı: 1 |
