Mounir Gehan M, Abolfotouh Mostafa A
Family Health Department (School Health), High Institute of Public Health, Alexandria University, Egypt.
J Egypt Public Health Assoc. 2005;80(3-4):475-93.
Type 1 diabetes mellitus is a chronic disease that may have an impact on children's psychosocial adjustment. The aim of the present work was to study the psychosocial characteristics of diabetic students and to determine predictors of diabetes control. A cross-sectional study of 150 diabetic students who attended the diabetic school health insurance clinic of Sporting Student's Hospital in Alexandria governorate within a period of one month was conducted. A pre-designed interviewing questionnaire was used to collect--from the child and/or his/her parents--personal data, data about the child social relationships and school and disease characteristics. School adjustment index and stress symptom index were used to assess the school performance and the stress symptoms respectively. The result revealed that 34% of the diabetic students were maladjusted to school and 31.3% were symptomatic based on the stress index. Generally speaking, diabetic children reported good relationship to peers (65.3%), parents (57.3%) and siblings (51.3%), most of them have good friendship (82%) and those involved in one or more kind of hobby were about three fourth of all. Both age (P<0.05), sex (P<0.05), social class (P<0.05), disease duration (P<0.05) and stress symptoms (P<0.05) were all significantly associated with the disease control. However after adjustment for other variables, students of low social class families (OR=5.1, p<0.01) and those of longer disease duration (6-10 years) (OR=7.9, p<0.05) were significant predictors of diabetes control. In conclusion diabetes per se might have no significant association with academic performance or social relationship. Students with large diabetic duration-especially those of low social class families--are at increased risk of suboptimal glycaemic control and should be targeted for interventional strategies.
1型糖尿病是一种可能影响儿童心理社会适应的慢性疾病。本研究的目的是探讨糖尿病学生的心理社会特征,并确定糖尿病控制的预测因素。对150名糖尿病学生进行了一项横断面研究,这些学生在一个月内前往亚历山大省体育学生医院的糖尿病学校健康保险诊所就诊。使用预先设计的访谈问卷从儿童和/或其父母那里收集个人数据、儿童社会关系数据、学校和疾病特征数据。学校适应指数和压力症状指数分别用于评估学业成绩和压力症状。结果显示,根据压力指数,34%的糖尿病学生对学校适应不良,31.3%有症状。总体而言,糖尿病儿童报告与同龄人(65.3%)、父母(57.3%)和兄弟姐妹(51.3%)关系良好,他们中的大多数有良好的友谊(82%),参与一种或多种爱好的人约占总数的四分之三。年龄(P<0.05)、性别(P<0.05)、社会阶层(P<0.05)、疾病持续时间(P<0.05)和压力症状(P<0.05)均与疾病控制显著相关。然而,在对其他变量进行调整后,低社会阶层家庭的学生(OR=5.1,p<0.01)和疾病持续时间较长(6-10年)的学生(OR=7.9,p<0.05)是糖尿病控制的重要预测因素。总之,糖尿病本身可能与学业成绩或社会关系没有显著关联。糖尿病病程较长的学生,尤其是低社会阶层家庭的学生,血糖控制不佳的风险增加,应针对他们采取干预策略。