Amillategui B, Calle J R, Alvarez M A, Cardiel M A, Barrio R
Spanish Diabetes Foundation, Madrid, Spain.
Diabet Med. 2007 Oct;24(10):1073-9. doi: 10.1111/j.1464-5491.2007.02250.x.
The aims of this observational study were to identify the special needs of children with Type 1 diabetes in schools from the parents' point of view and the difficulties experienced with full integration, and to define a series of interventions which may improve the situation.
Parents of children aged 3-18 years with Type 1 diabetes were eligible. Those who agreed to participate completed a self-reporting questionnaire which determined the effects of the disease on children, parents and school personnel, and addressed aspects including children's integration, glycaemic control, insulin administration, meals, sports, trips and attitudes of teachers and school colleagues to their disease.
A total of 499 questionnaires were completed and validated. Median age of children was 11.5 years (95% CI 7.8-15.2). Only 34% of parents believed that teachers could recognize the symptoms of a mild hypoglycaemic episode. Seventeen per cent of parents experienced problems at their schools when they informed staff about their children's disease, 5% were finally not accepted and 8% were forced to change school. In some cases, they had to modify glucose monitoring (9%) and treatment administration (16%) because of a lack of cooperation from the school.
Training sessions on Type 1 diabetes, an increase in the number of nurses, better availability of resources from diabetic associations to schools and improved communication between school personnel and parents were identified as key factors that may improve the full integration of the diabetic child in this setting.
本观察性研究的目的是从家长的角度确定1型糖尿病儿童在学校的特殊需求以及完全融入学校所遇到的困难,并确定一系列可能改善这种状况的干预措施。
年龄在3至18岁的1型糖尿病儿童的家长符合条件。同意参与的家长完成一份自我报告问卷,该问卷确定了疾病对儿童、家长和学校工作人员的影响,并涉及儿童融入、血糖控制、胰岛素给药、饮食、运动、旅行以及教师和学校同事对其疾病的态度等方面。
共完成并验证了499份问卷。儿童的中位年龄为11.5岁(95%可信区间7.8 - 15.2)。只有34%的家长认为教师能够识别轻度低血糖发作的症状。17%的家长在告知学校工作人员孩子的病情时遇到问题,5%最终未被学校接受,8%被迫转学。在某些情况下,由于学校缺乏合作,他们不得不改变血糖监测方式(9%)和治疗给药方式(16%)。
关于1型糖尿病的培训课程、护士数量的增加、糖尿病协会向学校提供更多资源以及学校工作人员与家长之间更好的沟通被确定为可能改善糖尿病儿童在这种环境中完全融入情况的关键因素。