Gómez Manchón M, Gómez Carrasco J A, Ramírez Fernández J, Díez Fernández T, García de Frías E
Servicio de Pediatría, Hospital Universitario Príncipe de Asturias, Departamento de Especialidades Médicas, Alcalá de Henares, Madrid, España.
An Pediatr (Barc). 2009 Jan;70(1):45-52. doi: 10.1016/j.anpedi.2008.07.004. Epub 2008 Nov 12.
The daily care of a diabetic (IDDM) child is essential for the short and long term evolution of the disease, and must include the hours the child spends in school. The presence of Trained personnel are needed who will be able to intervene in time if a serious complication, such as hypoglycemia, occurs. Their presence can help to ensure correct control of the disease and avoid long term complications.
To understand of the day to day life of children with IDDM, focusing on their school hours. To understand the attitude of primary and secondary school teachers towards pupils with IDDM.
Descriptive and transversal study on IDDM patients between the ages of 3 and 18, treated within the Healthcare Area number 3 in the Madrid Region, and their teachers. Two different kinds of surveys were distributed: the 1st survey by Fundación para la Diabetes (Foundation for Diabetes) contained 80 questions aimed at patients between the ages of 3 and 18 and their parents. Questions were related to patient's daily life and school environment. The 2nd survey, which allowed free response, was aimed at primary and secondary school teachers about their own experiences working as professionals with pupils with IDDM.
Fifty questionnaires addressed to parents and patients were valid in our remit, and we emphasize the following: the ages of major participation were 10 to 14 years; 86% of children knew how to measure blood glucose and 66% how to administer insulin; 74% had no problems with school integration, however, up to 50% of children under 6 years had suffered a problem occasionally; on the 50% of the occasions when a patient needed insulin administration during school hours, it was done by a relative; 66% of hypoglycaemias were resolved by the patient. Health personnel is present only in 8% of the schools studied; 98% of those surveyed think teachers should have written instructions on the signs and symptoms and action to be taken if a hypoglycemia occurs. Questionnaires for teachers were answered by 54% of them (76 of a total of 140), we would like to point out the following: 71% of them recognise having a diabetic pupil; the degree of teacher knowledge on diabetes, rated on a scale from 1 to 7 shows a median of 3 and a mode of 4; 47% of teachers feel insecure when having a diabetic pupil because they do not have instructions on actions to take in case a complication occurs; 97% of teachers affirm to know what a hypoglycaemia is, however only 67% and 57% of them recognise its signs and symptoms and know how to act when they occur.
The school integration and acceptance of pupils with IDDM is good, according to both teachers and parents. Children with IDDM take responsibility for their disease at an early age and are able to develop certain skills. However they still need help, which they get from their family even during school hours. Generally, teachers are willing to learn new skills to be able to help these children, however, further training is required to improve the understanding and management of this disease.
糖尿病(胰岛素依赖型糖尿病)患儿的日常护理对该疾病的短期和长期发展至关重要,且必须涵盖患儿在学校度过的时间。需要有经过培训的人员,以便在发生低血糖等严重并发症时能够及时进行干预。他们的存在有助于确保疾病得到正确控制并避免长期并发症。
了解胰岛素依赖型糖尿病患儿的日常生活,重点关注其在校时间。了解中小学教师对胰岛素依赖型糖尿病学生的态度。
对马德里自治区第3医疗区治疗的3至18岁胰岛素依赖型糖尿病患者及其教师进行描述性横断面研究。发放了两种不同的调查问卷:第一份由糖尿病基金会发放,包含80个针对3至18岁患者及其父母的问题。问题涉及患者的日常生活和学校环境。第二份调查问卷允许自由作答,针对中小学教师,询问他们作为专业人员与胰岛素依赖型糖尿病学生打交道的经历。
在我们的研究范围内,50份发给家长和患者的问卷有效,我们强调以下几点:主要参与年龄为10至14岁;86%的儿童知道如何测量血糖,66%知道如何注射胰岛素;74%的儿童在融入学校方面没有问题,然而,6岁以下的儿童中有多达50%偶尔会遇到问题;在50%的情况下,患者在上学时间需要注射胰岛素时,由亲属进行;66%的低血糖情况由患者自行解决。在所研究的学校中,只有8%有卫生人员;98%的受访者认为教师应该有关于低血糖症状及应对措施的书面说明。54%的教师(共140人中有76人)回答了教师问卷,我们想指出以下几点:71%的教师认识有糖尿病学生;教师对糖尿病的了解程度,以1至7分评分,中位数为3,众数为4;47%的教师在有糖尿病学生时感到不安,因为他们没有关于并发症发生时应对措施的说明;97%的教师肯定知道什么是低血糖,然而,其中只有67%和57%的人能识别其症状,知道发生时如何应对。
根据教师和家长的说法,胰岛素依赖型糖尿病学生在学校的融入和接受情况良好。胰岛素依赖型糖尿病患儿在年幼时就对自己的疾病负责,并能够培养一定的技能。然而,他们仍然需要帮助,即使在上学时间也能从家人那里得到帮助。一般来说,教师愿意学习新技能以帮助这些孩子,然而,需要进一步培训以提高对这种疾病的理解和管理能力。