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多学科教育流程与儿童在被诊断患有 1 型糖尿病时出院有关——一项定性研究。

A multi-disciplinary education process related to the discharging of children from hospital when the child has been diagnosed with type 1 diabetes--a qualitative study.

机构信息

Division of Nursing, Department of Health Sciences, Lund University, Lund, Sweden.

出版信息

BMC Pediatr. 2010 May 27;10:36. doi: 10.1186/1471-2431-10-36.


DOI:10.1186/1471-2431-10-36
PMID:20507611
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2889941/
Abstract

BACKGROUND: Worldwide, insulin-dependent type 1 diabetes is one of the most frequently diagnosed long-term endocrine disorders found in children and the incidences of this diseased is still increasing. In Sweden the routines are, according to national guidelines, when the child is diagnosed with type 1 diabetes, the child and its family remains at the hospital for about two weeks. There is limited knowledge about how a diabetes team handles a child and its family from admission to discharge, therefore the purpose of this study was to seek a deeper understanding of how the diabetes team's parent/child education process works, from admission to discharge, among families with a child newly diagnosed with type 1 diabetes. METHODS: Qualitative data collection was used. Four focus-group interviews, with a sample of three diabetes teams from different paediatric hospitals in the south western part of Sweden, were conducted and the data recorded on tape and then analysed using qualitative content analysis. RESULTS: The results indicate that achieving a status of self-care on the part of the patient is the goal of the diabetes education programme. Part of the programme is aimed at guiding the child and its parents towards self-help through the means of providing them with knowledge of the disease and its treatment to enable the whole family to understand the need for cooperation in the process. To do this requires an understanding, by the diabetes team, of the individualities of the family in order to gain an overall picture. CONCLUSION: The results of this study show that the diabetes education programme is specifically designed for each family using the internationally recommended clinical practice guidelines with its specific aims and objectives. Achieving the families' willingness to assist in the self-care of the child care is the goal of the parent education process. To achieve this, the paediatric diabetes specialist nurse and the diabetes specialist paediatrician immediately and deliberately start the process of educating the family using a programme designed to give them the necessary knowledge and skills they will need to manage their child's type 1 diabetes at home.

摘要

背景:在全球范围内,胰岛素依赖型 1 型糖尿病是儿童中最常见的长期内分泌紊乱之一,其发病率仍在上升。在瑞典,根据国家指南,当孩子被诊断出患有 1 型糖尿病时,孩子及其家人在医院大约待两周。关于糖尿病团队如何从入院到出院处理孩子及其家庭,我们知之甚少,因此本研究的目的是深入了解新诊断出 1 型糖尿病的儿童家庭中,糖尿病团队的家长/儿童教育过程是如何运作的,从入院到出院。

方法:使用定性数据收集。在瑞典西南部的三家不同儿科医院的糖尿病团队中,进行了四次焦点小组访谈,对样本进行了录音,并使用定性内容分析对数据进行了分析。

结果:结果表明,实现患者的自我护理状态是糖尿病教育计划的目标。该计划的一部分旨在通过向孩子及其父母提供有关疾病及其治疗的知识,引导他们走向自助,使整个家庭理解合作的必要性,从而实现这一目标。要做到这一点,糖尿病团队需要了解家庭的个性,以全面了解家庭情况。

结论:本研究结果表明,糖尿病教育计划是根据国际推荐的临床实践指南,针对每个家庭专门设计的,具有明确的目标和目的。使家庭愿意协助孩子进行自我护理是家长教育过程的目标。为了实现这一目标,儿科糖尿病专科护士和儿科糖尿病专家立即并有意地开始使用专门设计的方案对家庭进行教育,该方案旨在为他们提供管理孩子 1 型糖尿病所需的必要知识和技能。

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本文引用的文献

[1]
Diabetes education in children and adolescents.

Pediatr Diabetes. 2009-9

[2]
A UK wide survey of insulin initiation in children with type 1 diabetes and nurses' perceptions of associated decision-making.

J Clin Nurs. 2009-5

[3]
The delivery of ambulatory diabetes care: structures, processes, and outcomes of ambulatory diabetes care.

Pediatr Diabetes. 2008-12

[4]
Are family factors universally related to metabolic outcomes in adolescents with Type 1 diabetes?

Diabet Med. 2008-4

[5]
Psychological care of children and adolescents with diabetes.

Pediatr Diabetes. 2007-10

[6]
Families' needs when a child is long-term ill: a literature review with reference to nursing research.

Int J Nurs Pract. 2007-6

[7]
Routine hospital admission versus out-patient or home care in children at diagnosis of type 1 diabetes mellitus.

Cochrane Database Syst Rev. 2007-4-18

[8]
Swedish families' lived experience when a child is first diagnosed as having insulin-dependent diabetes mellitus: An ongoing learning process.

J Fam Nurs. 2006-11

[9]
What does make the difference?

Diabet Med. 2006-9

[10]
Children with a long-term illness: parents' experiences of care.

J Pediatr Nurs. 2006-4

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