Särnblad S, Berg L, Detlofsson I, Jönsson A, Forsander G
Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; School of Medicine Sciences, Örebro University, Örebro, Sweden.
Pediatr Diabetes. 2014 Dec;15(8):550-6. doi: 10.1111/pedi.12133. Epub 2014 Mar 17.
Parents of children with type 1 diabetes often raise complaints about self-care support during school time. The aim of this study was to investigate attitudes to diabetes care in school reported by children with type 1 diabetes, their parents, and their diabetes teams.
Children who had completed preschool class or at least one grade in the 9-yr compulsory school system were invited to participate. Data were collected using separate questionnaires for the children and their parents. In addition, the members of the diabetes team answered a separate questionnaire. All pediatric diabetes centers in Sweden were invited to participate in the study.
All Swedish children and adolescents with diabetes are treated at pediatric diabetes centers. Out of 44 eligible centers, 41 were able to participate. The questionnaires were completed by 317 children and adolescents and 323 parents. The mean age was 11.4 ± 2.7 yr and hemoglobin A1c (HbA1c) was 61.8 ± 12.4 mmol/mol (7.8 ± 1.1%). For 57% of the children, there was no member of staff at the school with principal responsibility to support diabetes self-care. A written action plan for hypoglycemia existed for 60% of the children. Twenty-one percent of the parents regularly gave less insulin than they calculated would be needed at breakfast because of fear of hypoglycemia during school time.
Although Sweden has legislation underlining the specific need for diabetes care in school, this nationwide study demonstrates deficiencies in the support of self-care management.
1型糖尿病患儿的家长经常对孩子在校期间的自我护理支持提出抱怨。本研究的目的是调查1型糖尿病患儿、其家长及其糖尿病治疗团队对学校糖尿病护理的态度。
邀请已完成学前班课程或在9年义务教育体系中至少就读过一个年级的儿童参与研究。使用分别针对儿童及其家长的问卷收集数据。此外，糖尿病治疗团队成员回答一份单独的问卷。瑞典所有的儿科糖尿病中心均受邀参与本研究。
瑞典所有患有糖尿病的儿童和青少年均在儿科糖尿病中心接受治疗。在44个符合条件的中心中，41个能够参与研究。317名儿童和青少年以及323名家长完成了问卷。平均年龄为11.4±2.7岁，糖化血红蛋白（HbA1c）为61.8±12.4 mmol/mol（7.8±1.1%）。对于57%的儿童，学校没有主要负责支持糖尿病自我护理的工作人员。60%的儿童有低血糖书面行动计划。21%的家长因担心孩子在校期间发生低血糖，早餐时经常给予比他们计算所需剂量更少的胰岛素。
尽管瑞典有立法强调学校对糖尿病护理的特殊需求，但这项全国性研究表明，自我护理管理的支持存在不足。
