Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK.
The Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, UK.
Diabet Med. 2017 Aug;34(8):1050-1060. doi: 10.1111/dme.13362. Epub 2017 May 15.
To explore the everyday experiences of children (aged ≤ 12 years) with Type 1 diabetes to identify factors that help or hinder diabetes self-management practices.
Eight databases (Embase, Medline, CINAHL, Web of Science, PsychInfo, ASSIA, ERIC and ProQuest Dissertations) were searched in 2016 to identify qualitative studies exploring children's views about self-managing diabetes. Data were extracted, coded and analysed using thematic synthesis.
Eighteen studies from five countries were included in the review. Synthesis of studies' findings resulted in the identification of three overarching analytical themes. The first theme, 'Understandings of diabetes and involvement in self-management', outlines ways in which children understand diabetes and develop self-management responsibilities. The second theme, 'Disruption to life and getting on with it', reports children's frustrations at disruptions to everyday life when managing diabetes, and how attempts to appear normal to family and friends affect self-management practices. The third theme, 'Friends' support', describes how friends' reactions and responses to diabetes affect children's ability to appear normal and willingness to disclose information about diabetes, and support provided by 'informed friends', or peers with diabetes.
Although the synthesis has identified how children's everyday life experiences inform ways in which they undertake diabetes self-management, it was not possible to determine new ways to provide support. To help children optimise their glycaemic control, further work should be undertaken to identify their need for support and which takes into account the potential ways in which parents, friends and peers can offer assistance.
探索 12 岁以下儿童(患有 1 型糖尿病)的日常经历,以确定有助于或阻碍其糖尿病自我管理实践的因素。
2016 年,我们在 8 个数据库(Embase、Medline、CINAHL、Web of Science、PsychInfo、ASSIA、ERIC 和 ProQuest Dissertations)中进行了搜索,以确定探索儿童对自我管理糖尿病的看法的定性研究。使用主题合成法对数据进行提取、编码和分析。
本综述纳入了来自五个国家的 18 项研究。对研究结果的综合分析得出了三个总体分析主题。第一个主题是“对糖尿病的理解和参与自我管理”,概述了儿童理解糖尿病和发展自我管理责任的方式。第二个主题是“日常生活的干扰和继续下去”,报告了儿童在管理糖尿病时对日常生活干扰的挫败感,以及试图向家人和朋友表现正常如何影响自我管理实践。第三个主题是“朋友的支持”,描述了朋友对糖尿病的反应和态度如何影响儿童表现正常和愿意透露糖尿病信息的意愿,以及有糖尿病知识的“知情朋友”或同龄人的支持。
尽管综合分析已经确定了儿童的日常生活经历如何影响他们进行糖尿病自我管理的方式,但仍无法确定提供支持的新方法。为了帮助儿童优化血糖控制,应进一步努力确定他们对支持的需求,以及考虑父母、朋友和同龄人可以提供帮助的潜在方式。