Eisenhofer Simone, Neininger Martina P, Bertsche Astrid, Kiess Wieland, Bertsche Thilo, Kapellen Thomas M
Drug Safety Center and Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University, Bruederstr. 32, 04103 Leipzig, Germany.
Department of Pediatric Neurology, University Medicine Greifswald, Fleischmannstraße 6, 17489 Greifswald, Germany.
Children (Basel). 2023 Jul 31;10(8):1319. doi: 10.3390/children10081319.
Parents of pediatric patients with type I diabetes require competence in hypoglycemia management and skills in glucagon administration to deal with potentially life-threatening severe hypoglycemia. We aimed to compare parents' subjective self-ratings to an objective expert assessment of competences and skills in dealing with severe hypoglycemia.
We interviewed 140 participants to assess their subjective self-ratings. The objective expert assessments used a standardized clinical case scenario of severe hypoglycemia and a practical demonstration of glucagon administration.
The participants self-rated their competence in hypoglycemia management as good (5) or very good (6), and their skills in administering glucagon as acceptable (3) [Scale: very poor (1) to very good (6)]. In the standardized clinical case scenario, 1.4% (2/140) of participants named all relevant steps of severe hypoglycemia management. In the practical demonstration of glucagon administration, 92.9% (130/140) of participants committed at least one drug handling error; 52.1% (73/140) committed at least one drug handling error rated with high clinical risk.
We found discrepancies regarding participants' subjective self-ratings compared to their performance in the respective objective expert assessments. These discrepancies indicate a lack of error awareness and the need for intervention studies to improve competence in hypoglycemia management and glucagon administration.
1型糖尿病患儿的家长需要具备低血糖管理能力以及胰高血糖素给药技能，以应对可能危及生命的严重低血糖。我们旨在比较家长对自身能力的主观自评与专家对其处理严重低血糖的能力和技能的客观评估。
我们采访了140名参与者以评估他们的主观自评。客观专家评估采用了严重低血糖的标准化临床病例场景以及胰高血糖素给药的实际演示。
参与者将他们在低血糖管理方面的能力自评评为良好（5）或非常好（6），将他们在胰高血糖素给药方面的技能自评评为可接受（3）[评分标准：非常差（1）至非常好（6）]。在标准化临床病例场景中，1.4%（2/140）的参与者说出了严重低血糖管理的所有相关步骤。在胰高血糖素给药的实际演示中，92.9%（130/140）的参与者至少犯了一项药物操作错误；52.1%（73/140）的参与者至少犯了一项被评为具有高临床风险的药物操作错误。
我们发现参与者的主观自评与他们在各自客观专家评估中的表现存在差异。这些差异表明缺乏错误意识，并且需要进行干预研究以提高低血糖管理和胰高血糖素给药方面的能力。
