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ORIGINAL ARTICLE
Year : 2017  |  Volume : 14  |  Issue : 2  |  Page : 179-189

Effect of instructions on selected self-care practices among type-1 diabetic children


Department of Pediatric Nursing, Faculty of Nursing, Cairo University, Cairo, Egypt

Correspondence Address:
Eman Abdel Fattah Hassan
Department of Pediatric Nursing, Faculty of Nursing, Cairo University, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ENJ.ENJ_19_17

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Background Type 1 diabetes (T1D), which tends to develop in childhood, needs certain self-care practices to achieve optimal glycemic control. Aim The study aimed to evaluate the effect of instructions on selected self-care practices among T1D children. Patients and methods A quasi-experimental one-group design with pre–post assessment was used in this study, which was carried out in the Pediatric Diabetes and Endocrine Unit at El Monira University Pediatric Hospital, on a purposive sample of 100 diabetic children. The data were collected using a structured interview questionnaire and four observational checklists for self-care practices of insulin injection by syringe and by pen, blood glucose test, and foot care. Results Children’s age ranged between 6 and 14 years, with female predominance. Their readiness for self-care was high, especially for insulin injection, and none of the children had adequate performance of any of the procedures before the intervention. At the postintervention phase, there were statistically significant improvements in all procedures, reaching 76% for insulin injection by syringe, 82 for injection by pen, 77% for blood glucose testing, and 58% for feet care (P<0.001). In total, 80% adequate performance after the intervention was detected (P<0.001). In multivariate analysis, the applied intervention was the main independent statistically significant positive predictor of the child’s performance score, with child age and performance of exercise having a less but statistically significant influence. All children (100%) recommended the program for other diabetic children. Conclusion The study concluded that children’s practice scores of self-care activities improved significantly after the intervention, and readiness of children plays an active role in improving these scores. The participation of parents, particularly with very young children, and more emphasis on foot care are needed. The study recommends that the intervention should be implemented in settings providing care to children with T1D. Feet care for children with T1D was done by parents until the children realize the importance of caring and examining their feet periodically. The impact of the program on glycemic control needs further research.


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