Age appropriate targets for self care education for children with diabetes
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Age-appropriate targets for self-care education for children with diabetes. The newly-diagnosed child. Admission to hospital: duration normally 3–5 days, depending on the child’s condition and the family situation treatment for ketoacidosis

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Age appropriate targets for self care education for children with diabetes

Age-appropriate targets for self-care education for children with diabetes

The newly diagnosed child
The newly-diagnosed child

  • Admission to hospital:

    • duration normally 3–5 days, depending on the child’s condition and the family situation

    • treatment for ketoacidosis

    • starting subcutaneous insulin-treatment and diabetes education

  • The education:

    • co-ordinated by the diabetes nurse and carried out by members of the multi-disciplinary diabetes team

Starting diabetes education 1
Starting diabetes education 1

  • First conversation with the family:

    • try to establish good contact and create confidence

    • talk about the experiences before and during the stay in hospital

    • try to remove any sense of guilt

    • promise:

      • “it can be done”

      • 24-hour hot-line service

      • good life with minimum restrictions

Starting diabetes education 2
Starting diabetes education 2

  • Necessary knowledge before discharge from hospital:

    • administration and injection of insulin

    • testing blood glucose

    • knowing acceptable blood glucose values

    • symptoms and treatment of hypoglycaemia

    • simple principles for food administration

    • talk to the social worker about reimbursement of:

      • diabetes devices

      • sick-leave for one parent for a short period

  • Instruct about daily contact by telephone to discuss adjusting insulin dose

Out patient diabetes education 1
Out-patient diabetes education 1

  • Starts 1–2 weeks after discharge from hospital

  • Lasts about 6 months

  • Primarily carried out by the diabetes nurse and the dietician

  • Includes training/visits to childcare institutions, schools etc.

  • Home visits also possible

Out patient diabetes education 2
Out-patient diabetes education 2

  • Who is educated?

    • patient and parents

    • brothers, sisters and friends

    • other members of the family

    • personnel in childcare institutions/school

    • other 'baby-sitters'

Out patient diabetes education 3
Out-patient diabetes education 3

  • Qualifications of the educator:

    • great practical and theoretical knowledge

    • open and good listener

    • able to treat each family individually according to the family’s abilities

Out patient diabetes education 4
Out-patient diabetes education 4

  • Important to find the balance between optimum and sufficient knowledge

Special problems 1
Special problems 1

  • Age:

    • infants

    • young people/adolescents

  • Culture/language/religion:

    • immigrants/refugees

  • Social problems

Special problems 2
Special problems 2

  • Aim of education:

    • to secure good diabetes regulation without complications but at the same time create possibility of a good childhood/youth – 'development without tripping'

  • Small children:

    • achieve normal physical, psychological and intellectual 'milestones'

  • Young people:

    • knowledge and experience + family trust and support = better accept and compliance

Other offers of education 1
Other offers of education 1

  • Groups:

    • social activities for children arranged by a local section of the national diabetes association

    • group for parents with very young children run by psychologist and social worker

    • group arrangements for children of the same age together with their parents – combination of out-patient clinic and education.

    • special projects for small group of young people in puberty

Other offers of education 2
Other offers of education 2

  • Groups:

    • education on different topics for young people aged 12–15 and 16–18 years – each twice a year

  • This year’s topics:

    • pizza, hamburgers, alcohol and parties

    • physical activity

    • good regulation/insulin management

    • sickness/ketoacidosis

Written material 1
Written material 1

  • Coping with Diabetes:

    • large numbers of papers on different topics and levels

    • intended as short and precise guidelines in practical diabetes management

    • always handed out in connection with oral instruction

Written material 2
Written material 2

  • Age-appropriate education and evaluation material:

    • created by teachers, psychologists and diabetes nurses

    • describes practical and theoretical knowledge of diabetes for children and young people aged 16–17 years

    • goals are adjusted and adapted to the educational level, abilities and psychological development of the child

Written material 3
Written material 3

  • Age-appropriate education and evaluation material includes:

    • age-appropriate goals for members of the team

    • guidelines for the diabetes patient and family

    • evaluation of material/methods

Transfer to the diabetes out patient clinic
Transfer to the diabetes out-patient clinic

  • First visit maximum 6 months after diagnosis

  • Visits every 2–3 months until aged 18 years

  • Meets:

    • doctor/paediatrician

    • diabetes nurse

    • dietician

    • laboratory technician

    • chiropodist

    • social worker (if needed)

    • psychologist (if needed)

  • If needed, re-education should be offered (e.g. as the child grows older or metabolic control is poor)

Age appropriate goals general 1
Age-appropriate goals:general 1

  • 6–7 years:

    • parents are responsible for the daily diabetes care

      • the child could be encouraged to help

  • 8–9 years:

    • child takes over a larger part of the practical responsibility for diabetes care

      • the parents, however, still have the main responsibility

  • 10–11 years:

    • child needs only limited theoretical background, but should be able to take practical responsibility for diabetes care

      • the parents should assist in dosing insulin

Age appropriate goals general 2
Age-appropriate goals: general 2

  • 12–13 years:

    • the child takes practical care of the diabetes and begins to acquire the theoretical background

  • 14–15 years:

    • the young person takes care of the diabetes and has now acquired the requisite theoretical background

  • 16–17 years:

    • preparations are made for adult life, as the diabetes becomes a matter between the young person and the diabetes team

      • he/she is motivated to obtain further knowledge and experience, practical as well as theoretical

Age appropriate goals detail
Age-appropriate goals:detail

  • Knowledge of diabetes

  • 'Rules of the game':

    • food, insulin and exercise.

  • Blood glucose:

    • testing

    • hypo- and hyperglycaemia

  • Special precautions:

    • sickness

    • eating/sleeping away from home

    • hyperglycaemia

  • Complications of diabetes