Educating diabetic children: integrating representations by children aged 7 to 11 and their parents

A patient living with a chronic disease develops illness-related knowledge, representations, and specific behaviour leading to attitudes. Our objective was to assess the interaction between representations from diabetic children 7 to 11 years of age and their parents, on the disease and its treatment, in order to improve the therapeutic education process.

A qualitative approach was developed. Semi-structured interviews and free association technique were used on 10 children 7 to 11 years of age and 10 parents, in the Toulouse Hospital, France. Qualitative and quantitative (Alceste(R) software) discourse analysis relating to representations was performed (distribution, frequency, and meaning of word sequences were compared).

Children seemed to cope naturally with their environment in order to manage their disease. Their attitudes were neutral and their behaviour pragmatic. The parents' representations were more conceptual and negative. They expressed their fear of the disease, their difficulty to endorse the responsibilities and overcome everyday constraints.

The educator must adapt his language level to integrate the child's universe and facilitate assimilation of knowledge. The therapeutic education process for diabetic children should integrate a specific support and training for parents. These results have influenced our choice of a strategy involving continuous group education focusing parents.