Self-care of school-age children with diabetes: an integrative review

This paper is a report of an integrative review of findings from empirical studies on self-care in school-age children with type 1 diabetes. The purpose is to generate insight into opportunities to develop empowering patient education.

Managing diabetes is demanding and requires parental involvement in care. Good self-care forms the basis for diabetes management and self-care patterns are established at school age, but how and to what extent school-age children increase their self-care capabilities is unclear.

A search for studies from 1998 to 2010 focusing on self-care in school-age children with diabetes was conducted through electronic databases.

Using integrative methods, quantitative and qualitative papers surveyed were analysed separately, but the themes that arose were combined at the end of the analysis.

Self-care is formed in a learning process involving the objectives of normality, being able to cope and independence. The content of self-care is a combination of knowledge and skills. Children have the technical skill, but they need their parents to participate in the care and share responsibility for it. The factors related to self-care comprised the characteristics of the child; the nature of the illness and care; and support from the parents, school environment, peers and healthcare team.

A balance between diabetes care requirements and a child's maturity should be found. Nurses must adopt an empowering manner of education and recognize and assess a child's readiness to learn diabetes care and bear responsibility for it. Nurses must also help parents and other adults to gradually shift the responsibility to the children.