In-hospital survival skills training for type 1 diabetes: perceptions of children and parents

When a child is diagnosed with type 1 diabetes, parents and/or children must gain significant knowledge and learn specific skills to maintain health. Children in the United States who experience diabetic ketoacidosis (DKA) at the time of diagnosis typically spend 3 days in the hospital learning these life-saving skills. The purpose of this study was to gain knowledge concerning children's and parents' perceptions of this hospitalization period and of the initial education and support received from nurses.

The study used qualitative descriptive methods. A child interview guide and written parent survey were used to elicit children's and parents' perceptions. Two outside experts reviewed these tools. Twenty children aged 8 to 15 years along with 25 parents participated. Reductionistic and constructionistic steps were used to analyze the qualitative data.

During this hospitalization, children were most disturbed by the invasiveness of the required interventions while parents reported significant emotional distress related to the diagnosis. Children and parents alike felt the Survival Skills Training they received was effective. Education involving demonstration and return demonstration, supervision of skill performance, positive feedback from nurses about skill performance, and reassurance for long-term quality of life were nurse behaviors found to be helpful.

Implications for care include age-appropriate information in a variety of formats, minimizing the invasive nature of the treatment, providing opportunities for demonstration/return demonstration of skills, providing positive support and reassurance, and delivering concentrated instruction related to carbohydrate counting.