A structured educational insulin pump therapy programme: the views of children/young people and their parents
DOI:
https://doi.org/10.1002/edn.220Keywords:
insulin pumps, type 1 diabetes mellitus, children, young peopleAbstract
AbstractThis study aimed to determine the views and experiences of parents and children regarding the training and services they had received at a London teaching hospital, when the child commenced insulin pump therapy; and to inform future services.
Face-to-face semi-structured interviews were conducted with children/young people (n=34) aged 5–17 years, using pump therapy, and their parents (n=38). Interviews were audio-recorded, transcribed verbatim and analysed using established qualitative analytical procedures.
Parents and children/young people had their own concerns on starting pump therapy: constant attachment of the child to an insulin pump and the cannula-insertion procedure respectively, being the greatest concerns. The hospital-based diabetes team supported families to overcome such issues. They provided families with 24-hour telephone contact, contacted schools and nurseries, ran a two-day Pump School at the start of pump therapy and provided ongoing services to ease patients’ transition from insulin injections to pumps. The programme and services provided were generally perceived positively by children and parents. However, some limitations were reported and suggestions for improvement were made.
In conclusion, the insulin pump therapy programme was appreciated by the majority of families, and provided children and their parents with support for easier transition from insulin injections to pumps. As the numbers of young people using pump therapy increase, the results of this study can inform the development of similar services, by considering this programme as a model for establishing such a service in other specialised diabetes centres.
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References
Diabetes Control and Complications Trial Research Group. Effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engi J Med 1993;329:977–86.
Diabetes Control and Complications Trial Research Group. Effect of intensive therapy on the microvascular complications of type 1 diabetes mellitus. JAIVIA 1994;287:2563–9.
Pickup J, et al. Glycaemic control with con-tinuous subcutaneous infusion compared with intensive insulin injections in patients with type 1 diabetes: meta-analysis of ran-domized controlled trials. BMJ 2002; 324:705–8.
Wilson DM, et al. A two-center randomized controlled feasibility study of insulin pump therapy in young children with diabetes. Diabetes Care 2005;28:15–9.
Phillip M, et al. Use of insulin pump therapy in the pediatric age-group. Diabetes Care 2007;30:1653–62.
Weinzimer SA, et al. A randomized trial com-paring continuous subcutaneous infusion of insulin aspart versus insulin lispro in chil-dren and adolescents with type 1 diabetes. Diabetes Care 2008;31:210–5.
Churchill JN, et al. Use of continuous insulin infusion pumps in young children with type 1 diabetes: a systematic review. J Pediatr Health Care 2009;23:173–9.
Alsaleh FM, et al. Insulin pumps: from incep-tion to the present and toward the future. J Clin Pharm Ther 2010;35:127–38.
Alsaleh FM, et al. Experiences of children/young people and their parents, using insulin pump therapy for the manage-ment of type 1 diabetes: qualitative review. J Clin Pharm Ther 2012;37:140–7.
Pickup J. Insulin Pump Therapy and Continuous Glucose Monitoring. UK: Oxford University Press, 2009.
Department of Health. National Service Framework for Children, Young People and Maternity Services: Core Standards. UK, DoH, 2007.
National Institute for Health and Clinical Excellence. Continuous Subcutaneous Insulin Infusion for the Treatment of Diabetes Mellitus: Review of Technology Appraisal Guidance 57. UK: NICE, 2008.
National Institute for Health and Clinical Excellence. Continuous Subcutaneous Insulin Infusion for the Treatment of Diabetes Mellitus (Review of Technology Appraisal Guidance No 57): Costing Template and Report Implementing NICE Guidance. UK NICE, 2008.
Thompson R. 'Pump school' a structured education programme to empower children and young people using insulin pump therapy. Eur Diabetes Nurs 2008;5:108–11.
Thompson R. The Relationship between Education, Support and the Success of CSII Initiation in Children, Young People and their Families: A Review. City University, 2005. [Dissertation.]
Kaufman F, et al. Insulin pump therapy in young children with diabetes. Diabetes Spectr 2001;14:84–9.
Maniads AK, et al. Life with continuous sub-cutaneous insulin infusion (CSII) therapy: child and parental perspectives and predic-tors of metabolic control. Pediatr Diabetes 2001;2:51–7.
Lincolin Y, Guba E. Naturalistic Inquiry. San Francisco: SAGE, 1985.
Sullivan-Bolyai S, et al. Parents' reflections on managing their children's diabetes with insulin pumps. J Nurs Scholarsh 2004; 36:316–23.
Wagner J, et al. Brief Report: glycemic con-trol, quality of life, and school experiences among students with diabetes. J Pediatr Psychol 2006;31:764–9.
Christie D, et al. Attitudes to psychological groups in a pediatric and adolescent dia-betes service: implications for service deliv-ery. Pediatr Diabetes 2008;9:388–92.
Hampson SE, et al. Effects of educational and psychosocial interventions for adoles-cents with diabetes mellitus: a systematic review. Health Technol Assess 2001;5:1–79.
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