Determination of Factors Affecting School Life of Children Aged 7-12 with Type 1 Diabetes: A Sample of a University Hospital

Year 2024, Volume: 8 Issue: 1, 88 - 96, 29.04.2024

Hediye Yapıcılar , Remziye Semerci

https://doi.org/10.25048/tudod.1363641

Abstract

Aim: This research aims to investigate the factors influencing the school experiences of children with Type 1 Diabetes.
Material and Methods: The descriptive and cross-sectional study was conducted with 100 children aged 7-12, diagnosed with Type 1
diabetes mellitus. Research data was collected using the "Diabetes Management at School: Child Questionnaire." Descriptive statistics
and chi-square tests were used for data analysis.
Results: There is a relationship between children's age and receiving assistance with insulin pump application at school (t=21.782,
p<0.05). There was no significant relationship between children's HbA1c levels and missing school due to diabetes-related issues
(t=0.410, p>0.05). A significant relationship was found between the age at first diabetes diagnosis and missing school due to diabetesrelated
issues (t=5.141, p<0.05). There is a significant relationship between children's HbA1c levels and experiencing failure at school
due to diabetes (t= 16.504, p<0.05). A significant relationship exists between children's age at first diabetes diagnosis and experiencing
failure at school due to diabetes (t=16.504 (p<0.05).
Conclusion: 50% of those diagnosed with diabetes between ages 0-5 had to miss school due to diabetes-related reasons. 75% of those
with poor HbA1c levels experienced failure at school due to diabetes. Children diagnosed with diabetes before the age of five experienced
more failure at school. This study concludes that HbA1c level and age at diagnosis are significant factors affecting a child's school
attendance and performance. Education planning for the child, family, and school personnel, active involvement of school nurses in
education planning, and implementing education programs from the time of diagnosis are recommended.

Keywords

Child, Type 1 Diabetes Mellitus, school experience, nursing

7-12 Yaş Tip 1 Diyabetli Çocukların Okul Yaşantısını Etkileyen Faktörlerin Belirlenmesi: Bir Üniversite Hastanesi Örneği

Abstract

Amaç: Bu araştırmanın amacı Tip 1 diabetes mellitus tanılı çocukların okul yaşantısını etkileyen faktörlerin incelenmesidir.
Gereç ve Yöntemler: Tanımlayıcı ve kesitsel tipteki çalışma, Tip 1 Diyabet tanılı 7-12 yaşındaki 100 çocukla yürütüldü. Araştırma
verileri “Okulda Diyabet Yönetimi: Çocuk Soru Formu” ile toplandı. Verilerin değerlendirilmesinde tanımlayıcı istatistikler ve ki-kare
testleri kullanıldı.
Bulgular: Çocukların yaşı ile okulda insülin pompa uygulamasında yardım alma durumu arasında bir ilişki vardır (t=21.782, p<0.05).
Çocukların HbA1c düzeyi ile diyabete bağlı okula ara verme/devamsızlık yapma durumları arasında anlamlı bir ilişki yoktu (t=0.410,
p>0.05). Çocukların ilk diyabet tanı alma yaşı ile diyabete bağlı okula ara verme / devamsızlık yapma durumları arasında anlamlı bir
ilişki vardı (t=5.141, p<0.05). Çocukların HbA1c düzeyi ile diyabete bağlı okulda başarısızlık yaşama durumları arasında anlamlı bir
ilişki vardı (t= 16.504, p<0.05). Çocukların ilk diyabet tanı alma yaşı ile diyabete bağlı okulda başarısızlık yaşama durumları arasında
anlamlı bir ilişki vardı (t=16.504 (p<0.05).
Sonuç: İlk diyabet tanısını 0-5 yaş arasında alanların %50’si diyabete bağlı olarak okula ara verme/devamsızlık yaptığı belirlendi. HbA1c
düzeyi kötü olanların ise %75’ inin diyabete bağlı olarak okulda başarısızlık yaşadıkları belirlendi. İlk diyabet tanı alma yaşı beş yaşından
daha erken olan çocukların okulda başarısızlık yaşama durumları daha fazla idi. Bu çalışma sonucunda HbA1c değeri ve tanı alma
yaşının, çocuğun okula devamsızlık süresini ve okuldaki başarısını etkileyen önemli faktörler olarak belirlenmiştir. Çocuğa, aileye ve
okul personellerine eğitim planlanması, eğitim programı ve danışmanlık konularında okul hemşirelerinin aktif rol alması ve eğitim
programlarının tanı anından itibaren uygulanması önerilmektedir

Keywords

Çocuk, Tip 1 Diabetes Mellitus, okul yaşantısı, hemşirelik

Ethical Statement

The ethical committee approval and necessary permissions were obtained following the Helsinki Declaration. The process was carried out as follows: The research obtained ethical committee approval on October 31, 2018, with protocol number 2018.183.IRB3.124. Written permission was obtained from the Koç University Hospital Directorate, where the data were collected. The researcher provided detailed information about the research to the children and families who agreed to participate. Written consent was obtained from the children and their families who agreed to participate in the research.

Supporting Institution

There is no sources of support or funding

Thanks

There was no conflict of interest in this study. There was no financial gain or other interest in a product or distributor of a product. There was no association, consultation, stock ownership or other interest, or patent-licensing arrangement. No funding was required for this research study. The authors are grateful to the children and their parents who spent their time and shared their experiences during the study

References

• 1. Arslan M, Kalkan İ, Aydemir İ. Evaluation of Emotional Appetite States of Adult Individuals with Applying Carbohydrate Counting and Determination of Its Relationship with Body Mass Index. Turk Diyab Obez. 2019;3:137-143.
• 2. Karaca Aydoğan Z, Battal F. Retrospective Evaluation of Diagnosis and Treatment of Cases with Type 1 Diabetes Mellitus. Turk J diab Obes. 2021;2: 111-117.
• 3. American Diabetes Association. Type 1 diabetes [internet]. 2019 [Date of access: 11.01.2023] Access address: http://www. diabetes.org/diabetes-basics/type-1/?loc=util-header_type1
• 4. International Diabetes Federation. Diabetes Atlas. 10th Edition [internet]. 2021 [Erişim tarihi: 11.01.2023] Erişim adresi: https://diabetesatlas.org/atlas/tenth-edition/
• 5. Yeşilkaya E, Cinaz P, Andıran N, Bideci A, Hatun Ş, Sarı E, Türker T, Akgül Ö, Saldır M, Kılıçaslan H, Açıkel C, Craig ME. First report on the nationwide incidence and prevalence of type 1 diabetes among children in Turkey. Diabetic Medicine 2017;34(3):405-410.
• 6. Ertem GS, Ergün S, Özyazicioğlu N. Metabolic control in children and adolescents with Type 1 Diabetes. YOBÜ Faculty of Health Sciences Journal 2021;2(1):28-37.
• 7. Forouhi NG, Wareham NJ. Epidemiology of diabetes. Medicine 2019;47(1):22-27.
• 8. Altundağ S. The effect of education and social support on the adaptation of children with Type 1 Diabetes to the disease. Pamukkale Medical Journal 2018;11(2):137-144.
• 9. Murillo M, Bel J, Pérez J, Corripio R, Carreras G, Herrero X, Mengibar JM, Rodriguez-Arjona D, Ravens-Sieberer U, Raat R, Rajmil L. Health-related quality of life (HRQOL) and its associated factors in children with Type 1 Diabetes Mellitus (T1DM). BMC Pediatrics 2017;17(1):1-9.
• 10. Çövener Özçelik Ç, Aktaş E. Nocturnal hypoglycemia in Type 1 Diabetes “do parents know how to prevent it?’’: A descriptive study. Turk J Diab Obes 2023:1:72-80.
• 11. Çövener Özçelik Ç, Şen Celasin N. Nutritional habits and quality of life of children/adolescents with Type 1 Diabetes. Turk J Diab Obes 2021;3: 302-311.
• 12. Çelik G, Öztürk İ. Tip 1 diyabetli adölesanlarda diyete uyum durumu ile diyabulimia riskinin HbA1c düzeyine etkisi. Akdeniz Tıp Dergisi 2023; 9(3): 296-301.
• 13. Fleming M, Fitton CA, Steiner MFC, McLay JS, Clark D, King A, Lindsay RS, Mackay DF, Pell JP. Educational and health outcomes of children treated for type 1 diabetes: Scotland-wide record linkage study of 766,047 children. Diabetes Care 2019;42(9):1700-1707.
• 14. Cook AJ. Caring for Children with Type 1 Diabetes during the School Day: Challenges and Recommendations.Master’s Thesis. University of Pittsburgh; Pittsburgh, PA, USA: 2007. [(accessed on 22 August 2022)].
• 15. Glaab LA, Brown R, Daneman D. School attendance in children with Type 1 diabetes. Diabet Med 2005;22(4):421-426.
• 16. Thingholm PR, Gaulke A, Eriksen TM, Svensson J, Skipper N. Association of prodromal type 1 Diabetes with school absenteeism of Danish school children: A population-based case-control study of 1,338 newly diagnosed children. Diabetes Care 2020;43(11): 2886-2888.
• 17. Doğan Z. Diabetes management in the school environment of children with Type 1 Diabetes aged 7-12, followed in university hospitals. Unpublished Master’s Thesis. Istanbul: Istanbul University; 2009.
• 18. Tarı S, Kitiş Y. Difficulties experienced by children with Type 1 Diabetes management at school. Ege University Faculty of Nursing Journal 2016;32(2):44-60.
• 19. Ekim A, Pek H. Insulin administration skills of children with type 1 diabetes. Journal of Diabetes Nursing 2010;14(2):70-74.
• 20. Korbel CD, Wiebe DJ, Berg CA, Palmer DL. Gender differences in adherence to type 1 diabetes management across adolescence: The mediating role of depression. Children’s Healthcare. 2007;36(1);83-98.
• 21. Franconi F, Campesi I, Occhioni S, Tonolo G. Sex-gender differences in diabetes vascular complications and treatment. Endocr Metab Immune Disord Drug Targets 2012;12(2):179-196.
• 22. Kautzky-Willer A, Harreiter J, Pacini G. Sex and Gender Differences in Risk, Pathophysiology and Complications of Type 2 Diabetes Mellitus. Endocr Rev 2016;37(3):278-316.
• 23. Vetiska J, Glaab L, Perlman K, Daneman D. School attendance of children with type 1 diabetes. Diabetes Care. 2000;23;1706- 1707.
• 24. McCarthy AM, Lindgren S, Mengeling MA, Tsalikian E, Engvall J. Factors associated with academic achievement in children with type 1 diabetes. Diabetes Care 2003;26(1):112-117.
• 25. Wagner J, Heapy A, James A, Abbott G. Brief report: glycemic control, quality of life, and school experiences among students with diabetes. J Pediatr Psychol 2006;31(8):764-769.
• 26. Gorska-Ciebiada M, Masierek M, Ciebiada M. Improved insulin injection technique, treatment satisfaction and glycemic control: Results from a large cohort education study. J Clin Transl Endocrinol 2020;19:100217.
• 27. Ahmed AAM, Burbur AAS, Babiker SMA, Mohamed SOO, ELseed MEDF, Saad FM. Impact of type 1 diabetes mellitus on the academic performance of diabetic school children in Khartoum, Sudan. Sudan J Paediatr 2021;21(2):123-130.
• 28. Adolphus K, Hoyland A, Walton J, Quadt F, Lawton CL, Dye L. Ready-to-eat cereal and milk for breakfast compared with no breakfast has a positive acute effect on cognitive function and subjective state in 11-13-year-olds: a school-based, randomised, controlled, parallel groups trial. Eur J Nutr 2021;60(6):3325-3342.
• 29. Knight MF, Perfect MM. Glycemic control influences on academic performance in youth with Type 1 diabetes. Sch Psychol 2019;34(6):646-655.
• 30. Aziz BM, Sulaiman KH. School performance among a sample of Type1 Diabetic children and adolescents in Erbil city. Pakistan Journal of Medical & Health Sciences 2023;17(2): 317.
• 31. Cooper MN, McNamara KA, de Klerk NH, Davis EA, Jones TW. School performance in children with type 1 diabetes: a contemporary population-based study. Pediatr Diabetes 2016;17(2):101-111.