A pediatric diabetes toolbox for creating centres of reference

Lange, Karin; Klotmann, Susan; Saßmann, Heike; Aschemeier, B; Wintergerst, E. S.; Gerhardsson, P.; Kordonouri, Olga; Szypowska, Agnieszka; Danne, Thomas

doi:10.1111/j.1399-5448.2012.00913.x

Cited by 27 publications

(82 citation statements)

References 14 publications

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“…In this overall positive situation it is challenging to improve the metabolic and psychological outcomes. This quite positive situation at study onset might not be representative for other pediatric diabetes units in Germany or worldwide [47]. …”

Section: Discussionmentioning

confidence: 99%

Reducing stress and supporting positive relations in families of young children with type 1 diabetes: A randomized controlled study for evaluating the effects of the DELFIN parenting program

et al. 2012

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BackgroundTo assess initial efficacy and feasibility of a structured behavioural group training (DELFIN) for parents of children with diabetes type 1, in order to reduce parenting stress and to improve parenting skills.MethodsA randomized controlled study was conducted between July 2008 and September 2010, at a children’s hospital in Hannover with parents of children with type 1 diabetes (2–10 yrs) (intervention group n = 37; control group n = 28). Parenting skills, parents’ psychological burden, children’s behavioural difficulties and quality of metabolic control were assessed before, 3 months after and 12 months after participating in the training program.ResultsIn the intervention group parenting behaviour in conflict situations improved significantly after 3 months (Z = −3.28; p ≤ 0.001). It remained stable over 12 months (Z = −2.94; p ≤ 0.01). Depression and anxiety scores of parents decreased (Z = −1.93; p ≤ .05; Z = −2.02; p ≤ .05). Even though the outcome in the intervention group was more positive, the differences between both study arms failed to reach statistical significance. Unexpectedly parenting behaviour in the control group improved also (Z = −2.45; p ≤ .05). Anxiety as well as stress scores decreased in this group (Z = −2.02; p ≤ .05 and Z = −2.11; p ≤ .05). In both groups the initial metabolic control was good and without significant differences (A1c 7.2±0.8% vs. 7.1±0.4%; p > 0.5). It remained stable in the DELFIN group (A1c 7.1±0.8%; p > 0.5), but it increased slightly in controls (A1c 7.3±0.5%; Z = −2.79; p = .005).ConclusionsThis study has brought first evidence for the efficacy and feasibility of the program. A multicentre study with a larger sample is necessary to confirm these first results.

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Section: Discussionmentioning

confidence: 99%

Reducing stress and supporting positive relations in families of young children with type 1 diabetes: A randomized controlled study for evaluating the effects of the DELFIN parenting program

et al. 2012

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“…Children and adolescents, their primary care givers, and other care providers should have easy access to and be included in the educational process. Also, care givers in nurseries or kindergarten and teachers in school should have access to an appropriate structured diabetes education …”

Section: Universal Principlesmentioning

confidence: 99%

“…Educators (pediatric endocrinologist or physician trained in the care of children and adolescents with diabetes, diabetes educators, dieticians, psychologists, social workers, and other health care providers) should have access to continuing specialized training in current principles of insulin therapy, new diabetes technologies, advances in diabetes education and educational methods …”

Section: Universal Principlesmentioning

confidence: 99%

“…The evidence base for the effectiveness of structured education vs informal unstructured education in improving metabolic control and preventing severe hypoglycemia and restoring awareness of hypoglycemia comes mainly from studies involving adults with diabetes. The studies have been performed mainly in North America, Australia, and Europe and have been extensively reviewed in various publications …”

Section: What Is Diabetes Education?mentioning

confidence: 99%

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ISPAD Clinical Practice Consensus Guidelines 2018: Diabetes education in children and adolescents

et al. 2018

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“…Both Hvidore 30 and SWEET, 31 as well as other similar initiatives, focus on large, well-known centers for pediatric diabetology in different countries. However, patients attending these centers, as well as the care provided, are most likely not representative for all patients from the respective country.…”

Section: Multinational Comparisons Of Multicenter/population-based Rementioning

confidence: 99%

Standardized Documentation in Pediatric Diabetology

Hofer

Schwandt

Holl

et al. 2016

J Diabetes Sci Technol

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An essential feature of standardization of measurement is that it allows for detection and learning from variation present in a health care system. Standardized documentation has the advantage to improve patient care due to better exchange of information among members of a medical team and, in addition allows both, internal and external quality control. This article addresses the latter aspect, based on 20 years of experience from the Austrian/German quality initiative DPV.The aspect of quality of medical care has somewhat different challenges in chronic diseases, as opposed to acute medical disorders. For acute problems, QC (quality control) will focus on the question whether the problem has been solved to the complete satisfaction of patients, whether side effects did occur, for example infection or postsurgery bleeding following a surgical procedure, and what the costs arise for the patient (length of hospitalization, pain, number of control exams, direct financial burden for the patient) as well as for society (time not at work) or reimbursement companies. These aspects are often quite easy to cover with a limited number of items.1 In contrast, the nature of chronic disorders provides specific challenges that have to be addressed when standardized documentation for chronic disorders like diabetes are implemented. 3 The St. Vincent declaration identified 5 major goals to be achieved during the next 5 years (Table 1). 4 The use of standardized documentation and information technology together with the application of quality control techniques developed previously in automobile manufacturing especially in Japan were listed among other tools to improve diabetes care. A specific data set and a documentation tool were developed in Europe (DiabCare or QUALIDIAB), with modifications for children. The St. Vincent initiative has had long-lasting effects on the public health aspects of diabetology 5 and has been adopted to other regions of the world like the "Declaration of the Americas" 6

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A pediatric diabetes toolbox for creating centres of reference

Cited by 27 publications

References 14 publications

Reducing stress and supporting positive relations in families of young children with type 1 diabetes: A randomized controlled study for evaluating the effects of the DELFIN parenting program

Reducing stress and supporting positive relations in families of young children with type 1 diabetes: A randomized controlled study for evaluating the effects of the DELFIN parenting program

ISPAD Clinical Practice Consensus Guidelines 2018: Diabetes education in children and adolescents

Standardized Documentation in Pediatric Diabetology

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