Evaluating Self-Care Practices of Children with Type 1 Diabetes Mellitus in Northern West Bank: A controlled Randomized Study Utilizing Orem- Self Care Theory

Abstract

Background: Diabetes mellitus, a non-communicable disease and a major public health problem. It is a chronic disorder of metabolism characterized by partial or complete deficiency of the insulin hormone. Diabetes, which historically has been a phenomenon in older people, has now crept into the lives of young children. Self– cared diabetes involves a complex set of tasks and the key to successful management of diabetes is adherence to these tasks. Diabetes self-care education is a critical element of care for all people with diabetes and necessary to improve patient outcomes. Design: Quasi-experimental design utilized in the current study. Sample, include176 patients attending diabetic clinics of primary health care centers in Northern West Bank districts (Nablus, Tulkarem, Jenin, Tubas, Salfit, and Qalqellia). Research instrument: Two tools developed by the researchers, a structured questionnaire for participants and an observational performance checklist. First tool: A structured questionnaire developed to assess participants’ knowledge and self-care practices. Second Tool: An Observational self-care practices checklist developed by the researchers to observe self-care practices of diabetic children. Aim of the study: to assess specific knowledge of diabetes mellitus and self-care practices accompanied with observational self-care practices checklist by researchers among children with type 1 diabetes mellitus, based on Orem self-care theory a health education program was developed and administered in the targeted clinics. Procedure: the study was conducted in two phases; phase I pre-test for both the intervention and control groups. The intervention group attended health education program and the control group received routine care. After 3 months from intervention program, phase II post-test with the same tool applied for both the intervention and control groups. Results: The mean scores of diabetic knowledge in the intervention group at post-test was higher than pre-test 1.94&1.619respectively. For self-care practices was 3.53 in post-test and 2.73 in pre-test. For observational self- care practices checklist in insulin injection technique was 3.45 in post-test and 2.56 in pre-test. For blood glucose test was 3.68 in post-test and 2.84 in pre- test. For urine test for glucose and ?or ketones was 3.39 in post-test and 2.07 in pre-test. In addition, for hygiene care was 1.89 in post- test and 1.54 in pre-test at P. value 0.05.Conclusions: The current study indicate that the intervention program utilizing Orem's self care theory is effective in transferring diabetic children from wholly or partly compensatory to educative ? supportive system to accomplish self care practices.

Keywords: Type1 diabetes mellitus, Self-care practices, Children.