Diabetic Management Skills in a Paediatric Population: Accuracy, Responsibility and Satisfaction

Abstract

The skills associated with performing blood tests and preparing and delivering insulin injections were assessed in a population of children (n=30) attending a paediatric diabetic clinic. The division of responsibility between children and their parents for these tasks and the satisfaction of both parents and children with the arrangements were also assessed. Clinical assessment of the children’s reading of prereacted BM sticks and their glucose solution de terminations suggested a high level of skill. Age, sex and duration of diabetes were only marginally, if at all, related to skill level. Consistent with other reports some steps in the self monitoring of blood glucose procedure, in the glucose solutions determination tests and in the preparation and delivery of injections, were invariable performed more correctly than others. Overall there was reasonably good agreement between parents and children about responsibility for blood testing and injecting. However, children with greater perceived responsibility for these tasks were not significantly more skilled at them and neither, in general, was family satisfaction with this division of responsibility related to the children’s observed skills levels, their age or the duration of their diabetes. Clinicians should be cautious of assuming that family perception of, and satisfaction with, the responsibility taken by the child for his/her diabetic management is a valid measure of actual ability. Behavioural observation of performance is a necessary part of comprehensive assessment and care. Recommendations are made for the assessment, in the paediatric diabetic clinic setting, of these important self management skills.