الفهرس 
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Abstract
Type I diabetes is a common health problem of chronic
nature. The objectives of diabetic management are to eliminate
symptoms, prevent acute complications to achieve these
objectives self- management education is the cornerstone of
treatment for diabetic children and to learn additional
knowledge and skills related to illness and treatment (hay et al,
2008)
This study is a descriptive study and carried out to assess
the parents care of school age children with type I diabetes the
study was conducted at the settings:
1. Outpatient department in Health Insurance Hospital in
Fayoum affiliated to Health Insurance Organization
2. Outpatient department in Abshway Hospital affiliated to
Ministry of Health.
3. Outpatient in Sinores Hospital affiliated to Ministry of
Health.
The sample composed all diabetic school children aged
7-15 years who attended in the previously mentioned settings
for a period of five months (100 school diabetic children).The collection of data started from the first of August
2011 up to the end of December 2011.
Tools:
Three tools data collections were involved in this study:
1- An interviewing questionnaire: consisted of two parts:
A) characteristics of the child and his family, and concerned
with the following:
Socio- demographic characteristic of parent.
Bio- social characteristics of diabetic children.
Physical assessment of diabetic children.
B) Parent’s knowledge:
Knowledge of parents about insulin, complication,
monitoring of blood glucose (MBG), hygienic care, etc…..
C) Children’s knowledge:
Knowledge of diabetic children about insulin, serum
monitoring of blood glucose (SMBG), urine analysis, personal
hygiene, etc…….
2) An observational checklist:
Five observational checklists were constructed to
evaluate the performance of parents care of diabetic children, it
included:
Insulin preparation and injection.
Monitoring of blood glucose.Foot care.
Teeth brushing.
Coping with child disease.
3) An attitudinal scale toward diabetes regarding personal
care, awareness, body image, coping with disease.
Statements were designed to ascertain parents and
diabetic children’s attitude toward diabetes.
The Main Results:
Less than half (25%) of diabetic school children were in age
group of 7-10, while the rest of them (38%) were in age
group>13 years. Regarding sex, it was found that more than
half (53%) of diabetic children were boys.
· The greatest proportions (83%) of diabetic school children
were in basic education.
· Less than half (46%) of parents of diabetic school children
were in different education (diploma or secondary) school.
· More than half (56%) living in center. Regarding care giver
relationship there was all children take care by their mother.
· Less than half (46%) of diabetic school children were ill for
a period of time >12– 24 and more than two third (82%) of
them had positive family history of diabetes.
· Most of diabetic school children (64%) had negative
previous hypoglycaemic episode (last month), but (41%) of
them had previous hyperglycemic episode (last month), it
was found that all of diabetic school children had abnormal
blood investigation and abnormal urine test.
· For physical health assessment of diabetic children it was
found less than half of them (48%) under weight, while
(55%) of them was correspond with age, while 67%had
abnormal teeth EX. Loose teeth and same swelling gums,
also 85%have problem with eyes like gradual loss of vision
and glaucoma.
· Regarding assessment parent’s care, it was found that 49%
was done regular follow up. And 61% of parent was known
how to store insulin, and 49% of them done rotation of
insulin injection.
· And 57% of children carrying diabetic identification and
sweet,
· Regarding assessment of parents and children knowledge
about diabetes mellitus, it was found, 54% of patens of
diabetic children reported a complete answer about clinical
manifestation of diabetic, while 10% only reported a wrong
answer, but for children clinical manifestation Knowledge
there is 62% of children has incomplete answer and 21% has
complete answer, At the same time 48% of parents and 20%
of children had a complete answer about diagnosis of
diabetes; wile 14% of parents and 8% of children had a
wrong answer, Complication of diabetic were known
completely for 18% of parents and 25% of children, while
more than 69% of parent and 53% of children reported
incomplete answer about complication.
· It was found also that 52% and 28% of parents had a
complete answer about pre-hypoglycaemic and prehyperglycemic
coma manifestation where 23% and 30% of
parents reported a wrong answer, but for children it’s
unknown for 7%. In relation to the first aid in
hypoglycaemic and hyperglycemic coma, it was found that
82% and 46%of parents reported a complete answer, while
only 2% and 20% of them had a wrong answer while it’s
known completely for 35% and 32% of children.
· About importance of insulin 55% have complete answer and
14% have wrong answer, but for children it’s known
completely for 29% while 11% of them reported a wrong
answer. While 30% of parents have incomplete answer
about rout of insulin administration but for children its
unknown for 13% while it’s known completely for 22% of
them. And about normal range of blood glucose it’s known
for 68% of parents while it’s unknown for 23% of them but
for children it’s known for 45% while it’s unknown for 35%
of them.
· Meanwhile two thirds of mothers were positive coping
responses; there were insignificant association between
mother’s knowledge and care provided to their children.
Assessment parents care revealed out of 78 mothers less
than two-thirds of them perform subcutaneous injection
successfully and out of 18 mothers the majority of them
used glucometer properly.
The Main Recommendations are
In the light of the finding of the present study, it was
suggested the following recommendations:
· Ambulatory health care service based on diabetes child
needs accessible to rural families equipped with community
health nurse, family’s physician and first aids kit for the
management hypo/hyperglycaemic attacks and wound care.
· The community health nurse through home visit should
educate parents of diabetes children the self-blood
monitoring of sugar, insulin injection, and storage and routes
of insulin administration.
· Community health nurse assess the home environment and
give instruction about sanitation and preparation of diet
necessary for diabetic child.
· Health teaching about importance of periodic follow-up
daily exercise, foot care, use glycometer set and normal
range of blood glucose.
· School health nurse to be trained on care of diabetic children
in school, management of hypo/hyper glycaemic attack and
daily record the health problems and results of
managements.
· Emphasizing to parents and children and public in
community the importance of diabetes self-identity and
carrying sugar.