Intensive insulin therapy in the early primary school setting: A meta-ethnography — ASN Events
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Intensive insulin therapy in the early primary school setting: A meta-ethnography (#397)

Anne Marks 1 , Lesley Wilkes 1 2 , Stacy Blythe 1 , Rhonda Giffiths 1
  1. School of Nursing and Midwifery, University of Western Sydney, Penrith, NSW, Australia
  2. Centre for Nursing Research and Practice Development, Nepean Blue Mountains Local Health District, Penrith, NSW, Australia

Aim: To examine how intensive insulin therapy is integrated into the early primary school setting to identify support strategies in order to inform policy and practice.

Background: Type 1 diabetes is one of the most common, and fastest growing, chronic health conditions in childhood 1-4. The rising number of children with type 1 diabetes in the younger age groups and the use of intensive insulin therapy, has placed more demands on the early primary school setting. Young children may face obstacles when they enter the school system, with implications for diabetes care.

Methods: Cinahl, Scopus, Medline, Health source nursing, psycINFO and ERIC data bases were searched for articles between January 2005 and January 2015. The search terms included: diabetes mellitus type 1, primary school, diabetes educator, teachers, parents and insulin therapy. A synthesis of qualitative research was then conducted using a meta-ethnographic comparative approach, with reciprocal translation and line of argument synthesis. Quality appraisal of articles was also conducted.

Findings: 14 studies were included in the meta-ethnography 5-18. 7 major themes were identified: Oh, it’s needles!, great expectations, I’m not a diabetes expert, cover your back, like everyone else, worried about safety and working together. Risk management, competent diabetes care and a sense of normality and understanding were key areas that required addressing to improve integration of intensive insulin therapy. Collaboration and planning between the home, health, education and legal systems is also essential.

Conclusion: Intensive insulin therapy has not been well integrated into the early primary school setting, and has created issues for children, parents, education and diabetes staff.  Health and education systems need to advocate for the development of consistent legal frameworks and the provision of an adequate workforce to cope with the increasing numbers of children with type 1 diabetes.

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