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家长对新诊断出糖尿病的幼儿的学校/日托经历的看法。

Parent Perspectives of School/Daycare Experiences in Young Children Newly Diagnosed With Diabetes.

机构信息

Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, USA.

Clinical and Translational Research, Children's National Hospital, USA.

出版信息

J Pediatr Psychol. 2023 May 20;48(5):490-501. doi: 10.1093/jpepsy/jsad011.

Abstract

OBJECTIVE

A central part of family adjustment to a new diagnosis of type 1 diabetes (T1D) is integrating T1D management into the child's school/daycare. This may be particularly challenging for young children who rely on adults for their diabetes management. This study aimed to describe parent experiences with school/daycare during the first 1.5 years following a young child's T1D diagnosis.

METHODS

As part of a randomized controlled trial of a behavioral intervention, 157 parents of young children with new-onset (<2 months) T1D reported on their child's school/daycare experience at baseline and at 9- and 15-month post-randomization. We used a mixed-methods design to describe and contextualize parents' experiences with school/daycare. Qualitative data were collected via open-ended responses, and quantitative data were collected from a demographic/medical from.

RESULTS

While most children were enrolled in school/daycare at all time points, over 50% of parents endorsed that T1D affected their child's enrollment, rejection, or removal from school/daycare at 9 or 15 months. We generated five themes related to parents' school/daycare experiences: Child factors, Parent factors, School/Daycare factors, Cooperation between Parents and Staff, and Socio-historical factors. Parents of younger children and those with lower subjective socioeconomic status were significantly more likely to endorse challenges with school/daycare enrollment.

CONCLUSIONS

School/daycare settings present challenges for parents of young children with T1D. Changes may need to occur across contexts to support early childhood education, including advocacy resources for parents to navigate school policies, increased training for school staff, and healthcare team outreach initiatives to parents and schools.

摘要

目的

家庭适应 1 型糖尿病(T1D)新诊断的一个核心部分是将 T1D 管理融入儿童的学校/日托。对于依赖成人进行糖尿病管理的幼儿来说,这可能特别具有挑战性。本研究旨在描述幼儿 T1D 诊断后最初 1.5 年内父母在学校/日托的经历。

方法

作为一项行为干预随机对照试验的一部分,157 名患有新确诊(<2 个月)T1D 的幼儿的父母在基线和随机分组后 9 个月和 15 个月时报告了他们孩子的学校/日托经历。我们使用混合方法设计来描述和背景化父母在学校/日托的经历。定性数据通过开放式回答收集,定量数据来自人口统计学/医疗信息。

结果

尽管大多数孩子在所有时间点都入读了学校/日托,但超过 50%的父母表示 T1D 影响了他们孩子在 9 或 15 个月时的入学、拒绝或被学校/日托除名。我们生成了五个与父母学校/日托经历相关的主题:儿童因素、父母因素、学校/日托因素、父母与工作人员之间的合作以及社会历史因素。年龄较小的儿童和主观社会经济地位较低的父母更有可能对学校/日托入学存在挑战。

结论

学校/日托环境对幼儿 T1D 父母来说是一个挑战。可能需要在各个方面做出改变,以支持幼儿教育,包括为父母提供政策指导、为学校工作人员提供更多培训以及为父母和学校提供医疗团队外联倡议等资源。

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