الفهرس 
Diabetes MellitusOnly 14 pages are availabe for public view
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Abstract
Type 1 diabetes mellitus is a common childhood problem faced by health care personnel including doctors, nurses and others in both hospitals and community settings. Lack of knowledge and presence of conflicting information regarding management of children having diabetes influence the quality of care and children’s health. Conflicting knowledge related to the management of diabetes continue to be the most prevalent childhood health issues encountered by parents. Children with diabetes face a lot of psychological, social and biological problems. The purpose of the study was to: -The purpose of this study is to assess the effect of bio psychosocial model on parents’ self-efficacy and coping strategies among children with type 1 Diabetes Mellitus.Hypotheses: -Children with type (1) Diabetes Mellitus who receive bio-psychosocial intervention model will have better biological,psychological, and social coping strategies on post-test than on pre-test.Parents of children with type (1) Diabetes Mellitus who receive bio-psychosocial intervention model will have better self-efficacy for disease management on post-test than on pre-test.Research design: -A Quasi- experimental design was used (pre, post-test and follow-up test)Setting: -This study was conducted in the out-patient clinic at Menoufia University Hospital, Shebein Elkom Teaching Hospital and special out patient clinics.Sampling: -A purposive sample of 60 diabetic children with (type 1 diabetes) and their parents of diabetic children who agree to participate in the study and meet the criteria of sample selection was included. Instruments of the study: -In order to achieve the purpose of the study, the following instruments were used: Instrument one: A Structured Interview Questionnaire:It was developed by (La Clare, 2013) and adopted by the researchers. It was used to collect data about children, and their parents. It includes four parts: Part one: characteristics of children and their parents, It includes:Characteristic of children with type (1) diabetes: It involves questions about age, sex and duration since diagnosis Parent’s characteristics: It includes age, marital status, parent’s education, job, family income, and telephone number.• Parent’s knowledge about diabetes: it includes questions about what is the meaning of diabetes?, what are the manifestations of diabetes?,what are the sites of insulin injection?, What are the complications of diabetes ?Part two: Adjustment of children and their parents to Diabetes: It developed by researcher it included five open ended questions to assess adjustment of affected children and their parents to type 1 diabetes Part three: Children’s Adherence to Diabetes regimen: It developed by researcher it includes fourteen questions that were designed to assess diet regimen adherence by children under the influence of their parents. Part four: Laboratory investigation record: It includes Random and fasting blood Sugar.Hemoglobin A1C (HbA1c) level.Instrument two: Children’s Coping Strategies Inventory. It is a coping strategies inventory for Children and Adolescents that was developed by Rosenstein and Keefe, (1983) and adopted by the researchers. It included 17-item self-report instrument to measure the frequency and effectiveness of coping strategies used by children and adolescents in response to stressful events. Instrument three: Parents’ Self-Efficacy Likert Scale. It was developed by Ralf & Matthias, (1993) and adopted by the researcher.It includes eight-items to assess parent level of self-efficacy regarding management of diabetes. The main results of the study showed that:More than half of studied children (51.7%) aged between 6<9 years with mean age 1.78 ± 8.817 years.• More than half of studied children (60.0%) had diabetes for less than 5years.Around half of studied children (48.3%) their weight was 30<40kg.• More than three quadrant of Parents (80%) aged 20<40 years.The mean score of parents’ knowledge on pre-test was 10.17 ± 2.89 compared to 12.10 ± 3.71 and 15.40 ± 3.13 on post and follow-up tests respectively.Children had the highest mean total scores of adjustment on post-test. On pre-test was 9.95 ± 1.407 compared to 11.35 ± 1.62 & 12.73 ± 1.24
on post and follow-up tests.Children had higher mean total score of regimen adherence to diabetes on post-test and follow-up compared to pre-test (34.10 ± 3.61 & 38.36 ±3.76) compared to (29.71 ± 5.70) respectively.The mean score of children’s coping on pre-test was 47.05 ± 5.96 compared to 52.18 ± 7.240 & 62.65 ± 3.965 on post and follow-up tests
respectively.Parents of diabetic children had higher mean total score of self-efficacy on follow-up and post-test (11.25 ± 1.80 & 13.20 ± 1.95) compared to pre-test compared to (9.60 ± 1.56) respectively.There was appositive correlations between children’s age and Level of adjustment of children to diabetes, level of children’s coping and
children’s regimen adherence to diabetes at 0.0001% level of statistical significance.The study concluded that:Based on the results of the present study, it was concluded that bio-psychosocial model had a significant effect on parents’ self-efficacy and coping strategies among children with type 1 Diabetes Mellitus. Also, it contributed to higher levels of knowledge about diabetes and its management.Based on the results of the study, it was recommended that:In the light of the findings obtained from the current study and conclusion, the following recommendations are suggested:Recommendations for Nursing Practice: -• Applying bio psychosocial model for diabetes management in outpatient clinics and Pediatric diabetes care centers.All parents of children with diabetes should be provided with the required supplies to demonstrate the appropriate up to date management for children with diabetes (e.g. digital or electronic blood sugar measurement machine).Integrating nursing practice guidelines (assessment of coping behavior,maintaining appropriate glucose monitoring , performing effective foot care, providing good health education , using effective communication,control of environmental stressors, encouraging parental presence and participation in child care and reassessment of coping behavior) into the outpatient clinics and Pediatric diabetes care centers .Recommendations for Education: Ongoing in-service health education programs based on application of bio psychosocial model for children with diabetes should be designed and implemented into the outpatient clinics and diabetes care centers to improve management of children with diabetes.Different methods of teaching and learning such as group discussion,presentations, demonstration and re-demonstration should be used for improving parents’ knowledge about diabetes in outpatient clinics and Pediatric diabetes care centers Libraries containing books, electronic media and internet access for all parents should be established at outpatient clinics and should contain scientific materials regarding application of bio-psychosocial model and up to date care for their children with diabetes.Standardized bio-psychosocial model for children with diabetes should be integrated into pediatric nursing curriculum.Recommendations for diabetes centers:• Pediatric diabetes care centers administrative authorities should develop policies that encourage the utilization of bio-psychosocial model for the management of children with diabetes.Providing online workshops and sessions about new trends in diabetes management. Recommendations for Research: -Further studies should be implemented on a larger sample of children and their parents in other pediatrics departments to ensure the generalizability of results..