Health literacy of mothers in managing emergency situations of their children with diabetes
DOI:
https://doi.org/10.18554/refacs.v8i0.5016Keywords:
Health literacy, Diabetes mellitus, Type 1, Pediatric nursing, Mothers, Emergencies.Abstract
This is a qualitative and descriptive study, carried out between 2018 and 2019, in an outpatient clinic and pediatric wards of a public university hospital in the interior of the state of São Paulo, aiming to identify how Health Literacy helps mothers in the management of emergency situations of their children with type 1 diabetes mellitus. Individual semi-structured interviews were conducted with 10 mothers aged between 25 and 44 years (mean=34.1 years; SD±6.5). The number of emergency situations experienced: more than 10 (n=1); between 5 and 10 (n=3); and less than 5 (n=6). The respondents’ children and adolescents were aged between 8 and 17 years (mean=12.2 years; SD±3.4) and time since diagnosis of T1D was between 3 months and 11 years (mean=4.1 years; SD ± 3.5). Four themes emerged: “Getting information related to diabetes care”; “Understanding information about diabetes”; “Assessing emergency situations: recognizing and interpreting signs and symptoms of hypoglycemia and hyperglycemia”; and “Applying knowledge: conduct of mothers in an emergency situation”. The skills on access and understanding were insufficient, but the mothers constantly evaluated their children and referral to hospitals during emergencies was frequent, in the applying knowledge competence. It is concluded that mothers' literacy is dynamic, since competences are used according to their experiences in urgent situations, so health professionals must consider this dynamism and the need to provide support and promote mothers’ health literacy.
References
International Diabetes Federation. IDF Diabetes Atlas [Internet]. Ninth. Brussels: IDF; 2019 [citado em 05 out 2020]. 168p. Disponível em: https://www.diabetesatlas.org/upload/resources/material/20200224_151105_IDFATLAS9e-final-web.pdf
American Diabetes Association. Classification and diagnosis of diabetes: standards of medical care in diabetes - 2020. Diabetes Care [Internet]. 2020 Jan 20 [citado em 05 out 2020]; 43(Suppl 1):S14–31. Disponível em: http://care.diabetesjournals.org/lookup/doi/10.2337/dc20-S002
Mayer-Davis EJ, Kahkoska AR, Jefferies C, Dabelea D, Balde N, Gong CX, et al. ISPAD Clinical Practice Consensus Guidelines 2018: definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes [Internet]. 2018 [citado em 05 out 2020]; 19:7-19. Disponível em: http://doi.wiley.com/10.1111/pedi.12773
Okido ACC, Almeida A, Vieira MM, Neves ET, Mello DF, Lima RAG. Care demands of children with type 1 Diabetes Mellitus. Esc Anna Nery Rev Enferm. [Internet]. 2017 [citado em 05 out 2020]; 21(2):e20170034. Disponível em: https://www.scielo.br/pdf/ean/v21n2/en_1414-8145-ean-21-02-e20170034.pdf
Chiang JL, Maahs DM, Garvey KC, Hood KK, Laffel LM, Weinzimer SA, et al. Type 1 diabetes in children and adolescents: a position statement by the American Diabetes Association. Diabetes Care [Internet]. 2018 Sep [citado em 05 out 2020]; 41(9):2026–44. Disponível em: http://care.diabetesjournals.org/lookup/doi/10.2337/dci18-0023
Hermes TSV, Viera CS, Rodrigues RM, Toso BRGO, Fonseca LMM. Criança diabética do tipo 1 e o convívio familiar: repercussões no manejo da doença. Saúde Debate [Internet]. 2018 out [citado em 05 out 2020]; 42(119):927-39. Disponível em: https://www.scielo.br/pdf/sdeb/v42n119/0103-1104-sdeb-42-119-0927.pdf
Sparapani VC, Jacob E, Nascimento LC. What is it like to be a child with type 1 diabetes mellitus? Pediatr Nurs. [Internet]. 2015 [citado em 05 out 2020]; 41(1):17–22. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/26281271
Rifshana F, Breheny M, Taylor JE, Ross K. The parental experience of caring for a child with type 1 diabetes. J Child Fam Stud. [Internet]. 2017 Nov 9 [citado em 05 out 2020]; 26(11):3226–36. Disponível em: http://dx.doi.org/10.1007/s10826-017-0806-5
Sullivan-Bolyai S, Deatrick J, Gruppuso P, Tamborlane W, Grey M. Constant vigilance: mothers’ work parenting young children with type 1 diabetes. J Pediatr Nurs. [Internet]. 2003 Feb [citado em 05 out 2020]; 18(1):21–9. Disponível em: https://linkinghub.elsevier.com/retrieve/pii/S088259630243905X
Wolfsdorf J, Glaser N, Sperling MA. Diabetic ketoacidosis in infants, children, and adolescents: a consensus statement from the American Diabetes Association. Diabetes Care [Internet]. 2006 May 1 [citado em 05 out 2020]; 29(5):1150–9. Disponível em: http://care.diabetesjournals.org/cgi/doi/10.2337/dc06-9909
American Association of Diabetes Educators. Cultural and health literacy considerations with diabetes [Internet]. Chicago: American Association of Diabetes Educators; 2019 [citado em 05 out 2020]. p. 1-10. (AADE Pratice paper). Disponível em: https://www.diabeteseducator.org/docs/default-source/practice/educator-tools/cultural-and-health-literacy-considerations-with-diabetes.pdf?sfvrsn=2
Keim-Malpass J, Letzkus LC, Kennedy C. Parent/caregiver health literacy among children with special health care needs: a systematic review of the literature. BMC Pediatr. [Internet]. 2015 [citado em 05 out 2020]; 15(1):92. Disponível em: http://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-015-0412-x
Saboga-Nunes L, Sørensen K, Pelikan JM. Hermenêutica da literacia em saúde e sua avaliação em Portugal (HLS-EU-PT). In: VIII Congresso Português de Sociologia 40 anos de democracias: progressos, contradições e prospetivas [Internet]; 2014; Lisboa. Lisboa, Portugal: Associação Portuguesa de Sociologia; 2014 [citado em 05 out 2020]. p. 15. Disponível em: https://docplayer.com.br/4153200-Hermeneutica-da-literacia-em-saude-e-sua-avaliacao-em-portugal-hls-eu-pt.html
Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health [Internet]. 2012 [citado em 05 out 2020]; 12(1):80. Disponível em: http://www.biomedcentral.com/1471-2458/12/80
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Heal Care [Internet]. 2007 Sept 16 [citado em 05 out 2020]; 19(6):349-57. Disponível em: https://academic.oup.com/intqhc/article-lookup/doi/10.1093/intqhc/mzm042
Tracy SJ. Qualitative quality: eight “big-tent” criteria for excellent qualitative research. Qual Inq. [Internet]. 2010 Dec [citado em 05 out 2020]; 16(10):837–51. Disponível em: http://journals.sagepub.com/doi/10.1177/1077800410383121
Elo S, Kääriäinen M, Kanste O, Pölkki T, Utriainen K, Kyngäs H. Qualitative content analysis. SAGE Open [Internet]. 2014 [citado em 05 out 2020]; 4(1):215824401452263. Disponível em: http://journals.sagepub.com/doi/10.1177/2158244014522633
Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. [Internet]. 2008 [citado em 05 out 2020]; 62(1):107-15. Disponível em: http://doi.wiley.com/10.1111/j.1365-2648.2007.04569.x
Bowes S, Lowes L, Warner J, Gregory JW. Chronic sorrow in parents of children with type 1 diabetes. J Adv Nurs. [Internet]. 2009 [citado em 05 out 2020]; 65(5):992-1000. Disponível em: http://doi.wiley.com/10.1111/j.1365-2648.2009.04963.x
Noser AE, Dai H, Marker AM, Raymond JK, Majidi S, Clements MA, et al. Parental depression and diabetes-specific distress after the onset of type 1 diabetes in children. Health Psychol. [Internet]. 2019 Feb [citado em 05 out 2020]; 38(2):103–12. Disponível em: http://doi.apa.org/getdoi.cfm?doi=10.1037/hea0000699
Holt RIG, Nicolucci A, Kovacs Burns K, Escalante M, Forbes A, Hermanns N, et al. Diabetes - attitudes, wishes and needs second study (DAWN2TM): cross-national comparisons on barriers and resources for optimal care-healthcare professional perspective. Diabet Med. [Internet]. 2013 July [citado em 05 out 2020]; 30(7):789–98. Disponível em: http://doi.wiley.com/10.1111/dme.12242
American Diabetes Association. Children and adolescents: standards of medical care in diabetes-2020. Diabetes Care [Internet]. 2020 Jan 20 [citado em 05 out 2020]; 43(Suppl 1):S163–82. Disponível em: http://care.diabetesjournals.org/lookup/doi/10.2337/dc20-S013
Barry M, Dixon M, Armstrong C, Keane F. The pillow project, infant choking, and basic life support training for prospective parents. J Perinat Neonatal Nurs. [Internet]. 2019 [citado em 05 out 2020]; 33(3):260-7. Disponível em: http://insights.ovid.com/crossref?an=00005237-201907000-00015
Marker AM, Monzon AD, Nelson E-L, Clements MA, Patton SR. An intervention to reduce hypoglycemia fear in parents of young kids with type 1 diabetes through video-based telemedicine (Redchip): trial design, feasibility, and acceptability. Diabetes Technol Ther [Internet]. 2020 [citado em 05 out 2020]; 22(1):25–33. Disponível em: https://www.liebertpub.com/doi/10.1089/dia.2019.0244
Abraham MB, Jones TW, Naranjo D, Karges B, Oduwole A, Tauschmann M, et al. ISPAD Clinical Practice Consensus Guidelines 2018: assessment and management of hypoglycemia in children and adolescents with diabetes. Pediatr Diabetes [Internet]. 2018 Oct [citado em 05 out 2020]; 19(May):178-92. Disponível em: http://doi.wiley.com/10.1111/pedi.12698
Wolfsdorf JI, Glaser N, Agus M, Fritsch M, Hanas R, Rewers A, et al. ISPAD Clinical Practice Consensus Guidelines 2018: diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatr Diabetes [Internet]. 2018 Oct [citado em 05 out 2020]; 19(April):155–77. Disponível em: http://doi.wiley.com/10.1111/pedi.12701
Barnard K, Thomas S, Royle P, Noyes K, Waugh N. Fear of hypoglycaemia in parents of young children with type 1 diabetes: a systematic review. BMC Pediatr. [Internet]. 2010 [citado em 05 out 2020]; 10(1):50. Disponível em: https://bmcpediatr.biomedcentral.com/articles/10.1186/1471-2431-10-50
Freckleton E, Sharpe L, Mullan B. The relationship between maternal fear of hypoglycaemia and adherence in children with type-1 diabetes. Int J Behav Med. [Internet]. 2014 Oct 5 [citado em 05 out 2020]; 21(5):804–10. Disponível em: http://link.springer.com/10.1007/s12529-013-9360-8
Lindström C, Åman J, Norberg AL, Forssberg M, Anderzén-Carlsson A. “Mission impossible”: the mothering of a child with type 1 diabetes – from the perspective of mothers experiencing burnout. J Pediatr Nurs [Internet]. 2017 [citado em 05 out 2020]; 36:149-56. Disponível em: https://linkinghub.elsevier.com/retrieve/pii/S0882596316301063
Arevalo S. It takes a village to control diabetes. AADE Pract. [Internet]. 2017 [citado em 05 out 2020]; 5(3):28-32. Disponível em: http://journals.sagepub.com/doi/10.1177/2325160317698180
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