The purpose of this study was to explore the feasibility of using human patient simulation (HPS) to teach type 1 diabetes (T1DM) management to grandparents of grandchildren with T1DM.
Methods
Thirty grandparents (11 male, 19 female) of young grandchildren (aged 12 and under) with T1DM were recruited from an urban medical center. Experimental group (n = 14) grandparents received hands-on visual T1DM management education using an HPS intervention, and control group (n = 16) grandparents received similar education using a non-HPS intervention.
Findings
This study demonstrated the feasibility of recruiting and retaining grandparents into a clinical trial using HPS to teach T1DM management. Post intervention, all grandparent scores for T1DM knowledge, confidence, and fear showed significant improvement from time 1 to time 2, with HPS group grandparent scores showing consistently larger improvement.
Conclusions
The consistency of larger HPS-taught grandparent score improvement is suggestive of a benefit for the HPS teaching method. Early multimethod Certified Diabetes Educator (CDE)–provided T1DM education is an important point of entry for inducting grandparent members onto the grandchild’s diabetes care team.
Get full access to this article
View all access options for this article.
References
1.
LeeMGardnerJ. Grandparents’ involvement and support in families with children with disabilities. Educ Gerontol. 2010;36:467-499.
2.
MitchellW. Grandparents and family support: the role played by grandparents in family support and learning: considerations for mainstream and special schools. Support for Learning. 2008;23(3):126-135.
3.
RempelGRRogersLGRavindranVMagill-EvansJ. Facets of parenting a child with hypoplastic left heart syndrome. Nurs Res Pract. 2012:2-9.
4.
MargettsJLe CouteurACroomS. Families in a state of flux: the experience of grandparents in autism spectrum disorder. Child Care Health Dev. 2006;32(5):565-574.
5.
RavindranVPRempelGR. Grandparents and siblings of children with congenital heart disease. J Adv Nurs. 2011;67(1):169-175.
PattersonCCGyürüsERosenbauerJ. Trends in childhood type 1 diabetes incidence in Europe during 1989-2008: evidence of non-uniformity over time in rates of increase. Diabetologia. 2012;55(8):2142-2147.
8.
VehikKDabeleaD. The changing epidemiology of type 1 diabetes: why is it going through the roof?Diabetes Metab Res Rev. 2011;27(1):3-13.
9.
PowersSWByarsKCMitchellMJPattonSRStandifordDADolanLM. Parent report of mealtime behavior and parenting stress in young children with type 1 diabetes and in healthy control subjects. Diabetes Care. 2002;25(2):313-318.
10.
GinsburgKRHoweCJJawadAF. Parents’ perceptions of factors that affect successful diabetes management for their children. Pediatrics. 2005;116(5):1095-1104.
11.
HoffALMullinsLLGillaspySRPageMCVan PeltJCChaneyJM. An intervention to decrease uncertainty and distress among parents of children newly diagnosed with diabetes: a pilot study. Fam Syst Health. 2005;23(3):329-342.
12.
Sullivan-BolyaiSDeatrickJGruppusoPTamborlaneWGreyM. Constant vigilance: mothers’ work parenting young children with type 1 diabetes. J Pediatr Nurs. 2003;18(1):21-29.
13.
SmaldoneARitholzMD. Perceptions of parenting children with type 1 diabetes diagnosed in early childhood. J Pediatr Health Care. 2011;25(2):87-95.
14.
De OliveiraIRNascif-JúniorIARochaSM. Promoting health in families of children with type 1 diabetes mellitus. Clin Excell Nurse Pract. 2010;16(2):106-111.
15.
BarnardKThomasSRoylePNoyesKWaughN. Fear of hypoglycaemia in parents of young children with type 1 diabetes: a systematic review. BMC Pediatr. 2010;10(50):18.
16.
LowesLGregoryJWLyneP. Newly diagnosed childhood diabetes: a psychosocial transition for parents?J Adv Nurs. 2005;50(3):253-261.
17.
Sullivan-BolyaiSKnaflKDeatrickJGreyM. Maternal management behaviors for young children with type 1 diabetes. MCN Am J Matern Child Nurs. 2003;28(3):160-166.
18.
McDougalJ. Promoting normalization in families with preschool children with type 1 diabetes. J Spec Pediatr Nurs. 2002;7(3):113-120.
19.
LowesLLynePGregoryJW. Childhood diabetes: parents’ experience of home management and the first year following diagnosis. Diabet Med. 2004;21:531-538.
20.
SilversteinJKlingensmithGCopelandK. Care of children and adolescents with type 1 diabetes a statement of the American Diabetes Association. Diabetes Care. 2005;28(1):186-212.
21.
HaasLMaryniukMBeckJ. National standards for diabetes self-management education and support. Diabetes Educ. 2012;38(5):619-629.
22.
FunnellMMBrownTLChildsBP. National standards for diabetes self-management education. Diabetes Care. 2009;32(suppl 1):S87-S94.
23.
JeffriesP. A framework for designing, implementing, and evaluating simulations used as teaching strategies in nursing. Nurs Educ Perspect. 2005;26(2):96-103.
WrightMTaekmanJMBarberLHobbsGNewmanMFStafford-SmithM. The use of high-fidelity human patient simulation as an evaluative tool in the development of clinical research protocols and procedures. Contemp Clin Trials. 2005;26:646-659.
26.
JohnsonJE. Self-regulation theory and coping with physical illness. Res Nurs Health. 1999;22(6):435-448.
27.
LeventhalH. Findings and theory in the study of fear communications. Adv Exp Soc Psychol. 1970;5:119-186.
28.
Sullivan-BolyaiSJohnsonKCullenK. Tried and true: self-regulation theory as a guiding framework for teaching parents diabetes education using human patient simulation. ANS Adv Nurs Sci. 2014;37(4):340-349.
29.
ThoolenBDe RidderDBensingJGorterKRuttenG. Beyond good intentions: the development and evaluation of a proactive self-management course for patients recently diagnosed with type 2 diabetes. Health Educ Res. 2008;23(1):53-61.
30.
MaguireL. Adapting a parent diabetes education intervention for grandparents using focus group data. Nurs Res. 2013;62(2):E83-E84.
31.
Sullivan-BolyaiSBovaCLeeMJohnsonK. Development and pilot testing of a parent education intervention for type 1 diabetes. Diabetes Educ. 2012;38(1):50-57.
32.
HeidgerkenADMerloLWilliamsLB. Diabetes awareness and reasoning test: a preliminary analysis of development and psychometrics. Child Health Care. 2007;36(2):117-136.
33.
GrossmanHYBrinkSHauserST. Self-efficacy in adolescent girls and boys with insulin-dependent diabetes mellitus. Diabetes Care. 1987;10(3):324-329.
34.
ClarkeWLGonder-FrederickLASnyderALCoxDJ. Maternal fear of hypoglycemia in their children with insulin dependent diabetes mellitus. J Pediatr Endocrinol Metab. 1998;11(suppl):189-194.
35.
ResnickBInguitoPOrwigD. Treatment fidelity in behavior change research: a case example. Nurs Res. 2005;54(2):139-143.
36.
ArainMCampbellMJCooperCLLancasterGA. What is a pilot or feasibility study? A review of current practice and editorial policy. BMC Med Res Methodol. 2010;10(1):67.
37.
ThabaneLMaJChuR. A tutorial on pilot studies: the what, why and how. BMC Med Res Methodol. 2010;10(1):1-10.
38.
VozenilekJHuffSReznickMGordonJA. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004;11(11):1149-1154.
39.
GreenS. Grandma’s hands: parental perceptions of the importance of grandparents as secondary caregivers in families of children with disabilities. Int J Aging Hum Dev. 2001;53(1):11-33.
40.
HastingsRThomasHDelwicheN. Grandparent support for families of children with Down’s syndrome. J Appl Res Intellect Disabil. 2002;15:97-104.
41.
SearRMaceR. Who keeps children alive? A review of the effects of kin on child survival. Evol Hum Behav. 2008;29(1):1-18.
42.
KingVRussellSTElderGH. Grandparenting in family systems: an ecological perspective. In: Handbook on Grandparenthood, SzinovaczME, ed. Westport, CT: Greenwood Press; 1998: 53-69.
43.
UhlenbergPHammillBG. Frequency of grandparent contact with grandchild sets: six factors that make a difference. Gerontologist. 1998;38(3):276-285.
44.
RabbaniAAlexanderGC. The association between family structure, reports of illness and health care demand for children: evidence from rural Bangladesh. J Biosoc Sci. 2009;41(5):645-660.
45.
KirkKFedeleDWolfe-ChristensenC. Parenting characteristics of female caregivers of children affected by chronic endocrine conditions: a comparison between disorders of sex development and type 1 diabetes mellitus. J Pediatr Nurs. 2011;26:e29-e36.
