Cristy Davis and Dr. Donna Freeborn, Nursing

The purpose of my project was to determine the effectiveness of interventional workshops to help children manage their type 1 diabetes. This project comprised the third and fourth phases of a larger interventional study, conducted by Dr. Donna Freeborn. The first two stages of the study focused on gathering and analyzing data about the needs of children/adolescents with type 1 diabetes. During the first two stages of the study Dr. Freeborn conducted a series of focus groups with children/adolescents with type 1 diabetes. From these focus groups, Dr. Freeborn identified four themes that were of concern for children/adolescents with diabetes. The four themes identified after the focus groups were: “Dealing with Low Blood Sugars”, “The Inconvenience of Diabetes”, “Being Different” and “Cheating.” These themes were used as the themes of the interventional workshops.

Under the direction of Dr. Freeborn, I, and three other nursing students planned and conducted the workshops for children with diabetes. The workshops were conducted as a pilot study to evaluate if this type of intervention would be helpful and feasible for children with diabetes. The workshops were meant to address challenges of living with diabetes, provide opportunities for social modeling, and promote peer interactions among children with diabetes. The workshops were held once a month for four months and each one focus on a different theme identified in the focus groups. Each workshop lasted two hours and included a welcome activity to help the kids feel comfortable, a pre and post test to measure learning or growth in the participants, a review from the previous workshop, and activities to teach the current topic.

I was in charge of planning and leading the second workshop focusing on “The Inconvenience of Diabetes.” In preparation for this workshop, I read research articles and the book 487 Really Cool Tips for Kids with Diabetes (Nasmyth Loy & Nasmyth Loy, 2004). I also used the book Sibshops: Workshops for Siblings of Children with Special Needs (Meyer & Vadasy, 2008), as a reference for planning activities. These resources helped me understand the needs of the participants and provided ideas for how to effectively teach and plan activities for this age group. From my research, I discovered that the best method for teaching children is through interactive play. Therefore, I planned a series of activities in order to teach the participants about ways to overcome the inconveniences of having diabetes.

One of the recommendations made by Meyer & Vadasy (2008), in their book, was to have a welcome activity to help children feel more comfortable in a new environment. At the start of my workshop I had the children each pick five different colored beads. Each color represented a question they had to answer about themselves, such as, “How many siblings do you have?” or “What is your favorite sport.” This activity helped the children relate to each other and find things they had in common besides diabetes. Once the children were comfortable with each other and the nursing students they were more willing to participate in the rest of the activities and share their feelings. The other activities used for this workshop included a scavenger hunt and making clay sculptures to represent the hardest part about having diabetes. These venues allowed the children to express their feelings in a non-threatening way and relate to the other children.

After the completion of the four workshops we saw mostly qualitative improvements in the participants attitude about diabetes. The pre/post tests given to the participants at each workshop proved to be an ineffective measurement of the children’s growth and learning. We found that the children were too young to understand the questions and therefore the results were inaccurate. However, at the conclusion of the entire intervention the participants and their parents were asked to evaluate their experience and the effectiveness of the intervention. The parents all stated that they saw “some difference” to a “big difference” in their child’s understanding of diabetes and adherence to their plan of care after the workshops. Both parents and the children expressed that they would be willing to participate in similar workshops in the future.

I believe that the qualitative improvements we saw in the participants’ attitudes support our hypothesis that interventional workshops could be a helpful intervention for children with diabetes. However, this study was not without limitations. The original pilot study only included three participants from age seven to ten. The small sample size and lack of reliable data indicate a need for further research. While our results may not definitively prove the effectiveness of this type of intervention on a large scale, they show that workshops are feasible and may be helpful. Therefore, the goals of this pilot study were achieved and the groundwork for future research was laid.

This fall I submitted an abstract of my research to the Nursing research office and was selected to present at The 34th Annual Nursing Research Conference at BYU. At the conference I shared our experience and how it applies to the nursing profession. I also explained our plans for the future, which included holding another round of workshops. This fall I participated in the second round of workshops, which also included a class for parents. This second round of workshops attracted twice the number of participants as the original study. With a larger number of participants we noticed more collaboration and sharing of feelings among the children. They seemed to have a greater sense of belonging because they recognized how many other children also had diabetes. In the future we hope to find a local organization that could take over these workshops and keep them going on a continual basis. We believe that it would be a very useful community resource for families of children with diabetes. We also intend to publish our work as a pilot study.

References

• Meyer, D., & Vadasy, P. (2008). Sibshops: Workshops for Siblings of Children with Special Needs. Baltimore: Paul H. Brookes Publishing.
• Nasmyth Loy, S., & Nasmyth Loy, B. (2004). 487 really cool tips and tricks for kids with diabetes. Alexandria, VA: The American Diabetes Association.