Type 1 Diabetes Mellitus: Article Analysis

Summary of the Article

The study entitled, “What Is It Like to Be a Child with Type 1 Diabetes Mellitus?” by Sparapani, Jacob, and Nascimento (2015) is essentially where nineteen children between the ages of seven and twelve years old, who were diagnosed with type 1 diabetes and had the diagnosis for at least one year were chosen and had parental consent to participate in the study while they were being treated in an outpatient clinic of a university hospital in Sao Paulo, Brazil. The researchers (Sparapani, Jacob, and Nascimento, 2015) had the children make puppets that represented not only themselves but also people that they interacted with on a daily basis such as family members, friends, teachers, as well as devices such as syringes and glucose monitors. In order to collect data, the researchers used puppets and a stage in order to “create scenes that the children would encounter in their daily lives in order

to get the children to talk about their daily routine and how they would manage their diabetes throughout the day” (Sparapani, Jacob and Nascimento, 2015, p. 18). Through their collection of data, Sparapani, Jacob and Nascimento (2015) analyzed the data and were able to pin point the “four types of feelings that emerged that described the experience of ‘what it is like’ to be a child with type 1 diabetes mellitus; which were conflicting desires, insecurity, fear and pain” (p.19).
Analysis and Critique
“Type 1 diabetes mellitus is a common chronic disease that effects a person’s quality of life, psychological well-being and sense of control, and approximately two-thirds of all diabetes cases are diagnosed in children” (Sparapani, Jacob and Nascimento, 2015, p.17). The purpose of this study was to increase understanding of what it is like for a child to have type 1 diabetes and to target what factors may hinder disease management (Sparapani, Jacob and Nascimento, 2015, p.17). The article entitled, “What Is It Like to Be a Child with Type 1 Diabetes Mellitus?” not only was successful in increasing ones understanding of this chronic disease from a child’s standpoint; it also was very enlightening about how a nurse could better care for the entire patient by teaching their patients about what is going on in their body, and to realize that it effects the whole person and their quality of life. Dealing with type 1 diabetes mellitus is a disease that effects ones “quality of life, psychological well-being, and sense of control” (Sparapani, Jacob and Nascimento, 2015, p.17)
Problems and Purpose
The article provides information that Sparapani, Jacob and Nascimento gathered through interviewing 19 children through the use of puppets. Sparapani, Jacob and Nascimento decided to perform this study because they had found that there was very little research done on examining ‘what it is like’ to be a child with type 1 diabetes and thought that by “investigating children’s own experiences with living with diabetes, nurses may promote successful disease management and build educational and psychosocial programs that best support the needs of children with type 1 diabetes and their families (Sparapani, Jacob and Nascimento, 2015, p. 17). There did not seem to be many problems with this study in general the only thing that could have possibly made it better would be to have included the questions that were asked of the children and having a larger sample group of children for the study that were from various regions rather than just one outpatient clinic of a university hospital in Brazil.
Research Method
Sparapani, Jacob, and Nascimento (2015) chose to perform qualitative interviews with 19 children about their daily life and what it is like to have diabetes. The sample of children “consisted of 13 girls and 6 boys, all between the ages of 7 and 12 years old, and all having been diagnosed with type 1 diabetes for at least 1 year, but not more than 10 years” (p.19). From the qualitative interviews that were performed with puppets to get the children to open up about their daily lives and what it is like to live with diabetes as a child Sparapani, Jacob and Nascimento found out that there were major themes that arose after talking to the children, those being: “conflicting desires; insecurity, fear and pain; worry about long term effects; inadequate knowledge of the disease; prejudice, rejection and shame” (2015, p.19-20).
Relationship between Study’s Problem and Method
Sparapani, Jacob and Nascimento (2015) assert that with finding out the child’s perspective of what it is like living with diabetes, that nurses could play a more active role is successful disease management and build more educational programs to help support not only the children with type 1 diabetes, but also their families (p.17). The choice of using puppets to perform qualitative studies with these children was extremely appropriate considering the age range that was used by Sparapani, Jacob and Nascimento (2015) and probably the most effective way to get the children to open up about their daily lives and what it is like to live with diabetes as a child.
Evaluation and Recommendations
Sparapani, Jacob, and Nascimento (2015) were very thorough with their study using puppets to perform qualitative interviews with children between the ages of seven and twelve years, who were diagnosed and had type 1 diabetes mellitus for at least 1 year in order to examine their “thoughts, feelings, and how they managed having diabetes.” They did not provide the specific questions that they had asked the children; however they did include transcribed answers that were made by the children that also included the participants’ nonverbal behaviors.

Upon the analysis of the answers given by the children, Sparapani, Jacob and Nascimento (2015) determined that there were “four types of feelings emerged that described what types of experiences of ‘what it is like’ to be a child with type 1 diabetes: conflicting desires, insecurity, fear and pain.” Yet it was unclear as to how they made this determination besides them stating that after going through all the passages, categories and subcategories occurred, which in turn allowed data coding to be

accomplished.
Although this study did provide a lot of qualitative data, it really should have had more participants than just 19 children, just to have a larger sample to make it easier to find any outliers. To make the study even better, it should have included children from more than just one university hospital, just to ensure the results of Sparapani, Jacob and Nascimento (2015) did not only reflect the thoughts and feelings of what it is like to be a child with type 1 diabetes in just that region.
New Information Learned
The new information learned from this study was that when caring for a patient, especially a child, there are many things to take into consideration besides just treating the disease. Factors such as letting them know what it is going to feel like, as far as pain, making sure that they understand what is going on with their body, explaining to the child that there is nothing that they need to be ashamed of, and attempting to be there for them if they do have any questions about how to deal with everyday lifestyle changes that are required due to the diagnosis of type 1 diabetes.
How the information of the article will be helpful to the students in the clinical area during this semester
The information of this article will be helpful to the students in the clinical area during this semester because it provides a child’s insight on how it is to have and attempt to manage having Type 1 diabetes mellitus. It also provides ideas for nurses, as to effective ways to develop educational activities for children who are diagnosed with type 1 diabetes as well as reminders of things to think about when interacting or treating a young child who has diabetes; such as the pain of the needles, the fear of the needles, and the other emotional and psychosocial aspects that come along with having any long term disease.

Reference
Sparapani, V.C., Jacob, E., & Nascimento, L. C. (2015). What Is It Like to Be a Child with Type 1 Diabetes Mellitus?. Pediatric Nursing, 41(1), 17-22.