Insights into sources of distress, and ways to reduce them
Diabetes can take an emotional toll on adults and adolescents. And person-centred care is valued by adults with diabetes. But is the same true for young children? Patricia DeCosta and her PhD supervisor, the ACBRD’s Timothy Skinner, set out to explore this question.
This study explored the health care of young children with diabetes. The researchers interviewed health professionals (nurses, doctors, psychologists and dietitians) who work in paediatric (children’s) diabetes clinics. They found four themes.
1. Support immediate emotional needs. Be aware of triggers for anxiety and stress for young children. These include injections, being around strangers, and being in an unfamiliar place. To help a child to feel safe, it is important to minimise medical procedures (e.g. injections) during the clinic visit. Explain things in child-friendly terms and use visual aids. To build trust, it is important for children to see the same professionals at each visit. So, continuity of care is essential. Children also pick up on parents’ emotions, be mindful of this.
2. Put the child before the diabetes. Recognise that diabetes is only one part of the child’s life. Ask them about their life, e.g. what they enjoy, their friends, their pets. If the child tells you something about their life, take an interest. Then, note it in their clinical record and ask about it next time. Be aware that young children may not have the words to explain their emotions, thus, they may show how they feel in other ways (e.g. ‘acting out’).
3. Encourage meaningful participation. Young children want to be involved in what is happening to them. But they will get bored if there is too much ‘adult talk’. Involve the child when you can. If there needs to be some ‘adult talk’, let the child know they are free to play (with toys etc.). To reduce any fears of medical procedures (e.g. inserting a pump or sensor), demonstrate it on yourself or a soft toy. Then, ask the child if they would be ok with trying it too.
4. Playful communication. Use play, humour, and praise in consults. Get down to their level – sit on the floor or a low couch, play with toys. Diversions and incentives can help distract from pain (e.g. blood test). A fun and playful atmosphere can counteract fear and anxiety.
This study offers helpful insights into the emotional needs of young children, and useful tips for how to talk about diabetes with them. You can read the full paper here.
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Reference: DeCosta P, Grabowski D, Jespersen LN and Skinner TC. Playful Communication and Care: Exploring Child-Centred Care of Young Children With Type 1 Diabetes Through the Framework of Zone of Proximal Development. Frontiers in Clinical Diabetes and Healthcare, 2022, 2, p.707553, https://doi.org/10.3389/fcdhc.2021.707553.
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