Abstract
Background: type 1 Diabetes Mellitus is a chronic disease that affects mostly children and young people. In its treatment, insulin therapy is essential. Insulin can be administered by Multiple Daily Injections (MDI) or by continuous subcutaneous insulin infusion (CSII) system. The latter has advantages, but the adaptation process is demanding. Objective: to identify mother’s views regarding the PSCI system in the treatment of DM1 of adolescents. Methodology: qualitative descriptive and exploratory study. Data collection was performed by semi-structured interview with 10 mothers of adolescents with DM1 who underwent treatment for DM1 with CSII. Its analysis was performed by Bardin's content analysis method. Results: from the analysis of the interviews, four categories emerged: The transition to CSII, Adolescent and family well-being, Adolescent autonomy and Limitations of the device and respective subcategories that expose the perception of mothers of adolescents with DM1 about treatment with CSII. Conclusion: treatment with CSII provides a better quality of life for adolescents and their families and favors the autonomy of adolescents. The adaptation process poses challenges and the support of health professionals is essential. Some limitations were identified in the device that hopefully will be overcome by the current technological innovations.
References
Alvarenga, C.S., La Banca, R.O., Neris, R.R., de Cássia Sparapani, V., Fuentealba-Torres, M., Cartagena-Ramos, … & Nascimento, L.C. (2022). Use of continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes mellitus: a systematic mapping review. BMC Endocrine Disorders, 22(1), 43. https://doi.org/10.1186/s12902-022-00950-7
Alsaleh, F.M., Smith, F.J., & Taylor, K.M. (2012). Experiences of children/young people and their parents, using insulin pump therapy for the management of type 1 diabetes: qualitative review. Journal of clinical pharmacy and therapeutics, 37(2), 140-147. doi: 10.1111/j.1365-2710.2011.01283
Alsaleh, F.M., Smith, F.J., Thompson, R. & Taylor, K.M. (2013). A structured educational insulin pump therapy programme: the views of children/young people and their parents. European Diabetes Nursing, 10, 25-30. https://doi.org/10.1002/edn.220
Alsaleh, F.M., Smith, F.J., Thompson, R., Al-Saleh, M.A., & Taylor, K.M. (2014). Insulin pump therapy: impact on the lives of children/young people with diabetes mellitus and their parents. International Journal of Clinical Pharmacy, 36(5), 1023–1030. https://doi.org/10.1007/s11096-014-9990-1
Blair, J.C., McKay, A., Ridyard, C., Thornborough, K., Bedson, E., Peak, M., ... & Gamble, C. (2019). Continuous subcutaneous insulin infusion versus multiple daily injection regimens in children and young people at diagnosis of type 1 diabetes: pragmatic randomised controlled trial and economic evaluation. BMJ, 365. https://doi.org/10.1136/bmj.l1226
Bardin, L. (2009). Análise de conteúdo. Edições 70
Florêncio, A., & Cerqueira, M., (2021). A família da criança com doença crónica no domicílio: emoções no cuidar. Revista de Investigação & Inovação em Saúde, 4(2). https://doi.org/10.37914/riis.v4i2.109
Fureman, A.L., Lilja, M., Lind, T., Särnblad, S., Bladh, M., & Samuelsson, U. (2021). Comparing Continuous
Subcutaneous Insulin Infusion and Multiple Daily Injections in children with type 1 diabetes in Sweden from 2011 to 2016–a longitudinal study from the Swedish National Quality Register (SWEDIABKIDS). Pediatric Diabetes. https://doi.org/10.1111/pedi.13217
Gajewska, K.A., Biesma, R., Bennett, K., & Sreenan, S. (2020). Barriers and facilitators to accessing insulin pump therapy by adults with type 1 diabetes mellitus: a qualitative study. Acta Diabetologica, 58(1), 93-105. doi:10.1007/s00592-020-01595-5
Iversen, A.S., Graue, M., Haugstvedt, A., & Råheim, M. (2018). Being mothers and fathers of a child with type 1 diabetes aged 1 to 7 years: a phenomenological study of parents’ experiences. International Journal of Qualitative Studies on Health and Well-being, 13(1), 1487758. https://doi.org/10.1080/17482631.2018.1487758
Katsarou, A., Gudbjörnsdottir, S., Rawshani, A., Dabelea, D., Bonifacio, E., Anderson, B.J., … Lernmark, Å. (2017). Type 1 diabetes mellitus. Nature Reviews Disease Primers, 3, 17016. https://doi.org/10.1038/nrdp.2017.16
Mueller-Godeffroy, E., Vonthein, R., Ludwig-Seibold, C., Heidtmann, B., Boettcher, C., Kramer, M., . . . Therapy, P. (2018). Psychosocial benefits of insulin pump therapy in children with diabetes type 1 and their families: The pumpkin multicenter randomized controlled trial. Pediatric Diabetes, 19(8), 1471-1480. doi:10.1111/pedi.12777
Nadella, S., Indyk, J.A., & Kamboj, M.K. (2017). Management of diabetes mellitus in children and adolescents: engaging in physical activity. Translational pediatrics, 6(3), 215. doi:10.21037/tp.2017.05.01
Patterson, C.C., Karuranga, S., Salpea, P., Saeedi, P., Dahlquist, G., Soltesz, G., & Ogle, G.D. (2019). Worldwide estimates of incidence, prevalence and mortality of type 1 diabetes in children and adolescents: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Research and Clinical Practice, 157. doi:10.1016/j.diabres.2019.107842
Rankin, D., Harden, J., Noyes, K., Waugh, N., Barnard, K., & Lawton, J. (2015). Parents' experiences of managing their child's diabetes using an insulin pump: a qualitative study. Diabetic Medicine: a Journal of the British Diabetic Association, 32(5), 627–634. https://doi.org/10.1111/dme.12683
Rankin, D., Kimbell, B., Hovorka, R., & Lawton, J. (2021). Adolescents' and their parents' experiences of using a closed-loop system to manage type 1 diabetes in everyday life: qualitative study. Chronic illness, 1742395320985924. Advance online publication. https://doi.org/10.1177/1742395320985924
Reidy, C., Bracher, M., Foster, C., Vassilev, I., & Rogers, A. (2018). The process of incorporating insulin pumps into the everyday lives of people with Type 1 diabetes: A critical interpretive synthesis. Health Expectations, 21(4), 714-729. https://doi.org/10.1111/hex.12666
Shee, A., Prior, S., Reeves, N., Smith, M., & Luccisano, S. (2019). Parental satisfaction on multiple daily injections, insulin pump and flexible multiple daily injections used for children with Type 1 diabetes mellitus. American Journal of Pediatrics, 5(2), 43-50. https://doi.org/10.1016/j.jcjd.2020.08.101
Sociedade Portuguesa de Diabetologia (2016). Diabetes: factos e números - O ano de 2015 - Relatório anual do Observatório Nacional da Diabetes. Lisboa. https://www.sns.gov.pt/wp-content/uploads/2017/03/OND-2017_Anexo2.pdf
Rego, A., Pina, M., & Meyer Jr, V. (2018). Quantos participantes são necessários para um estudo qualitativo? Linhas práticas de orientação. Revista de Gestão dos Países de Língua Portuguesa, 17(2), 43-57.
Ribeiro, L. (2010). Investigação e Avaliação em Psicologia e Saúde (2ª ed). Placebo
Rosner, B., & Roman-Urrestarazu, A. (2019). Health-related quality of life in paediatric patients with Type 1 diabetes mellitus using insulin infusion systems. A systematic review and meta-analysis. PLoS One, 14(6), e0217655. doi:10.1371/journal.pone.0217655
Trandafir, L.M., Moisa, S.M., Vlaiculescu, M.V., Butnariu, L.I., Boca, L.O., Constantin, M.M.L., ... & Burlacu, A. (2022). Insulin Pump Therapy Efficacy and Key Factors Influencing Adherence in Pediatric Population—A Narrative Review. Medicina, 58(11), 1671. https://doi.org/10.3390/medicina58111671
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Lígia Lima, Rute Silva, Luísa Andrade