Education and telephone case management for children with type 1 diabetes: a randomized controlled trial.
The purpose of the study was to compare three nursing interventions and their impact on glycemic control among children with type I diabetes. The 75 subjects' mean +/- SD age was 12.5 +/- 3.4 years, 55% were boys, and 55% were White. Subjects were randomly assigned to a standard care (SC), an education (ED), or an education and telephone case management (ED + TCM) group. The primary outcome measure was glycemic control (hemoglobin A1c, or HbA1c). Secondary outcome measures were diabetes knowledge (KNOW), parent-child teamwork (TEAM), and adherence (ADH). After 6 months of follow-up, results demonstrated no significant differences among groups in HbA1c. KNOW and TEAM scores improved slightly in the ED and ED + TCM groups, but no statistically significant differences were found among the three groups. Significant improvement in ADH scores among ED + TCM groups was reported when compared with the ED and SC groups. This change may represent a move toward improved adherence to diabetes care and subsequent improvement in diabetes control. The challenges of recruitment and retention of subjects in this study will also be discussed.
Howe
Carol J
CJ
Diabetes Center for Children, The Children's Hospital of Philadephia, PA 19104, USA.
Jawad
Abbas F
AF
Tuttle
Alan K
AK
Moser
Joanne T
JT
Preis
Christina
C
Buzby
Marianne
M
Murphy
Kathryn M
KM
D000293:Adolescent; D000704:Analysis of Variance; D019090:Case Management / Q000458:organization & administration*; D002648:Child; D002675:Child, Preschool; D003299:Cooperative Behavior; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism / Q000451:nursing / Q000517:prevention & control*; D004521:Educational Measurement; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care; D010287:Parent-Child Relations; D010349:Patient Compliance / Q000523:psychology; D010353:Patient Education as Topic / Q000458:organization & administration*; D010371:Pediatric Nursing / Q000458:organization & administration*; D015143:Philadelphia; D015397:Program Evaluation; D012648:Self Care / Q000523:psychology; D011795:Surveys and Questionnaires; D013689:Telephone
D006442:Glycated Hemoglobin