الفهرس 
Introduction and Aim of the StudyOnly 14 pages are availabe for public view
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Abstract
Diabetes is increasing significantly throughout the world, in Egypt the problem of children with diabetes consider a disaster for the families, also, soon Egypt become the nation with the largest number of children affected with diabetes. This situation is particularly acute for the children population for whom diabetes is a costly, chronic condition and a major cause of disability. Recent studies attribute the burden of diabetes complications to poor child practices of self-management, lack of education and limited knowledge of the clinical complexities of diabetes (Coster et al., 2015, Welschen et al., 2015).
Aim of the study
This study aimed to assess parent’s awareness regarding care of their children suffering from diabetes mellitus.
The subject& methods of the current study was portrayed under the following 4 designs
I. Technical design
II. Operational design
III. Administrative design
IV. Statistical design
I. Technical design:
Technical design for the study includes research design, setting of the study, subjects, and tools for data collection.
Research Design
A descriptive design was used to conduct this study.
Setting:
The study was conducted in the Endocrinology Outpatient Clinic at Pediatric Hospital Affiliated to Ain Shams University.
Subjects:
A purposive sample that composed of 50 children from both sex regardless their age and education level, was suffering from diabetes and their parents attended in the previously mentioned setting over 6 months period.
Tools and technique of data collection
Data were collected through use of the following two tools:
I. A predesigned interviewing questionnaire: it was designed and written in simple Arabic language by the researcher and based on scientific literature review included the two parts:
Part I: it was concerned with:
1. Characteristic of studied children include: age, gender, educational level, ranking, residence ….etc.
2. Characteristic of studied parent include: age, gender, educational level, working condition, monthly income ….etc.
Part II: it was concerned with :
Knowledge of parents awareness about diabetes mellitus such as definition , causes ,signs and symptoms.
Knowledge of child awareness about complication of diabetes mellitus and child’s awareness of laboratory measurements that indicate control or lack of control of diabetes.
Scoring system for knowledge questions:
The correct answer were scored three, incomplete correct answer were scored two, incorrect answer were scored one and those do not know were scored zero. These scores were summed-up and converted into a percent score. The scoring system classified as follows:
Score less than 50% referred to poor awareness.
Score from 50%<75% referred to average awareness.
Score more than 75% ≤ 100% referred to good awareness.
II. Second tool: Observational checklist: it used to parent’s awareness regarding care of their children suffering from diabetes mellitus; it consisted of the following procedures. glucose analysis in urine by strip (6) steps, glucose analysis in blood by strip (13) steps, insulin administration (16)
Scoring system:
The total score of the checklist was 35 grades, each step that checked as ”done” took one score, and step that checked as ”not done” took zero.
Score less than 75% referred to unsatisfied.
Score more than 75% ≤ 100% referred to satisfied.
validity and reliability:
It was ascertained by a group of experts in pediatric nursing. Their opinions elicited regarding the format, layout, consistency, accuracy and relevancy of the tools.
II. Operation Design:
Preparatory Phase
This phase included reviewing of literature related to parent’s awareness regarding care of their children suffering from diabetes mellitus, knowledge about diabetes mellitus. This served to develop the study tools for data collection. During this phase, the researcher also visited the selected places to get acquainted with the personnel and the study settings. Development of the tools was under supervisors’ guidance and experts’ opinions were considered.
Ethical Consideration:
Verbal approval was obtained from the parents before conduct the study; a clear and simple explanation was given according to their level of understanding, physical and mental readiness. They secured that all the gathered data was confidential and used for research purpose only.
The ethical research considerations include the following:
The research approval was obtained from the faculty ethical committee before starting the study.
The researcher was clarify the objectives and aim of the study to parents included in the study before starting
The researcher was assuring maintaining anonymity and confidentiality of subjects’ data included in the study
The parent was informed that they are allowed to choose to participate or not in the study and they have the right to withdraw from the study at any time.
Pilot Study
Pilot study was carried out before starting the data collection in December 2014 for three weeks, to test the applicability, and the clarity of the study tools. It was applied on 10 studied samples, simple modification in the form of rephrasing were done for the study tools according to the obtained results from the pilot study.
Fieldwork
The actual field work started from the beginning of January 2015 to ended by the June 2015, the researcher was available to previous mention setting 2 days per week during morning shift from 9.00 Am to 1.00 pm over six months period, the researcher introducing herself to studied sample and giving the brief idea about the aim of the research. parent’s verbal consent was obtained. Questionnaire sheet was filled by parent at available time within 30-40 minutes for the educated parents but the researcher filled the tools for the non-educated parents.
III. Administrative design
An official permission to conduct the study was obtained from the medical and nursing director of Endocrinology Outpatient Clinic at Pediatric Hospital Affiliated to Ain Shams University. The researcher then met the hospital director and explained the purpose and the methods of the data collection.
IV. Statistical analysis
Data collected from the studied sample was revised, coded and entered using PC. Computerized data entry and statistical analysis were fulfilled using the Statistical Package for Social Sciences (SPSS) version 20.Data were presented using descriptive statistics in the form of frequencies, percentages. Chi-square test(X2) was used for comparisons between qualitative variables. P value is used as a test of significance of results, Insignificant P> 0.05, Significant P<0.05 and highly significant P <0.001.
Results:
Findings of the current study can be summarized as the following:
• More than half of the studied sample (56.0%) ware males, 40.0% of them were in the age group of 9-12 years, Mean ±SD (10.32±1.11), 48.0%of them were the second child in the family. In addition to the highest percentage of them (58.0%) is at primary school.
• More than one third (36.0%) of the mothers their age between 30<40 years old compared with more than one third (38.0%) of the fathers their age between 40<50 years old with no statistical significant difference.
• More than three quarters of them (94.0%) were nuclear family, more than half of them(52.0%) from urban areas and (56.0%)of them their family consists from 4<6 members and (56.0%) had not sufficient income.
• The majority (64.0%, 78.0% & 100.0) of the studied children had normal weight, height & head circumference respectively.
• Nearly half (46.0 %) of the studied sample had diabetes for three years and 78.0% of them discovered through symptoms, 74.0% of them are regular follow up.
• The majority (96.0 % & 90.0) of the studied sample had taken insulin regular & follow dietitian program respectively.
• Nearly half (44.0 %) of the studied sample had practice exercise, (57.0%) playing football and (420%) of them mentioned to control body weight.
• The majority (64.0 % & 80.0%) of the studied sample done urine & blood analysis in a regular time respectively.
• Two thirds (68.0 %) of the studied sample done independent self-care.
• More than half (56.0 %) of the studied sample not aware about definition of diabetes. In relation to causes of diabetes (64.0%) of the studied sample mentioned insulin not enough as a common cause of diabetes.
• The majority (100.0 % & 92.0% )of the studied sample mentioned insulin injection & follow up dieting style to control diabetes respectively.
• Three quarters (70.0 % & 64.0%) of the studied sample mentioned hyperglycemia & hypoglycemia as acute complications of diabetes respectively.
• Less than half (40.0%) of the studied sample had good score of awareness, (34.0%) had average score of awareness while (26.0%) of them had poor score of awareness regarding to diabetes.
• Nearly half (48.0%) of the studied sample was able to do glucose analysis in urine by strip also nearly two thirds (62.0%) of them were able to do glucose analysis in blood by strip.
• More than half 60.0% of them were able to administrate insulin.
• More than half (56.0%) of the studied sample had satisfied score of awareness, while 44.0% of them had unsatisfied score of awareness regarding to care of their children with diabetes.
• There was statistically significant differences between age, level of education, residence, family history of diabetes attend training about care of diabetes, of the studied parents and their awareness regarding diabetes.
• There was statistically significant differences between level of education, residence, family history of diabetes, of the studied parents and their awareness regarding care of their children with diabetes.
• There was no statistical significant different between occupation, monthly income of the studied parents and their awareness regarding diabetes.
• There was no statistical significant different between age, occupation, monthly income, attend training about care of diabetes of the studied parents and their awareness regarding care of their children with diabetes.
Conclusion
The current study concluded that:
Parent’s awareness, regarding to care of their children suffering from diabetes mellitus. Concerning different aspects of the disease, namely, etiology, ideal measurements, complications, follow up and management as life style modifications and treatment ranged from good to average and poor. In addition, there was statistically significant differences between age, level of education, residence, family history of diabetes attend training about care of diabetes, of the studied parents and their awareness regarding diabetes.
Recommendations
In the light of the study findings, the following recommendations are suggested:
Education programme, counseling should be established as possible to parents in order to improve their level of awareness regarding care for their children suffering from diabetes mellitus.
Health care providers should take time to explain in depth on diabetes, causes and prevention and control through health and self-care measures to prevent complications because poor awareness and practices are some of the important variables influencing the development and progression of diabetes and its’ complications which was largely preventable.
A multidisciplinary approach with involvement of physicians, dietitians, nutritionists, health educators, diabetic educators, social workers, and psychiatrists is highly recommended.
Encourage using updated methods for education including mobile messages, social media, one to one diabetes education and care: intervention for children education, evaluation of knowledge, practical application, and children with Type 1 diabetes in rural areas nutrition and behavioral assessments to improve awareness.
Further researches are needed to measure awareness in Egypt and its effect on the child care about diabetes mellitus.