A therapeutic education programme for diabetic children: recreational, creative methods, and use of puppets.

Patient education is an important aspect of care to young diabetic children. The use of playthings and recreational activities is an effective way to help children develop harmoniously by integrating the paradox of having to become compliant with treatment and medication while becoming autonomous in life. This paper presents the evaluation of a therapeutic education programme which was attended by 14 young diabetic patients aged 10-12. In order to take into account the learning capacities and strategies linked to the children's age and development stage, the programme's methods were mainly interactive and recreational. In particular, puppets were used as a means to enable the children to express themselves on different aspects of diabetes-related difficulties in their everyday life. The results of the study show that recreational methods and tools can effectively be implemented into therapeutic patient education programmes so as to enable children to develop various treatment-related skills. As far as the psychosocial skill of expressing one's difficulties and emotions is concerned, the use of puppets was found to be an effective means to facilitate the development of such a skill. Moreover, puppets were found to have a projective and transactional function that allowed children to make decisions and react autonomously, and thus regain control on situations in which they had previously felt disempowered.

[1]  Ivan Illich,et al.  Medical Nemesis: The Expropriation of Health , 1977 .

[2]  D. Etzwiler WHAT THE JUVENILE DIABETIC KNOWS ABOUT HIS DISEASE , 1962, Pediatrics.

[3]  J Silverstein,et al.  Who learns what at diabetes summer camp. , 1983, Journal of pediatric psychology.

[4]  J. Pennebaker,et al.  Confronting a traumatic event: toward an understanding of inhibition and disease. , 1986, Journal of abnormal psychology.

[5]  R. M. Anderson,et al.  Empowerment: from philosophy to practice. , 1995, Patient education and counseling.

[6]  K. Reschke,et al.  Playing games in promoting childhood dental health. , 2001, Patient education and counseling.

[7]  K. Slifer,et al.  Distraction for Children of Different Ages Who Undergo Repeated Needle Sticks , 2002, Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology Nurses.

[8]  A. Brewster Chronically ill hospitalized children's concepts of their illness. , 1982, Pediatrics.

[9]  D. Winnicott Playing and Reality , 1971 .

[10]  G. Landreth,et al.  The efficacy of intensive individual play therapy for chronically ill children. , 2002 .

[11]  R Spillar,et al.  Cognitive and behavioral knowledge about insulin-dependent diabetes among children and parents. , 1982, Pediatrics.

[12]  J. Skyler,et al.  Performance of Technical Skills of Diabetes Management: Increased Independence After a Camp Experience , 1978, Diabetes Care.

[13]  C. Saudek,et al.  Is HbA(1c) affected by glycemic instability? , 2003, Diabetes care.

[14]  J. Smyth,et al.  Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis: a randomized trial. , 1999, JAMA.

[15]  D. Lieberman,et al.  Management of chronic pediatric diseases with interactive health games: theory and research findings. , 2001, The Journal of ambulatory care management.

[16]  Stuart J Brink,et al.  Education and Multidisciplinary Team Care Concepts for Pediatric and Adolescent Diabetes Mellitus , 2002, Journal of pediatric endocrinology & metabolism : JPEM.

[17]  J. Rodrigue,et al.  Concepts of Illness Causality in a Pediatric Sample , 1995, Clinical pediatrics.

[18]  C H Gibson,et al.  A concept analysis of empowerment. , 1991, Journal of advanced nursing.