Diabetes Mellitus in Maltese Youth Examining Feelings, Knowledge and Perceptions of Maltese Children and Adolescents

1. Diabetes Mellitus in Maltese YouthExamining Feelings, Knowledge and Perceptions of Maltese Children and Adolescents Judith Rocchiccioli, PhD., RN, Karen Jagiello, MSN, RNC, Emily Cleaves, Rachel Crockett, Samantha Muntean, Andrea VirdenJames Madison University in conjunction with the Malta Institute of Health Introduction Malta has the largest incidence of Diabetes Mellitus in the world. Currently it is estimated that over 10% of the Maltese population have diabetes with the incidence steadily increasing, particularly among children who are vulnerable and obese. Children and adolescents with juvenile diabetes live a different life than other youth their age. Juvenile diabetes requires children to be placed on strict diets and exercise regimens, causing them to feel differently physically, emotionally and socially. This research examines the experience of Maltese children with juvenile diabetes, focusing on their outlook of the disease itself, current knowledge of the disease and their feelings about the treatment they receive. • Methods • Qualitative study using the Grounded theory (Glaser & Strauss, 1967; Strauss & Corbin, 1998) • Participants divided into two focus groups (7-12 and 13-18 years of age) • Sample recruited by Mater Dei Hospital of children who had been diagnosed with Diabetes Mellitus for 6 months or longer • Sample comprised of 11 participants: Children’s group 6 (4 female, 2 male) Adolescent group 5 (3 female, 2 male) • Interview directed by faculty with JMU students recording verbal and non-verbal responses of subjects. A recording of the interview was made to compare those results. • Transcripts and recordings analyzed for common themes Themes • Feelings of Anger, Fear or Shame • Children’s Group • -“Sometimes when I play football with my friends and when I feel a hypo we entirely stop the game because of me. I feel a bit jealous” • - “I feel scared when I feel very low and you’re a lot away from home to get some sweets and to get the sugar up” • Adolescent Group • - “This past two weeks I’ve been getting angry, I feel like I want to miss these injections because I don’t have time to study” • -“I am quite a lot scared if I have diabetes. But I am quite scared having diabetes and not being with my family” Six Common Themes Identified • Limitations • Cultural differences between American researchers and Maltese children. • The subjects did not feel comfortable discussing their illness to “strangers” • - The subjects felt obligated to strictly answer the questions given and not elaborate into further conversation. • -The female subjects were shy around the male subjects. • - Limited to the country of Malta. • Perceptions of Being Treated Differently • Children’s Group • -“Cause when I play when I feel dizzy at least I have my friends helping me. They go call my mom and they come down and bring my glucose” • -“They (parents) are a bit overprotective because every hour, did you check it? Did you check it? It kind of bugs me when every hour they say.” • Adolescent Group • -“I think all of them, my teachers from school, because if they see me laying down, they ask me if I’m not feeling well. They let me leave class if I’m not supposed to.” • -“My parents annoy me about my sugar being ok. So, yes I feel like I am treated differently at times Purpose The purpose of this study was to assess the perceptions and knowledge of Diabetes Mellitus (DM) in Maltese children who have been diagnosed with diabetes mellitus for at least 6 months. This research represents a beginning effort to learn more about Maltese children diagnosed with Juvenile Diabetes with regard to their social needs, feelings and perceptions of the disease. The research question asked “what are the perceptions of Maltese children aged 7 – 18 regarding their disease, their ability to cope socially and their learning needs related to DM” was asked to two focus groups of Maltese children and adolescents. Directed Questions: 1. What is the hardest thing about having Diabetes? 2. Does having diabetes make you feel different? If so, how? 3. Do you feel you are treated differently by the following: -your parents -your friends -your school -others (please name) 4. Do you understand your diet and exercise? If not, what do you need help with? 5. Do you ever feel angry or sad about having this disease? When? 6. Does having diabetes make you feel scared or frightened? When? 7. If you would be granted just one wish relating to your disease, what would you wish for? • Feelings of Embarrassment • Children’s Group • -“ I’m not saying that they do this, but they can make fun of me because I have diabetes” • -“I wait until everyone is out of the classroom and I go to the back of the class” • -“I don’t tell my friends that I have diabetes because I like to play with my neighbors and I don’t tell them cause’ I’m shy and they do not know what it means” • Adolescent Group • -“It makes me quite different because before the break at school I have to get injections, so I go out of the class and do my injection. It is annoying because all of my friends ask where I am going, and I say the toilet; I don’t want everyone knowing where I am going” Conclusions Children with diabetes need added support from their friends, families, and health professionals Emotional factors should be taken into consideration when treating both young children and adolescents with diabetes. More studies of this type are needed to build theory on how to care for these children. Many thanks to the staff at Mater Dei Hospital Diabetes Clinic for their assistance with this study.