Aim: The aim of study was to assess the adherence of children with type 1 diabetes to the treatment with an emphasis on insulin application using insulin pen. Method: The method of observation was used to gather empirical data. Observation form contained 15 items (representing individual interventions of insulin application technique) which were monitored directly during administration and were based upon the recommendations on the interventions leading to proper application of insulin by insulin pen. Sample: We observed 45 children with type 1 diabetes at the age of 6-18 years who administered insulin by insulin pen. The study was conducted in the household of children, at the Clinic of Children and Adolescents of the University Hospital in Martin and at the Paediatric Department of the National Endocrinology and Diabetology Institute in Ľubochňa. Results: Adhering to recommendations for proper application of insulin was particularly noticeable in following interventions: choosing the right injection site, adjusting the right insulin dose, injection site disinfection, verification of insulin cartridge. Failure to comply with recommendations for proper application of insulin using insulin pen appeared most frequently in the interventions: applying pressure to the injection site, handwashing prior the application. With regard to adherence, age period 13-18 years was noticed to be a problematic one. In this period, we recorded the lowest percentage of success in performing the interventions while administering insulin. When comparing individual interventions of insulin application in relation to the age, statistically significant differences (p < 0.05) were confirmed in following skills: handwashing prior the application, insulin administration in 90 degree angle, and applying pressure to the injection site. Conclusions: The age and developmental maturity are significant factors that affect not only children’s adherence to the treatment but also their responsibility for insulin application that is closely related to the adherence.

Univerzita Komenského v Bratislave Jesseniova lekárska fakulta v Martine Ústav ošetrovateľstva

Insulin administration by insulin pen in children with type 1 diabetes – adherence to the treatment

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