A study on care systems for school children with Type 2 diabetes providing a manual for school personnel

本研究的目的是为了明确学校护士在减少2型糖尿病儿童从医疗服务中辍学的作用。目的是：(1)检查学校尿液检测的随访情况，(2)调查医生、护士和学校护士如何照顾定期求医的2型糖尿病儿童，(3)阐明学校护士、医生和护士如何了解不定期来医院的2型糖尿病儿童，(4)为学校工作人员提供糖尿病持续护理手册。研究活动包括对岩手县的学校护士和医生进行问卷调查，对患者、家长和学校工作人员进行访谈，访问洛杉矶的小学和儿童糖尿病护理中心，与岩手县的学校护士进行研究会议，并编写糖尿病护理手册。发现尿糖阳性的学龄儿童被送去做进一步检查，并将结果报告给学校护士。但是，那些不来学校卫生所的人被忽视了。在学校需要注射胰岛素和监测血糖的1型糖尿病儿童是学校护士关注的主要问题。受访的2家医院无2型糖尿病患儿辍学。采访显示，学校护士和班主任希望了解糖尿病和糖尿病管理方面的知识。孩子们和家长们希望学校工作人员了解糖尿病，并像对待其他孩子一样对待他们。学校护士应该倾听孩子和家长的心声，为他们提供关怀和支持。所有的专业人士都应该帮助孩子们看到自己的长处，这样他们就会变得自信，并拥有快乐的学校生活。利用这些发现和从美国小学和糖尿病中心获得的信息，我们完成了糖尿病护理手册，这是本研究的最终成果。

The purpose of this study was to clarify the role of school nurse to reduce dropouts of Type 2 diabetes children from medical services. Objectives were to:(1)examine the follow-up of school urine testing, (2)investigate how physicians, nurses and school nurses were taking care of children with Type 2 diabetes who were seeking medical services regularly, (3)clarify how school nurses, physicians and nurses were aware of those with Type 2 who did not come to hospitals regularly, (4)provide a diabetes continuing care manual for school personnel.Study activities performed were studies by questionnaire for school nurses and physicians in Iwate Prefecture, interviews with patients, parents and school personnel, visit to elementary schools and diabetes care center for children in Los Angeles, study meeting with school nurses in Iwate, and writing a diabetes care manual.Findings School children found urine glucose positive were sent for further examination and reported the results to school nurses. But, those who do not come to school health office are disregarded. Children with Type 1 diabetes who need insulin injection and blood glucose monitoring at school are the main concern of school nurses. 2 hospitals where interviews were conducted had no dropouts of Type 2 diabetes children. The interview showed school nurses and class teachers wanted knowledge about diabetes and diabetes management. Children and parents wanted school personnel to understand diabetes and to see them equally with other children. School nurses should provide caring and support to children and parents by listening to what they say. All professionals should help children looking at their strength so that they become self confident and have happy school days.Using these findings and information obtained from American elementary schools and a diabetes center, we completed a diabetes care manual, the final product of this study.