The concerns of school staff in caring for children with diabetes in primary school

Boden S, Lloyd CE, Gosden C, Macdougall C, Brown N, Matyka K. The concerns of school staff in caring for children with diabetes in primary school. Objectives: Primary school children spend 25% of their waking hours in school. Education authorities have a duty of care to support children with chronic illnesses within schools, but this is very variable. This study has examined the concerns of primary school staff working with children with Type 1 diabetes and their parents, and related these concerns to the views of health-care professionals (HCP) working with school personnel. Methods: We undertook in-depth, semi-structured face-to-face interviews with 22 primary school staff and 5 multidisciplinary HCP from the local healthcare team. Interview transcripts were analysed using a structured, iterative approach grouping together key themes and issues to create a coding scheme. Results: Primary school staff expressed a range of concerns about injecting and blood glucose testing, the ability of children to mishandle their condition, and corresponding reactions of parents to school decisions on health-based matters. These fears had some convergence with the perspectives of HCP who also highlighted the institutional nature of primary schools and dynamics of home/family life as factors impacting upon care of children with diabetes at school. Conclusions: Increased training for teachers having direct and current responsibility for children with diabetes was thought to lessen anxiety. Greater and more accessible knowledge about diabetes for all staff was requested. A range of practical management strategies were highlighted, including fostering good communication and teamwork between child, parent, school, and HCP. Professionals felt that support services would improve by using community-based dieticians and including psychological input into the diabetes team.