Diabetes

Managing a life-long condition such as Type 1 diabetes requires important decisions every day. Healthcare staff need to understand how best to involve and support child patients, in decision-making. 

• The interviews showed that children's key goals were to be “normal” and “just get on with their lives”.
• The children described managing a complicated balance between the sometimes competing goals of social health i.e. “being normal” and physical health i.e. managing their diabetes.
• However, the interviews showed that children's experiences of diabetes meant they could make informed and “wise” decisions in their own best interests, even at a young age.

• Professor Priscilla Alderson
• Dr Katy Sutcliffe

• Alderson, P., Sutcliffe, K. and Curtis, K. (2006). Children as partners with adults in their medical care. Archives of disease in childhood, 91(4), 300–303
• Sutcliffe K., Alderson P. and Curtis, K. Children as partners in their diabetes care: an exploratory research study. London, SSRU, IOE, 2004
• Alderson, P., Sutcliffe, K., and Curtis, K. (2006). Children's consent to medical treatment. Hastings Centre Report 36: 25-34

Shared decision-making means involving children and parents in the process of making healthcare decisions. It draws on healthcare practitioners' professional expertise as well as children's and parents' experience and values.

This study aimed to understand children's and parents' views about shared decision-making and the factors that support successful approaches.

Children and parents valued individualised support and sufficient time for discussion, as well as friendly and approachable practitioners who respect their opinions.

The findings show that many children want to be involved and contribute their informed and considered opinions when discussing with practitioners. Some described how parents can support children by acting as an intermediary if children are not confident to speak up when talking to practitioners. Children and parents appreciated practitioners who made efforts to include children in discussions.

Children described how fitting diabetes into their everyday lives can be challenging but that knowledge and experience helps them to do this. Flexible regimes that offer greater freedom and choice are valued. 

• Dr Katy Sutcliffe

• Sutcliffe, K. (2010). Shared decision-making: an evidence-based approach for supporting children, parents and practitioners to manage chronic conditions. IOE, University of London, London.