Effect of Quality Improvement Interventional Tool on Emotional, Behavioural and Self-perception Profile of Children with Type 1 Diabetes Mellitus: A Pretest, Post-test Quasi-experimental Study

Abstract

Introduction: Psychological stress associated with Type 1 Diabetes Mellitus (T1DM) in children is relatively higher in developing countries due to limited health resources. However, no data are available regarding the impact of a Quality Improvement (QI) intervention on emotional, behavioural, and self-perception in paediatric patients with T1DM. Aim: To study the impact of a QI interventional tool on the emotional, behavioural, and self-perception profile in children with T1DM. Materials and Methods: This pretest, post-test quasiexperimental study was conducted at PGIMS, Rohtak, Haryana, India from August 2021 to July 2022. A total of 50 children, aged between 6-14 years with T1DM, were enrolled from the paediatric outpatient department and paediatric ward for the study. Initially, baseline data were collected, and patients were followed-up for six months during which required interventions were given, including one-on-one counseling with mother and child, demonstration of insulin injection, providing them with a booklet for recording blood glucose at home, etc. After six months, data were collected again for comparison. The Strengths and Difficulties Questionnaire (SDQ) and Self-perception Profile for Children (SPPC) questionnaires were used for the study. Data were statistically analysed using a paired t-test. Results: In the present study, there were 27 (54%) males and 23 (46%) females with an average age of 9.64±2.3 years. Positive outcomes were noted in the emotional, behavioural, and selfperception profiles of children following the intervention. HbA1C values (pre: 13.12±1.02%, post: 10.63±1.07%), hypoglycaemic episodes (pre: 2.54±0.88, post: 1.24±0.43), and Diabetic Ketoacidosis (DKA) episodes (pre: 2.76±0.52, post: 1.08±0.27) significantly reduced following the intervention. The SDQ score was significantly lower (pre: 16.97±1.48, post: 7.76±2.14), and the SPPC score was significantly higher (pre: 76.52±0.61, post: 94.34±1.06) after the intervention. Conclusion: In the present study, it was found that psychological and behavioural interventions have a beneficial effect on children with diabetes in terms of better compliance with therapy, glycaemic control, as well as better relationships with family and peers, and improved coping capability.