RESUMO
OBJECTIVES: To evaluate the usefulness and effectiveness of a new structured education module for children with type 1 diabetes: Structured Education Reassuring Empowering Nurturing (SEREN) 'Diabetes at Diagnosis'. DESIGN: Retrospective questionnaire-based service evaluation. SETTING: 12/14 paediatric diabetes centres across Wales took part. PARTICIPANTS: Children diagnosed with type 1 diabetes 1 year before (pre-SEREN group) and 1 year after the introduction of SEREN (post-SEREN group) were selected using a national diabetes register. RESOURCE: 'Diabetes at Diagnosis' delivers structured education to empower children and families with self-management of type 1 diabetes. EVALUATION: Primary outcomes were patient-reported effectiveness and user-friendliness of the educational resources and quality of life (PedsQL). Age-appropriate child and parent questionnaires were provided. Clinical outcomes included glycated haemoglobin (HbA1c) at 6 and 12 months, service engagement and diabetes-related hospital admissions in the first year. RESULTS: 89/106 responded pre-SEREN and 108/115 post-SEREN, with no demographic differences at diagnosis. Parent scores for educational package evaluation significantly improved post-SEREN, with a non-significant trend towards improved results in children. PedsQL scores were similar. There was no change in HbA1c overall. Subgroup analyses at 12 months showed a trend towards a lower HbA1c in key stage 1-2 (62 vs 58 mmol/mol, p=0.06) and increased HbA1c in key stage 3-4 (56 vs 66 mmol/mol, p=0.009). There were no differences in hospital admissions or missed clinic appointments. CONCLUSIONS: This is an evaluation of the only standardised type 1 diabetes structured education programme in use for children throughout Wales. This module improved parent-reported outcomes and showed a non-significant trend towards improved usefulness in children, without a difference in a PedsQL scores overall. Ongoing evaluation of the cohort who received subsequent SEREN modules may show the long-term benefit of the programme.
