Educational technologies for families and children with type 1 diabetes: a scoping reviewABSTRACT
Objective: To map scientific evidence on educational technologies developed for family members and children with type 1 diabetes.
Method: Scoping review, according to JBI recommendations, and described in accordance with the checklist PRISMA-ScR. Searches were carried out in the LILACS, BDENF, PUBMED, COCHRANE, CINAHL, EBSCO, Scopus and Embase/Elsevier, Web of Science/Clarivate Analytics, Scielo, VHL Regional Portal and gray literature databases.
Results: Fifty-three studies published between 1980 and 2023 were included. The evidence was categorized into digital educational technologies, which provide innovative resources to educate and support children and families, and non-digital educational technologies, which provide practical and interactive opportunities for learning about diabetes.
Conclusion: The results highlight the relevance of educational technologies in the care of children with type 1 diabetes. However, they reveal a gap in the assessment of the effectiveness of these interventions in the long term, with regard to adherence to treatment and improvement in quality of life. Research is required to evaluate the effectiveness of these technologies and the impact of educational interventions.
DESCRIPTORS
Diabetes Mellitus; Type 1; Educational Technology; Child; Caregivers; Health Education
RESUMO
Objetivo: Mapear as evidências científicas sobre tecnologias educacionais desenvolvidas para familiares e crianças com diabetes tipo 1.
Método: Revisão de escopo, segundo as recomendações do JBI, e descrita de acordo com o checklist PRISMA-ScR. As buscas foram realizadas nas bases LILACS, BDENF, PUBMED, COCHRANE, CINAHL, EBSCO, Scopus e Embase/Elsevier, Web of Science/Clarivate Analytics, Scielo, Portal Regional da BVS e literatura cinzenta.
Resultados: Foram incluídos 53 estudos publicados entre 1980 e 2023. As evidências foram categorizadas em tecnologias educacionais digitais, que oferecem recursos inovadores para educar e apoiar crianças e familiares, e tecnologias educacionais não digitais, que proporcionam oportunidades práticas e interativas para o aprendizado sobre diabetes.
Conclusão: Os resultados destacam a relevância das tecnologias educacionais no cuidado de crianças com diabetes tipo 1. Contudo, revelam uma lacuna na avaliação da eficácia dessas intervenções em longo prazo, no que diz respeito à adesão ao tratamento e à melhoria da qualidade de vida. São necessárias pesquisas que avaliem a eficácia dessas tecnologias e o impacto das intervenções educativas.
DESCRITORES
Diabetes Mellitus Tipo 1; Tecnologia Educacional; Criança; Cuidadores; Educação em Saúde
RESUMEN
Objetivo: Mapear evidencia científica sobre tecnologías educativas desarrolladas para familias y niños con diabetes tipo 1.
Método: Revisión del alcance, según recomendaciones del JBI, y descrita de acuerdo con el lista de verificación PRISMA-ScR. Las búsquedas se realizaron en las bases de datos LILACS, BDENF, PUBMED, COCHRANE, CINAHL, EBSCO, Scopus y Embase/Elsevier, Web of Science/Clarivate Analytics, Scielo, Portal Regional de la BVS y literatura gris.
Resultados: Se incluyeron 53 estudios publicados entre 1980 y 2023. La evidencia se clasificó en tecnologías educativas digitales, que ofrecen recursos innovadores para educar y apoyar a los niños y las familias, y tecnologías educativas no digitales, que brindan oportunidades prácticas e interactivas para aprender sobre la diabetes.
Conclusión: Los resultados resaltan la relevancia de las tecnologías educativas en el cuidado de niños con diabetes tipo 1. Sin embargo, revelan una brecha en la evaluación de la efectividad a largo plazo de estas intervenciones, en lo que respecta a la adherencia al tratamiento y la mejora de la calidad de vida. Se necesita investigación para evaluar la efectividad de estas tecnologías y el impacto de las intervenciones educativas.
DESCRIPTORES
Diabetes Mellitus Tipo 1; Tecnología Educacional; Niño; Cuidadores; Educación en Salud
INTRODUCTION
Type 1 Diabetes Mellitus (DM1) is the second most prevalent chronic disease in childhood, with an average of 600,000 cases among children and adolescents aged 0 to 14 years. Brazil is the third country with the highest number of children and adolescents with type 1 diabetes in the world, with a prevalence of approximately 51 thousand cases in the age group from 0 to 14 years old(1).
DM1 is caused by an autoimmune process where the immune system attacks the pancreatic beta cells, resulting in decreased or absent insulin production(1). It is considered one of the most common and serious chronic childhood diseases, due to the complications it can cause in the short, medium, and long term, such as damage to blood vessels, the heart and brain, retinopathy, neuropathy, nephropathy and diabetic ketoacidosis, among which kidney disease is the most frequent and earliest found in young people with diabetes(1,2).
Chronic illness in childhood limits daily activities, affects the growth and development process, requires ongoing health care, and affects the daily lives of all family members. Therefore, family members who assume responsibility for care need to acquire knowledge about nutrition, signs and symptoms of hypoglycemia and hyperglycemia, in addition to being trained in the preparation and administration of insulin(3).
Health education is an important structure in the care of children with diabetes, promoting actions to improve and make care provided in the home environment more effective for children with this chronic disease(4).
In the context of DM1, different educational technologies (ET) can be incorporated to support the educational actions of health professionals, facilitate learning, and promote adherence to treatment and self-care(5).
Therefore, a preliminary search was carried out in July 2023 at PROSPERO (International Prospective Register of Systematic Reviews) and in the main databases and no current or ongoing scoping or systematic review on the subject was identified.
Considering the relevance of the topic, this review aims to map, through scientific productions, educational technologies for family members and children with type 1 diabetes mellitus.
It is expected that this scoping review will provide support for new studies on the topic in question, to encourage the participation of family members and children through educational technologies in coping DM1.
METHOD
Design of Study
This is a scoping review, conducted in accordance with JBI recommendations(6) and described in accordance with the checklist Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR)(7). In the exploratory phase of this review, we aimed to ensure the absence of a recent research report similar to the topic under study or record of a review protocol. Subsequently, the protocol of this review was registered on the platform Open Science Framework (https://doi.org/10.17605/OSF.IO/A72F4).
Identifying the Research Question
Review driven by the following question: “What are the educational technologies for families and children with type 1 diabetes? To construct the research question, the mnemonic strategy PCC (Population, Concept and Context) was used, considering as population (P) – children with type 1 diabetes and/or family members; the concept (C) – educational technologies; and the context (C) – health care environments.
The inclusion criteria were studies whose population consisted of children aged 2 to 12 years and adolescents, and the exclusion criteria were studies whose population was exclusively composed of adolescents, studies that specifically deal with diabetic ketoacidosis and studies aimed exclusively at teachers or health professionals.
Selection Criteria
Experimental and quasi-experimental studies (randomized and non-randomized controlled studies, before-and-after studies, and interrupted time series studies), analytical observational studies (prospective and retrospective cohort studies, case-control studies and cross-sectional analytical studies), descriptive observational studies (case series, individual case reports and descriptive cross-sectional studies), and qualitative studies were considered. Systematic reviews that met the inclusion criteria were also considered for analysis and selection of their reference lists.
Search Strategy
The search was carried out in the LILACS, BDENF, Coleciona SUS databases, among others from the BVS Regional Portal, MEDLINE via Pubmed/NLM, Pubmed Central/NLM, COCHRANE Library, CINAHL, EBSCO, Scopus and Embase/Elsevier, Web of Science/Clarivate Analytics, Scielo, according to the syntax and indexing terms appropriate for each database. Likewise, Google, Google Scholar and grey literature sources such as Science.gov and USA.gov were considered. The search strategy is listed in Chart 1. References from all included sources of evidence were screened for additional studies. To expand on the findings, the reviewers defined the strategy with the help of a librarian.
Study Selection
For the initial stages of study selection, the Rayyan QCRI® platform (the Systematic Reviews web app) was used. Two independent reviewers verified the relevance of the selected studies by reading the titles and abstracts. Disagreements regarding the inclusion of articles were resolved through discussion among the reviewers, without the need for intervention by a third reviewer. Subsequently, the selected articles were read in full, which preceded their inclusion in the final sample.
Data Extraction and Synthesis
To systematize the results, the extracted data were compiled, in a descriptive manner, in a chart developed by the authors and adapted to the recommendations of the JBI manual(6). The following information was highlighted: author, year, country, type of study, participants, type and content of technologies.
RESULTS
The database search took place from September to December 2023. The search strategy used resulted in 4375 records, of which, after removing duplicates, 3296 articles were included for initial screening and analysis of titles and abstracts. From this stage, 165 articles were selected for full reading. Among those selected, 86 were excluded because they did not fully address the topic and 29 could not be recovered, totaling 50 articles included. Furthermore, after analyzing the references, 3 more studies were added, composing a final sample of 53 studies selected for the review (Figure 1).
PRISMA-ScR flow diagram of the review publication selection process. Niterói, RJ, Brazil, 2023.
Most articles were published between 2014 and 2020. Regarding the origin of the studies, Brazil was the country with the largest scientific production on the subject, accounting for 17 articles, followed by the United States, with 16 articles. The largest concentration of studies was experimental trials (13 studies) (Chart 2).
Characterization of the studies included in the final review sample – Niterói, RJ, Brazil, 2023.
Categorization of Educational Technologies
Educational technologies were organized into two categories: digital and non-digital educational technologies, comprising the most relevant data found in this study. Digital ETs were websites, platforms, videos, video games, applications, digital games, human patient simulators and text messages (via cell phone). The non-digital ones were booklets, leaflets, books, comics, therapeutic toys, lectures, quizzes, puppets, workshops, groups, and educational programs. The central themes explored in the ET addressed insulin therapy, glycemic monitoring, hyperglycemia, hypoglycemia, physical activity, nutrition, pathophysiology of diabetes, late complications, school and technologies for diabetes.
Digital Educational Technologies
37 articles were found that address digital technologies(8,11,14,17-22,25,26,28,29,31-34,36-39,41-47,50,52-58,60).
Regarding the videos(8,10,22,53,55,56), these provide an accessible approach, with good cultural acceptance and effective in disseminating information. As for video games(11,19,32,36,47,54,57), they are presented as tools with an innovative approach for children with DM.
Mobile applications and serious games(14,17,25,28,31,52) are useful as they provide resources such as support messages, glycemic monitoring and emotional recording, providing training in the player’s operational and behavioral skills.
Some studies highlight the potential of mobile technologies, such as mobile messaging(18,39,50) and telemedical educational programs(43.45), to provide accessible diabetes education outside of the clinical setting. The use of human patient simulators(21,26,33,34,38,44,46), home educational materials, and computer-assisted teaching programs(29,37,41,42,53,55,56,58) was also highlighted.
Non-Digital Educational Technologies
In this category, 18 articles were included(9,10,12,13,15,16,23,24,27,30,35,40,48,49,51,55,56,59) that address non-digital technologies. Among these, 3 studies(9,55–56) have adopted approaches that combine both digital and non-digital technologies to achieve their educational goals.
Therapeutic toys(13,15,16,21,23) were used, as well as printed materials (booklets, pamphlets, books, comics)(10,12,27,48,55,56), educational programs implemented both in specialized diabetes camps(40,49,51) and in a hospital outpatient setting(59), in which a variety of activities were conducted, including storytelling, use of puppets, games, dramatizations, lectures and quizzes. Dynamics and workshops were also proposed(24,35), as well as specific strategies to address each difficulty reported by both the child and the mother, with personalized activities adapted to the level of understanding of each dyad(9).
DISCUSSION
Digital ETs play a crucial role in the management of DM1 by providing culturally sensitive and personalized resources to educate patients and their families. This includes the use of video games, mobile applications, simulators and online interventions, which aim to promote knowledge about DM1, encourage self-care, and improve patients’ quality of life. The use of technological resources, which are more attractive and focused on reality, can facilitate training, stimulate reasoning and the ability to solve problems(61).
Videos, cited by 5 studies in this review, are accessible technologies that can be edited and adapted to cultural diversity and are effective in disseminating information. They can be translated into different languages, dubbed or subtitled, and so are used with different audiences, and also easily distributed to patients through websites, social media, text messages. Also, LIBRAS interpreters may be included and thus the hearing impaired public. Educational videos are an effective strategy, as they capture the public’s attention, stimulate creativity and arouse curiosity about the topic, facilitating educational practice in a direct and simple way(62).
Video games, which were also technologies found in the review, present themselves as innovative educational tools. These games are developed based on behavioral theories and encourage children’s active participation, promoting knowledge about the disease and self-care behaviors in a playful way. Video games provide cognitive benefits, such as attention focus, problem-solving skills, and stimulating creativity. They also have positive repercussions on motivation, mood and positive feelings. Furthermore, they favor social behaviors, such as cooperation and commitment(63).
Mobile apps were identified as important educational technologies, as they offer features such as supportive messaging, blood glucose monitoring, and emotional recording. This way, they complement the self-management of DM1 in children and adolescents, in a combination of educational information and practical tools to control the disease more efficiently. These findings highlight the effectiveness of mobile technologies in empowering parents and supporting the care of children with DM1, encouraging self-care, better glycemic control, physical activity, adoption of healthy eating, and maintenance of prescribed medication(64).
Mobile technologies, such as mobile messaging and telemedical educational programs showed to be able to provide accessible diabetes education outside of the clinical setting. Studies indicate that teleconsultation and telecare allow the monitoring of pediatric patients, enabling assessment and supervision in their usual environments, such as home, school and community. This approach improves access to and quality of health care(65).
Another educational technology described in the literature is human patient simulators (HPS). These simulators are technological devices designed to mimic real clinical situations, allowing caregivers to practice DM1 management skills in a simulated environment. Realistic simulation has emerged as a more effective approach to teaching and learning than traditional teaching. This strategy provides a practical experience closer to reality, contributing to safer and risk-free care(66).
New technologies, such as the use of the Internet to share educational materials, online communications for DM1, and computer-assisted programs, emerged in the review as promising tools to improve care. In this regard, studies on online health platforms and chronic disease management indicate that virtual interactions contribute to greater patient knowledge of the disease, through the sharing of experiences and information; better self-management of the chronic condition, due to the exchange of experiences and advice; and greater social support, including positive reinforcement and sharing of information and experiences(67).
Regarding non-digital technologies, therapeutic toys aimed at children living with DM1 emerged as a playful-therapeutic intervention that promotes the exchange of experiences between the child and the health professional, as well as between peers during group activities. As benefits, it expands knowledge about the disease and facilitates practical training in essential skills for diabetes care, such as blood glucose monitoring and insulin administration. The results obtained in this review show effectiveness in promoting self-care among children.
Games and toys play a significant therapeutic role, encouraging children to express their feelings and anxieties regarding their health condition, helping them to alleviate the tension imposed by their reality. Furthermore, these activities promote greater child-professional interaction(68).
The various types of printed educational materials found in the review results are used as resources for self-study and complement the guidance provided by health professionals. According to studies, printed materials, such as booklets, are resources that remain available for consultation by users and their families when they have questions, facilitating the process of autonomy, and greater adherence to treatment and understanding of the influence of their own actions on their health pattern(69).
Educational programs, with recreational activities and lectures, developed in camps and outpatient clinics were identified as possibilities for action with the study population. These interactive and recreational methods provide children with an opportunity to express and share their diabetes-related difficulties, while also supporting psychosocial skills. As evidenced in a systematic review of educational strategies used in teaching insulin therapy to children and adolescents with DM1, educational programs must prioritize not only strategies that take into account the needs and particularities of the target population, but also ensure ongoing support. This is essential for developing and maintaining self-care behaviors, achieving better results over time(70).
The central themes explored in the ETs presented in this review show the need for an integrated approach that encompasses not only insulin therapy and glycemic monitoring, but also nutrition, physical activity, and coping skills. These are topics consistent with the recommendations of the American Diabetes Association (ADA), which emphasizes the importance of comprehensive and ongoing education to optimize health outcomes in patients with diabetes(2), providing a solid foundation to effectively guide children with DM1 and their families in self-care and in the promotion of a better quality of life.
This review identified as a potential limitation the exclusion of 29 articles not retrieved in full, which may generate a bias in the review, as these studies could contain relevant data that were not considered.
Regarding the implications for nursing practice, this review provides a synthesis of educational technologies and topics addressed in the care of children with diabetes described in the literature, which can be replicated, adapted, and used by nurses in their health education interventions aimed at children with diabetes and their families. This analysis supports effective management of diabetes and promotes improved quality of life for these patients and their families.
CONCLUSION
This scoping review highlighted the diversity and importance of educational technologies in the management of DM1 in children, revealing a range of digital and non-digital tools used to promote self-care and support families. The studies analyzed indicated that these technologies not only increase knowledge about the disease, but also contribute to the development of practical and behavioral skills necessary for the effective management of DM1.
However, several gaps were identified in the literature. Many studies have focused mainly on describing the development of educational technologies, without delving into the analysis of the thematic content covered. Furthermore, the scientific dissemination of these technologies is still limited, restricting their access to a wider audience. There was also a lack of studies evaluating the long-term effectiveness of these technologies and their impact on treatment adherence and the quality of life of children and their families.
Therefore, there is a clear need for future studies that evaluate the effectiveness of educational technologies over time, considering different cultural and socioeconomic contexts; investigate the implementation of these technologies on a large scale, aiming at their integration into public health systems; and explore the thematic content of educational interventions in greater depth, providing specific guidelines for health professionals.
These future investigations can help to consolidate existing evidence and expand the use of educational technologies, promoting more effective and comprehensive care for children with type 1 diabetes and their families.
-
Financial support: This work was carried out with financial support from the agreement between the Coordination for the Improvement of Higher Education Personnel – Brazil (CAPES) and the Federal Council of Nursing (COFEN) – CAPES/COFEN Notice – Support for Postgraduate Programs - Professional Master’s Modality – Nursing Area. Acronym COFEN – 2021. Case number 04477686706/COFEN-20211946906P.
REFERENCES
-
1. International Diabetes Federation. IDF Guide for diabetes epidemiological studies [Internet]. Brussels: IDF; 2021 [cited 2023 Aug 8]. Available from: https: https://diabetesatlas.org/atlas/tenth-edition/
» https://diabetesatlas.org/atlas/tenth-edition/ -
2. American Diabetes Association. Children and adolescents: standards of medical care in diabetes— 2021. Diabetes Care. 2021;44(suppl 1): S180–99. doi: http://doi.org/10.2337/dc21-S013. PubMed PMID: 33298424.
» https://doi.org/10.2337/dc21-S013 -
3. Gomes GC, Moreira MAJ, Silva CD, Mota MS, Nobre CMG, Rodrigues EF. Vivências do familiar frente ao diagnóstico de diabetes mellitus na criança/adolescente. J Nutr Health. 2019;9(10):e19910. doi: http://doi.org/10.15210/jonah.v9i1.13393.
» https://doi.org/10.15210/jonah.v9i1.13393 -
4. Teixeira LB, Santos ABAS, Coêlho LPI, Guedes TSA, Marques VGPS, Soares MS, et al. O cuidador familiar frente a criança com diabetes mellius tipo 1: ações educativas. RECIMA21. 2021;2(9):e29735. doi: http://doi.org/10.47820/recima21.v2i9.735.
» https://doi.org/10.47820/recima21.v2i9.735 -
5. Rodrigues SC, Schelder GL. Tecnologia educacional para pessoas em uso de insulina. Ciênc Cuid Saúde. 2020,19:1–12. doi: http://doi.org/10.4025/ciencuidsaude.v19i0.50376.
» https://doi.org/10.4025/ciencuidsaude.v19i0.50376 -
6. Peters MD, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil H. Chapter 11: scoping reviews. In: Aromataris E, Munn Z, editors. JBI manual of evidence synthesis. Adelaide: JBI; 2020. doi: http://doi.org/10.46658/JBIMES-20-01.
» https://doi.org/10.46658/JBIMES-20-01 -
7. Tricco AC, Lilie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. In: Aromataris E, Munn Z, editors. JBI manual of evidence synthesis [Internet]. Adelaide: JBI; 2020 [cited 2023 Jul 4]. Available from: https://jbi-global-wiki.refined.site/space/MANUAL
» https://jbi-global-wiki.refined.site/space/MANUAL -
8. Sunni M, Kyllo J, Brunzell C, Majcozak J, Osman M, Dhunkal AM, et al. A picture is worth a thousand words: a culturally-tailored video-based approach to diabetes education in somali families of children with type 1 diabetes. J Clin Transl Endocrinol. 2023;31:100313. doi: http://doi.org/10.1016/j.jcte.2023.100313. PubMed PMID: 36820203.
» https://doi.org/10.1016/j.jcte.2023.100313 -
9. Merino M FGL, Shibukawa BMC, Rissi GP. Crianças e adolescentes com diabetes: ações educativas no desenvolvimento de habilidades para o autocuidado. Nursing Edição Brasileira. 2022;25(292):8700–13. doi: http://doi.org/10.36489/nursing.2022v25i292p8700-8713.
» https://doi.org/10.36489/nursing.2022v25i292p8700-8713 -
10. Ribeiro ALT, de Araújo ÉF, de Pinho IVOS, Melo MC, Martins RGG, Lara CCQ. Avaliação de tecnologia educativa para crianças com diabetes: estudo metodológico. Esc Anna Nery. 2021;25(5):e20200282. doi: http://doi.org/10.1590/2177-9465-ean-2020-0282.
» https://doi.org/10.1590/2177-9465-ean-2020-0282 -
11. Sparapani VC, Fels S, Kamal N. Ortiz La Banca R, Nascimento LC. A video game for Brazilian T1D children about knowledge of disease and self-care: a methodological study. J Diabetes Sci Technol. 2022;16(6):1444–1450. doi: https://dor.org/10.1177/19322968211017555.
» https://doi.org/10.1177/19322968211017555 -
12. Araújo EF, Ribeiro ALT, de Pinho IVOS, Melo MC, de Abreu VJ, Nascimento ETS, et al. Elaboração de tecnologia educacional sobre educação em saúde para crianças com diabetes mellitus tipo i. Enferm Foco. 2022;11(6):185–91. doi: http://doi.org/10.21675/2357-707X.2020.v11.n6.3915.
» https://doi.org/10.21675/2357-707X.2020.v11.n6.3915 -
13. La Banca RO, Brandão MCM, Sparapani VC, Souza NS, Neves ET, Cavicchioli MGS, et al. A fun way to learn about diabetes: using therapeutic play in a Brazilian camp. J Pediatr Enfermagem. 2020;53:e35–e40. doi: https://do.org/10.1016/j.pedn.2020.02.002.
» https://doi.org/10.1016/j.pedn.2020.02.002 -
14. Chaves FF, Paraíso EC, Pagano AS, Reis IA, Silva IN, Torres HC. Elaboração, validação e adequação de protocolo para aplicativo em diabetes tipo 1. Acta Paul Enferm. 2020;33:eAPE20190253. doi: http://doi.org/10.37689/acta-ape/2020AO0253.
» https://doi.org/10.37689/acta-ape/2020AO0253 -
15. La Banca RO, Laffel LMB, Volkening LKC, Sparapani V, de Carvalho EC, Nascimento LC. Therapeutic play to teach children with type 1 diabetes insulin self-injection: a pilot trial in a developing country. J Spec Pediatr Nurs. 2021;26(1):e12309. doi: http://doi.org/10.1111/jspn.12309. PubMed PMID: 32945620.
» https://doi.org/10.1111/jspn.12309 -
16. La Banca RO, Ribeiro CA, Freitas MS, Freitas MAO, Nascimento LC, Monteiro OO, et al. Therapeutic play in the teaching of insulin therapy to children with diabetes: a qualitative case study. Rev Eletr Enferm. 2019;21:52591. doi: http://doi.org/10.5216/ree.v21.52591.
» https://doi.org/10.5216/ree.v21.52591 -
17. Serafim ARRM, Silva NAS, Alcântara CM, Queiroz MVO. Construction of serious games for adolescents with type 1 diabetes mellitus. Acta Paul Enferm. 2019;32(4):37. doi: http://doi.org/10.1590/1982-0194201900052.
» https://doi.org/10.1590/1982-0194201900052 -
18. Albanese-O’Neill A, Schatz DA, Thomas N, Bernhardt JM, Cook CL, Haller MJ, et al. Designing online and mobile diabetes education for fathers of children with type 1 diabetes: mixed methods study. JMIR Diabetes. 2019;4(3):e13724. doi: http://doi.org/10.2196/13724. PubMed PMID: 31389338.
» https://doi.org/10.2196/13724 -
19. Rafeezadeh E, Ghaemi N, Miri HH, Rezaeian A. Effect of an educational video game for diabetes self-management on adherence to a self-care regimen in children with type 1 diabetes. Evidence Based Care. 2019;9(2):74–83. doi: http://doi.org/10.22038/ebcj.2019.40293.2058.
» https://doi.org/10.22038/ebcj.2019.40293.2058 -
20. Marker AM, Monzon AD, Goggin KJ, Clements MA, Patton SR. Iterative development of a web-based 35 intervention for families of young children with type 1 diabetes: DIPPer Academy. Clin Pract Pediatr Psychol. 2019;7(1):20–30. doi: http://doi.org/10.1037/cpp0000263. PubMed PMID: 31662953.
» https://doi.org/10.1037/cpp0000263 -
21. Kyfonidis C, Lennon M. Making diabetes education interactive: tangible educational toys for children with type-1 diabetes. In: Proceedings of the CHI ’19: CHI Conference on Human Factors in Computing Systems; 2019 May 4–9; Glasgow, Scotland. New York: Association for Computing Machinery; 2019. doi: http://doi.org/10.1145/3290605.3300671.
» https://doi.org/10.1145/3290605.3300671 -
22. Emiliana P, Agustini N, Allenidekania, Rustina Y. A preliminary study on “PRISMA” education in improving self-management and level of compliance in children with type-1 diabetes mellitus. Compr Child Adolesc Nurs. 2019;42(sup1):115–121. doi: http://doi.org/10.1080/24694193.2019.1578432.
» https://doi.org/10.1080/24694193.2019.1578432 -
23. Pennafort VPS, Queiroz MVO, Gomes ILV, Rocha MFF, Queiroz MVO, Gomes ILV, et al. Instructional therapeutic toy in the culture care of the child with diabetes type 1. Rev Bras Enferm. 2018;71(Suppl 3):1334–42. doi: http://doi.org/10.1590/0034-7167-2017-0260. PubMed PMID: 29972532.
» https://doi.org/10.1590/0034-7167-2017-0260 -
24. Kaneto LA, Damião EBC, Verissimo MLÓR, Rossato LM, Toriyama ATM, Szylit R. Educational Workshop using games improves self-monitoring of blood glucose among children. Rev Latino-Am Enferm. 2018;26:e3039. doi: https://doi.org/10.1590/1518-8345.2400.3039.
» https://doi.org/10.1590/1518-8345.2400.3039 -
25. Bernier A, Fedele D, Guo Y, Chavez S, Smith MD, Warnick J, et al. New-onset diabetes educator to educate children and their caregivers about diabetes at the time of diagnosis: usability study. JMIR Diabetes. 2018;3(2):e10. doi: http://doi.org/10.2196/diabetes.9202. PubMed PMID: 30291069.
» https://doi.org/10.2196/diabetes.9202 -
26. Henkemans OAB, Bierman BPB, Janssen J, Looije R, Neerincx MA, van Dooren MMM, et al. Design and evaluation of a personal robot playing a self-management education game with children with diabetes type 1. Int J Hum Comput Stud. 2017;106:63–76. doi: http://doi.org/10.1016/j.ijhcs.2017.06.001.
» https://doi.org/10.1016/j.ijhcs.2017.06.001 -
27. Moura DJM, Moura NS, Menezes LC, Barros AA, Guedes MV, Menezes LCG, et al. Development of a booklet on insulin therapy for children with diabetes mellitus type 1. Rev Bras Enferm. 2017;70(1):7–14. doi: http://doi.org/10.1590/0034-7167-2016-0183. PubMed PMID: 28226036.
» https://doi.org/10.1590/0034-7167-2016-0183 -
28. McCulloch V, Hope S, Loranger B, Rea P. How to effectively design and create a concept mobile application to aid in the management of type 1 diabetes in adolescents. J Vis Commun Med. 2017;40(3):101–8. doi: http://doi.org/10.1080/17453054.2017.1366828. PubMed PMID: 28925769.
» https://doi.org/10.1080/17453054.2017.1366828 -
29. Bechara GM, Castelo Branco F, Rodrigues AL, Chinnici D, Chaney D, Calliari LEP, et al. “KiDS and Diabetes in Schools” project: experience with an international educational intervention among parents and school professionals. Pediatr Diabetes. 2018;19(4):756–60. doi: http://doi.org/10.1111/pedi.12647. PubMed PMID: 29504189.
» https://doi.org/10.1111/pedi.12647 -
30. Mauri A, Schmidt SA, Sosero V, Sambataro M, Nollino L, Fabris F, et al. A structured therapeutic education program for children and adolescents with type 1 diabetes: an analysis of the efficacy of the “Pediatric Education for Diabetes” project. Minerva Pediatr (Torino). 2017;73(2):159–66. doi: http://doi.org/10.23736/S2724-5276.17.04634-5. PubMed PMID: 28176508.
» https://doi.org/10.23736/S2724-5276.17.04634-5 -
31. Nilsson S. How young people can learn about newly diagnosed type 1 diabetes. Nurs Child Young People. 2016;28(3):22–6. doi: http://doi.org/10.7748/ncyp.28.3.22.s21. PubMed PMID: 27063051.
» https://doi.org/10.7748/ncyp.28.3.22.s21 -
32. Joubert M, Armand C, Morera J, Tokayeva L, Guillaume A, Reznik Y. Impact of a serious videogame designed for flexible insulin therapy on the knowledge and behaviors of children with type 1 diabetes: the LUDIDIAB pilot study. Diabetes Technol Ther. 2016;18(2):52–8. doi: http://doi.org/10.1089/dia.2015.0227. PubMed PMID: 26440963.
» https://doi.org/10.1089/dia.2015.0227 -
33. Ramchandani N, Maguire LL, Stern K, Quintos JB, Lee M, Sullivan-Bolyai S. PETS-D (parents education through simulation-diabetes): parents’ qualitative results. Patient Educ Couns. 2016;99(8):1362–7. doi: http://doi.org/10.1016/j.pec.2016.03.019. PubMed PMID: 27021779.
» https://doi.org/10.1016/j.pec.2016.03.019 -
34. Sullivan-Bolyai S, Crawford S, Johnson K, Ramchandani N, Quinn D, D’Alesandro B, et al. PREP-T1 (Preteen Re-Education With Parents–Type 1 Diabetes) feasibility intervention results. J Fam Nurs. 2016;22(4):579–605. doi: http://doi.org/10.1177/1074840716676589. PubMed PMID: 27903941.
» https://doi.org/10.1177/1074840716676589 -
35. Queiroz MVO, Brito LMMC, Pennafort VPS, Bezerra FSM. Sensitizing children with diabetes to self-care: contributions to educational practice. Esc Anna Nery. 2016;20(2):337–43. doi: http://doi.org/10.5935/1414-8145.20160046.
» https://doi.org/10.5935/1414-8145.20160046 - 36. Chomutare T, Johansen SG, Hartvigsen G, Årsand E. Serious game co-design for children with type 1 diabetes. Stud Health Technol Inform. 2016;226:83–6. PubMed PMID: 27350472.
-
37. Price KJ, Knowles JA, Fox M, Wales JKH, Heller S, Eiser C, et al. Effectiveness of the Kids in Control of Food (KICk-OFF) structured education course for 11-16 year olds with type 1 diabetes. Diabet Med. 2016;33(2):192–203. doi: http://doi.org/10.1111/dme.12881. PubMed PMID: 26248789.
» https://doi.org/10.1111/dme.12881 -
38. Maguire LL, Crawford S, Sullivan-Bolyai S. Grandparent education through simulation-diabetes. Diabetes Educ. 2015;41(6):678–89. doi: http://doi.org/10.1177/0145721715607982. PubMed PMID: 26424677.
» https://doi.org/10.1177/0145721715607982 -
39. Bin-Abbas B, Jabbari M, Al-Fares A, El-Dali A, Al-Orifi F. Effect of mobile phone short text messages on glycaemic control in children with type 1 diabetes. J Telemed Telecare. 2014;20(3):153–6. doi: http://doi.org/10.1177/1357633X14529244. PubMed PMID: 24643953.
» https://doi.org/10.1177/1357633X14529244 -
40. Kang N, Ahn Y, Lee JE, Sohn M. Effect of self-care education at a diabetes camp on diabetes management behaviors, knowledge and self-efficacy in children with type 1 diabetes. Child Health Nurs Res. 2014;20(3):168–75. doi: http://doi.org/10.4094/CHNR.2014.20.3.168.
» https://doi.org/10.4094/CHNR.2014.20.3.168 -
41. Jaser SS, Whittemore R, Chao A, Jeon S, Faulkner MS, Grey M. Mediators of 12-month outcomes of two Internet interventions for youth with type 1 diabetes. J Pediatr Psychol. 2014;39(3):306–15. doi: http://doi.org/10.1093/jpepsy/jst081. PubMed PMID: 24163439.
» https://doi.org/10.1093/jpepsy/jst081 -
42. Grey M, Whittemore R, Jeon S, Murphy K, Faulkner MS, Delamater A. Internet psycho-education programs improve outcomes in youth with type 1 diabetes. Diabetes Care. 2013;36(9):2475–82. doi: http://doi.org/10.2337/dc12-2199. PubMed PMID: 23579179.
» https://doi.org/10.2337/dc12-2199 -
43. Hanberger L, Ludvigsson J, Nordfeldt S. Use of a web 2.0 portal to improve education and communication in young patients with families: randomized controlled trial. J Med Internet Res. 2013;15(8):e175. doi: http://doi.org/10.2196/jmir.2425. PubMed PMID: 23973555.
» https://doi.org/10.2196/jmir.2425 -
44. Ramchandani N, Johnson K, Cullen K, Hamm T, Bisordi J, Sullivan-Bolyai S. CDE Perspectives of providing new-onset type 1 diabetes education using formal vignettes and simulation. Diabetes Educ. 2017;43(1):97–104. doi: http://doi.org/10.1177/0145721716676893. PubMed PMID: 28118129.
» https://doi.org/10.1177/0145721716676893 -
45. Nicholas DB, Fellner KD, Frank M, Small M, Hetherington R, Slater R, et al. Evaluation of an online education and support intervention for adolescents with diabetes. Soc Work Health Care. 2012;51(9):815–27. doi: http://doi.org/10.1080/00981389.2012.699507. PubMed PMID: 23078013.
» https://doi.org/10.1080/00981389.2012.699507 -
46. Sullivan-Bolyai S, Bova C, Lee M, Johnson K. Development and pilot testing of a parent education intervention for type 1 diabetes: parent education through simulation-diabetes. Diabetes Educ. 2012;38(1):50–7. doi: http://doi.org/10.1177/0145721711432457. PubMed PMID: 22222512.
» https://doi.org/10.1177/0145721711432457 -
47. Fuchslocher A, Niesenhaus J, Krämer N. Serious games for health: an empirical study of the game “Balance” for teenagers with diabetes mellitus. Entertain Comput. 2011;2(2):97–101. doi: http://doi.org/10.1016/j.entcom.2010.12.001.
» https://doi.org/10.1016/j.entcom.2010.12.001 -
48. Souza LR, Martins TSS, Maciel RO, Dias LS, Gentil AB. O cuidado de enfermagem junto à criança com diabetes mellitus tipo 1: elaboração de um folheto educativo. Rev Enferm UFPE (Online). 2020;4(3):1299–303. doi: http://doi.org/10.5205/reuol.1064-8019-4-LE.0403esp201051.
» https://doi.org/10.5205/reuol.1064-8019-4-LE.0403esp201051 -
49. Martin C, Liveley K, Whitehead K. A health education group intervention for children with type 1 diabetes. J Diabetes Nur [Internet]. 2009[cited 2023 Jul 4];13(1):32037. Available from: https://diabetesonthenet.com/wp-content/uploads/jdn13-1pg32-7-1.pdf
» https://diabetesonthenet.com/wp-content/uploads/jdn13-1pg32-7-1.pdf -
50. Wangberg SC, Årsand E, Andersson N. Diabetes education via mobile text messaging. J Telemed Telecare. 2006;12(1, suppl):55–6. doi: http://doi.org/10.1258/135763306777978515. PubMed PMID: 16884582.
» https://doi.org/10.1258/135763306777978515 -
51. Pélicand J, Gagnayre R, Sandrin-Berthon B, Aujoulat I. A therapeutic education programme for diabetic children: recreational, creative methods, and use of puppets. Patient Educ Couns. 2006;60(2):152–63. doi: http://doi.org/10.1016/j.pec.2004.12.007. PubMed PMID: 16442458.
» https://doi.org/10.1016/j.pec.2004.12.007 -
52. Aoki N, Ohta S, Okada T, Oishi M, Fukui T. INSULOT: uma ferramenta de aprendizagem educacional baseada em telefone celular para crianças com diabetes tipo 1. Diabetes Care. 2005;28(3):760. doi: http://doi.org/10.2337/diacare.28.3.760. PubMed PMID: 15735232.
» https://doi.org/10.2337/diacare.28.3.760 -
53. Nordfeldt S, Johansson C, Carlsson E, Hammersjö J-Å. Persistent effects of a pedagogical device targeted at prevention of severe hypoglycaemia: a randomized, controlled study. Acta Paediatr. 2005;94(10):1395–401. doi: http://doi.org/10.1111/j.1651-2227.2005.tb01810.x. PubMed PMID: 16299869.
» https://doi.org/10.1111/j.1651-2227.2005.tb01810.x - 54. Aoki N, Ohta S, Masuda H, Naito T, Sawai T, Nishida K, et al. Edutainment tools for initial education of type-1 diabetes mellitus: initial diabetes education with fun. Stud Health Technol Inform. 2004;107(Pt 2):855–9. PubMed PMID: 15360933.
-
55. Nordfeldt S, Johansson C, Carlsson E, Hammersjo J. Prevention of severe hypoglycaemia in type I diabetes: a randomised controlled population study. Arch Dis Child. 2003;88(3):240–5. doi: http://doi.org/10.1136/adc.88.3.240. PubMed PMID: 12598392.
» https://doi.org/10.1136/adc.88.3.240 -
56. Nordfeldt S, Ludvigsson J. Self-study material to prevent severe hypoglycaemia in children and adolescents with type 1 diabetes: a prospective intervention study. Pract Diabetes Int. 2002;19(5):131–6. doi: http://doi.org/10.1002/pdi.363.
» https://doi.org/10.1002/pdi.363 -
57. Brown SJ, Lieberman DA, Gemeny BA, Fan YC, Wilson DM, Pasta DJ. Educational video game for juvenile diabetes: results of a controlled trial. Med Inform (Lond). 1997;22(1):77–89. doi: http://doi.org/10.3109/14639239709089835. PubMed PMID: 9183781.
» https://doi.org/10.3109/14639239709089835 -
58. Engvall JC. Use of computer-assisted instruction in diabetes education. Diabetes Educ. 1994;20(5):433–6. doi: http://doi.org/10.1177/014572179402000512. PubMed PMID: 7851257.
» https://doi.org/10.1177/014572179402000512 -
59. Rogari GL, Uster M. Islet Pilots: an educational program for children with diabetes. Diabetes Educ. 1988;14(2):118–118. doi: http://doi.org/10.1177/014572178801400209. PubMed PMID: 3349911.
» https://doi.org/10.1177/014572178801400209 -
60. James VH, Susan JL. Evaluating a learning device for juvenile diabetic children. Diabetes Care. 1980;3(6):668–71. doi: http://doi.org/10.2337/diacare.3.6.668. PubMed PMID: 7449598.
» https://doi.org/10.2337/diacare.3.6.668 -
61. Guizardi FL, Dutra EB, Passos MFD. Em mar aberto: colaboração e mediações tecnológicas na educação permanente em saúde. Porto Alegre: Rede Unida; 2020. doi: http://doi.org/10.18310/9786587180267.
» https://doi.org/10.18310/9786587180267 -
62. Campos BL, Góes FG, da Silva LF, da Silva AC, Silva MA, Silva LJ. Elaboração e validação de vídeo educativo sobre o banho domiciliar do recém-nascido a termo. Enferm Foco. 2021;12(5):1033–9. doi: http://doi.org/10.21675/2357-707X.2021.v12.n5.4684.
» https://doi.org/10.21675/2357-707X.2021.v12.n5.4684 -
63. Morais ER, Vergara CMAC, de Brito FO, Sampaio HAC. Serious games for children’s oral hygiene education: an integrative review and application search. Ciênc Saúde Colet. 2020;25(8):3299–310. doi: https://doi.org/10.1590/1413-81232020258.11782018.
» https://doi.org/10.1590/1413-81232020258.11782018 -
64. Benevides AMLN, Rabelo JAF, Soares PRH, Barros Filho EM, Ferreira LFA, Medeiros MS. Desenvolvimento de uma plataforma digital para orientar na conduta do diabetes mellitus tipo 2. 2021;10(14):e249101421823. doi: http://doi.org/10.33448/rsd-v10i14.21823.
» https://doi.org/10.33448/rsd-v10i14.21823 -
65. Samuel David BA, Ruales Andrea D, Heidy Liliana AG, Nicolás Ignacio RR, Erwin Hernando HR, de la Hoz Valle JA. Telemedicina en pediatría para el manejo de enfermedades crónicas y de grupos vulnerables. Rev Cuba Inf Cien [Internet]. 2023 [cited 2023 Jul 4];34:E2474. Available from: http://scielo.sld.cu/scielo.php?script=sci_abstract&pid=S2307-21132023000100045&lng=es&nrm=iso&tlng=en
» http://scielo.sld.cu/scielo.php?script=sci_abstract&pid=S2307-21132023000100045&lng=es&nrm=iso&tlng=en -
66. da Silva T, Ramos AR, de Quadros A. Use of realistic simulation as a teaching strategy for undergraduate nursing courses. CONJ. 2021;21(6):221–42. doi: http://doi.org/10.53660/CONJ-338-612.
» https://doi.org/10.53660/CONJ-338-612 -
67. Alencar D de C, Carvalho DBF, Vasconcellos-Silva PR. Online support of virtual communities to diabetes mellitus carrier: bibliometric review. Rev Pesqui. 2021;12:1208–14. doi: http://doi.org/10.9789/2175-5361.rpcfo.v12.9301.
» https://doi.org/10.9789/2175-5361.rpcfo.v12.9301 -
68. Pedrinho LR, Shibukawa BMC, Rissi GP, Uema RTB, Merino MFGL, Higarashi IH. Therapeutic toy for children with type i diabetes mellitus: home interventions. Esc Anna Nery. 2021;25(3):e20200278. doi: http://doi.org/10.1590/2177-9465-ean-2020-0278.
» https://doi.org/10.1590/2177-9465-ean-2020-0278 -
69. Torres HC, Paula DV. Evaluation of a primer giving guidance on Diabetes Mellitus self-care. Rev Enferm UERJ. 2019;27:e7722. doi: http://doi.org/10.12957/reuerj.2019.7722.
» https://doi.org/10.12957/reuerj.2019.7722 -
70. La Banca RO, Sparapani VC, Bueno M, Costa T, Carvalho EC, Nascimento LC. Estratégias para educar jovens com diabetes mellitus tipo 1 sobre insulinoterapia: revisão sistemática. Texto Contexto Enferm. 2020;29:e20180338. doi: http://doi.org/10.1590/1980-265x-tce-2018-0338.
» https://doi.org/10.1590/1980-265x-tce-2018-0338
