Self-care behaviors of children with diabetes in Puerto Rico
Description
Self-care behaviors in a primarily low SES sample of children with Insulin-dependent Diabetes Mellitus (IDDM; N = 41) from Puerto Rico were examined using the 24-hour recall interview (Johnson, Silverstein, Rosenbloom, Carter, & Cunningham, 1986). Children (6-17 years of age) and their mothers were interviewed independently on three separate occasions concerning daily self-care behaviors. Measures of 11 different adherence behaviors were constructed based on information obtained from the interviews. Results indicated that children from Puerto Rico came close to achieving many of the self-care guidelines recommended by the American Diabetes Association (ADA). For example, they consumed 29% of their daily calories from fat and 52% from carbohydrates, achieving the ideal for fat intake and approaching the ideal for carbohydrate intake recommended by the ADA. In contrast, Puerto Rican children exercised approximately 18 minutes once a day, indicating great difficulty attaining ADA recommended exercise goals of six times daily for approximately 30 minutes each time. Children from Puerto Rico took their insulin 7.4 minutes before eating, much later than recommended by the ADA (30-60 minutes before meal). In comparison to a sample of children from the United States, Puerto Rican children displayed better self-care behaviors for blood glucose testing frequency, eating frequency, ideal percentage of calories from fat, and ideal percentage of calories from carbohydrates. In contrast, the U.S. sample of children exercised more frequently and for longer periods of time on average than did children from Puerto Rico. Results indicated that parent-child agreement for the Puerto Rican sample was strong for 8 of the 11 measures, similar to previous research (Johnson, et al., 1986). Predictors of self-care behavior in the Puerto Rican sample indicated that child gender and disease duration significantly predicted different self-care behaviors, but age did not, contrary to the literature. Overall, this study provided a description of diabetes self-care behaviors in a primarily low SES sample of children from Puerto Rico. Children appeared to meet most of the ADA recommendations, indicating that despite poor economic conditions in Puerto Rico and the overburdened health care system, the sample of children in this study engaged in relatively good self-care