Case Managed Telephone Follow-Up of Diabetic Children


Name: Heidi Jackson

Rank: LTC (ret), USA

Organization: Henry M. Jackson Foundation

Performance Site: Walter Reed Army Medical Center, Washington, DC

Year Published: 1994

Abstract Status: Final


Approximately 120,000 American children have diabetes, with management challenges possibly best approached by a consistent case manager. This study tested telephone follow-up for newly diagnosed diabetic children using nurse-managed hospital-to-community case-management, and described satisfaction, concerns, and educational needs.The study used a two-group, repeated-measures design and a focused interview. The experimental group received standard follow-up visits and additional telephone calls weekly for 8 weeks, then monthly up to 6 months. The controls received only standard follow-up visits. Outcomes included diabetes knowledge (discharge, 6, and 24 weeks); readmissions and length of stay (24 weeks); HbA1c concentration (baseline and weeks 2, 6, 12, and 24); management behaviors (weeks 6 and 24); and satisfaction with care.Children aged 6 to 14 were recruited at Walter Reed Army Medical Center or National Naval Medical Center and randomly assigned to standard follow-up or the telephone intervention. Four females and four males completed the study; average age, 12 years (6-14).Variables were examined by repeated measures analysis using SPSS 6.1.3 for Windows. Qualitative data were pattern coded for categories/themes and analyzed for change.No significant differences were found. Both groups appreciated the case manager. Parents' concerns were keeping the diabetes "under control," adjusting family routines, finances, and the future. They appreciated military health care but worried about coverage later.Children resisted dietary restrictions until they learned to fit favorite foods into their diets. Most were active in their treatment and tried to make it part of their lives. All could participate in previous activities. Other worries were: diet, blood sugar monitoring, insulin administration, recognition of low or high blood sugar, and emotional response. Parents wanted their children to be independent and have a normal life.This study might be replicated with a larger sample or the addition of a non-casemanagement group for comparison.Final Report is available on NTRL: