School-based management of type 1 diabetes in the Republic of Ireland: a cross-sectional mixed-methods analysis

Background Qualitative research regarding the experience of diabetes self-care management in schools is underrepresented in published literature. In addition, there are methodologic limitations in some of the existing studies. Aims To investigate experiences of school-based diabetes self-care management in children and adolescents with type 1 diabetes. Methods Cross-sectional mixed-methods questionnaire survey. Sentiment analysis was undertaken of free-text responses by primary caregivers of young children and adolescents or adolescents themselves in relation to experiences regarding school-based support for self-care. Statements were rated on a 5-point Likert scale from strongly negative (1) to strongly positive (5). Responses were also grouped using thematic analysis. A quantitative analysis of the similarities and differences in responses between primary and secondary school students was undertaken. Results Text responses for analysis were present in 273 (65%) primary and 226 (56%) secondary school questionnaires. Sentiment analysis yielded mean scores of 3.5 and 2.8 for primary and secondary students, respectively. Three major themes were identified in the statements, namely attitude, education/knowledge, and resources. Scores within each theme were significantly higher for primary compared to secondary students. Attitude scored highest and education/knowledge scored lowest in both groups. Comments in relation to resources were significantly more frequent in primary school questionnaires, and comments regarding education and knowledge were more commonplace in secondary school responses. Conclusion Our findings suggest that experiences regarding self-care management of type 1 diabetes are generally more positive among primary school students. Education and knowledge of school staff should be a particular area of focus in both cohorts.