ESPE2023 Poster Category 1 Diabetes and Insulin (55 abstracts)
Knowledge of healthcare practitioners before and after paediatric T1DM diagnosis and management training
Aman B. Pulungan 1,2 , Muhammad Faizi 3 , Gassani Amalia 1 , Salsabila Septira 1 , Nabila Vathania 1 , Ghaisani Fadiana 2 , Ismi Citra Ismail 4 , Karina Sugih Arto 5 , Siska Mayasari Lubis 5 , Melda Deliana 5 , Saraswati Dewi 6 & Ahmad Nuri 7
1Changing Diabetes in Children Indonesia, Jakarta, Indonesia. 2Department of Child Health, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia. 3Department of Child Health, Faculty of Medicine Airlangga University-Dr Soetomo Hospital, Surabaya, Indonesia. 4Department of Child Health, Dr. H. Abdul Moeloek Hospital, Bandar Lampung, Indonesia, Bandar Lampung, Indonesia. 5Department of Child Health, Faculty of Medicine Universitas Sumatera Utara, Medan, Indonesia. 6Dr. Soebandi Hospital, Jember, Indonesia. 7Indonesia Pediatric Society, East Java Branch, Surabaya, Indonesia
Background: An underestimated figure of 1,249 children with type 1 diabetes mellitus (T1DM) was diagnosed in Indonesia from 2017 to 2019. In 2021, there were around 0.05 paediatricians per 1,000 children in Indonesia. Only 1.2% (n=54) were pediatric endocrinologists practising in 17 out of 38 provinces populating urban areas in Indonesia. Therefore, Changing Diabetes in Children (CDiC) Indonesia, a public-private partnership, has delivered training for healthcare professionals (HCPs) to improve access to healthcare for young people with T1DM. This study assesses the knowledge of HCPs before and after paediatric T1DM diagnosis and management training in Indonesia.
Methods: A quasi-experimental study was conducted in three urban areas in Indonesia (Jember, Lampung, and Medan) from August 2022 to March 2023. Total sampling was done on HCPs who completed pre-test and post-test (consisting of 15 multiple-choice questions) before and after the paediatric T1DM diagnosis and management training. The training was organised by CDiC Indonesia, consisted of one-day in-person, two-days hybrid, and two-days in-person seminar and workshop sessions in Lampung, Medan, and Jember, respectively. The sessions were delivered and facilitated by pediatric endocrinologists. Categorical variables were presented in frequencies and percentages. Continuous data were assessed visually and statistically for the distribution and shown in mean(SD) or median(IQR). Wilcoxon signed-rank test was used to compare the pre-test and post-test. Analysis was done using IBM SPSS Statistics 25.0.
Results: Data from 210 participants who completed the pretest and post-test were analysed. 157 (74.8%) were women, practised in Jember (n=120; 57.1%), Lampung (n=56; 26.7%), and Medan (n=34; 16.2%). Participants were general practitioners (n=101; 48.1%), paediatricians (n=80; 38.1%), nurses (n=17; 8.1%), and dietitians (n=12; 5.7%). Before and after training, less than half of the participants could correctly answer four questions regarding insulin dose (40.5% and 50.0%), diabetic ketoacidosis management (31.0% and 41.9%), operation for T1DM (26.2% and 20.5%), and urine albumin-creatinine ratio (20% and 45.7%). There was strong evidence of median (IQR) increase of the pre-test and post-test results before and after the training, which was 53.3 (20) and 73.3 (20), respectively (P<0.001).
Conclusions: Paediatric T1DM diagnosis and management training for HCPs was associated with increasing HCPs’ knowledge of T1DM before and after training. However, HCPs’ knowledge of T1DM was low, mainly about the appropriate operation timing for T1DM patients. Pre-test and post-test results suggest the importance of training evaluation to improve the participants’ understanding and material retention.
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