A therapeutic education programme for diabetic children:: recreational, creative methods, and use of puppets

Patient education is an important aspect of care to young diabetic children. The use of playthings and recreational activities is an effective way to help children develop harmoniously by integrating the paradox of having to become compliant with treatment and medication while becoming autonomous in life. This paper presents the evaluation of a therapeutic education programme which was attended by 14 young diabetic patients aged 10-12. In order to take into account the learning capacities and strategies linked to the children's age and development stage, the programme's methods were mainly interactive and recreational. In particular, puppets were used as a means to enable the children to express themselves on different aspects of diabetes-related difficulties in their everyday life. The results of the study show that recreational methods and tools can effectively be implemented into therapeutic patient education programmes so as to enable children to develop various treatment-related skills. As far as the psychosocial skill of expressing one's difficulties and emotions is concerned, the use of puppets was found to be an effective means to facilitate the development of such a skill. Moreover, puppets were found to have a projective and transactional function that allowed children to make decisions and react autonomously, and thus regain control on situations in which they had previously felt disempowered. (c) 2004 Elsevier Ireland Ltd. All rights reserved.