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Diabetes-1_Pg8_150Blue tears. Devil horns. Dazed eyes.

These artistic features drawn by young patients with diabetes caught the attention of pediatric nurse practitioner Shari Liesch.

In 2014, Liesch started asking the youth she treated in the endocrine clinic at Children’s Hospital of Wisconsin-Fox Valley to draw what diabetes would look like if it had a face.

The drawings—created in the time it took Liesch to check meds and update medical histories—turned out to be quite revealing.

Diabetes-2_Pg8_150“While collecting the art, I realized that the normal clinic visit assessment of data barely tapped into the significance of the youths’ ‘lived experience’ with this chronic condition,” she explained. “There were many emotions, feelings, concerns and worries expressed through their art, which allowed increased discussion about their feelings reflected in their drawings.”

Liesch reached out to UWO College of Nursing assistant professor Kathy Elertson for help with researching and analyzing the drawings of 242 youth—ages 5 to 19—with type I diabetes who were attending routine, follow-up appointments.

Results of the descriptive, pilot study recently were published in the Journal of Patient Experience.

Diabetes-3_Pg8_300Elertson, a pediatric nurse practitioner by trade, is interested in chronic, complex diagnoses and studying the stigmas related to chronic health problems.

In this initial study, Elertson said they found that drawing a picture during a routine appointment can “give voice to how the patients are feeling, so that thoughts and feelings can come out that they may not be able to express verbally.”

For example, the drawings showed “diabetes” as a figure that is crying, has no ears, is a blood-sucking monster or is trapped or benched at a sporting event.

“While we could assess the art for patterns and similarities, we had questions about the meaning to the artist. Why did so many use the colors red and black? Why did many add devil features? We also noted that the ‘tools’ for self-care were ‘supersized’ in the drawings, which is consistent with information obtained from the literature review,” Liesch said.

Diabetes-4_Pg8_150That’s why in future collaborative studies the researchers plan to bring in an art therapist who can evaluate more closely the use of color and other aspects of the drawings.

“We are determining if the drawings are a good mechanism for the youth to share how they are feeling, providing a starting point for discussion,” Elertson said. “We don’t want to just treat their numbers and their sugars but also take a closer look at the whole person. The youth need to know they are so much more than their numbers.”

Diabetes-5_Pg8_150Liesh said Elertson’s involvement with the project—analyzing the information, synthesizing the data and guiding the development of a new study to delve further—has been invaluable.

“Working together toward a focused goal raises the bar to greater heights. We can do so much more together,” she said.

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