Diabetes Nurses Research Articles

Application Effect of Humanized Nursing in Diabetes Nursing

Application Effect of Humanized Nursing in Diabetes Nursing

Experiences of Online COVID-19 Information Acquisition among Persons with Type 2 Diabetes and Varying eHealth Literacy.

During the COVID-19 pandemic, the Internet has been a major source of information for people to keep updated with news and guidelines. However, concerns have been raised about the ‘infodemic’, which includes the overabundance of online information and the spread of misleading information. Adequate eHealth literacy skills among world citizens have therefore been emphasized as vital during the pandemic. Persons with type 2 diabetes have been at increased risk of severe outcomes of COVID-19 disease. This study aimed to explore online COVID-19 information acquisition experiences among persons with type 2 diabetes and varying eHealth literacy. Fifty-eight participants filled out the eHealth Literacy Scale (eHEALS), along with a qualitative questionnaire with free-text questions. Additionally, 10 participants were interviewed. Thematic analysis was applied to identify patterns in participants’ experiences. Two domains were identified: perceived challenges with online information about COVID-19, and coping strategies to manage challenges. The perceived challenges were: being exposed to information overload, dealing with conflicting information, and being strongly emotionally affected. The related coping strategies were: protecting oneself, trusting authorities, taking command, and using common sense. These strategies often involved triangulation of the information obtained, including participants consulting their common sense, various sources, or family and friends. This paper highlights the crucial role of authorities in delivering online information, that according to health literacy principles, is easy to access, understand, and use. Furthermore, our results reinforce the importance of diabetes nurses, as well as healthcare professionals in general, in encouraging patients to share their Internet findings, promote information from reliable sources, and deliver tailored information that suits individual needs. Because our results underline the importance of social support in eHealth literacy and the assessment of online health information, the inclusion of family and friends needs to be increasingly considered in diabetes care. Due to the small homogenous sample, the results of this study cannot be generalized. However, the reader can assess the transferability to other situations and settings based on our contextual descriptions.

The Role of Whole-course Health Education Model in Diabetes Nursing Management

The Role of Whole-course Health Education Model in Diabetes Nursing Management

Oral Health Knowledge and Habits of People With Type 1 and Type 2 Diabetes

ObjectivesThis study aimed to collect information about oral health knowledge and the habits of people living with diabetes (PwD), primarily type 1 diabetes, using the newly developed World Health Organisation Oral Health Questionnaire for Adults (Annex 7). Materials and methodsComparable and reliable questionnaires, comprising 23 questions for PwD, were sent to diabetes social media groups, mailing lists, and associations. The survey explored the relationships amongst demographic factors, age, dental education, eating habits, and other factors. ResultsThe 23-question survey was answered by 307 individuals from 60 different countries. Alcohol and tobacco use, dental anxiety, and bad habits were often reported. Of the participants, 61.2% (n = 188) had at least 1 drink during the past 30 days. Of the participants, 22.8% (n = 70) were smokers. In total, 80.8% (n = 248) of the participants consumed biscuits, 76.2% (n = 234) consumed sweets, and 63.2% (n = 194) consumed soft drinks regularly. A total of 26.4% (n = 81) of the participants reported being afraid of dental treatment. Of the participants, 48.5% (n = 149) reported dry mouth and other oral complications. The frequency of visits to the dentist was satisfactory. A total of 71.3% (n = 219) of the participants reported visiting a dentist during the past 12 months. ConclusionsThere is a need for proper oral health education for PwD. Trained diabetes advocates could be core messengers. However, interdisciplinary cooperation is mandatory for both education and the clinical aspect of diabetes care. For example, diabetes nurses need to be educated with the help of dentists or oral hygienists.

Application of Health Education Clinical Nursing Pathway in Diabetes Nursing

Application of Health Education Clinical Nursing Pathway in Diabetes Nursing

Application of Whole-course Health Education Nursing Mode in Diabetes Nursing in Endocrinology Department

Application of Whole-course Health Education Nursing Mode in Diabetes Nursing in Endocrinology Department

Identifying critical features of type two diabetes prevention interventions: A Delphi study with key stakeholders.

AimsThis study aims to identify critically important features of digital type two diabetes mellitus (T2DM) prevention interventions.MethodsA stakeholder mapping exercise was undertaken to identify key end-user and professional stakeholders, followed by a three-round Delphi procedure to generate and evaluate evidence statements related to the critical elements of digital T2DM prevention interventions in terms of product (intervention), price (funding models/financial cost), place (distribution/delivery channels), and promotion (target audiences).ResultsEnd-user (n = 38) and professional (n = 38) stakeholders including patients, dietitians, credentialed diabetes educators, nurses, medical doctors, research scientists, and exercise physiologists participated in the Delphi study. Fifty-two critical intervention characteristics were identified. Future interventions should address diet, physical activity, mental health (e.g. stress, diabetes-related distress), and functional health literacy, while advancing behaviour change support. Programs should be delivered digitally or used multiple delivery modes, target a range of population subgroups including children, and be based on collaborative efforts between national and local and government and non-government funded organisations.ConclusionsOur findings highlight strong support for digital health to address T2DM in Australia and identify future directions for T2DM prevention interventions. The study also demonstrates the feasibility and value of stakeholder-led intervention development processes.

The Coronavirus Anxiety in the Elderly: The Role of Coping Styles with Stress and Meta-Worry

The Coronavirus Anxiety in the Elderly: The Role of Coping Styles with Stress and Meta-Worry

Significant Nursing Practices for the Management of Diabetes

Over the past few decades, diabetes turns out to be a progressively more and serious health problem worldwide. It has been reported that increasing number of people are getting affected and living with this disease with a significant rise. Diabetes Specialist Nurse work completely in diabetes care their support is considered vital in offering excellent patient care and advocating effective management. They will also offer training and support to other nurses on general practices and diabetes management. The responsibilities in the management of diabetes and patient care involves guidance on disease control & prevention, advocating behavioural modifications and health training. Other important roles include early assessment of Type II diabetes, fostering self-care, creating awareness on the importance of mental health and monitoring urine, blood and glucose levels. Diabetic specialist nurses have a major positive impact when counselling diabetes patients on self-management especially when merged with pre-emptive care.

Life satisfaction and emotional distress in people living with type 2 diabetes mellitus: The mediating effect of cognitive function

To explore the relationships among emotional distress, cognitive function, and life satisfaction in people living with type 2 diabetes mellitus (T2DM), and to verify the mediating role of cognitive function. People with T2DM face cognitive decline caused by age and disease complications. Emotional distress will reduce their life satisfaction, and cognitive function will also affect the life satisfaction, but whether cognitive function mediates the effect of emotional distress on life satisfaction has not been verified. A cross-sectional study. A total of 200 people living with T2DM in the community by convenience sampling were enrolled from November - December 2018. Data collection involved a demographic and disease characteristics questionnaire, Problem Areas in Diabetes Scale, Subjective and Objective Cognitive Function Evaluation, and Life Satisfaction Questionnaire. Data analysis included descriptive statistics and structural equation modeling. This report followed the STROBE guideline. The emotional distress and subjective memory complaints of cognitive function had a significant positive correlation, while both emotional distress and cognitive function showed significant negative correlations with life satisfaction. In addition, cognitive function completely mediated the relationship between emotional distress and life satisfaction. The cognitive function played a mediating role in life satisfaction and explain how emotional distress affects life satisfaction of people with T2DM. Therefore, it is suggested that diabetes nurses should early identify the decline of cognitive function, and to intervene at early stage. This study provides opinions on the mediating factors of cognitive function. Coping strategies and supporting resources to help the T2DM people to improve their life satisfaction is suggested.

147-LB: Targeted Intervention for At-Risk Patients with Diabetes to Reduce Readmissions

With benefits to patient outcomes, provider burden, and health system costs, the goal of reducing hospital readmissions for patients with diabetes mellitus (DM) is multifaceted. Current studies have neither elucidated a clear approach to accurately identify at-risk patients nor implemented reliable interventions to significantly reduce readmissions. We trialed a Quality Improvement project utilizing a diabetes Nurse Practitioner (NP)/Certified Diabetes Care and Education Specialist (CDCES) to see at-risk patients during initial hospitalization and in close clinic follow-up after discharge with an endpoint of reducing future readmissions. Over 21 months, 79 hospitalized patients with DM were identified as high-risk for readmission. Identifying factors included previous admission, DKA/HHS, new DM diagnosis, new to insulin, high-dose steroid use, or provider discretion. The NP/CDCES provided DM management, education, and coordinated discharge. Patients were called shortly after discharge and had a 2-4 week clinic follow-up with the NP/CDCES. The primary endpoint was number of readmissions 180 days post-discharge after NP/CDCES intervention versus number of previous readmissions pre-intervention. Change in hemoglobin A1C, time to post-hospital phone call, and time to outpatient follow-up were also evaluated. Pre- and post-intervention readmission rates remained unchanged; average pre-intervention readmissions per patient was 1.7 versus 1.88 post-intervention readmissions (p=0.74). However, a secondary endpoint of reduction in A1C was statistically significant, with a mean decrease in A1C of 0.97% per patient (p=0.0025). Time to post-hospital phone call and early follow-up did not affect readmission rates. While targeted inpatient-to-outpatient intervention for high-risk patients with DM did not reduce readmission rates, our data suggests coordinated inpatient intervention with close hospital follow-up may improve A1C in high-risk patients with diabetes. Disclosure A. Harris: None. K. Grdinovac: None.

Genomic Testing for Monogenic Diabetes in the UK: A Three-Fold Increase in Diagnoses Since 2009

Background: Maturity Onset Diabetes of the Young (MODY) is a rare monogenic form of diabetes. In 2009, >80% of UK cases were estimated to be misdiagnosed. Since then, there have been a number of initiatives to improve detection of MODY: the Genetic Diabetes Nurse (GDN) education programme, the MODY probability calculator, and targeted next generation sequencing (tNGS). We aimed to determine an up-to-date prevalence estimate for UK MODY and assess how these initiatives have impacted case finding. Methods:UK referrals for genetic testing for monogenic diabetes diagnosed >1y of age from 1/1/1996 to 31/12/2019 were examined. Positive-test rates were compared for referrals reporting involvement of the GDNs/MODY calculator with those that did not. Findings: A diagnosis of MODY was confirmed in 3860 individuals, >3-fold higher than 2009 (n=1177). Median age at diagnosis in probands was 21y. GDN involvement was reported in 21% of referrals; these referrals had a higher positive-test rate than those without GDN involvement (32% v 23%, p<0.001). MODY calculator usage was indicated on 74% of eligible referrals since 2014; these referrals had a higher positive-test rate than those not using the calculator (32% v 24%, p=0.001). 374 (10%) cases were identified through tNGS. MODY prevalence was estimated to be 248 cases/million (double that estimated in 2009 due to increased case-finding). Interpretation: Since 2009, referral rates and case diagnosis has increased three-fold. This is likely to be the consequence of tNGS, GDN education and the MODY calculator. Funding: NIHR, Scottish Government Declaration of Interest: None

Support Strategies of Certified Nurses in Diabetes Nursing for Type 1 Diabetes Patients During Puberty/Adolescence

Study objective: To elucidate the support strategy of certified nurses who provide support for type 1 diabetes patients in puberty/adolescence. Study methods: We conducted focus group interviews with eight certified nurses who had at least one year of activity after certification and experience of providing support to type 1 diabetes patients in puberty/adolescence. The contents of the interviews were transcribed as data. We conducted qualitative and descriptive analysis with a focus on the context of conscious involvement, efforts, and thoughts toward patients being able to effectively manage their own condition. Results: The result of the analysis led to 12 subcategories which were grouped into five main categories as follows: << Adjusting the parent-child relationship associated with the care >>, << Linking the relationship with patients >>, << Being involved with the patient’s own perspective >>, << Identifying the management method that utilizes patients’ strength >>, and << Understanding and managing financial problems that develop from changes in the insurance system >>. Conclusions: As a strategy, certified nurses interacted with patients based on the developmental characteristics of puberty and adolescence, and adjusted relationships within the family in order to promote independence of the patient. In addition, certified nurses made efforts and provided support to prevent interruption of care management due to financial problems for patients at 20 years of age, when the medical care system changes.

Alignment between outcomes and minimal clinically important differences in the Dutch type 2 diabetes mellitus guideline and healthcare professionals' preferences.

To evaluate the clinical benefit of new medicines for type 2 diabetes mellitus (T2DM), the Dutch guideline committee T2DM in primary care established the importance of outcomes and minimal clinically important differences (MCIDs). The present study used an online questionnaire to investigate healthcare professionals’ opinions about the importance of outcomes and preferences for MCIDs. A total of 211 physicians, pharmacists, practice nurses, diabetes nurses, nurse practitioners and physician assistants evaluated the importance of mortality, macro‐ and microvascular morbidity, HbA1c, body weight, quality of life, (overall) hospital admissions and severe and other hypoglycemia on a 9‐point scale. All outcomes were considered critical (mean scores 7–9), except for body weight and other hypoglycemia (mean scores 4–6). Only HbA1c and hospital admissions were valued differently by the guideline committee (not critical). Other relevant outcomes according to the respondents were adverse events, ease of use and costs. Median MCIDs were 4 mmol/mol for HbA1c (guideline: 5 mmol/mol) and 3 kg for body weight (guideline: 5 kg weight gain and 2,5 kg weight loss). Healthcare professionals preferred relative risk reductions of 20% for mortality (guideline: 10%) and macrovascular morbidity (guideline: 25%) and 50% for other hypoglycaemia (guideline: 25%). The MCID of 25% for microvascular morbidity, hospital admissions and severe hypoglycaemia corresponded to the guideline‐MCID. Healthcare professionals’ preferences were thus comparable to the views of the guideline committee. However, healthcare professionals had a stricter view on the importance of HbA1c and hospital admissions and the MCIDs for mortality and other hypoglycemia.

Development Of Diabetes Self-Care Management Using Audio-Visual Media

Introduction: Complications due to diabetes can prevented if patients able to independently handle the disease properly. According several studies, there is a significant relationship between diabetes self-management (DSM) and glycemic control. Diabetes Self Management education (DSME) is the provision of health education by experienced medical personnel about the daily behavior of diabetics such as self-monitoring blood glucose (SMBG), diet, health care, monitoring of medication and physical activity. Objective: To understood the education response in DM patient using video approached. Methods: The design of this study used a Research and Development approach with a quasi-experimental research design pretest-posttest with control group. The research began with the making of a DSME educational video which was carried out in three stages : exploration, development and validation stages. After the video was produced, further testing was carried out to determine the effectiveness of the video in increasing knowledge of DM. Result: The analysis showed that after the intervention there was an increase in knowledge in the treatment group from 10% to 43.3% while in the control group from 13.3% to 23.3%. Chi square results p value 0.023 (p &lt;0.05), there was a significant difference between the experiment group and the control group after intervention. Conclusion: The DSME through audio-visual media can be more effective in increasing knowledge of diabetes. The use of video as a learning medium would help someone get better information because used of interesting features, authentic and real language. Audio visual as a learning medium made it easier for nurses in diabetes as educators.

Nurses' experiences of caring for and managing hospitalized patients with schizophrenia and diabetes-An interpretative phenomenological analysis.

The purpose of this study is to describe psychiatric nurses' and diabetes nurses' experiences of care with hospitalized patients with schizophrenia and diabetes. Eight psychiatric nurses and diabetes nurses were interviewed, and the data material was analyzed using interpretative phenomenological analysis (IPA). The analysis showed that nurses lack knowledge about schizophrenia, diabetes, and intersectoral collaboration. It triggers feelings of uncertainty and incapacity. There is a need for more knowledge and organizational adjustments to underpin a more cohesive care to improve living conditions, so that patients may be able to self-manage their illnesses.

The division and transfer of care responsibilities in paediatric type 1 diabetes: A qualitative study on parental perspectives.

AimTo determine which factors other than child age play a role in the division and transfer of diabetes care responsibilities between parents and children with type 1 diabetes.DesignQualitative focus group study.MethodsAcross four sites in the Netherlands, 18 parents (13 mothers) of children (9–14 years) with type 1 diabetes participated in four focus groups in 2015–2016, as part of the research project 'Whose diabetes is it anyway?'. Qualitative content analysis and the constant comparison method were used to analyse the data.ResultsAccording to parents, the transfer process included both direct and indirect tasks, had different levels (remembering, deciding, performing), was at times a difficult and stressful process, and showed large variation between families. A large number of child, parent and context factors were identified that affected the division and transfer of diabetes care responsibilities according to parents. Both positive and negative consequences of the transfer process were described for parental and child health, behaviour and well‐being. Parental final evaluations of the division and transfer of diabetes care responsibilities appeared to be dependent on parenting values.ConclusionHow families divide and transfer diabetes care tasks appeared to be affected by a complex interplay of child, parent and context characteristics, which had an impact on several parent and child domains.ImpactParents struggle with the right timing of transfer, which calls for more support from diabetes nurses. The identified factors can be used as input for integrating a more family‐based approach into current age‐based guidelines, to improve regular care.

Development of the professional role of diabetes nurses in specialised diabetes and primary care in Catalonia

ObjectivesThe aim of this study was to describe therapeutic education programmes in diabetes in Catalonia and the differences according to the healthcare setting in which the patients are attended (primary care [PC] and specialised diabetes care [SDC]). MethodWe performed a descriptive, cross-sectional, comparative study of diabetes nurses (DN) in SDC and PC in Catalonia. The sample was obtained from all the DN in SDC and a randomised cluster sample of DN in PC. The questionnaire of the Study of European Nurses in Diabetes (SEND) validated in Spanish was used. ResultsA total of 287 questionnaires were analysed (24.3% SDC and 75.6% PC). More training in diabetes through masters, postgraduate courses and continuing education was observed in SDC (p<0.001) as well as structured, written, education programmes and the combination of individual and group education strategies (p<0.05). The roles of educator, consultant, researcher, manager, liaison or collaborator and innovator and the telematic follow-up of patients was also more developed in SDC (p<0.05). The grade of work satisfaction was elevated in both groups. Conclusions(1) Nursing professionals in SDC assume more roles of specialised clinical nursing and also have more training in diabetes and therapeutic education than PC professionals. (2) Professionals in SDC work with a greater proportion of structured diabetes therapeutic education programmes although this should improve in both settings. According to the results obtained and the scientific evidence currently available, the training of DN working in the care of people with diabetes should be accredited in order to increase the use of structured programmes and investigation by DNs in both healthcare settings.

Public relations needs and problem for diabetes nursing

Public relations needs and problem for diabetes nursing

EPS2.04 The role of Flash Glucose Monitoring System at annual review during the COVID-19 restrictions, within Cystic Fibrosis Diabetes Service at Blackpool Adult Cystic Fibrosis Centre, UK

Objectives: The gold standard of care for diagnosing Cystic Fibrosis-Related Diabetes (CFRD), as recommended by CF Trust and American Diabetes Association guidelines (Bridges et al., 2018), is to use the Oral Glucose Tolerance Test (OGTT). Flash Glucose Monitoring System (FGMS) was introduced for CF patients, shielding due to COVID-19, as part of their CF annual review (A/R) alongside chest status, weight and HbA1c. Methods: • A/R information sheet outlining reason for using FGMS and sharing data agreement via Libre View. • Video consultation with Dietitian/CF Diabetes Nurse to discuss and support insertion of Libre sensor and link to sharing data. • Patients completed 2 weeks of daily scanning and food diary. • 2 weekly CFRD MDT data analysis, using the Brompton CGM criteria for CFRD diagnosis (see table 1). [Table presented] Results: • Good uptake of CFRD screening process. • 13 patients screened with FGMS (see table 2). • Monitoring of glucose against timely food diary, using Libre View App. • FGMS has identified patients with impaired glucose handling that may have been missed on OGTT. • Patients able to observe effect of food on blood glucose levels. [Table presented] Conclusion: Using the FGMS has enhanced patient's compliance with A/R screening for CFRD. The FGMS has identified early diagnosis of patients with CFRD and patients with delayed insulin response leading to effective insulin treatment and appropriate dietary changes. Feedback to the patient following A/R has been quicker and more efficient due to video consultations and the sharing of glucose results and food diary via the App and Libre View sharing agreement. The role of FGMS at annual review allows closer analysis of glucose trends which otherwise would have been missed on the OGTT screening.