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Olsen MT, Klarskov CK, Pedersen-Bjergaard U, Hansen KB, Kristensen PL. Summary of clinical investigation plan for The DIATEC trial: in-hospital diabetes management by a diabetes team and continuous glucose monitoring or point of care glucose testing - a randomised controlled trial. BMC Endocr Disord 2024; 24:60. [PMID: 38711112 DOI: 10.1186/s12902-024-01595-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 04/30/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Worldwide, up to 20 % of hospitalised patients have diabetes mellitus. In-hospital dysglycaemia increases patient mortality, morbidity, and length of hospital stay. Improved in-hospital diabetes management strategies are needed. The DIATEC trial investigates the effects of an in-hospital diabetes team and operational insulin titration algorithms based on either continuous glucose monitoring (CGM) data or standard point-of-care (POC) glucose testing. METHODS This is a two-armed, two-site, prospective randomised open-label blinded endpoint (PROBE) trial. We recruit non-critically ill hospitalised general medical and orthopaedic patients with type 2 diabetes treated with basal, prandial, and correctional insulin (N = 166). In both arms, patients are monitored by POC glucose testing and diabetes management is done by ward nurses guided by in-hospital diabetes teams. In one of the arms, patients are monitored in addition to POC glucose testing by telemetric CGM viewed by the in-hospital diabetes teams only. The in-hospital diabetes teams have operational algorithms to titrate insulin in both arms. Outcomes are in-hospital glycaemic and clinical outcomes. DISCUSSION The DIATEC trial will show the glycaemic and clinical effects of in-hospital CGM handled by in-hospital diabetes teams with access to operational insulin titration algorithms in non-critically ill patients with type 2 diabetes. The DIATEC trial seeks to identify which hospitalised patients will benefit from CGM and in-hospital diabetes teams compared to POC glucose testing. This is essential information to optimise the use of healthcare resources before broadly implementing in-hospital CGM and diabetes teams. TRIAL REGISTRATION Prospectively registered at ClinicalTrials.gov with identification number NCT05803473 on March 27th 2023.
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Affiliation(s)
- Mikkel Thor Olsen
- Department of Endocrinology and Nephrology, Copenhagen University Hospital - North Zealand, Hilleroed, Denmark.
| | - Carina Kirstine Klarskov
- Department of Endocrinology and Nephrology, Copenhagen University Hospital - North Zealand, Hilleroed, Denmark
| | - Ulrik Pedersen-Bjergaard
- Department of Endocrinology and Nephrology, Copenhagen University Hospital - North Zealand, Hilleroed, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Katrine Bagge Hansen
- Steno Diabetes Center Copenhagen, Copenhagen University Hospital - Herlev-Gentofte, Herlev, Denmark
| | - Peter Lommer Kristensen
- Department of Endocrinology and Nephrology, Copenhagen University Hospital - North Zealand, Hilleroed, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Wang Y, Zhang Y, Guo T, Han J, Fu G. Knowledge level and health information-seeking behavior of people with diabetes in rural areas: a multicenter cross-sectional study. Front Public Health 2024; 12:1285114. [PMID: 38751583 PMCID: PMC11094202 DOI: 10.3389/fpubh.2024.1285114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 04/10/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction There is a lack of research on the current level of diabetes knowledge and health information-seeking behaviors among patients with diabetes in rural areas of China's economically underdeveloped regions during COVID-19, as well as a lack of up-to-date evidence on glycemic control and the incidence of complications among rural patients with diabetes. Objectives To investigate the prevalence of glycemic control and complications among patients with diabetes in rural areas, to explore the current status and correlation of diabetes knowledge level and health information-seeking behavior, and to analyze the factors affecting diabetes knowledge level. Methods From January 2022 to July 2022, we conducted a screening on diabetic complications and a questionnaire survey among 2,178 patients with diabetes in 15 county hospitals in rural areas of Guangxi Zhuang Autonomous Region. The patients' knowledge level and health information-seeking behavior were investigated. Spearman correlation analysis was used to assess the correlation between diabetes knowledge and health information-seeking behavior. Multiple linear regression analysis was used to test how demographic information and health information-seeking behavior influenced the level of diabetes knowledge. Results Of 2,178 patients with diabetes in rural areas, 1,684 (77.32%) had poor glycemic control, and the prevalence of diabetic complications was estimated to be 72.13%. Patients with diabetes had poor diabetes knowledge and health information-seeking behavior, and there is a strong positive correlation between them. Diabetes knowledge level was influenced by per capita household disposable income, occupational status, gender, age, ethnicity, family history of diabetes, insulin use, glycated hemoglobin, education level, number of complications and health information-seeking behavior. Conclusion Patients with diabetes in rural areas have poor glycemic control and a high incidence of diabetic complications. Patients with diabetes in rural areas have poor knowledge and inadequate health information-seeking behavior. Systematic and standardized education should be provided to improve patients' diabetes knowledge and thus improve their self-management ability.
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Affiliation(s)
- Yudong Wang
- Department of Nursing, Liaocheng People’s Hospital, Liaocheng, China
- Department of Geriatric Endocrinology and Metabolism, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yanping Zhang
- Department of Geriatric Endocrinology and Metabolism, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Tingting Guo
- Department of Nursing, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- School of Nursing, Youjiang Medical University for Nationalities, Baise, China
| | - Jiaxia Han
- Department of Endocrinology and Metabolism, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Guifen Fu
- Department of Nursing, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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Zhu Y, Zhang H, Xi Y, Zhu H, Lu Y, Luo X, Tang Z, Lei H. The Implication of Diabetes-Specialized Nurses in Aiming for the Better Treatment and Management of Patients with Diabetes Mellitus: A Brief Narrative Review. Diabetes Ther 2024; 15:917-927. [PMID: 38472627 PMCID: PMC11043239 DOI: 10.1007/s13300-024-01558-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
Diabetes mellitus (DM) is regarded as one of the most critical public health challenges of the 21st century. It has evolved into a burgeoning epidemic since the last century, and today ranks among the major causes of mortality worldwide. Diabetes specialist nurses (DSNs) are central to good patient care and outcomes including confident self-care management. Evidence shows that DSNs are cost-effective, improve clinical outcomes, and reduce length of stay in hospital. In this brief narrative review, we aim to describe the roles of DSNs and their contribution in the treatment and management of patients with DM. This narrative review describes the importance of DSNs in healthcare practice, in the inpatient and outpatient departments, in the pediatrics department, in managing diabetic foot ulcers, in the treatment and management of gestational diabetes, in prescribing medications for DM and in diabetes self-management education on glycosylated hemoglobin, and cardiovascular risk factors. To conclude, DSNs have a crucial role in the treatment and management of patients with DM and its complications. DSNs have a great impact on diabetes therapy, and hence implementation of DSNs and nurse-led diabetic clinics might be beneficial for the health care system. Finally, having DSNs might significantly contribute to good healthcare practice and support. Even though DSNs are not available in several regions around the globe, and even though this post is still new to several health care institutions, the presence of DSNs recognized and certified by the various healthcare systems would be very useful.
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Affiliation(s)
- Yefang Zhu
- Department of Rehabilitation Medicine, Huzhou Shushan Geriatric Hospital First Ward, Huzhou, 313000, Zhejiang, People's Republic of China
| | - Hongmei Zhang
- Department of Endocrinology, Ezhou Central Hospital, Hubei, 436000, Ezhou, People's Republic of China
| | - Ying Xi
- The Outpatient Department, The First People's Hospital of Longquanyi District, Chengdu, West China Longquan Hospital, Sichuan University, Sichuan, 610100, People's Republic of China
| | - Hongli Zhu
- Department of Health Management, The First People's Hospital of Longquanyi District, Chengdu, West China Longquan Hospital, Sichuan University, Sichuan, 610100, People's Republic of China
| | - Yan Lu
- The Outpatient Department, The First People's Hospital of Longquanyi District, Chengdu, West China Longquan Hospital, Sichuan University, Sichuan, 610100, People's Republic of China
| | - Xue Luo
- Department of Neurosurgery, The First People's Hospital of Longquanyi District, Chengdu, West China Longquan Hospital, Sichuan University, Sichuan, 610100, People's Republic of China
| | - Zhangui Tang
- Department of Cardiology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Hong Lei
- Department of Health Management, The First People's Hospital of Longquanyi District, Chengdu, West China Longquan Hospital, Sichuan University, Sichuan, 610100, People's Republic of China.
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Dailah HG. The Influence of Nurse-Led Interventions on Diseases Management in Patients with Diabetes Mellitus: A Narrative Review. Healthcare (Basel) 2024; 12:352. [PMID: 38338237 PMCID: PMC10855413 DOI: 10.3390/healthcare12030352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
The global prevalence of people with diabetes mellitus (PWD) is rapidly increasing. Nurses can provide diabetes care for PWD in several areas. Interventions led by nurses can support PWD for effective management of diabetes, which can positively improve clinical outcomes. Nurse-led diabetes self-management education (DSME) is an effective strategy to manage diabetes mellitus (DM) since it improves self-care practice and knowledge regarding diabetes. PWD often need to stay in hospitals longer, which involves poorer patient satisfaction and clinical outcomes. Nurse-led clinics for DM management are a new strategy to possibly ameliorate the disease management. Diabetes specialist nurses can play an important role in improving diabetes care in inpatient settings. Various studies have revealed that nurses can independently provide care to PWD in collaboration with various other healthcare providers. Studies also demonstrated that the nurse-led education-receiving group showed a significantly reduced level of average glycosylated haemoglobin A1c level. Moreover, nurse-led interventions often result in significant improvements in diabetes knowledge, psychological outcomes, self-management behaviours, and physiological outcomes. The purpose of this literature review was to identify the impact of nurse-led interventions on diabetes management. Moreover, in this review, a number of nursing interventions and the nurses' roles as educators, motivators as well as caregivers in DM management have been extensively discussed. This article also summarises the outcomes that are measured to evaluate the impact of nursing interventions and the strategies to overcome the existing and emerging challenges for nurses in diabetes care.
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Affiliation(s)
- Hamad Ghaleb Dailah
- Research and Scientific Studies Unit, College of Nursing, Jazan University, Jazan 45142, Saudi Arabia
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Wright MMM, Kvist TA, Mikkonen SJ, Jokiniemi KS. Finnish Version of the Specialist Outcomes and Barriers Analysis Scale: Evaluation of Psychometric Properties. CLIN NURSE SPEC 2023; 37:281-290. [PMID: 37870514 PMCID: PMC10886455 DOI: 10.1097/nur.0000000000000779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
PURPOSE To evaluate the psychometric properties of the Finnish version of the Specialist Outcomes and Barriers Analysis Scale. DESIGN This was a cross-sectional survey study. METHODS Cultural adaptation of the translation and content validity of the translated instrument were assessed by expert panelists (n = 5) using the content validity index. The construct validity was assessed with principal component analysis using the survey data of Finnish registered nurses (n = 60). Scale reliability was assessed with Cronbach's α values. All study phases were conducted in 2021. RESULTS The items (n = 59) of the scale were critically evaluated by the experts. The full-scale content validity was revealed as excellent (0.92). In terms of construct validity, the scale was analyzed separately for outcomes and barriers. The outcomes section revealed a 5-component structure with an overall Cronbach's α coefficient of .96, and the barriers section, a 2-component structure with an overall Cronbach's α coefficient of .82, indicating adequate reliability of the scale. CONCLUSION The Finnish version of the scale showed excellent content and construct validity. The Cronbach's α values represented adequate reliability of the Specialist Outcomes and Barriers Analysis scale when measuring nurses' perceived practice outcomes and barriers in the Finnish context.
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Affiliation(s)
- Mea Mirella Marjatta Wright
- Author Affiliations: PhD student (Ms Wright), Professor (Dr Kvist), University lecturer (Dr Jokiniemi), Department of Nursing Science, Faculty of Health Sciences; and Research Manager (Dr Mikkonen), Department of Technical Physics, Faculty of Science and Forestry, University of Eastern Finland, Kuopio
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Wang Y, Zhang Y, Han J, Chen Y, Li L, Wei X, Fu G. Diabetes knowledge and training needs among non-endocrinology nurses. Heliyon 2023; 9:e15985. [PMID: 37215767 PMCID: PMC10196786 DOI: 10.1016/j.heliyon.2023.e15985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 05/24/2023] Open
Abstract
Background It is necessary to determine the diabetes knowledge level among non-endocrinology nurses in primary care hospitals to develop continuing education strategies. Method A questionnaire survey was conducted among 6819 non-endocrinology nurses in 70 primary hospitals in the Guangxi Zhuang Autonomous Region to assess their diabetes knowledge level and training needs. Factors affecting knowledge level were analyzed using multiple linear regression models. Results Diabetes knowledge was low, particularly for diabetes monitoring. Knowledge was higher in nurses who had in-service education and training in diabetes; most believed that training was necessary and hoped to improve their ability to care for diabetic patients. The most suitable training method was considered to be each nurse was taught by an assigned person after centralized specialized education and training. Conclusion Non-endocrinology nurses in primary care hospitals lack knowledge of diabetes and have a strong need for training. Systematic training is required to ensure that patients receive high-quality and comprehensive care.
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Affiliation(s)
- Yudong Wang
- School of Nursing, Youjiang Medical University for Nationalities, Baise, China
- Department of Nursing, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Department of Nursing, Liaocheng People's Hospital, Liaocheng, China
| | - Yanping Zhang
- Department of Geriatric Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jiaxia Han
- Department of Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yongfeng Chen
- Department of Nursing, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Lirong Li
- Clinical Tumor Center, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xiaohui Wei
- School of Nursing, Youjiang Medical University for Nationalities, Baise, China
- Department of Nursing, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Guifen Fu
- Department of Nursing, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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Franco-Rodríguez A, Domínguez-Martís EM, Mosteiro-Miguéns DG, López-Ares D, Cotón-Sánchez B, Domínguez-Varela M, Novío S. Translation, Cross-Cultural Adaptation, and Validation of the Galician Version of the Nurse Prescribing Self-Efficacy Scale. Healthcare (Basel) 2022; 10:healthcare10122563. [PMID: 36554086 PMCID: PMC9778594 DOI: 10.3390/healthcare10122563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Low self-efficacy has been identified as one of the factors that could hinder the prescribing competence of nurses. No valid and reliable existing instruments assess Galician nurses' confidence to prescribe. The aim of this study was to determine the reliability and validity of the Galician version of the Nurse Prescribing Self-Efficacy Scale (G-NP-SES, 19 items). The study was conducted in two phases: the translation and adaptation to the Galician version of the NP-SES, and the assessment of its psychometric properties. G-NP-SES was sent to nurses working in primary healthcare centers in Galicia (Spain) between March and June of 2022. Its content, construct and discriminant validity, and internal consistency reliability were examined. A total of 193 people participated in the study. As the original scale, G-NP-SES also had three dimensions (% of cumulative variance = 80.82%). It showed good internal consistency (Cronbach's alpha coefficient (α) = 0.90, with each factor ranging from 0.86 to 0.89), high content validity (scale's content validity index = 0.92, with item-content validity index ranged from 0.87 to 1), and good discriminant validity. G-NP-SES is an instrument with good psychometric properties which could be used to accurately assess Galician nurses' self-efficacy to prescribe and consequently to improve their job performance.
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Affiliation(s)
| | - Eva María Domínguez-Martís
- Galician Public Healthcare Service, Healthcare Centre of Concepción Arenal, C/Santiago León de Caracas 12, 15701 A Coruña, Spain
| | - Diego Gabriel Mosteiro-Miguéns
- Galician Public Healthcare Service, Healthcare Centre of Concepción Arenal, C/Santiago León de Caracas 12, 15701 A Coruña, Spain
| | - David López-Ares
- Galician Public Healthcare Service, University Hospital Complex of A Coruña (CHUAC), 15006 A Coruña, Spain
| | | | | | - Silvia Novío
- Department of Psiquiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, C/ San Francisco s/n, 15782 A Coruña, Spain
- Correspondence:
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Sun Y, Zang C, An L, Bie Y. Effect of comprehensive nursing intervention model on quality of life and blood glucose level of type 2 diabetic patients. Minerva Med 2022; 113:1053-1054. [PMID: 32744810 DOI: 10.23736/s0026-4806.20.06846-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Yunxiang Sun
- Department of General Medicine, People's Hospital of Rizhao, Rizhao, China
| | - Chunyan Zang
- Department of Internal Medicine Cardiovascular, People's Hospital of Rizhao, Rizhao, China
| | - Lei An
- Department of Chronic Disease Management Center, People's Hospital of Rizhao, Rizhao, China
| | - Yanna Bie
- Department of Stomatology, People's Hospital of Rizhao, Rizhao, China -
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Yaagoob E, Hunter S, Chan S. The effectiveness of social media intervention in people with diabetes: An integrative review. J Clin Nurs 2022; 32:2419-2432. [PMID: 35545822 DOI: 10.1111/jocn.16354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/21/2022] [Accepted: 04/25/2022] [Indexed: 12/29/2022]
Abstract
AIM This integrative review aimed to synthesise the available quantitative and qualitative studies on the effectiveness of diabetes self-management education (DSME) delivered through social media on glycaemic control (HbA1c), knowledge, health-related quality-of-life (HRQoL), anxiety, depression and self-efficacy in people with diabetes mellitus. BACKGROUND DSME is the main component of diabetes management which contributes to behavioural changes and the improvement of metabolic control and self-monitoring skills. Due to limited face-to-face access to healthcare services, social media has increasingly been used to deliver DSME for people with diabetes. However, there is a paucity of reviews addressing the effectiveness of using social media in delivering DSME. DESIGN An integrative review was conducted based on Whittemore and Knafl's (2005) methodology. METHODS The following databases were searched for relevant studies published between 2000 and 2020: Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, Cochrane Library, PsycINFO, EMBASE, EMCare and Google Scholar. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool. The PRISMA checklist for systematic reviews was used. RESULTS A total of 13 studies met the inclusion criteria and were included in this review. Facebook and WhatsApp were the most common social media platforms used to deliver DSME intervention. Nurses were the most frequent DSME providers. The duration and content of DSME in the reviewed studies varied. Consistent positive outcomes were found on glycaemic control, diabetic knowledge and self-efficacy. No studies considered the effect of DSME on HRQoL, anxiety and depression. CONCLUSIONS Social media DSME can be effective in reducing HbA1c levels, increasing diabetic knowledge and self-efficacy. Further studies are needed to examine the effectiveness of using social media to deliver DSME intervention on HRQoL, anxiety and depression. RELEVANCE TO CLINICAL PRACTICE This review provides nurses and healthcare professionals with evidence to support the use of social media to deliver DSME for people with diabetes. DSME delivered via social media supported by nurses would overcome limitations of face-to-face delivery such as geographical distance, travelling time, or other limited resources by patients with diabetes.
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Affiliation(s)
- Esmaeel Yaagoob
- School of Nursing and Midwifery, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Sharyn Hunter
- School of Nursing and Midwifery, The University of Newcastle, Callaghan, New South Wales, Australia
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Application of Deep Neural Network Model Combined with Factor Analysis in Clinical Nursing Effect Analysis of Blood Glucose Level in Elderly Type 2 Diabetic Patients. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:3462128. [PMID: 34557288 PMCID: PMC8455219 DOI: 10.1155/2021/3462128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 08/28/2021] [Accepted: 09/03/2021] [Indexed: 11/23/2022]
Abstract
In order to explore the clinical nursing effect of blood glucose level in elderly type 2 diabetic patients, this paper combines the deep neural network model and factor analysis from the perspective of multifactor analysis to construct a multifactor analysis model for the clinical nursing effect of blood glucose levels in elderly type 2 diabetic patients. Moreover, this paper analyzes the effects through experimental methods, collects cases through hospitals, and formulates research methods and related standards based on nursing research needs. In addition, this paper uses statistical methods to perform data processing, uses factor analysis to screen critical factors, and uses deep neural networks to process nursing data. The statistical results of the experimental research show that the deep neural network model combined with factor analysis can play a certain role in the clinical nursing effect. Thus, the blood glucose level analysis in elderly type 2 diabetic patients can provide a reference direction for the clinical care of blood glucose levels in elderly type 2 diabetic patients.
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Akiboye F, Sihre HK, Al Mulhem M, Rayman G, Nirantharakumar K, Adderley NJ. Impact of diabetes specialist nurses on inpatient care: A systematic review. Diabet Med 2021; 38:e14573. [PMID: 33783872 DOI: 10.1111/dme.14573] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 03/07/2021] [Accepted: 03/27/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND People with diabetes have longer hospital stays and poorer clinical outcomes. Diabetes inpatient specialist nurses have been introduced to improve care. AIMS To assess the evidence for the benefit of diabetes specialist nurses in the inpatient setting. METHODS A systematic search of MEDLINE (ovid), Embase (ovid), CINAHL (EBSCO) and Web of Science core collection from January 1998 to September 2019 was performed using key terms for diabetes specialist nurses and hospital setting. Studies measuring patient care using any standardised or validated outcome measures after introduction of a dedicated diabetes specialist nurse or nursing team were eligible for inclusion and findings reported by narrative synthesis. RESULTS There were 10 studies which met the inclusion criteria. One was a randomised controlled study and the remaining nine studies were before and after studies with three of them using a time series analysis methodology. The majority reported length of stay (LOS) and showed a reduction in median LOS by between 0.5 and 3 days. Reductions in bed occupancy ranged from 39% to 47%. There was a paucity of evidence for outcomes related to patient care with some measures limited to single studies. These included a 52% reduction in total drug errors, improved patient knowledge, higher patient satisfaction and improved glycaemic control post-discharge. There was no reduction of mortality observed. CONCLUSIONS These studies suggest a reduction in LOS and improved clinical care for patients with diabetes after the introduction of diabetes inpatient specialist nurses. Future research should examine a range of benefits associated with diabetes inpatient specialist nurse delivered services, including reduction of inpatient complications such as infections and cardiovascular events.
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Affiliation(s)
- Funke Akiboye
- Institute of Applied Health Sciences, University of Birmingham, Birmingham, UK
| | - Harpreet K Sihre
- Institute of Applied Health Sciences, University of Birmingham, Birmingham, UK
| | - Munerah Al Mulhem
- Institute of Applied Health Sciences, University of Birmingham, Birmingham, UK
| | - Gerry Rayman
- Diabetes Centre and Diabetes Research Unit, Ipswich Hospital, Ipswich, UK
| | | | - Nicola J Adderley
- Institute of Applied Health Sciences, University of Birmingham, Birmingham, UK
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Oliver N. People power. Diabet Med 2021; 38:e14619. [PMID: 34289184 DOI: 10.1111/dme.14619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lawler J, Cook R, Dosanj R, Trevatt P, Leary A. Examining the impact of Diabetes Inpatient Specialist Nursing in acute trusts in London. J Adv Nurs 2021; 77:4081-4088. [PMID: 34124801 DOI: 10.1111/jan.14917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 03/12/2021] [Accepted: 05/03/2021] [Indexed: 11/28/2022]
Abstract
AIMS To examine if the introduction of Diabetes Inpatient Specialist Nurses impacted on length of stay and rates of readmission. DESIGN Knowledge discovery through data mining as part of a larger realist evaluation of the role. METHODS Data from January 2017 to January 2019 was extracted and examined. A subset of performance data from July 2017-November 2018 was analysed. This consisted of 7320 records for Hospital Episode Statistics and 272 incident reports (Datix). The data were analysed via Generalised Linear Model regression routines in R. Analysis of readmission rates utilized binary logistic regression, while for the Length of Stay a count regression method was employed. RESULTS Four trusts were found to have complete and rich data sets. All Trusts that returned complete data were found to have varying decreased length of stay and reduced readmission rates. In two trusts there were significant decreases in patient readmissions and length of stay after the introduction of the Diabetes Inpatient Specialist Nurses. A marked decrease (approximately half) in patient length of stay was found in one London trust after the introduction of the post. Issues with data quality were noted. CONCLUSION Reduced patient length of stay and rate of readmission were found since introduction of Diabetes Specialist Nurses. Patient safety data was incomplete and varied significantly between trusts. IMPACT The project sought to understand the impact of employing Diabetes Inpatient Specialist Nurses in hospitals in London. Overall, the specialist nurses helped reduce length of stay and the rate of readmissions. The research will have an impact on the workforce in diabetes and also people with diabetes who need hospital care.
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Affiliation(s)
- Jessica Lawler
- Department of Health and Social Care, London South Bank University, London, UK
| | - Robert Cook
- School of Health, Birmingham City University, Birmingham, UK
| | | | - Paul Trevatt
- Central and North West London NHS Foundation Trust, London, UK
| | - Alison Leary
- Department of Health and Social Care, London South Bank University, London, UK.,School of Health, University of South Eastern Norway, Notodden, Norway
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Nikitara M, Constantinou CS, Andreou E, Latzourakis E, Diomidous M. Facilitators and barriers to the provision of type 1 diabetes inpatient care: An interpretive phenomenological analysis. Nurs Open 2021; 8:908-919. [PMID: 33570292 PMCID: PMC7877146 DOI: 10.1002/nop2.699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 08/07/2020] [Accepted: 09/03/2020] [Indexed: 11/28/2022] Open
Abstract
AIM The aim and objective of this study was to understand how non-specialized nurses understand the possible barriers and facilitators of inpatient care for type 1 diabetes. DESIGN An interpretative phenomenology approach was conducted. METHODS The sample consisted of non-specialized nurses (N = 24) working in medical, surgical and nephrology wards in the state hospitals in Cyprus. The data were collected during 2016-2018 from one focus group with nurses (N = 6) and individual semi-structured interviews with nurses (N = 18) conducted. The Standards for Reporting Qualitative Research checklist used to ensure the quality of the study. RESULTS It is evident from the study findings that nurses experience several barriers in diabetes inpatient care reported which are of great concern since this could have adverse effects on patients' outcomes. Only one facilitator has been reported by few nurses.
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Affiliation(s)
- Monica Nikitara
- Department of Life & Health SciencesUniversity of NicosiaNicosiaCyprus
| | | | - Eleni Andreou
- Department of Life & Health SciencesUniversity of NicosiaNicosiaCyprus
| | | | - Marianna Diomidous
- Department of Public HealthNational and Kapodistrian University of AthensAthensGreece
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Letta S, Aga F, Yadeta TA, Geda B, Dessie Y. Barriers to Diabetes Patients' Self-Care Practices in Eastern Ethiopia: A Qualitative Study from the Health Care Providers Perspective. Diabetes Metab Syndr Obes 2021; 14:4335-4349. [PMID: 34712054 PMCID: PMC8547594 DOI: 10.2147/dmso.s335731] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/13/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND All types of diabetes can damage the heart, blood vessels, eyes, kidneys, nerves and increase the overall risk of disability and premature death. Diabetes mellitus requires a range of self-care practices, scientifically recommended to control the glycemic level and maintain the patient's health. However, perceived barriers that hinder patients from fully implementing these diabetes self-care practices and obstacles have not been thoroughly explored. Therefore, this study aimed to explore the barriers to diabetes patients' self-care practices from the perspective of health care providers in two public hospitals in Harar City, Eastern Ethiopia. METHODS Researchers conducted an exploratory qualitative study among 26 health care providers working in two public hospitals from March to June 2021. The study participants were recruited from different disciplines working on diabetes care. Interviews were conducted in the Amharic language until the saturation point was reached. The interviews were tape-recorded, transcribed, and translated to English. Each transcript was read, re-read, and then exported to ATLAS.ti 7 software for coding. Field notes were used to supplement verbatim transcriptions. Initial codes were generated. The consistency between the two coders and their alignment with research questions were checked and applied to all subsequent transcripts after reached on consensus. The thematic analysis was employed in line with the primary set research question. RESULTS Researchers identified barriers to diabetes patients' self-care practices such as system, health care providers, and patient-level. These barriers were categorized under three main themes: lack of organized diabetes care services, limited collaborative care practices, and perceived lack of knowledge on self-care practices. In addition, the lack of multidisciplinary team care, lack of training for health care providers on diabetes self-care practices, and availability of laboratory tests and diabetes medication were prominent barriers. CONCLUSION Multi-level barriers to diabetes patients' self-care practices such as system, health care providers, and patients were identified. Therefore, interventions targeting proper service integration, building providers' and patients' capacity on diabetes self-care practices, and ensuring the sustainability of laboratory tests and medication supplies are essential. These interventions need to be accomplished through multi-level stakeholders' engagement and one-to-one or group interventions covering the multi-level challenges.
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Affiliation(s)
- Shiferaw Letta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Correspondence: Shiferaw Letta School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. Box: 235, Harar, EthiopiaTel +251911771934 Email
| | - Fekadu Aga
- School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Biftu Geda
- Department of Nursing, College of Health Sciences, Madda Walabu University, Shashamene Campus, Shashamene, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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