Nurse-led family-based approach in primary health care for patients with type 2 diabetes mellitus: a qualitative study

PURPOSE

The prevalence of Type 2 diabetes is rapidly increasing, with 537 million people estimated to have diabetes in 2021. The literature suggests that nurses can deliver effective person-centred diabetes care and that families can be essential in supporting patients. Thus, a Nurse-led Family-based (NLFB) approach may be particularly effective. This study aims to explore the perceptions of nurses, adults with type 2 diabetes, and family members regarding the NLFB intervention.

METHODS

Guided by the UK Medical Research Council Framework, this seminal study adopted a qualitative, descriptive approach with content analysis. Data were obtained through 16 semi-structured, in-depth interviews. Themes emerged based on an inductive process using constant comparison (Graneheim and Lundman 2004). The COREQ checklist was used in ensuring rigour.

RESULTS

Three main themes emerged includes: (1) nurses' experiences with current diabetes care practices, (2) stakeholders' views on the development of a NLFB approach, and (3) merging the nurse-led family aspects into the diabetes care. The key challenges are the dominant medical model, lack of specialist nurses, and time. The key facilitators are knowledge and social support.

CONCLUSION

The study recommends stakeholders embrace nursing empowerment strategies and involve families to enhance the nurses' advanced roles and family inclusion in healthcare.

Etiological Beliefs, Treatments, Stigmatizing Attitudes toward Schizophrenia. What Do Italians and Israelis Think?

Background: Although scientific research on the etiology of mental disorders has improved the knowledge of biogenetic and psychosocial aspects related to the onset of mental illness, stigmatizing attitudes and behaviors are still very prevalent and pose a significant social problem. Aim: The aim of this study was to deepen the knowledge of how attitudes toward people with mental illness are affected by specific personal beliefs and characteristics, such as culture and religion of the perceiver. More precisely, the main purpose is the definition of a structure of variables, namely perceived dangerousness, social closeness, and avoidance of the ill person, together with the beliefs about the best treatment to be undertaken and the sick person' gender, capable of describing the complexity of the stigma construct in particular as far as schizophrenia is concerned. Method: The study involved 305 university students, 183 from the University of Padua, Italy, and 122 from the University of Haifa, Israel. For the analyses, a latent class analysis (LCA) approach was chosen to identify a latent categorical structure accounting for the covariance between the observed variables. Such a latent structure was expected to be moderated by cultural background (Italy versus Israel) and religious beliefs, whereas causal beliefs, recommended treatment, dangerousness, social closeness, and public avoidance were the manifest variables, namely the observed indicators of the latent variable. Results: Two sets of results were obtained. First, the relevance of the manifest variables as indicators of the hypothesized latent variable was highlighted. Second, a two-latent-class categorical dimension represented by prejudicial attitudes, causal beliefs, and treatments concerning schizophrenia was found. Specifically, the differential effects of the two cultures and the religious beliefs on the latent structure and their relations highlighted the relevance of the observed variables as indicators of the expected latent variable. Conclusion: The present study contributes to the improvement of the understanding of how attitudes toward people with mental illness are affected by specific personal beliefs and characteristics of the perceiver. The definition of a structure of variables capable of describing the complexity of the stigma construct in particular as far as schizophrenia is concerned was achieved from a cross-cultural perspective.

Measurement Invariance and Convergent Validity of Anger and Sadness Self-Regulation Among Youth From Six Cultural Groups

The present study examined measurement invariance and convergent validity of a novel vignette-based measure of emotion-specific self-regulation that simultaneously assesses attributional bias, emotion-regulation, and self-efficacy beliefs about emotion regulation. Participants included 541 youth-mother dyads from three countries (Italy, the United States, and Colombia) and six ethnic/cultural groups. Participants were 12.62 years old ( SD = 0.69). In response to vignettes involving ambiguous peer interactions, children reported their hostile/depressive attribution bias, self-efficacy beliefs about anger and sadness regulation, and anger/sadness regulation strategies (i.e., dysregulated expression and rumination). Across the six cultural groups, anger and sadness self-regulation subscales had full metric and partial scalar invariance for a one-factor model, with some exceptions. We found support for both a four- and three-factor oblique model (dysregulated expression and rumination loaded on a second-order factor) for both anger and sadness. Anger subscales were related to externalizing problems, while sadness subscales were related to internalizing symptoms.