A qualitative study of patient experiences of Type 2 Diabetes care delivered comparatively by General Practice Nurses and Medical Practitioners

Boyle, Eileen M.; Saunders, Rosemary; Drury, Vicki

doi:10.1111/jocn.13219

Cited by 29 publications

(26 citation statements)

References 21 publications

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“…Among the health care professionals involved in DM management and patients care, the role of the nurses is of increasing importance because of the increasing global prevalence of DM 10 . Consequently, nurses are essential in the multidisciplinary team to provide appropriate care to DM patients and to manage DM, both in primary and secondary care settings 11 . Several papers have assessed the knowledge of dental students and dental care providers [12][13][14][15][16] , internists and endocrinologists 3,17,18 , diabetes educators 19 and diabetic patients [20][21][22][23][24] of the association between DM and oral health.…”

Section: Resultsmentioning

confidence: 99%

Awareness of oral complications and oral hygiene habits of subjects with diagnosed Diabetes Mellitus

Çankaya¹,

Güneri²,

Epstein

et al. 2018

Balkan J Dent Med

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SummaryBackground/Aim: The aim was to evaluate Diabetes Mellitus (DM) patients’ awareness of their risk for oral and dental complications, to evaluate their oral health behaviors, assess their sources of related information, and to detect the influence of their awareness on oral health and dental management.Material and Methods: Total of 240 DM patients presenting to a university outpatient dental facility for routine care completed a self-administered questionnaire about demographic-socioeconomic characteristics, oral health care and awareness on oral complications of DM. Dental status of each patient was recorded. Data were analyzed with Chi- square test; p was set as 0.05.Results: The patients’ mean age was 52.85 years; the majority had Type 2 DM (72.1%) and 61.7% were females. Two thirds of the patients had tooth loss; 65% brushed daily and used toothpick for interproximal cleaning (35%). Only 12.9% had regular dental visits and 37.5% reported their oral health as “poor”. DM patients rarely received guidance from their health care professionals regarding their oral health (28.3%). Even though 62.5% were aware of oral complications of DM, only 46.3% knew that oral health may affect DM. The patients with Type 1 and Type 2 DM had similar perceptions about their oral health status (p=0.15>0.05). However, insulin users were more aware of the interaction between oral health and DM (p>0.05), and were more likely to consider their oral health as “poor” (p>0.05).Conclusions: DM patients’ awareness of the effect of DM on oral health was higher than that of the effect of oral health on DM management. Medical health care providers were failing to provide the necessary information regarding these issues when compared to dentists.

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Section: Resultsmentioning

confidence: 99%

Awareness of oral complications and oral hygiene habits of subjects with diagnosed Diabetes Mellitus

Çankaya¹,

Güneri²,

Epstein

et al. 2018

Balkan J Dent Med

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“…Although most international literature established the positive impact nurses in advanced practice bring to care, role delineation between RNs and advanced practice nurses (APNs) remains unclear (Boyle, Saunders, & Drury, ; Woo, Zhou, Lim, & Tam, ). For instance, Australian health care consumers reported their inability to differentiate nurse practitioners (NPs) from other categories of nurses and were perplexed about the NP role and scope of practice (Parker et al, ).…”

Section: Introductionmentioning

confidence: 99%

Registered nurses' perceptions towards advanced practice nursing: A nationwide cross‐sectional study

et al. 2019

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Aims:To explore registered nurses' perceptions towards the role of advanced practice nurses and to examine registered nurses' interests in becoming advanced practice nurses.Background: Globally, the development and implementation of advanced practice nurses have been deemed propitious. Advanced practice nurses are recruited and developed from the current pool of registered nurses. Empirical research is needed to inform practice on ensuring the sustainability of the advanced practice nurse workforce through the recruitment and development of the current population of registered nurses. Methods:A nationwide cross-sectional online survey was conducted in Singapore.Registered nurses from all public health care institutions were surveyed.Results: Respondents (n = 1,025) displayed optimism and acceptance towards advanced practice nurses. However, only 30.7% hoped to become advanced practice nurses.Nursing leaders were reported to have a low success rate in identifying registered nurses who were both suitable and interested in the advanced practice nurse role.Conclusions: Registered nurses' positive perspectives towards the role of advanced practice nurses do not translate into interests in the role. The study offers pragmatic applicability in ensuring the sustainability of the advanced practice nurse workforce. Implications for Nursing Management:Advanced practice nurse-specific residency programmes for pre-master registered nurses may be facilitative to retaining and recruiting registered nurses for the advanced practice nurse workforce. K E Y W O R D Sadvanced practice nurses, nurse practitioners, personnel recruitment, professional image, registered nurses, staff nurses

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“…Adopting this perspective leads to considering the evidence of effectiveness to be insufficient for the question at hand. Two qualitative studies7 8 were identified and provided some of the needed details. The studies shed light on the psychological factors that should be addressed when delivering diabetes management programmes and provided insight on the factors that affect adherence to such programmes (table 1).…”

Section: Examplementioning

confidence: 99%

“…For example, studies demonstrated that before providing education in diabetes, we should address negative feelings that individuals have (anger about the initial diagnosis, and subsequently negotiate loss of control of a person's own lifestyle and environment) 7. Qualitative studies also provided explanation to lack of adherence to a programme (individual, organisational and content factors) 8.…”

Section: Examplementioning

confidence: 99%

Grading the quality of evidence in complex interventions: a guide for evidence-based practitioners

et al. 2016

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Evidence-based practitioners who want to apply evidence from complex interventions to the care of their patients are often challenged by the difficulty of grading the quality of this evidence. Using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach and an illustrative example, we propose a framework for evaluating the quality of evidence that depends on obtaining feedback from the evidence user (eg, guideline panel) to inform: (1) proper framing of the question, (2) judgements about directness and consistency of evidence and (3) the need for additional contextual and qualitative evidence. Using this framework, different evidence users and based on their needs would consider the same evidence as high, moderate, low or very low.Complex interventions in medicine are defined as interventions that contain several interacting components within the experimental and control interventions, multiple behaviours required by those delivering or receiving the intervention, multiple groups or organisational levels targeted by the intervention, and permit for variable flexibility and tailoring of the intervention.1 An example is care management programmes for type 2 diabetes. In one systematic review, programmes varied across studies in terms of team composition ( physician, nurse, case manager, diabetes educator), delivery method (face-to-face, telephone, online, outpatient, inpatient), intensity and frequency of the intervention, and other factors. 2 Complex interventions are increasingly used in studies of behavioural change, psychotherapy, education, public health, health services, quality improvement, social policy and many other fields. The challengeJust as with any other intervention, evidence-based practitioners who want to apply evidence from complex intervention to the care of their patients need to select the evidence (hopefully through a systematic review process) and appraise it (ie, identify the extent to which this evidence is trustworthy, also called, rating the quality of evidence). The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach is a modern method for rating the quality of evidence with good transparency and reliability. 3 A study of Cochrane systematic reviews showed that the outcomes of complex interventions were more likely to be rated as 'very low' quality of evidence compared with those of simple interventions (37.5% vs 9.1%). None of the outcomes of complex intervention reviews were rated as 'high'. 4 We believe these low ratings are inconsistent with the definition of quality of evidence in GRADE, which is a construct that reflects the trustworthiness of evidence, and we attribute this phenomenon to improper framing of the clinical question for which the quality of evidence is being rated. 5 RationaleComplex interventions are inherently heterogeneous; thus, we may be tempted to lower the quality of evidence for heterogeneity (inconsistency across studies). Complex interventions are also likely to have components that a...

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A qualitative study of patient experiences of Type 2 Diabetes care delivered comparatively by General Practice Nurses and Medical Practitioners

Abstract: The findings are relevant to primary health care clinicians providing diabetes care to inform more relevant supportive care by general practice nurses.

Cited by 29 publications

References 21 publications

Awareness of oral complications and oral hygiene habits of subjects with diagnosed Diabetes Mellitus

Awareness of oral complications and oral hygiene habits of subjects with diagnosed Diabetes Mellitus

Registered nurses' perceptions towards advanced practice nursing: A nationwide cross‐sectional study

Grading the quality of evidence in complex interventions: a guide for evidence-based practitioners

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