Nurses’ Role in Caring for the Diabetic
Diabetes is a group of diseases caused by failure of the body to regulate insulin production, thus, leading to inconsistent blood glucose levels in blood. There are several complications related to the disease, such as hypertension, blindness, amputations, hypoglycemia and others. The disease can cause premature death, but proper healthcare can minimize the co-morbid conditions and prolong the life of the patient for many years. The prevalence of the disease is high worldwide and is projected by WHO to reach 380 million in 2015. USA has approximately 9 percent of its population with diabetes. It is also ranked as the seventh among the top causes of deaths in USA. Nurses can play a vital in management and treatment of the disease in order to decrease the fatalities caused by diabetes. The following are studies outlining nurses’ role in caring for the diabetic.
Siminerio, L. M., Funnell, M. M., Peyrot, M., & Rubin, R. R. (2007). US nurses’ perceptions of their role in diabetes care: results of the cross-national Diabetes Attitudes Wishes and Needs (DAWN) study. The Diabetes Educator, 33(1), 152-162. EBSCO Medline
The study by Siminerio et al. (2007) involved investigating the perceptions of nurses and physicians in USA on the contribution and role of nurses in caring for the diabetic. Using a cross-sectional design, interviews were conducted among health care professionals in 13 countries from Asia, Australia, Europe, and North America. Nurses and physicians from USA were interviewed including 51 generalist nurses, 50 diabetes specialist nurses, 166 generalist physicians, and 50 diabetes specialist physicians. There was consensus among nurses and physicians that nurses ought to have a larger role in managing diabetes. The rationale for their argument was that nurses spend more time with patients than physicians; therefore, they have time to educate the patient on self-management and prevention of opportunistic infections. In addition, they were perceived as able to communicate and understand psychological and social needs of the patients. Thus, the research concluded that nurses should have a larger role in caring for diabetic patients especially the specialist nurses, in diabetes care.
Lenz, E. R., Mundinger, M. O. N., Hopkins, S. C., Lin, S. X., & Smolowitz, J. L. (2002). Diabetes care processes and outcomes in patients treated by nurse practitioners or physicians. The Diabetes Educator, 28(4), 590-598. EBSCO Medline
In this study, a comparison was done on the outcomes on selected diabetes care processes and outcomes of nurse practitioners (NPs) and physicians (MDs) in the primary care of adults with type 2 diabetes. The participants of the study were adults with type 2 diabetes who had no regular source of primary care. They were enrolled from the emergency room and randomized to an NP or MD practice (Lenz et al., 2002). Chart reviews were conducted to assess processes of care; patient interviews and hemoglobin Al C testing were performed to measure patient outcomes. The results indicated that NPs had higher chances than MDs to document provision of general diabetes education and education about nutrition, weight, exercise, and medications. They were more likely to document patient height, urinalyses results, and Al C values. There were no established differences in documenting present medicines; alcohol, illicit drug, or tobacco use; depression; weight and blood pressure; foot and cardiovascular exams; blood glucose and creatinine testing; or referral to ophthalmologists. No differences were established in patient outcomes. The study indicated interdisciplinary differences in primary care given by NPs and MDs in caring for patients with type 2 diabetes. Nonetheless, these dissimilarities were not reflected in 6-month patient outcomes.
Britneff, E., Winkley, K. (2013). The role of psychological interventions for people with diabetes and mental health issues. Journal of Diabetes Nursing 17: 305–10. Retrieved from http://www.thejournalofdiabetesnursing.co.uk/media/content/_master/3451/files/pdf/jdn17-8-305-10.pdf
In this research article, Britneff and Winkley (2013) refer to the prevalence of mental health issues among the diabetic patients, whereby a third of diabetic patients have been observed to be depressed and or anxious. The reasons cited for the occurrence of mental sickness among people with diabetes have been lack of glycaemic control, psychological, and social factors. The patients have anxiety disorder, depression, mood swings, and adjustment disorders. According the authors, such mental illnesses can be managed through psychological interventions. Nurses being close the patients should be able to identify such mental health problems. In addition, nurses should educate the patients on self-management skills as well as empower them. Nurses can help them to acquire information through provision of self-help materials. In addition, nurses can change their behaviors through positive reinforcement or using MI technique. The article therefore echoes the obligation diabetes nurses have on caring for mental illnesses in diabetic patients.