Effects of nurse-initiated follow-up to insulin-treated diabetic patients with poor glycaemic control

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Effects of nurse-initiated follow-up to insulin-treated diabetic patients with poor glycaemic control


Author: Lin, Lai-har
Title: Effects of nurse-initiated follow-up to insulin-treated diabetic patients with poor glycaemic control
Degree: M.Sc.
Year: 2004
Subject: Hong Kong Polytechnic University -- Dissertations
Diabetes -- Nursing
Diabetes -- Treatment
Department: School of Nursing
Pages: 42, [14] leaves ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1772708
URI: http://theses.lib.polyu.edu.hk/handle/200/1015
Abstract: Objective: The objectives of the study were to investigate the differences of glycaemic control, treatment adherence to diet, exercise, insulin injection, and self-monitoring of blood glucose (SMBG) between insulin-treated diabetic patients with nurse-initiated follow-up group (experimental group) and a routine follow-up group (control group). Design: The study was an experimental design. Diabetic subjects were randomized into two groups: the nurse-initiated follow up group (Intervention group) and the routine follow-up (Usual Care group). Main outcome measures: The HbAlc level, patient's satisfaction survey and treatment adherence assessment of all subjects were obtained initially and after 12 weeks. Results: Subjects in intervention groups had significant improvements in HbAlc level, adherence to diet, SMBG, insulin injection and level of satisfaction with care after the study. However, there was no significant improvement in adherence to exercise. Subjects in control group had significant improvement in adherence to insulin injection. However, there were no significant improvement in HbAlc level, adherence to diet, exercise, SMBG, and the level of satisfaction with care. After 12 weeks of the study, there were significant differences between the two groups in HbAlc, adherence to diet and SMBG. Conclusion: There was statistical significance in decreasing HbAlc level in the intervention group but the HbAlc level was still far away from optimal glycaemic level. Therefore the subjects in the intervention group had to continuously receive intensive therapy until their optimal glycaemic controls were achieved. The interventions in nurse-initiated follow-up groups included comprehensive assessment, use of learning contract, regular phone follow-ups and adjustment in the insulin dose if needed. The results showed that interventions in the nurse-initiated follow-up group were effective in improving treatment adherence and ended up with overall improvement in glycemic control. Based on this study, education roles of Diabetic Nurses should be expanded and not only in knowledge and skills but also on behavior modification and patients' obligations regarding self-care management.

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