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- Annersten Gershater, Magdalena, et al.
(författare)
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Patient education for the prevention of diabetic foot ulcers. Interim analysis of a randomised controlled trial due to morbidity and mortality of participants
- 2011
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Ingår i: European Diabetes Nursing. - : John Wiley & Sons. - 1551-7853 .- 1551-7861. ; 8:3, s. 102-107b
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Tidskriftsartikel (refereegranskat)abstract
- This study was designed to explore whether participant-driven patient education in group sessions, compared to provision of standard information, will contribute to a statistically significant reduction in new ulceration during 24 months in patients with diabetes and high risk of ulceration. This is an interim analysis after six months. A randomised controlled study was designed in accordance with CONSORT criteria. Inclusion criteria were: age 35–79 years old, diabetes mellitus, sensory neuropathy, and healed foot ulcer below the ankle; 657 patients (both male and female) were consecutively screened. A total of 131 patients (35 women) were included in the study. Interim analysis of 98 patients after six months was done due to concerns about the patients’ ability to fulfil the study per protocol. After a six-month follow up, 42% had developed a new foot ulcer and there was no statistical difference between the two groups. The number of patients was too small to draw any statistical conclusion regarding the effect of the intervention. At six months, five patients had died, and 21 had declined further participation or were lost to follow up. The main reasons for ulcer development were plantar stress ulcer and external trauma. It was concluded that patients with diabetes and a healed foot ulcer develop foot ulcers in spite of participant-driven group education as this high risk patient group has external risk factors that are beyond this form of education. The educational method should be evaluated in patients with lower risk of ulceration. Eur Diabetes Nursing 2011; 8(3): 102–107
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- Annersten Gershater, Magdalena, et al.
(författare)
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Prevention of foot ulcers in patients with diabetes in home nursing : a qualitative interview study
- 2013
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Ingår i: European Diabetes Nursing. - : John Wiley & Sons. - 1551-7853 .- 1551-7861. ; 10:2, s. 52-57
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Tidskriftsartikel (refereegranskat)abstract
- Summary Diabetes mellitus and foot ulcer increase the risk of amputation, and prevention of foot ulcers are therefore important. Patients with diabetes and other concomitant diseases are often cared for in a home nursing service and the registered nurses (RNs) have the opportunity to practise preventive care to avoid foot ulcers. How prevention of foot ulcer is performed in home nursing settings has not been previously described. The objective of this study was to explore RNs’ professional work with foot ulcer prevention in home nursing settings for patients with diabetes mellitus. Qualitative interviews were analysed, using manifest content analysis. The setting was four municipalities in Sweden (large and small cities, and rural areas). Fifteen RNs actively working in a home nursing service with more than two years’ experience were recruited. The participants were all women, had worked as RNs for 3–41 years (median 25), and in home nursing for 2–18 years (median 8). The results showed that the RNs work through leadership, coordination, education and evaluation. Health care assistants perform most of the nursing actions to prevent foot ulcers such as assessment of feet, off-loading, nutrition and hygiene. The RNs have medical and nursing responsibility but without the formal tools to execute this fully. The RNs’ formal education was some years back and they relied mostly on experience-based knowledge. It was concluded that patient assessment and nursing actions to prevent foot ulcers are mostly performed by health care assistants. The RNs need to be given formal responsibility in their role as leaders and educators, and need more education in pedagogy and leadership. Eur Diabetes Nursing 2013; 10(2): 52–57 Key words diabetes; diabetic foot ulcer; education; elderly; foot care; foot health; nursing; home care; pressure ulcer; prevention
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- Annersten Gershater, Magdalena, et al.
(författare)
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Sharing innovations to maximise patient benefit
- 2012
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Ingår i: European Diabetes Nursing. - : John Wiley & Sons. - 1551-7853 .- 1551-7861. ; 9:3, s. 69-69
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Tidskriftsartikel (populärvet., debatt m.m.)
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- Annersten Gershater, Magdalena, et al.
(författare)
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Treatment satisfaction with insulin glargine in patients with diabetes mellitus in a university hospital clinic in Sweden
- 2009
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Ingår i: European Diabetes Nursing. - : Wiley-Blackwell. - 1551-7853 .- 1551-7861. ; 6:1, s. 17-22
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Tidskriftsartikel (refereegranskat)abstract
- Background: Few studies evaluate patients' perspectives when a new drug is introduced to treat chronic diseases such as diabetes mellitus. The clinical role of a new insulin treatment, in terms of the relationship between higher cost and better treatment outcomes (as defined from the patient perspective) has been discussed. We sought to explore patient satisfaction with a new insulin treatment (insulin glargine). At its launch in 2002/3 it was purported to provide constant, peakless insulin release following once- or twice-daily administration, thus leading to fewer hypoglycaemic episodes while providing metabolic control equivalent to that achieved with NPH human basal insulin. Aims: To investigate the indications used for prescription of a new drug and its clinical effects on glycosylated haemoglobin (HbA1c) levels, perceived hypoglycaemic events and patient satisfaction. Methods: The Diabetes Treatment Satisfaction Questionnaire (Status Version, DTSQ-s), which measures satisfaction with treatment regimen, and perceived frequency of hyperglycaemia and hypoglycemia, was circulated to all living patients who had ever started treatment with insulin glargine at the Department of Endocrinology at Malmö University Hospital. Medical records of 913 patients were assessed for HbA1c levels at 0 and 12 months after starting insulin glargine therapy. Results: Completed questionnaires were returned by 615 of 960 patients (64%) who had ever started insulin glargine. The main indications for starting treatment were physicians' or nurses' initiatives, desire for fewer fluctuations and improved metabolic control. HbA1c levels fell by 0.41% for patients with type 1 diabetes and by 0.68% for those with type 2 diabetes. The mean DTSQ-s score was 28.45 for satisfaction, whereas the mean perceived hypoglycaemic/hyperglycaemic events score was 3. Conclusion: Treatment satisfaction was very high and perceived frequency of hypoglycaemia/hyperglycaemia was very low. The indications for treatment of insulin glargine are being followed in accordance with national recommendations..
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- Annersten, Magdalena, et al.
(författare)
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How to write a research proposal
- 2006
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Ingår i: European Diabetes Nursing. - : John Wiley & Sons. - 1551-7853 .- 1551-7861. ; 3:2, s. 102-105
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- A structured written research proposal is a necessary requirement when making anapplication for research funding or applying to an ethics committee for approval of aresearch project. A proposal is built up in sections of theoretical background; aimand research questions to be answered; a description and justification of the methodchosen to achieve the answer; awareness of the ethical implications of the research;experience and qualifications of the team members to perform the intended study; abudget and a timetable.This paper describes the common steps taken to prepare a writtenproposal as attractively as possible to achieve funding
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- Boström, Eva, et al.
(författare)
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Diabetes specialist nurses' perceptions of their multifaceted role
- 2012
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Ingår i: European Diabetes Nursing. - : Maney Publishing. - 1551-7853 .- 1551-7861. ; 9:2, s. 39-44
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore diabetes specialist nurses' (DSNs') perceptions of their professional role in diabetes care.Exploratory interviews were used to elicit DSNs' perceptions of their professional role. Twenty-nine DSNs working in 23 primary health care centres in northern Sweden were interviewed in focus groups. Data were analysed using qualitative content analysis.The DSNs described their profession as encompassing five major roles: ‘expert’, ‘fosterer’, ‘executive’, ‘leader’, and ‘role model’. Challenges interpreted as role ambiguities included feeling uninformed, fragmented, resigned, pressed for time, and self-reproachful.The profession of DSN was interpreted as multifaceted, with various roles and role ambiguities. Patient-centred care and empowerment, which are recommended in diabetes care, can be difficult to achieve when DSNs experience role ambiguity.Lack of clarity about role demands and difficulty in reconciling different roles may have a negative impact on DSNs' attitudes in clinical encounters and could inhibit patient-centred care. The development of the DSN profession requires improved awareness of the DSN's professional role in the clinical encounter, not only to improve the care of patients with diabetes, but also to retain these professionals.
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