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Abstract
This study aimed to explore nurses’ perspectives on diabetes care for dependent older adults in home health care and nursing homes in Switzerland.
Growing numbers of old and very old adults with diabetes need professional care. In home health care older adults are usually in their 70s and in nursing homes they are about 10 years older. Inadequate diabetes care in older people leads to higher complication rates. Little is known about the views held and problems encountered by nurses working in home health care and nursing homes. Empirical information is lacking concerning perceptions of nurses caring for this dependent group.
A descriptive qualitative study of nurses’ perspectives on diabetes care was conducted with a purposive sample of 23 nurses caring for dependent older adults with diabetes in one region of Switzerland in 2008–2009. Semi-structured focus group interview data were analysed using thematic content analysis.
Qualitative data analysis of nurses’ transcripts elicited four themes: (a) actual situation in diabetes care – concerns about complications, inter-professional dependency, communication and continuity; (b) nurses’ experiences – apprehension about varied interest in diabetes, suitability of assessments, and current knowledge of disease and its influence on patient outcomes; (c) barriers to diabetes care – patient isolation, co-morbidities, lack of understanding; and (d) resources for diabetes care – patients’ social support, maintaining regular physical activities, adapting care to individuals’ needs.
It was concluded that level of communication, continuity of care and professional roles need clarification. Regular exposure to training through different methods would encourage professional and interpersonal skills and possibly will lead to better patient outcomes. Introducing consulting roles for advanced nurse practitioners specialised in diabetes care within home health care and nursing homes may advance diabetes care within these settings.