Qualitative study on nursing processes to support blood glucose pattern management in Japan
DOI:
https://doi.org/10.1080/20573316.2017.1402421Keywords:
Diabetes nursing, Pattern management, Qualitative synthesis method (KJ method), SMBG, EducationAbstract
A structured approach to self-monitoring of blood glucose and blood glucose pattern management (BGPM) is crucial in diabetes management. However, nursing processes for supporting BGPM among people with diabetes has not been studied. Here we described the process used by nurses certified in diabetes nursing in Japan to support BGPM among people with diabetes. Eleven nurses certified in diabetes nursing in Japan, with actual experience in supporting BGPM. We conducted semi-structured interviews with participants using an interview guide. The interview content was recorded on an IC recorder after obtaining consent. Qualitative analyses of data were conducted by qualitative synthesis. Based on the interviews with the 11 participants, 8 themes regarding the process of supporting BGPM were identified. These themes were as follows: ‘underlying supportive environment: a place where you can state what has been on your mind’, ‘sharing goals: exploring the person’s interest and finding clues’, ‘collaboration: finding patterns and devising measures’, ‘collaboration: considering effective and less burdensome blood glucose measurement and recording methods’, ‘leading to the next step: a long-range step-by-step perspective’, ‘support of active learning: utilising experiences and fostering independent thinking’, ‘mutual confidence: reward their efforts and trust their potential’ and ‘team approach: multilateral care’. Thereafter, the eight themes were schematised and the process of supporting BGPM was determined. Thus, we clarified the process of supporting BGPM and provided suggestions on how to utilise BGPM in ordinary nursing.
Downloads
References
Hinnen DA, Guthrie DW, Child BP, Friesen J, Rhiley DS, Guthrie RA. A core curriculum for diabetes education diabetes management therapies. In: Franz MJ, editor. Pattern management of blood glucose. Chicago: American Association of Diabetes Educators; 2003. p. 215–45.
Powers MA. Glucose pattern management teaches glycemia-related problem solving skills in a diabetes self-management education program. Diabetes Spectr. 2013;26:91–97. doi: 10.2337/diaspect.26.2.91
Austin MM, Haas L, Johnson T, Parkin CG, Parkin CL, Spollett G, et al. Self-monitoring of blood glucose: benefits and utilization. Diabetes Educ. 2006;32:835–47. doi: 10.1177/0145721706295873
Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of longterm complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;1993:977–86.
Karter AJ, Ackerson LM, Darbinian JA, D’Agostino RB, Ferrara A, Liu J, et al. Self-monitoring of blood glucose levels and glycemic control: the Northern California Kaiser Permanent Diabetes Registry. Am J Med. 2001;111:1–9. doi: 10.1016/S0002-9343(01)00742-2
Evans JM, Newton RW, Ruta DA, MacDonald TM, Stevenson RJ, Morris AD. Frequency of blood glucose monitoring in relation to glycemic control: observation study with diabetes database. BMJ. 1999;319:83–86. doi: 10.1136/bmj.319.7202.83
Murata GH, Shah JH, Hoffman RM, Wendel CS, Adam KD, Solvas PA, et al. Intensified blood glucose monitoring improves glycemic control in stable, insulin-treated veterans with type 2 diabetes. Diabetes Care. 2003;26:1759–63. doi: 10.2337/diacare.26.6.1759
McANDREW LM, Horowitz CR, Lancaster KJ, Quigley KS, Pogach LM, Mora PA, et al. Association between self-monitoring of blood glucose and diet among minority patients with diabetes. J Diabetes. 2011;3:147–52. doi: 10.1111/j.1753-0407.2011.00114.x
Bashan E, Hodish I. Frequent insulin dosage adjustments based on glucose readings alone are sufficient for a safe and effective therapy. J Diabetes Complications. 2012;26:230–6. doi: 10.1016/j.jdiacomp.2012.03.012
Silva DD, Bosco AA. An educational program for insulin self-adjustment associated with structured self-monitoring of blood glucose significantly improves glycemic control in patients with type 2 diabetes mellitus after 12 weeks: a randomized controlled pilot study. Diabetol Metabol Syndr. 2015;7:2–9. doi: 10.1186/1758-5996-7-2
DAFNE Study Group. Training in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes: dose adjustment for normal eating (DAFNE) randomised controlled trial. BMJ. 2002;325:746. doi: 10.1136/bmj.325.7367.746
Shearer A, Bagust A, Sanderson D, Heller S, Roberts S. Cost-effectiveness of flexible intensive insulin management to enable dietary freedom in people with Type 1 diabetes in the UK. Diabet Med. 2004;21:460–7. doi: 10.1111/j.1464-5491.2004.01183.x
Rankin D, Cooke DD, Clark M, Heller S, Elliott J, Lawton J. UK NIHR DAFNE Study Group. How and why do patients with Type 1 diabetes sustain their use of flexible intensive insulin therapy? A qualitative longitudinal investigation of patients’ self-management. Practices following attendance at a Dose Adjustment for Normal Eating (DAFNE) course. Diabet Med. 2011;28:532–8. doi: 10.1111/j.1464-5491.2011.03243.x
Polonsky WH, Fisher L, Schikman CH, Hinnen DA, Parkin CG, Jelsovsky Z, et al. Structured self-monitoring of blood glucose significantly reduces A1C levels in poorly controlled, noninsulin-treated type 2 diabetes: Results from the Structured Testing Program study. Diabetes Care. 2011;34:262–7. doi: 10.2337/dc10-1732
Mazze RS, Strock E, Wesley D, Borgman S, Morgan B, Bergenstal R, et al. Characterizing glucose exposure for individuals with normal glucose tolerance using continuous glucose monitoring and ambulatory glucose profile analysis. Diabetes Technol Ther. 2008;10:149–59. doi: 10.1089/dia.2007.0293
Lalić N, Tankova T, Nourredine M, Parkin C, Schweppe U, Amann-Zalan I. Value and utility of structured self-monitoring of blood glucose in real world clinical practice: findings from a multinational observational study. Diabetes Technol Ther. 2012;14:338–43. doi: 10.1089/dia.2011.0186
AADE. Core concepts the art & science of diabetes education continuing education program for diabetes educators supplementary course materials. 2014. Available from http://www.diabeteseducator.org/export/sites/aade/_resources/pdf/core_concepts/supplementary_course_materials.pdf.
Parkin CG, Davidson JA. Value of self-monitoring blood glucose pattern analysis in improving diabetes outcomes. J Diabetes Sci Technol. 2009;3:500–8. doi: 10.1177/193229680900300314
Linekin PL. Diabetes pattern management: the key to diabetes management and glycemic control. Home Healthcare Nurse. 2002;20:168–77. doi: 10.1097/00004045-200203000-00009
Lowe J, Linjawi S, Mensch M, James K, Attia J. Flexible eating and flexible insulin dosing in patients with diabetes: results of an intensive self-management course. Diabetes Res Clin Practice. 2008;80:439–43. doi: 10.1016/j.diabres.2008.02.003
Kubota M, Shindo Y, Kawaharada M. Identifying the contents of a type 1 diabetes outpatient care program based on the self-adjustment of insulin using the Delphi method. Jpn J Nurs Sci. 2014;11:299–309. doi: 10.1111/jjns.12035
Choudhary P, Genovese S, Reach G. Blood glucose pattern management in diabetes: creating order from disorder. J Diabetes Sci Technol. 2013;7:1575–84. doi: 10.1177/193229681300700618
Kawakita J. Hassoho [Abduction]. Tokyo: Chuokoron-Shinsha; 1967. (Japanese)
Kawakita J. Zoku Hassoho [Abduction: Part two]. Tokyo: Chuokoron-Shinsha; 1970. (Japanese)
Yamaura H. Theory and practice of the qualitative synthesis method (KJ Method) and ‘Cosmos Methodology’ which creates conceptions. Jpn J Nurs Res. 2008; 41(1):11–32. (Japanese)
Haruo, Y. Shitsuteki –tougouhou-nyuumon [the Qualitative Synthesis Method (KJ Method)]. Tokyo: Igaku-syoin; 2012. (Japanese)
Pearson J, Bergenstal R. Fine-tuning control: pattern management versus supplementation. View 1: pattern management: an essential component of effective insulin management. Diabetes Spectr. 2001;14:75–78. doi: 10.2337/diaspect.14.2.75
Franz MJ. A core curriculum for diabetes education fifth edition: diabetes management therapies. Am Assn Diabetes Educator; 2003.
Nicolucci A, Kovacs Burns K, Holt RI, Comaschi M, Hermanns N, Ishii H, et al. Diabetes Attitudes, Wishes and Needs second study (DAWN2): cross-national benchmarking of diabetes-related psychosocial outcomes for people with diabetes. Diabet Med. 2013;30:767–77. doi: 10.1111/dme.12245
Hopkins D, Lawrence I, Mansell P, Thompson G, Amiel S, Campbell M, et al. Improved biomedical and psychological outcomes 1 year after structured education in flexible insulin therapy for people with type 1 diabetes. Diabetes Care. 2012;35:1638–42. doi: 10.2337/dc11-1579
Polonsky WH, Jelsovsky Z, Panzera S, Parkin CG, Wagner RS. Primary care physicians identify and act upon glycemic abnormalities found in structured, episodic blood glucose monitoring data from non-insulin-treated type 2 diabetes. Diabetes Technol Ther. 2009;11:283–91. doi: 10.1089/dia.2008.0087
Polonsky WH, Fisher L, Schikman CH, Hinnen DA, Parkin CG, Jelsovsky Z, et al. A structured self-monitoring of blood glucose approach in type 2 diabetes encourages more frequent, intensive, and effective physician interventions: Results from the STeP study. Diabetes Technol Ther. 2011;13:797–802. doi: 10.1089/dia.2011.0073
Reach G. Can technology improve adherence to long-term therapies? J Diabetes Sci Technol. 2009;3:492–9. doi: 10.1177/193229680900300313
Reach G. A psychophysical account of patient non-adherence to medical prescriptions. The case of insulin dose adjustment. Diabetes Metab. 2013;39:50–55. doi: 10.1016/j.diabet.2012.08.009
Reach G. Patient non-adherence and healthcare-provider inertia are clinical myopia. Diabetes Metab. 2008;34:382–5. doi: 10.1016/j.diabet.2008.02.008
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2017 Foundation of European Nurses in Diabetes
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
