School of Nursing, University of Auckland, Auckland, New Zealand.
School of Population Health, University of Auckland, Auckland, New Zealand.
Diabet Med. 2019 Jun;36(6):734-741. doi: 10.1111/dme.13940. Epub 2019 Mar 13.
The study aim was to re-examine current work practices and evaluate time trends in the cardiovascular management of people with diabetes consulted by primary healthcare nurses in New Zealand.
Primary healthcare nurses in the Auckland region were surveyed in 2006-2008 and 2016, with about one-third of practice, home care and specialist nurses randomly selected to participate. Nurses completed a self-administered questionnaire about demographic and workplace details, and a telephone interview about clinical care provided for people with diabetes during nursing consultations. Information was collected on a representative sample of people with diabetes consulted on one randomly selected work-day in the previous week.
Of all people with diabetes consulted by nurses, practice nurses consulted significantly more in 2016 (83%) compared with 60% in 2006-2008, whereas specialist nurse consultations decreased from 23% to 8% (P = 0.01). In 2016, in people with diabetes, BMI was higher, and total cholesterol lower, yet the proportions of those receiving lifestyle advice (dietary and activity) remained unchanged from 2006-2008 levels. Smoking prevalence in people with diabetes was unchanged between the two surveys, although more people were asked if they wished to stop in 2016 compared with 2006-2008 (98% vs. 73%). In 2016, hours of nurses' diabetes education were associated with increased routine assessments of risk factors in people with diabetes and checking laboratory results.
Practice nurses are undertaking an increasing proportion of diabetes consultations. Although BMI in people with diabetes is increasing, the proportion of nurses offering lifestyle advice remains unchanged. Increasing diabetes education could strengthen the management of people with diabetes by community nurses.
本研究旨在重新审视当前的工作实践，并评估新西兰初级保健护士所咨询的糖尿病患者心血管管理的时间趋势。
2006-2008 年和 2016 年，奥克兰地区的初级保健护士接受了调查，约有三分之一的执业护士、家庭护理护士和专科护士被随机选中参与调查。护士们填写了一份关于人口统计学和工作场所细节的自我管理问卷，并通过电话采访了他们在护理咨询期间为糖尿病患者提供的临床护理情况。信息是在过去一周中随机选择的一个工作日咨询的具有代表性的糖尿病患者样本中收集的。
在所有接受护士咨询的糖尿病患者中，执业护士在 2016 年（83%）的咨询比例明显高于 2006-2008 年的 60%，而专科护士的咨询比例从 23%降至 8%（P=0.01）。2016 年，在糖尿病患者中，BMI 更高，总胆固醇更低，但接受生活方式建议（饮食和活动）的比例与 2006-2008 年的水平保持不变。糖尿病患者的吸烟率在两次调查中保持不变，尽管在 2016 年，与 2006-2008 年相比，更多的人被问及是否希望戒烟（98%对 73%）。2016 年，护士的糖尿病教育时间与对糖尿病患者的常规风险因素评估和检查实验室结果的次数增加有关。
执业护士承担的糖尿病咨询比例越来越高。尽管糖尿病患者的 BMI 有所增加，但提供生活方式建议的护士比例保持不变。增加糖尿病教育可以加强社区护士对糖尿病患者的管理。
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