Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, P.O. Box 7030, Bergen, NO-5020, Norway.
Nesodden municipality, Nesodden, Norway.
BMC Palliat Care. 2024 Oct 10;23(1):241. doi: 10.1186/s12904-024-01567-4.
At present, there are no specific guidelines for the treatment of diabetes in palliative care in Norway. The aim of this study was therefore to explore healthcare professionals' experiences of providing palliative care to individuals with diabetes in specialist as well as primary care settings.
We interviewed 12 healthcare professionals from two palliative care units in specialist healthcare, one hospice unit in a nursing home, and one dietary care unit providing counselling in the municipality in the eastern part of Norway. Thematic analysis was used to analyze the data.
Our analysis generated three main themes: 1) "Quality of life is the main focus", which showed that the healthcare professionals' main focus was on comforting patients through engagement and communication; 2) "An individualized approach", emphasizing that the treatment was tailored to the unique circumstances of each individual and considered factors such as life expectancy, difficult blood glucose control, and multidisciplinary collaboration, and 3) "Diabetes in the background", which highlighted that they had a modest focus on diabetes. Diabetes was seen as another aspect of health that they had to be aware of, but their limited knowledge of diabetes guidelines, technical tools, and treatment choices underscored that attentiveness to the diabetes treatment was not prominent.
The findings show that a lack of guidelines allowed for diverse approaches to the treatment of patients with diabetes in palliative care. Attentiveness to diabetes was based on the individual healthcare professionals' experience and expertise, professional views, and the circumstances of each individual.
目前，挪威在姑息治疗中没有针对糖尿病治疗的具体指南。因此，本研究旨在探讨医疗保健专业人员在专科和初级保健环境中为糖尿病患者提供姑息治疗的经验。
我们采访了来自挪威东部一个市的两家专科姑息治疗单位、一家疗养院的临终关怀单位和一家提供咨询的饮食护理单位的 12 名医疗保健专业人员。使用主题分析对数据进行分析。
我们的分析产生了三个主要主题：1）“生活质量是主要关注点”，表明医疗保健专业人员的主要关注点是通过参与和沟通安慰患者；2）“个体化方法”，强调治疗根据每个人的独特情况进行调整，并考虑到预期寿命、血糖控制困难和多学科合作等因素；3）“糖尿病背景”，突出表明他们对糖尿病的关注有限。糖尿病被视为他们必须注意的另一个健康方面，但他们对糖尿病指南、技术工具和治疗选择的有限了解强调了对糖尿病治疗的关注并不突出。
研究结果表明，缺乏指南允许姑息治疗中对糖尿病患者采用不同的治疗方法。对糖尿病的关注基于每个医疗保健专业人员的经验和专业知识、专业观点以及每个人的情况。
