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An Exploratory Study of Rural Australian Practice Nurse's Perceptions of and Beliefs about Diabetes Management

Thursday, 10 July 2008: 10:30 AM
Robyne F. Livingston, RN, RM, BaHSc, PGDipACN, MN , Home Nursing and Support Services, Bendigo Health, Bendigo, Australia
Trisha Dunning, AM, RN, MEdn, PhD , Barwon Health, Deakin University, Geelong, VIC, Australia

Learning Objective 1: determine the scope of PNs’ practice in diabetes management and education, and give examples of factors which may influence practice.

Learning Objective 2: identify the benefits of using a diabetes management and education framework for learning.

Objective: The overall objective was to explore and describe the practice nurses' (PN) role, perceptions of and beliefs about diabetes management. There is little research on the PNs' role and their approach to the delivery of diabetes care in rural and remote general practice.

Aims: The specific aims of the study were to:

1. Determine what was understood by the term ‘practice nurse' in relation to diabetes care.

2. Identify specific factors that impact on the PNs' role in diabetes management and rural and remote practice.

3. Ascertain diabetes education PNs feel they require to competently deliver diabetes management and education.

Method: An exploratory study undertaken in three phases:

1. Pilot to test the questionnaire.

2. One-shot cross-sectional survey using self-complete questionnaires.

3. Interviews.

Ten people completed the pilot test and 31 of 104 questionnaires were returned in the main study, four people participated in the interviews.

Results: All PNs were female RNs Division 1 or 2, worked in rural (88%) and remote (12%) practices, 67% worked ≤ 5 years. The majority worked part-time, 29% received diabetes education when they commenced work. Most indicated diabetes knowledge was adequate, 40% said time constraints were a barrier to providing diabetes management. Eighty percent identified obesity as a common diabetes risk factor. Sixty two percent named oral hypoglycaemics, diet, and physical activity as management of type 2 diabetes, 50% knew HbA1c is a measure of the average blood glucose level.

Conclusion: The sample was similar to some other samples from the same population and reflects the rural and remote demographics in relation to diabetes care. Knowledge about diabetes risk factors, complications, and diabetes screening procedures were less than optimal. Lack of competency to assess diabetes medication self-management practices might put some people at risk of medication-related adverse events.

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