Promoting health in type 2 diabetes: nurse-physician collaboration in primary care.
The purpose of this study is to examine effects of a nurse-physician collaborative approach to care of patients with type 2 diabetes and to determine possible effect sizes for use in computing sample sizes for a larger study. Forty patients from a family practice clinic with type 2 diabetes were randomly assigned to control or experimental groups. The control group received standard care, whereas the experimental group received standard care plus home visits from a nurse, as well as consultation with an exercise specialist and/or nutritionist. Follow-up continued for 3 months. Clinical end points included standard measures of diabetes activity as well as quality-of-life indicators. Focus group interviews were used to explore patients' responses to the program. Although findings were not statistically significant, a trend toward small to moderate positive effect sizes was found in glycosylated hemoglobin and blood pressure. Quality of life measures also showed a trend toward small to moderate, but nonsignificant, improvements in physical functioning, bodily pain, vitality, social and global functioning, energy, impact of diabetes, and health distress. Focus group interviews indicated a very positive response from patients, who expressed feelings of empowerment. In this study, patients treated with nurse-physician collaboration demonstrated small, but nonsignificant, improvements in blood chemistry after only 3 months. Physical and social functioning, energy, and bodily pain also showed a small improvement. Changes in awareness of effects of diabetes on health and an expressed sense of self-efficacy suggest that effects could be sustainable over the longer term.
Taylor
Katherine I
KI
Calgary Health Region; Alberta, Canada.
Oberle
Kathleen M
KM
Crutcher
Rodney A
RA
Norton
Peter G
PG
D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000451:nursing* / Q000628:therapy*; D004046:Dietetics; D015444:Exercise; D005260:Female; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration*; D018802:Patient-Centered Care; D019555:Physician-Nurse Relations; D011320:Primary Health Care / Q000458:organization & administration*; D011788:Quality of Life