title: Perspectives of patients with type 2 diabetes following a critical cardiac event - an interpretative approach.
abstract: OBJECTIVE
  This study aimed to gain in-depth understanding of the actual hospital and home experience of patients with diabetes and a critical cardiac event to assist in developing a pertinent diabetes self-management programme.
  
  
  BACKGROUND
  Type 2 diabetes can lead to cardiac complications requiring critical nursing care. Patients with diabetes and a history of cardiac disease are at greater risk of a further cardiac event. Greater self-efficacy or confidence in regulating diabetes and reducing the risk of a further cardiac event can be achieved through self-management programmes. However, the start of such a programme within the critical care environment presents challenges to critical care staff. It is important to understand patients' experiences and needs to improve quality of care.
  
  
  METHODS
  An interpretive approach comprising open-ended interviews was used to collect data from patients with type 2 diabetes experiencing a cardiac event who had a coronary care unit admission in 2002-2003.
  
  
  RESULTS
  The findings revealed that patients with diabetes who had a critical cardiac event experienced considerable feelings of hopelessness and fatigue. Patients also had concerns in the areas of self-confidence and confidence in health professionals. Patients indicated that greater self-confidence and confidence in health professionals would help their ability to manage their daily lives.
  
  
  CONCLUSIONS
  This paper provides in-depth understanding of the perspectives of patients with type 2 diabetes who have also been hospitalized for a critical cardiac event. This study concluded that further research is needed to fully explore whether enhancing self-confidence for these patients will lead to improved diabetes management, reduced negative feelings and more positive health outcomes.
  
  
  CONCLUSIONS
  The themes identified in this study provide direction and strategies for nursing staff to improve patients' confidence levels and reduce their feelings of hopelessness and fatigue.
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology & Mater Health Services, Queensland, Australia. c3.wu@qut.edu.au
authors.forename: Chiung-Jung
authors.initials: CJ
authors.lastname: Jo Wu
authors.forename: Anne M
authors.initials: AM
authors.lastname: Chang
authors.forename: Jan
authors.initials: J
authors.lastname: McDowell
mesh_terms: D003325:Coronary Care Units; D003924:Diabetes Mellitus, Type 2; D006331:Heart Diseases; D006801:Humans; D012648:Self Care; D020377:Self Efficacy