title: Challenges in managing elderly people with diabetes in primary care settings in Norway.
abstract: OBJECTIVE
  To explore the experiences and clinical challenges that nurses and nursing assistants face when providing high-quality diabetes-specific management and care for elderly people with diabetes in primary care settings.
  
  
  METHODS
  Focus-group interviews.
  
  
  METHODS
  Sixteen health care professionals: 12 registered nurses and four nursing assistants from nursing homes (10), district nursing service (5), and a service unit (1) were recruited by municipal managers who had local knowledge and knew the workforce. All the participants were women aged 32-59 years with clinical experience ranging from 1.5 to 38 years.
  
  
  RESULTS
  Content analysis revealed a discrepancy between the level of expertise which the participants described as important to delivering high-quality care and their capacity to deliver such care. The discrepancy was due to lack of availability and access to current information, limited ongoing support, lack of cohesion among health care professionals, and limited confidence and autonomy. Challenges to delivering high-quality care included complex, difficult patient situations and lack of confidence to make decisions founded on evidence-based guidelines.
  
  
  CONCLUSIONS
  Participants lacked confidence and autonomy to manage elderly people with diabetes in municipal care settings. Lack of information, support, and professional cohesion made the role challenging.
authors.affiliation: Centre for Evidence-Based Practice, Bergen University College , Bergen , Norway.
authors.forename: Marit
authors.initials: M
authors.lastname: Graue
authors.forename: Trisha
authors.initials: T
authors.lastname: Dunning
authors.forename: Marie Fjelde
authors.initials: MF
authors.lastname: Hausken
authors.forename: Berit
authors.initials: B
authors.lastname: Rokne
mesh_terms: D022126:Access to Information; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003920:Diabetes Mellitus / Q000451:nursing*; D005260:Female; D017144:Focus Groups; D005851:Geriatric Nursing / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D008875:Middle Aged; D009664:Norway; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000523:psychology* / Q000706:statistics & numerical data; D059017:Primary Care Nursing; D017009:Professional Autonomy; D036301:Qualitative Research; D020377:Self Efficacy; D012944:Social Support