title: Comparing the mortality risks of nursing professionals with diabetes and general patients with diabetes: a nationwide matched cohort study.
abstract: Nursing professionals have received comprehensive medical education and training. However, whether these medical professionals exhibit positive patient care attitudes and behaviors and thus reduce mortality risks when they themselves are diagnosed with chronic diseases is worth exploring. This study compared the mortality risks of female nurses and general patients with diabetes and elucidated factors that caused this difference.
  
  
  
  A total of 510,058 female patients newly diagnosed with diabetes between 1998 and 2006 as recorded in the National Health Insurance Research Database were the participants in this study. Nurses with diabetes and general population with diabetes were matched with propensity score method in a 1:10 ratio. The participants were tracked from the date of diagnosis to 2009. The Cox proportional hazards model was utilized to compare the mortality risks in the two groups.
  
  
  
  Nurses were newly diagnosed with diabetes at a younger age compared with the general public (42.01 ± 12.03 y vs. 59.29 ± 13.11 y). Nevertheless, the matching results showed that nurses had lower mortality risks (HR: 0.53, 95 % CI: 0.38-0.74) and nurses with diabetes in the < 35 and 35-44 age groups exhibited significantly lower mortality risks compared with general patients (HR: 0.23 and 0.36). A further analysis indicated that the factors that influenced the mortality risks of nurses with diabetes included age, catastrophic illnesses, and the severity of diabetes complications.
  
  
  
  Nurses with diabetes exhibited lower mortality risks possibly because they had received comprehensive medical education and training, may had more knowledge regarding chronic disease control and change their lifestyles. The results can serve as a reference for developing heath education, and for preventing occupational hazards in nurses.
authors.affiliation: Department of Aged Welfare and Social Work, Toko University, Taiwan, Republic Of China.|Department of Public Health and Department of Health Services Administration, China Medical University, Taiwan, Republic Of China.
authors.forename: Hsiu-Ling
authors.initials: HL
authors.lastname: Huang
authors.affiliation: Department of Nursing, Hengchun Tourism Hospital, Ministry of Health and Welfare, Taiwan, Republic Of China.
authors.forename: Chuan-Yu
authors.initials: CY
authors.lastname: Kung
authors.affiliation: Department of Urology, Hengchun Tourism Hospital, Ministry of Health and Welfare, Taiwan, Republic Of China.
authors.forename: Cheng-Chin
authors.initials: CC
authors.lastname: Pan
authors.affiliation: Department of Healthcare Administration, Asia University, Taichung, Taiwan, Republic Of China.
authors.forename: Pei-Tseng
authors.initials: PT
authors.lastname: Kung
authors.affiliation: Department of Aged Welfare and Social Work, Toko University, Taiwan, Republic Of China.
authors.forename: Shun-Mu
authors.initials: SM
authors.lastname: Wang
authors.affiliation: Department of Health Services Administration, China Medical University, 91, Hsueh-Shih Road, Taichung, Taiwan, 40402, Republic Of China.
authors.forename: Wen-Yu
authors.initials: WY
authors.lastname: Chou
authors.affiliation: Department of Health Services Administration, China Medical University, 91, Hsueh-Shih Road, Taichung, Taiwan, 40402, Republic Of China. wtsai@mail.cmu.edu.tw.
authors.forename: Wen-Chen
authors.initials: WC
authors.lastname: Tsai
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000401:mortality*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D009726:Nurses; D009790:Occupations; D057216:Propensity Score; D016016:Proportional Hazards Models; D012306:Risk
keywords: Cohort study; Mortality risk; National Health Insurance; Nurse with diabetes; Nursing health education; Occupational health