ABSTRACT
OBJECTIVE: The purpose of this study was to determine the effect of continuous glucose monitoring (CGM) on glycemic control in children, adolescents, and young adults ages 7-21 years with poorly controlled diabetes HbA1c 9.0% or more (74 mmol/mol IFCC). MATERIALS AND METHODS: The primary outcome was improvement in HbA1c. The secondary outcome included self-reported hypoglycemia. This 12-week study used a prospective, one-group, pre- and posttest pre-experimental design with a convenience sample. The study used the Medtronic Guardian CGM with Enlite Sensor. RESULTS AND CONCLUSIONS: Thirty-three subjects enrolled in the study. The mean age of the participants was 15.57 years, range was 11-20 years, 47.6% were male, and 52.4% were female. Twenty-one (63.6%) completed the final study visit. There was a clinically and statistically significant reduction of 1.46 (SD = 1.6711) (p = .001) in HbA1c at 12 weeks. Fifteen of the 21 participants (71.4%) had an HbA1c reduction of greater than 0.5%. The CGM monitor was worn a mean of 4.262 days a week. None of the subjects reported significant hypoglycemia while wearing the monitor. CGM was effective in improving glycemic control in this population with poorly controlled diabetes.
Subject(s)
Blood Glucose Self-Monitoring/instrumentation , Blood Glucose/analysis , Diabetes Mellitus, Type 1/blood , Hemoglobin A/analysis , Hypoglycemia/blood , Adolescent , Adult , Child , Drug Administration Schedule , Female , Humans , Male , Prospective Studies , Time Factors , Young AdultABSTRACT
The purpose of this research was to assess home health nurses' (HHNs) knowledge, comfort levels, barriers, and personal participation in advanced care planning (ACP), a practice that recognizes patient preferences for health care treatment. Licensed nurses who identified home care as their primary area of practice (N = 519) were surveyed about their knowledge of laws governing ACP and their perceptions of patients' preferences for ACP. Most respondents were women (97%), and the average age of the respondents was 54 years. Most nurses felt knowledgeable and capable of educating patients on advance directives (ADs), although the nurses' knowledge of laws governing ACP was limited and often inaccurate. Generally, nurses felt comfortable during ACP discussions with patients and families. HHNs perceived patient or family reluctance as the greatest barrier hindering discussions of ACP. No association was found between level of education and whether a nurse had a personal AD. Twenty percent of the nurses had their valid personal AD. A greater knowledge base concerning ACP would facilitate HHN discussions with patients and families. Recognition of patient preferences can be enhanced by understanding and overcoming barriers that hinder discussions of ACP. Educational opportunities focusing on ACP are encouraged for all health care providers.
Subject(s)
Advance Care Planning/organization & administration , Attitude of Health Personnel , Community Health Nursing/organization & administration , Home Care Services/organization & administration , Nursing Staff/psychology , Adult , Advance Care Planning/ethics , Attitude to Health , Clinical Competence/standards , Communication , Community Health Nursing/education , Community Health Nursing/ethics , Female , Health Knowledge, Attitudes, Practice , Home Care Services/ethics , Humans , Knowledge , Licensure, Nursing , Male , Mid-Atlantic Region , Middle Aged , Nurse's Role/psychology , Nurse-Patient Relations , Nursing Methodology Research , Nursing Staff/education , Nursing Staff/ethics , Nursing Staff/organization & administration , Patient Education as Topic , Professional-Family Relations , Self Efficacy , Surveys and QuestionnairesABSTRACT
PURPOSE/OBJECTIVES: To determine how and what women learn about breast cancer and screening practices and which factors influence women's breast cancer screening practices. DESIGN: Descriptive analysis of questionnaire data collected at the time of enrollment in a clinical trial. SETTING: Breast care center of a mid-Atlantic academic health sciences center. SAMPLE: 185 women in a predominantly Appalachian, entirely rural state. METHODS: Participants completed the Modified Toronto Breast Self-Examination Inventory and questions related to personal mammography practices at the time of enrollment before randomization in a longitudinal clinical intervention study. MAIN RESEARCH VARIABLES: Women's demographics, knowledge of breast cancer screening practices, adherence to breast cancer screening guidelines, and motivation, knowledge, and practice proficiency surrounding breast cancer screening. FINDINGS: These educated women had knowledge deficits about breast cancer, breast cancer risk factors, and screening guidelines, particularly the timing and practice behaviors of breast self-examination. Women who had received healthcare and cancer-screening instruction by healthcare providers, including advanced practice nurses, had greater knowledge of breast cancer and detection practices. CONCLUSIONS: Women still have knowledge deficits about breast cancer, breast cancer detection, and personal risk factors. In addition, some educated women in this study failed to practice breast cancer screening according to current guidelines. IMPLICATIONS FOR NURSING: Practitioners must continue to remind and update women about breast disease, and women's cancer-screening practices must be reinforced. All levels of providers should improve their rates of performing clinical breast examinations with physical examinations. Nurses, who greatly influence women's health care, must remain current in their knowledge of breast disease, screening, and treatment.