Does gender affect health-related quality of life in patients with type 2 diabetes (ADDQoL) in Central European countries?

OBJECTIVE: The aim of this study was to compare the impact of type 2 diabetes on quality of life (QoL), taking into account gender differences in relation to individual domains of Diabetes-Related Quality of Life Audit (ADDQoL) in adult men and women in Poland, the Czech Republic and Republic of Slovakia. MATERIAL AND METHODS: The participants were 608 patients from the three countries, of whom 278 were women and 330 men with type 2 diabetes mellitus. The tool used was the Audit of Diabetes-Dependent Quality of Life (ADDQoL). RESULTS: The overall average QoL was slightly higher in men than in women. In ADDQoL scores, mean weighted impact scores were negative for all domains. The domain which was the most affected by type 2 diabetes in both men and women from all three countries was the 'freedom to eat', while the 'living conditions' domain was the least affected. Diabetes had a slightly negative average weighted impact on most men and women - AWI<-3.0. Except for the different AWI scores in men with type 2 diabetes depending on their education, neither men nor women revealed any significant changes in terms of the impact of education, residence, marital status, smoking, hypertension, or taking anti-hypertensive drugs. CONCLUSIONS: Type 2 diabetes mellitus negatively affects all the domains of life, in both men and women in all three countries; however, this impact is insignificant. The participants assessed their quality of life as good and very good.

Implicit rationing of nursing care reported by nurses from different types of hospitals and hospital units.

AIMS AND OBJECTIVES: The study aimed to investigate differences in assessing implicit rationing of nursing care by Czech nurses with respect to the type of unit and type of hospital. BACKGROUND: Implicit rationing of nursing care may differ across different types of hospitals and hospital units. DESIGN: This study used a multicentre cross-sectional study design. METHODS: The STROBE checklist for observational cross-sectional studies was followed for reporting of the research study. The sample included 8209 nurses providing direct care to medical and surgical patients in 14 acute care Czech hospitals. The main outcome was implicit rationing of nursing care as measured with a Czech version of the Perceived Implicit Rationing of Nursing Care (PIRNCA) instrument. Data were collected from September 2019 to October 2020. RESULTS: The most frequently rationed nursing care activity was timely response to patient or family request/need, followed by emotional or psychological support and adequate supervision of delegated tasks. More implicitly rationed nursing care was reported in medical units. Statistical differences were found in rating 25 items and the PIRNCA total score. Nurses from middle-sized hospitals reported implicitly rationed care more frequently than those from large hospitals. CONCLUSION: More rationed care was reported by nurses from medical units and nurses from middle-sized hospitals. Organisational variables (the type of unit and type of hospital) influence the implicit rationing of nursing care in our study. RELEVANCE TO CLINICAL PRACTICE: The findings call for nursing managers to pay attention to organisational variables which may affect the implicit rationing of nursing care.

Rationed nursing care as one of the indicators of the occurrence of medication errors.

AIM: The aim was to analyze selected studies on rationed nursing care as one of the indicators that influence the occurrence of medication errors. METHODS: A descriptive review study. Articles and studies were searched in the following selected electronic databases: EBSCO (Academic Search Ultimate, Academic Search Complete), CINAHL Plus with Full Text, MEDLINE Complete, ScienceDirect and Central & Eastern European Academic Source. The search for relevant sources was based on the following English keywords: unfinished care, omitted care, rationing care, missed care, nursing care, medication errors. RESULTS: Total of 86 contributions found. After duplicit and irrelevant publications were the analysis comprised 8 primary studies and 2 systematic reviews. The studies were concerned with rationed or otherwise defined non-standard nursing care not merely related to medication errors. Each study described selected activities most frequently omitted by nurses with respect to medication: assessment of drug efficacy, medication errors, administration of incorrect drugs or doses, wrong time of administration, high-risk drug protocols and adhering to rules with each administration. The most frequently reported factor influencing the occurrence of missed care was understaffing and the related number of patients per nurse, resulting in a lack of time for selected patient activities. CONCLUSION: Despite difference in methods, all studies consistently claimed that rationed, unfinished, missed or omitted nursing care has or may have a negative impact on both patients and nurses. Some of the recommendations were increasing the number of nurses, improving team collaboration and work organization including setting systemic and preventive measures.

Comparison of Diabetes-Dependent Quality of Life (ADDQoL) in Patients with T2DM in Poland, The Czech Republic, and Slovakia.

INTRODUCTION: The purpose of the paper was to perform a comparative analysis of the impact of T2DM on QoL, including specific ADDQoL domains and associations between QoL, selected socio-demographic factors (including gender, age, education, residence, marital status, professional activity) or clinical parameters (HbA1c levels, fasting blood glucose, BMI, duration of DM, complications, treatment used), in adult diabetic patients from Poland, the Czech Republic and Slovakia. The study group included 608 patients diagnosed with T2DM. There were 214 patients from Poland, 196 from the Czech Republic and 198 from Slovakia. RESULTS: Overall, respondents from all three countries rated their QoL as good or very good. The mean scores for the item "If I did not have diabetes, my quality of life would be" were slightly higher for Poles than for Slovaks and Czechs. In the ADDQoL results, the weighted impact scores were negative for all domains. The lowest scores in all three countries were found for "freedom to eat" for all patients; the highest for "living conditions". For Polish patients, the linear regression model demonstrated the following significant AWI predictors: pre-university education and past smoking. For Czech patients, the linear regression model demonstrated that none of the characteristics analyzed were significant independent predictors of AWI. In the For Slovak patients, the linear regression model demonstrated the following significant AWI predictors: higher education and concurrent heart failure. CONCLUSION: In summary, our findings demonstrate that T2DM has a negative impact on all aspects of patients' QoL, which is the strongest in terms of the freedom to eat and dietary habits, regardless of the country. Education, past smoking, and concurrent heart failure were the only independent predictors of QoL in our study. This suggests a need for further research that would include more variables and a larger number of patients.