Abstract
Objective. To explore the experiences and clinical challenges that nurses and nursing assistants face when providing highquality
diabetes-specifi c management and care for elderly people with diabetes in primary care settings. Design. Focus-group
interviews. Subjects and setting. 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 confi dence and autonomy. Challenges to delivering high-quality care included complex,
diffi cult patient situations and lack of confi dence to make decisions founded on evidence-based guidelines. Conclusion.
Participants lacked confi dence and autonomy to manage elderly people with diabetes in municipal care settings. Lack of
information, support, and professional cohesion made the role challenging
AbstractObjective. To explore the experiences and clinical challenges that nurses and nursing assistants face when providing highqualitydiabetes-specifi c management and care for elderly people with diabetes in primary care settings. Design. Focus-groupinterviews. Subjects and setting. Sixteen health care professionals: 12 registered nurses and four nursing assistants fromnursing homes (10), district nursing service (5), and a service unit (1) were recruited by municipal managers whohad local knowledge and knew the workforce. All the participants were women aged 32 – 59 years with clinical experienceranging from 1.5 to 38 years. Results. Content analysis revealed a discrepancy between the level of expertise which theparticipants described as important to delivering high-quality care and their capacity to deliver such care. The discrepancywas due to lack of availability and access to current information, limited ongoing support, lack of cohesion among healthcare professionals, and limited confi dence and autonomy. Challenges to delivering high-quality care included complex,diffi cult patient situations and lack of confi dence to make decisions founded on evidence-based guidelines. Conclusion.Participants lacked confi dence and autonomy to manage elderly people with diabetes in municipal care settings. Lack ofinformation, support, and professional cohesion made the role challenging
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