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Well, who do I phone? Preparing for urgent care : a challenge for patients and service providers alike
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Coates, Vivien, McCann, Angela, Posner, Natasha, Gunn, Kathleen and Seers, Kate (2015) Well, who do I phone? Preparing for urgent care : a challenge for patients and service providers alike. Journal of Clinical Nursing, 24 (Issue 15-16). pp. 2152-2163. doi:10.1111/jocn.12814 ISSN 0962-1067.
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Official URL: http://dx.doi.org/10.1111/jocn.12814
Abstract
AIMS AND OBJECTIVES:
To investigate factors influencing patients' self-management of urgent diabetes problems that precipitated unscheduled hospital care.
BACKGROUND:
Diabetes is placing increasing resource demands on health services and current policy advocates management in primary care and community settings whenever possible. Such policy has implications for patient education and empowerment and on mechanisms within primary and community care to support the management of diabetes when urgent healthcare problems arise.
DESIGN:
Qualitative, descriptive investigation, across two contrasting sites.
METHODS:
Forty-five people admitted to hospital for urgent/emergency care due to diabetes-related problems were recruited from urban and rural localities in the UK. Semi-structured interviews were conducted and data analysed using nvivo version 8 and framework techniques.
RESULTS:
Self-management of diabetes was typically habitual, and urgent problems that proved difficult to resolve necessitated recourse to unscheduled hospital care. Though skills relating to problem-solving, decision-making, resource use and formation of patient-provider partnerships were evident among some participants, these required further development. Evidence of action planning or self-tailoring skills was sparse.
CONCLUSIONS:
Education plays an important role in assisting individuals to self-manage their diabetes on a daily basis, but urgent, unexpected health problems proved challenging for both patients and health service providers. A greater focus on empowering patients with core self-management skills is required to enhance ability to successfully manage unexpected diabetes complications, coupled with enhanced primary care resources, particularly out-of-hours.
RELEVANCE TO CLINICAL PRACTICE:
The importance of informal and structured diabetes education should not be underestimated; however, the challenge of improving skills such as problem-solving to manage urgent healthcare needs must be tackled. This study provokes debate regarding how best to deliver appropriate education and health services to cover urgent unscheduled care needs without automatically referring to emergency department hospital care.
| Item Type: | Journal Article | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > RT Nursing | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Warwick Research in Nursing > Royal College of Nursing Research Institute (RCN) (- July 2017) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Diabetes -- Patients -- Hospital care -- Interviews, Self-care, Health, Diabetes -- Nursing, Community health services | ||||||||
| Journal or Publication Title: | Journal of Clinical Nursing | ||||||||
| Publisher: | Wiley-Blackwell Publishing Ltd. | ||||||||
| ISSN: | 0962-1067 | ||||||||
| Official Date: | August 2015 | ||||||||
| Dates: |
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| Volume: | 24 | ||||||||
| Number: | Issue 15-16 | ||||||||
| Number of Pages: | 11 | ||||||||
| Page Range: | pp. 2152-2163 | ||||||||
| DOI: | 10.1111/jocn.12814 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||
| Funder: | National Institute for Health Research (Great Britain) (NIHR) | ||||||||
| Grant number: | PB-PG-0407-12243 | ||||||||
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