Purpose

The purpose of this study was to explore experiences of hospitalized patients as they transition insulin pump self-management from home to hospital and the experience of nurses caring for them. Patients are often more knowledgeable about the pump than their nurses, which could lead to undiscovered challenges. Little is known about the hospital experience related to insulin pump therapy from nurses’ and patients’ perspectives.

Methods

A qualitative approach with interpretive descriptive design and purposive sampling was used. Eligible patients were ≥18 years of age, able to read and speak English, and admitted to non-ICU settings ≥20 hours. Eligible nurses cared for at least 1 patient using an insulin pump. Patients and nurses were interviewed separately. Interviews were audiotaped and transcribed verbatim. Data were analyzed using a constant comparative method. Coding was performed independently and jointly to reach consensus on emerging themes.

Results

Hospitalized patients and nurses had an array of perceptions highlighting challenges and adaption to “finding the balance” in managing diabetes when patients wore their insulin pumps. There were 4 interrelated themes representing a continuum of trust to lack of trust, control versus lack of control, effective communication to limited communication, and staff knowledge to lack of knowledge.

Conclusions

Results of this study provide valuable insights into the challenges for both patients and nurses. A standardized approach to caring for this population is necessary. These findings can inform the development of nursing education programs and policies aimed at improving their experiences.

中文翻译：

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“寻找平衡”：对医院的胰岛素泵上护士和糖尿病患者的经验的定性研究

目的

这项研究的目的是探讨住院患者在胰岛素泵自我管理从家庭到医院过渡期间的经验以及护士照顾他们的经验。患者通常比护士更了解泵，这可能导致未发现的挑战。从护士和患者的角度来看，关于胰岛素泵治疗的医院经验知之甚少。

方法

定性方法采用解释性描述设计和目的抽样。符合条件的患者年龄≥18岁，能够阅读和说英语，并接受≥20小时的非ICU设置。合格的护士使用胰岛素泵护理至少1位患者。患者和护士分别接受了采访。采访录音和逐字记录。使用恒定比较方法分析数据。编码是独立和联合执行的，以就新兴主题达成共识。

结果

当患者戴上胰岛素泵时，住院患者和护士有一系列认识，突显了挑战和适应“寻找平衡”以管理糖尿病。有4个相互关联的主题，它们代表了信任到缺乏信任，控制与缺乏控制，有效沟通到有限沟通，员工知识到缺乏知识的连续性。

结论

这项研究的结果为患者和护士所面临的挑战提供了宝贵的见解。必须采取一种标准化的方法来照顾这一人群。这些发现可以为护理教育计划和政策的发展提供信息，以改善他们的经验。