Knowledge, comfort level and the perceived role of nurses in promoting nutritional management of diabetes

Trish Amber Carney

doi:10.17918/etd-3300

Diabetes Mellitus affects 18 million people in the United States. While the responsibility of diabetes education lies primarily with registered dietitians (RDs) and certified diabetes educators (CDEs) these professionals may not be available to patients as often as nurses. Ninety percent of nurses report receiving requests for nutrition advice from patients. A review of the literature suggests the current knowledge level of nutritional management of diabetes may be low among nurses. The objective of this research was to investigate the knowledge, comfort level and perceived role among nursing students regarding nutritional facts and the nurse's role in promoting nutritional management of diabetes. Three focus groups were conducted with nursing students who had already completed the nutrition requirements for their program. Participants were recruited via flyers and mass emails. A trained moderator led each group using open-ended questions. Discussions were audio recorded, transcribed and analyzed. A survey was developed based on the American Diabetes Association's nutrition guidelines and modified based on focus group results. The survey was then reviewed by a focus group expert, 2 doctoral nursing professionals and 2 Certified Diabetes Educators/Registered Dietitians and further modified as needed. The survey was administered via a mass emailing to all nursing students at Drexel University and nurses at Hahnemann University Hospital. Seven to eleven nursing students participated in each of three focus groups. Analysis of focus group transcripts revealed 4 main themes: 1) nurses play a vital role in providing basic nutrition advice to patients with diabetes 2) nursing students were not confident that they could recall many details learned in nutrition courses 3) nursing students were generally comfortable giving basic nutrition advice but 4) they were not able to identify carbohydrate content of foods to give specific advice. A total of 231 and nurses and nursing students participated in the survey. Survey results showed that 43% of respondents were not able to identify the carbohydrate content of 4oz orange juice and 56% did not consider milk a carbohydrate food. Thirty-one percent of respondents incorrectly selected one or more macronutrients to be excluded from diabetic meal plans and 50% of respondents were not aware that the carbohydrate content of foods is listed as "total carbohydrate" on food labels. Both focus group and survey results showed that greater than 80% of nurses and nursing students reported that when caring for a patient with diabetes nurses have a responsibility to provide and reinforce basic nutrition education and felt it is "very important" for nurses to have at least basic nutrition knowledge for diabetes management. Nursing students perceive nurses to have an important role in promoting nutrition management of diabetes to patients however they are not able to consistently identify accurate carbohydrate content of foods. This study indicates there may be a need for better nutrition education of nurses and nursing students with respect to nutrition knowledge for diabetes management given the growing number of patients with diabetes.

Knowledge, comfort level and the perceived role of nurses in promoting nutritional management of diabetes

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Knowledge, comfort level and the perceived role of nurses in promoting nutritional management of diabetes

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