Psychologycal insulin resistance among nurses when initiating insulin therapy in diabetic patients

Linh Le Thuy, Huyen Vu Thi Thanh

 ABSTRACT 

In view of the progressive decline in beta-cell function in type 2 diabetes, good glycaemic control often requires insulin therapy. Despite many benefits delaying attitude forward insulin therapy were reported in both patients and health care providers.

Objectives

To determine the percentage of psychological insulin resistance (PIR) amongst nurses and identify factors affect nurses’ psychological insulin resistance when initiating insulin therapy in diabetic patients.

Methods

This cross-sectional study was performed. A validated questionnaire was developed by investigators, based on the Physicians Attitude to Insulin Therapy questionnaire of Diabetes Attitudes, Wishes and Needs (DAWN) Japan was used to gather information.

Results

Proportion of PIR amongst nurses was 37.3%. More generalist nurses had PIR than diabetes specialist nurses (41.2% vs. 17.6%), and nurses who had under five years in practice were more likely to witness PIR than experienced nurses and (54.5% compare to 32.5%) (p<0.05). The most common reasons for PIR in nurses were assuming that patient could give up on insulin without consultation, considering burden related to self-inject, afraid of possibly insulin side effects: hypoglycemia, risk of uncontrollable weight gain. Additionally, nearly 40% of nurses considered it was time-consuming to explain for patients about converting to insulin therapy.  

Conclusions

The study indicated that non-specialist and less experiences were significantly associated with PIR in nurses. Misconception about insulin therapy and lack of adequate time for explanation served as prominent barriers in insulin using.

Keywords

Diabetes, psychological insulin resistance (PIR), nurses 

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