ABSTRACT
Providing care by telehealth has been an aspiration for many health care practices. However, regulatory barriers often prevented its implementation. The emergence of the COVID-19 virus provided a window of opportunity for federal policy change in telehealth during a national state of emergency. Telehealth policy is examined using Kingdon's multiple streams (policy) framework.
ABSTRACT
Patients with diabetes are sometimes overwhelmed with the burden of self-care associated with the disease. Although it may seem appropriate to diagnose patients experiencing such emotional burdens with depression, the literature over the past 20 years has matured the concept of diabetes distress, which may more accurately describe the phenomenon.
Subject(s)
Diabetes Mellitus/psychology , Self Care/psychology , Stress, Psychological/nursing , Diabetes Mellitus/therapy , Humans , Nurse Practitioners , Nurse-Patient Relations , Nursing Diagnosis , Psychiatric Status Rating ScalesABSTRACT
Occupational health clinicians often collect and/or interpret annual wellness biometrics for workers. It is now known that type 1 diabetes can present in stages including presymptomatic/normal glucose, presymptomatic/impaired glucose, and symptomatic/hyperglycemia. A workplace wellness screening case illustrates the concepts, along with background pathophysiology, recommendations for new staging and first degree relative screening, and implications for occupational health nurses.
Subject(s)
Diabetes Mellitus, Type 1/diagnosis , Mass Screening , Occupational Health Services , Prediabetic State/diagnosis , Adult , Diabetes Mellitus, Type 1/physiopathology , Female , Humans , Occupational Health Nursing , Prediabetic State/physiopathologyABSTRACT
Not all adults presenting with diabetes mellitus have type 2. NPs must become familiar with atypical presentations of type 1 and type 2 diabetes mellitus, especially in light of the current endocrinologist shortage. Two case studies illustrate variations of adult-onset diabetes along with discussion and diagnostic clues.
Subject(s)
Diabetes Mellitus, Type 1/diagnosis , Diabetes Mellitus, Type 2/diagnosis , Adult , Age of Onset , HumansABSTRACT
Obesity affects individuals physically and emotionally, contributing to direct and indirect employer costs. Targeted obesity interventions through the Diabetes Prevention Program Lifestyle Core Curriculum offered at the worksite could promote healthy lifestyle decisions resulting in weight improvement among overweight and obese employees. A pretest-posttest cohort design was used to evaluate changes in weight and body mass index among 35 Diabetes Prevention Program participants; they achieved statistically significant changes in body weight (p < .001) and body mass index (p < .001). As a process measure, Diabetes Prevention Program session attendance moderately correlated with weight loss (r = .51; p = .002). Many health care professionals, including occupational health nurses, can implement evidence-based worksite obesity interventions to support employee weight loss.
