Self-Care of Adults with Type 2 Diabetes During the COVID-19 Pandemic: A Qualitative Interpretive Description Study.

Due to coronavirus disease 2019 (COVID-19), diabetes services have been disrupted, causing difficulties for people with type 2 diabetes mellitus (T2DM), and understanding their experience could help improve diabetes care. Therefore, we used a qualitative interpretive description to explore the experience of self-care of adults with T2DM during the COVID-19 pandemic. Data were collected using semi-structured interviews and analyzed theoretically. The sample (N = 30) was composed of 7 females and 23 males, with a mean age of 69.9 years (60-77) and 19.4 mean years (3-40) of people living with T2DM. Our findings show reduced physical activity and increased smoking and alcohol consumption affected that self-care. Increased food consumption and stress eating, with greater stress and anxiety, caused worsening of glycemic values. Participants were able to contact healthcare professionals via eHealth or telephone. Others, even those with complications, were not able to receive care or advice. These results suggest that easier contact with health providers, continuous engagement, eHealth solutions, and formal peer support could help self-care in T2DM. Advanced nursing roles and services could solve many issues reported in this study during and after the pandemic.

[Pre-analytical errors in blood sampling: an observational study on specimen collection technique and laboratory results]. / Gli errori preanalitici nel prelievo ematico: uno studio osservazionale sulle modalità di raccolta dei campioni e sugli esiti di laboratorio.

INTRODUCTION: Around 60-70% of diagnostic and therapeutic decisions are based on blood exams. Several errors occur during the pre-analytic phase. AIMS: of this study were: to describe nurses' behaviours in blood specimen collection; to describe prevalence and type of pre-analytical errors; to assess the association between pre-analytical errors and occurrence of unsuitable specimens. METHODS: An observational cross-sectional study was conducted by means of a structured form based on up-to-date clinical recommendations. A researcher observed nurses' behaviors during 172 blood sampling procedures in medical, surgical and emergency care settings. Unsuitable procedures were registered. RESULTS: Most behaviours were correct, however some significantly diverged from recommended practices: active and passive patient identification; respect of antiseptic solution's drying time; rapid removal of tourniquet when blood started flowing. The prevalence of unsuitable specimen reports was significantly higher when the procedure involved a small calibre vein (RP: 0.19; IC95% 0.04 - 0.98; p = 0.03) and when blood drawing was difficult (RP; 3.83; IC95% 1.63 - 9.01; p <0.001). CONCLUSIONS: The pre-analytical phase is important for the diagnostic process and safety of patients. Although some factors ­ as patients' characteristics ­ are non-modifiable, some nurses' behaviours could be improved to reduce risk of pre-analytical errors. Further studies are needed to clarify the associations between pre-analytical errors and laboratory outcomes.

A literature review on self-care of chronic illness: definition, assessment and related outcomes.

INTRODUCTION: Chronic illnesses care represents a challenging issue for people well-being and future health systems' sustainability. Promotion of self-care is considered a key point for chronically ill patients' care. The aim of this literature was to explore: how self-care of chronic illness has been theoretically defined; how self-care can be assessed in clinical and research settings; what associations exist between self-care and health outcomes of chronically ill patients. RESULTS: A wide range of definitions and terminologies related to self-care of chronic illness has been found in the literature. Although some common elements useful to explain the concept of self-care have been identified, the physical, cognitive, emotional and social processes underlying self-care remain controversial and poorly defined. Valid and reliable disease-specific assessment tools have been developed and used in a growing number of studies; however, the lack of utilization of standardized instruments in clinical practice has been referred by many authors. Significant correlations between self-care of chronic illness and outcome measures e.g. general health status, quality of life and healthcare costs, are reported by a limited number of studies. CONCLUSION: Supporting patient self-care is recognized as a crucial factor in chronic illness care. A deeper analysis of variables and processes influencing self-care could help for a full description of the phenomenon. A systematic evaluation of self-care in health professionals' everyday clinical practice is strongly recommended. The development of general non-disease-specific assessment tools could facilitate the evaluation of complex patients, especially those with multiple co-morbidities. Although self-care has been recognized as a vital intermediate outcome, further large-scale studies clarifying the association between self-care and patients' and health systems' outcomes are needed.