Ongoing projects in diabetes nursing

Within the research group Clinical Diabetes and Metabolism we are a group of scientists who study diabetes nursing.

The patient's perspective and perception

Studies for evaluation of the patient's perspective and perception of diabetes nursing care.

A new questionnaire is needed, as there is no measurement that meets the ambition of a comprehensive diabetes-specific measure based on the capability approach. Within a pilot study, a first version of the questionnaire (the Diabetes Capabilities Questionnaire I) has been developed. The revised questionnaire has been successfully tested among 2000 patients with diabetes.  The final questionnaire will be implemented in National Diabetes Registry (NDR) during 2015. A comprehensive evaluation of diabetes and diabetes care from the patient’s perspective will enable the NDR to meet the ambition to follow up, improve and develop diabetes care based upon the individual’s situation. Another study has a phenomenological perspective about patient with diabetes experience of learning and support for learning and also diabetes nurses' experience of providing support for learning to live with diabetes.

Damage to the eye is the most feared complications of diabetes and one of the most common causes of vision loss is diabetic macular edema (DME). In January 2011 a new treatment for DME, called anti-VEGF treatment was approved. The aim is to evaluate the new treatment, anti-VEGF, using both qualitative and quantitative evaluation, by describing the patients experience and measuring their health-related quality of life as well as medical endpoint. The quantitative evaluation showed The result showed that the participants reported a relatively low general health with the patient reported measurements (PROMs) NEI VFQ-25, vision specific, and SF-36, a general measurement before treatment start. At the one year follow up 52 % of the participants had achieved an impaired visual acuity measured with ETDRS and a decreased macula swelling, measured with OCT this means that about half of the participants did not receive an improved visual acuity although they have undergone the same treatment. 

Janeth Leksell, Associate Professor
Therese Granström, PhD student
Maria Svedbo Engström, PhD student

Evaluation of models for self-management

Studies that evaluate models and educational programs preparing the patients for taking control of their self-management and health.

Person-centred care highlights the importance of knowing the human being behind the disease in order to engage the person as an active partner in his/her cares and treatment. Guided self-determination (GSD) is a patient educational model that intends to guide toward self-determination and to develop life skills to manage difficulties in self-management by using reflection sheets and communication methods. This model has been adapted to young people and their parents, Guided self-determination-Young, (GSD-Y). In an ongoing study we perform a randomized intervention study, which aims to evaluate the effect of an intervention with GSD-Y in groups of adolescents starting on insulin pumps and their parents on diabetes-related family conflicts, perceived health and quality of life (QoL), and metabolic control.

In another on-going study we carry out a randomized controlled study called: Acceptance and commitment therapy intervention. The aim is to test the effects of an ACT group intervention for patients with unsatisfactory blood glucose level, consisting of seven sessions and three follow-up sessions on blood glucose control and well-being.

Janeth Leksell, Assoc prof, RN
Anna Lindholm-Olinder, PhD, RN
Anna-Lena Brorsson, PhD student
Jan Eriksson, Prof, MD
Johan Fischier, RN

Equitable primary diabetes care?

Studies which highlight factors contributing to equitable primary diabetes care.

Diabetes care is a complex process with several factors influencing the process positively. The majority of people with type 2 diabetes are treated in primary care. Evaluations of the diabetes care by the Swedish National Board of Health and Welfare (NBHW) and the Swedish Association of Local Authorities and Regions (SALAR) show that resources and practices for people with type 2 diabetes who are treated in primary care are unequally distributed within the country. Thus, the aim with this project is to study how inequalities in the primary care’s resources and organization affect patient outcomes for people with type 2 diabetes. The project is a nationwide cross-sectional study based on primary health care centres (PHCC) level data from the Swedish National Survey of the Quality and Organization of Diabetes Care in Primary Healthcare (Swed-QOP) questionnaire and individual clinical data on persons with T2DM from the National Diabetes Register (NDR). These data are linked to individual level data on socioeconomic status and comorbidities from the Longitudinal Integration Database for Health Insurance and Labour Market Studies (LISA) and the Swedish National Patient Register (NPR), respectively. The questionnaire was answered by 880 (76%) of the 1152 PHCCs in Sweden. From the NDR, a total of 290 808 individuals were identified to have T2DM in 2013. In total, the final study population comprise 846 PHCCs and 230 958 persons with T2DM.

Rebecka Husdal, PhD-student
Janeth Leksell, Assoc prof
Eva Thors-Adolfsson, PhD
Andreas Rosenblad, Assoc prof, applied medical statistics and Epidemiology