Search

Purpose To investigate impacts of multiple daily insulin injections (MDII) and continuous subcutaneous insulin infusion (CSII) on disease management and patient lifestyle by patients and significant others (SOs). Hypotheses Older patients (>50 years) and their SOs will perceive differences in satisfaction between CSII and MDII impact on diabetes management and lifestyle. Methods Patient and paired SO completed parallel instruments framed by sociotechnical systems theory and the life patterns model. Alpha = .901–.940. Results Whites reported greater satisfaction with CSII and non-Whites with MDII. Both reported increased independence. CSII scored significantly higher than MDII. Age did not reduce positive impacts. CSII enhanced independence of SOs but 38.6% of SOs did not know how to suspend CSII for hypoglycemia; 47.3% of patients believed SOs would not know. Conclusions Neither age nor diabetes type contraindicate using CSII in older patients. CSII is perceived more impactful on disease management and lifestyle. Education of SOs needs emphasis.

N urses from the United States are increasingly being asked to assist their colleagues in other countries with the multifaceted tasks of curriculum development, strategic planning, health care interventions, and the often complicated processes of acquiring funds from local and international "agencies." This is clearly an exciting opportunity but requires considerably more talent and foresight than simply visiting another country and giving advice. The role of today's nurse consultant involves sharing information, exchanging ideas, learning from the host country, and being creative, innovative, and flexible in a complex, changing global environment.