The influence of an insulin pump experience on nursing students’ understanding of the complexity of diabetes management and ways to help patients: A Qualitative Study

Abstract

Background: Worldwide, 78,000 children develop type 1 diabetes annually with European cases increasing every year. In the United States, 215,000 children under 20 years of age have type 1 diabetes and over 6.5 million adults with either type 1 or type 2 diabetes need daily administration of insulin. Misunderstanding the complexity of diabetes management on the part of health care providers can affect their attitudes and negatively affect patient outcomes. The purpose of this descriptive qualitative study was to explore family nurse practitioner and undergraduate nursing students’ perceptions of diabetes management while using an insulin pump in order to more effectively prepare them to understand the complexities of diabetes management faced by patients with diabetes and, therefore, provide better patient care.

Methods: Nurse practitioner and undergraduate students, who participated in a week long diabetes simulation experience, were asked to participate. Consents were obtained allowing analysis of journals detailing their experiences. The journals were analyzed for common themes according to qualitative methodology.

Results: Three themes emerged from the data: 1) handling self-management issues, 2) living with an insulin pump, and 3) gaining an appreciation for those who live with diabetes. Self-management subthemes included making dietary changes and monitoring blood glucose levels. Making dietary changes included carbohydrate counting, eating a balanced diet, and not snacking all day. Issues related to the monitoring of  blood glucose levels included the pain of poking their fingers, difficulty getting enough blood, forgetting to check blood glucose, and not wanting to check blood glucose in front of people. Living with an insulin pump subthemes included learning where to wear the pump, having the pump get in the way, interfering with daily activities, including changing clothes or using the bathroom, interfering with intimacy, and having to change the needle site. Subthemes of gaining an appreciation for those who live with diabetes included having empathy for patients related to complying/not complying with treatment regimes, understanding the inconveniences of required lifestyle changes, and obtaining support from others having the same experience.

Conclusions: Diabetes requires many lifestyle changes. Study participants cited an increased understanding of the hassles and inconvenience of living with diabetes, particularly dietary changes, monitoring blood glucose, and living with an insulin pump. Undergraduate and graduate nursing students caring for patients with diabetes would benefit from a similar simulation experience in order to gain an understanding of the complexity of diabetes management and learn ways to help their patients. Nursing faculty should consider implementing a similar simulation experience in their curriculum.