Perception of patients with type 2 diabetic mellitus towards insulin therapy

Insulin therapy is one of the prominent treatment methods to regulate the glucose level in blood. However, there are certain patients who refuse to even begin the insulin therapy. It is importance to identify patients’ perception and their acceptance of insulin therapy. Purpose of this study is to determine the perception of patients with Type 2 diabetes mellitus towards insulin therapy. and to identify the differences in perception based on the respondents’ age, gender, occupations and educational level. Methods: This is a quantitative descriptive study and was done in one of diabetic clinic in Kota Kinabalu, involving 50 patients with Type 2 Diabetes Mellitus and was not on insulin therapy. Participants were recruited via purposive convenience sampling. Questionnaires were used as research instrument. Results: Majority of the participants (80%) have negative perceptions towards insulin therapy and 84% refused insulin therapy because it would interfere with their working time and routine. Acceptance of insulin therapy among the female patients (Mean = 3.0) was better than the male patients (Mean = 2.8). Patients with high educational level were more positive in accepting insulin therapy (SM > 0.5). Age and occupation factor were categorized as the strong influential factors (SM < 0.5) in determining the patients’ perception towards insulin therapy. The significant mean (mean ± SD) for gender and educational factor showed more than 0.5 hence suggests positive perception in accepting insulin therapy. While, the significant mean (mean ± SD) for age and occupation factor showed less than 0.5 thus suggests negative perception in accepting insulin therapy. Conclusion: Participants have negative perceptions towards insulin therapy and these negative perceptions may possibly deter them from receiving insulin therapy. Appropriate health education and counselling is necessary to help them change their negative perceptions

Lipohypertrophy prevalence and its associated risk factors in insulin-treated patients with type 2 diabetes in North Borneo, Malaysia

Background: Insulin-treated diabetes patients are at high risk of developing lipohypertrophy, which can negatively impact treatment outcomes. Early detection of lipohypertrophy is crucial to preventing blood glucose fluctuation. Unfortunately, this clinical issue is often overlooked by nurses, causing the development of vascular complications, which leads to an increase in the morbidity and mortality of the type 2 diabetes mellitus population.Objective: This study was conducted to identify lipohypertrophy prevalence and to establish the association between the presence of lipohypertrophy and its associated risk factors, including years on injection, total injection in a day, total insulin unit per day, often change needle, insulin injection site and move to a different area.Methods: This cross-sectional study included 128 patients with type 2 diabetes mellitus who received insulin therapy in an outpatient diabetic clinic. Questionnaires on socio-demographic and lipohypertrophy-associated risk factors were distributed among patients, and lipohypertrophy-assessment was done using a checklist. Descriptive statistics and Pearson Chi-square were used for statistical analysis.Results: The prevalence of lipohypertrophy was 51.6% (95% CI: 42.6, 60.5). Swelling on fatty tissue (46.1%) exhibited the highest percentage of lipohypertrophy features during the assessment. Pearson Chi-Square revealed a significant relationship between the presence of LH and BMI categories (χ2 = 10.059, df = 3, p = 0.018), duration of injection (χ2 = 15.001, df = 3, p = 0.002), frequency of needle replacement (χ2 = 9.525, df = 3, p = 0.023) and rotation of injection site (χ2 = 5.914, df = 1, p = 0.015).Conclusion: The high prevalence of lipohypertrophy indicates a need for a prevention strategy. Thus, nurses should play an important role in educating patients regarding the proper administration of insulin injections and performing a routine lipohypertrophy assessment and health education on the correct method of insulin injection

Prevalence of lipohypertrophy in insulin-treated type 2 diabetes mellitus

Introduction: Lipohypertrophy is one of the most common complications of insulin injection. Early detection of lipo¬hypertrophy is very important to prevent the risk of hyperglycemia or hypoglycemia, arisen due to inconsistencies in absorption of insulin. The purpose of this study is to determine the prevalence of lipohyperthrophy in insulin-treated type 2 Diabetes Mellitus. Methods: This is a quantitative descriptive study which was carried out from June to August 2017 in one of tertiary hospital in Sabah. Participants were recruited via purposive convenience sampling. This study was divided into 2 parts which includes questionnaire survey and examination of lipohyperthrophy based on inspec¬tion and palpation techniques. Study participants were patients with type 2 Diabetes Mellitus and on insulin injection more than 3 months. The finding of the injection site examination recorded as “presence” and “not presence” based on the features of lipohyperthrophy. The features of lipohyperthrophy include a palpable lump, swelling of fatty tissue around the subcutaneous insulin injection site, thickened ‘rubbery’ swelling of tissue that is soft and firm, and less pain sensation. Respondent who have one or more of these features considered as presence of lipohyperthrophy. Results: Out of 130 patients, more than half of respondents (51.5%, n=67) had lipohyperthrophy and 48.5% (n=63) without lipohyperthrophy. The occurrence of lipohyhertrophy is shown to be higher in patients who had a longer duration of insulin injection (p=0.002), Failure of changing needle (p=0.026) and failure of rotation injection site (p=0.017) at each time of injection. Conclusion: The high prevalence of lipohypertrophy shown in this study high¬lights the need for prevention strategies, which include regular assessment for the presence of lipohypertrophy and health education on insulin injection. Health education should emphasize on self-assessment of lipohypertrophy, and the importance of right injection techniques

Infusion phlebitis assessment method used in paediatric setting: a systematic review of literature

Phlebitis may localise to the insertion site or travel along the vein. The risk of phlebitis is higher in children as they have thin and weak blood vessels and move continuously due to the pain associated with insertion. Therefore, regular assessment of the risk of developing phlebitis is crucial. This review aimed to identify infusion phlebitis assessment tool used in the paediatric setting. Methods: Electronic databases used were Scopus, ProQuest, ScienceDirect, and Google Scholar. A total of ten studies which assess the development of infusion phlebitis on hospitalised children included in this reviewed. Study findings were discussed and concluded with a recommendation for clinical practice and future studies. Results: Phlebitis development rate was the primary outcome measures in ten studies. Of ten studies, six provided no actual definition of phlebitis. Eight reported phlebitis incidence and/or severity, eight used a scale and two used a definition alone in assessing the development of phlebitis. This review identified five different phlebitis assessment scales. Conclusion: Although there are applicable phlebitis scales can be used for paediatric setting, Limited studies have been conducted on infusion phlebitis assessment method in children. Therefore, it is suggested that more studies and vigorous test needed to identify applicable assessment tools in paediatric setting

Dataset on nurses' knowledge, attitude and practice in pressure injury prevention at Sabah, Malaysia

Pressure injuries are a significant problem in healthcare, and understanding the knowledge and practices of nurses in this area is critical to improving patient outcomes. This article presents dataset concerning a survey conducted to assess the knowledge, attitudes, and practices of pressure injury prevention and care among nurses in public hospitals in the West Coast division of Sabah, Malaysia. The study involved 448 nurses who completed a structured questionnaire between April and December 2021, using the Malay version of the Pieper-Zulkowski-Pressure Ulcer Knowledge Test (PZ-PUKT) 2016 questionnaire. The questionnaire included socio-demographic information and three outcome measures related to pressure injury prevention. Quantitative descriptive statistical analysis was used to analyze the survey results. The data suggest that this survey provides insights into nurses' knowledge, attitudes, and practices regarding pressure injury prevention and could inform the development of interventions to improve the prevention and management of pressure injuries in public hospitals

Peripheral intravenous canula (PIVC) assessment skills among pediatric nurses: audit-based approach study

Introduction: Peripheral Intravenous Cannula (PIVC) placement can cause undesirable effects, such as phlebitis. Poor PIVC care can irritate tunica intima layers of the superficial vein. The incidence of phlebitis had become a national nursing indicator, with a standard of less than 0.9%. The standard care of the patient with intravenous in¬cludes a routine PIVC assessment. However, what the assessment should be based on remained unclear. The objec¬tive of this study is to assess nurses’ skill in performing PIVC assessment. Methods: This is a descriptive study using an audit-based approach. It is conducted in a pediatric hospital. Nine pediatric wards were identified via stratified sampling methods. A total of 86 registered nurses consented to participate in this study. A validated research instru¬ments (α = 0.83), PIVC Assessment Skill (PIVC-AS) checklist is used to audit nurses in performing PIVC assessment. PIVC-AS consists of nine audit criteria (AC), AC1: communication skill, AC2 until AC7: PIVC assessment skill, AC8: documentation skill and AC9: PIVC management. Results: Nurses communication skills to patient as in AC1 shows compliance rate of seventy six percent. The compliance rate can be explained that this study was done in the pedi¬atric setting. Participants may skip this communication due to handling with a pediatric patient. More than eighty eight percent nurses comply with AC2 to AC6 which indicated their excellent skill in performing PIVC assessment every shift. However, in the AC7, only sixty seven percent comply to palpate PIVC area for any evidence of venous cord and warmth. Conclusion: This study concludes that communication between nurses and pediatric patients prior to PIVC assessment often missed out by nurses. The palpation techniques also not been carried out as compared to observation technique in pediatrics setting. Palpation technique is crucial to detect ‘warmth to touch’ because it differentiates between the early and medium stage of phlebitis

The role of debridement in wound bed preparation in chronic wound: A narrative review

Objective: To provide an overview of the types of wound debridement and update the available scientific consensus on the effect of wound debridement. Methods: The articles were searched through CINAHL, PubMed, Cochrane Library, and Medline database for relevant articles on all types of wound debridement. Articles included were all systematic review on the effectiveness of wound debridement-related outcome, published within the year 2017 until Aug 2021, in English. Results: A total of seven scientific articles had been selected for review out of 318 screened. The authors reviewed a total of 318 titles and abstracts related to wound debridement effectiveness. Seven articles that were selected were narratively reviewed by two authors. The findings of the review were organized into autolytic, enzymatic, sharp, surgical, biological, and mechanical debridement methods and includes the advantages and disadvantages of each. The author further explored on the role of wound debridement according to wound bed preparation model. Articles were synthesized and organized based on the authors, year, total studies included in the systematic review, study range of year, total sample, debridement method, wound types, and findings. Conclusion: Maggot debridement therapy showed a consistent finding in terms of effectiveness in debriding chronic wounds. The newer debridement method includes hydro-surgery, low-frequency ultrasonic and enzymatic collagenase debridement were getting more attention due to faster wound bed preparation and less painful. However, these newer method of debridement’s showed inconclusive findings and the patient safety was not clearly defined. A higher level of review is warranted in the future study