Amanda Dudley, Tiffany Ballentine, Tanya Cohn

Citation: Dudley A, Ballentine T, Cohn T (2022) Screening tool provides insight to the depths of diabetes-related Nursing. 26: [Early view publication]

Article points

1. Each day, people with diabetes are routinely faced with countless decisions regarding the management of their blood glucose levels.

2. This constant management can have emotional, psychological and physiological implications that can lead to diabetes-related distress.

3. If not identified through screening, diabetes related distress can lead to poor health outcomes and decreased self-care. Despite this, assessment is not routinely performed.

Key words - Burnout - Diabetes-related distress - Mental health

Authors Amanda Dudley, Critical Care Nurse; Tiffany Ballentine, Outpatient Surgical Nurse; Tanya Cohn, Associate Professor of Practice and Director of the Doctor of Nursing Practice Program, all at Simmons University, Boston, MA, USA.

      Diabetes-related distress differs from depression as it develops from the mental and emotional burden that comes from the constant management of diabetes. Despite the increased awareness and knowledge of diabetes-related distress, patients with diabetes are not routinely screened during clinic visits. In order to potentially encourage providers to implement the 17-item Diabetes Distress Scale (DDS-17) into practice and clinic appointments with patients, the authors researched and analysed results from voluntary and anonymous participants with diabetes, aged 18 years and older, who completed demographic survey questions and the DDS-17. The results revealed that areas of statistically significant distress can be found in people recently diagnosed with diabetes and occurs more often in those with type 1 diabetes compared with type 2 diabetes.

MARGARET SNEDDON Chair, British Lymphology Society, Member of Legs Matter Coalition, Hon. Sen Res Fellow, University of Glasgow

SAMANTHA HOLLOWAY Academic Editor, Wounds UK; Reader, Programme Director, Cardiff University School of Medicine, Cardiff

"...chronic wounds could be considered an additional frailty syndrome based partly on the notion of skin failure"

MWF van Leen is Elderly Care Physician, Ruitersbos, Breda Netherlands;

WIJ van Ratingen is Biometrician, WvR research & development, Neer, Netherlands;

JMGA Schols is Professor of Old Age Medicine, Caphri, Dept. Health Services Research, Maastricht University, Maastricht, Netherlands

      Besides pressure relief by using special support surfaces and repositioning, pressure ulcer guidelines on prevention and treatment nowadays also advise on shear force reduction and regulation of the microclimate by using silk-like mattress covers instead of cotton covers. Skincair® (Sense Textile), a newly developed breathable silk-like, 3-layer ventilating mattress sheet, reduces shear forces and is able to absorb excess fluid, which may result in better self-repositioning in bed, reduced nursing repositioning support and enhanced pressure ulcer (PU) prevention. Moreover, reducing the amount of fluid and improving the microclimate may result in lesser damage of the skin overall. A total of 112 residents of eight nursing homes at risk of PU development, participated in a 12-weeks observational study. Residents were selected, based on the following criteria: age >65 year, Braden score <18, laying on standard cotton mattress cover around a preventive mattress and need of nursing support for repositioning. During the first 6 weeks, all 112 residents laid on the cotton sheet (control period) and during the second 6 weeks all residents laid on the new 3-layer ventilating mattress sheet (intervention period) while receiving care as usual. There were no mattress changes during this 12-week period. On the cotton sheet all residents were unable to perform self-repositioning in bed and, therefore, needed nursing support for repositioning. At the end of the 6 weeks intervention period, 69.6% of the residents were able to change their position in bed without nursing support, implicating that the requirement of nursing support for repositioning decreased significantly. The development of pressure ulcers (PUs) was also monitored. In the control period, when residents were laying on the cotton sheet, 22 residents developed 41 PUs (category 2). In the intervention period, two residents developed a category 2 PU and one resident showed deterioration of a category 2 into a category 3 PU. This study showed that the use of the new breathable silk-like, 3-layer ventilating mattress sheet, which acts as the direct patient interface, improved self-repositioning of patients in bed and led to less need for nursing support during repositioning. Moreover, a lower PU incidence was observed.