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Aim: This article presents the results of a systematic review of descriptive cohort studies on the dynamics of glycaemia among adults admitted to hospital with acute stroke., Background: Hyperglycaemia is common among adults admitted to hospital with stroke., Design: Systematic review., Data Sources: A search for descriptive cohort studies published between January 1996-June 2011, was conducted in MEDLINE, PubMed and Embase electronic databases. The search was performed using the terms 'stroke', 'hyperglycaemia' and/or 'glucose' combined and limited to adults and English language publications. Searching of citations from identified studies supplemented the electronic searches., Review Methods: A systematic review was conducted of eight studies, meeting the criteria of: (1) descriptive cohort studies; (2) adults admitted to hospital with acute stroke; and (3) glycaemic status monitored over at least two consecutive days from admission to hospital. The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis standards., Results: The dynamics of glycaemia after stroke has been investigated in seven prospective cohort studies and one retrospective study. The patterns that emerged were persisting normoglycaemia, transient hyperglycaemia, persisting hyperglycaemia and delayed hyperglycaemia. Surges in glycaemia are likely on days 2 and 3 and some adults will not exhibit hyperglycaemia till day 7., Conclusion: Further large cohort studies are required to explore the dynamic of glycaemia after stroke for at least 1 week duration. The timing of formal screening for diabetes mellitus is important, as early screening may overestimate detection rates., (© 2012 Blackwell Publishing Ltd.)

Aim: This article presents the results of a systematic review of randomized controlled trials on the regulation of glycaemia among adults admitted to hospital with acute stroke., Background: Hyperglycaemia is commonly observed in acute stroke. International stroke guidelines recommend that hyperglycaemia is treated after stroke. Nurses have a key role in the monitoring and management of glycaemia., Design: Systematic review., Data Sources: A search for randomized controlled trials was conducted in MEDLINE and PubMed electronic databases, and original papers published between January 1996-June 2011 were identified. The search was performed using the terms 'stroke', 'hyperglycaemia', and 'treatment' combined. Searching of citations from identified studies was also used to supplement electronic searches. The search was limited to adults and English language publications., Review Methods: A systematic review was conducted for eight studies, meeting the inclusion criteria that: (i) insulin protocols were subjected to randomized controlled trial; and that (ii) only adults admitted to hospital with acute stroke were sampled. The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis reporting standards., Results: Intensive insulin therapy regimes have been investigated in a total of eight trials. Intravenous insulin therapy significantly lowers glucose levels when compared with controls but adherence to glucose monitoring and treatment protocols appeared to pose considerable challenge on nurses in routine stroke care. Trials conducted to date have been on poor to sound quality., Conclusion: There is currently no substantive evidence to support aggressive glucose lowering in the acute phase of stroke. Well-conducted, large randomized controlled trials are required., (© 2012 Blackwell Publishing Ltd.)

Aim: This paper is a report of a study to describe nurses' perceptions of decision-making and the evidence base for the initiation of insulin therapy., Background: Several theoretical perspectives and professional's attributes underpin decision-making to commence insulin therapy. The management of type 2 diabetes is moving from secondary to primary care and this affects how clinical decisions are made, by whom and the evidence base for these decisions., Method: A postal survey was conducted with a stratified sample of 3478 Diabetes Specialist Nurses and Practice Nurses with a special interest in diabetes across the four countries of the United Kingdom. A total of 1310 valid responses were returned, giving a response rate of 37.7%. The questionnaire was designed for the study and pilot-tested before use. Responses were given using Likert-type scales. Data were collected during 2005 and 2006, and one reminder was sent., Results: People with diabetes are seen as having little influence in decision-making. Consultant physicians appear to be influential in most decisions, and the nursing groups held varying perceptions of who made clinical decisions. Nurses' identified different responsibilities for those working solely in secondary care from those working in both community and secondary care. Practice nurses were not as involved as anticipated., Conclusion: Nurses working with people with diabetes need to encourage them to become more active partners in care. Clinical guidelines can assist in decision-making where nurses are least experienced in initiating insulin therapy.

Aim of the Study: The aim of this study is to adapt an instrument suitable for assessment of the informational needs of men with prostate cancer., Background: In recent years prostate cancer has become an important public health problem world-wide with considerable social and economic consequences. It is reported that it is the most common cancer affecting British men, with an average lifetime risk of occurrence of one in twelve., Design/methods: Methodological research was conducted to develop an instrument to assess the informational needs of men with prostate cancer on hormonal manipulation therapy (HMT) regarding their disease and treatment. The Toronto Informational Needs Questionnaire (TINQ-BC) (Galloway et al. 1997) was modified for use with this client group and was applied to a sample of 90 men generated from three urology centres in Northern Ireland., Results/findings: Construct and content validity of the instrument was established. Internal consistency reliability using Cronbach's alpha was calculated and found to be satisfactory (0.92). Using confirmatory factor analysis, factor loadings ranging from 0.37 to 0.90 were obtained and considered satisfactory. The subsections of the TINQ-BC categorized as Disease, Investigative tests, Treatment, Psychosocial and Physical needs were confirmed as individual factors. These results indicate that this instrument can be validly applied to this client group. As the instrument was initially developed in Canada and successfully used in the United Kingdom (UK), it is suggested that this instrument also has the potential for cross-cultural application. It has the potential to be used as a clinical reference instrument to assess the informational needs of this patient group. Health care professionals must be aware of the domains of information that these men perceive important so that educational interventions can be accurately and appropriately planned.

Aims of the Study: The aim of this study was to identify the job title, work setting, qualifications and training of the paediatric diabetes specialist nurse (PDSN) as well as to examine the composition of the multidisciplinary diabetes team. It also aimed to determine who is involved in diabetes education and to explore the teaching methods, approaches, tools and materials that the PDSN uses in the educational process., Design and Methods: A survey design was used. Questionnaires, which combined quantitative and qualitative approaches, were sent to 80 participants from eight opportunistically selected regions of the United Kingdom (UK). Access to names and addresses was gained through the directory of diabetes specialist nurses (DSNs). The selection criteria were nurses working full-time with children with diabetes or having children with diabetes on their caseloads. The overall response rate was 66 (82.5%)., Findings: The study findings showed that the majority of the respondents were based in both hospital and community, held paediatric qualifications and had undertaken further training to prepare as diabetes specialists. Respondents used a wide range of teaching methods and materials in the educational process. A substantial number of individuals and voluntary organizations were also involved in diabetes education., Conclusions: The findings of this study support the belief that the PDSN, as a member of the multidisciplinary paediatric diabetes team, has a key role in the education of children with diabetes and their parents/carers. However, the importance of the team approach as a whole should not be underestimated.

This study investigated the influence of a number of psychological factors upon the practice and outcome of diabetic self-management among young adults with insulin-dependent diabetes mellitus. Health beliefs, perception of control and knowledge were assessed by scales and questionnaires and glycosylated haemoglobin results and clinic attendance records obtained for 263 patients. The results demonstrated that the sample members perceived that they were responsible for the control of their diabetes, that the benefits of following treatment were greater than any barriers and that they were knowledgeable about their diabetes. However, these factors were not predictive of the outcome variables of metabolic control or clinic attendance according to multiple regression analysis. Implications of these results for nursing practice and for future research are discussed.

This paper is borne of the increasing interest and relevance of computers in nursing. It describes the method, and results obtained from a postal questionnaire survey distributed across the United Kingdom to gain information about the developments in computing in nursing education. The results indicate that considerable developments have been made, but that they are more piecemeal than co-ordinated. A selection of the results are presented and discussed, and one or two points concerning future proceedings are raised.

This paper describes an introductory computer course designed for student nurses facing a career in nursing in which computers will play a major part. Questionnaires were given before and after the course. The purpose of the questionnaires were (a) initially to gain information about the students' previous computing experience, motivation and expectations of the course, and (b) to enable an evaluation to be undertaken. The course content, structure and results of the questionnaires are presented; modifications made to the course following the evaluation are mentioned and finally some of the issues which need to be considered when developing a computer course for nurses are raised.