The Development of a Standardized Framework for Primary Nurse Specialists in Diabetes Care in China: A Delphi Study

10.1097/jnr.0000000000000330

Qiuling XING；Mingxia ZHANG；Fang ZHAO；Yingxia ZHOU；Yongzhen MO；Li YUAN

primary nurse specialists in diabetes care ； core competence ； systematic framework ； index weight

The Journal of Nursing Research

27卷6期（2019 / 12 / 01）

1 - 9-005

英文

Background: The number of patients with diabetes has been increasing rapidly according to a 2017 report by the International Diabetes Federation. Diabetes has become one of the most challenging public health problems, and there will be an estimated 143 million patients with diabetes in China by 2035. This puts considerable pressure on nurses who specialize in the care of patients with diabetes in China and increases related social and financial burdens. Clinical practice has proven that strengthening the core competencies of nurses and establishing an evaluation system of core competencies improve both healthcare quality and patient quality of life. However, no core-competence system framework currently addresses the unique characteristics of nurses in China. Purposes: The purpose of this study was to construct a core-competence system framework for primary nurse specialists in diabetes care. Methods: A brainstorming approach was conducted that worked to conceptualize the core competencies of nurse specialists in diabetes care in China. Next, a study group organized this information and conducted a seminar; 50 experts and patients with diabetes were invited to develop the first draft of the framework. Afterward, 50 experts were selected to participate in the Delphi survey. Most indicators were retained after a three-round Delphi process, and the superiority chart was used to determine the weights of the six dimensions. Results: Forty-seven experts completed the consultation. The experts' rate of response ranged from 94% to 100%, the authority coefficient was .91, and the Kendall's coefficients of concordance in Grades 1-3 were .793, .418, and .542, respectively. An increasingly detailed, three-grade system framework was developed, including six first-grade indicators (diabetes professional knowledge, diabetes-related knowledge, communication skills and health education ability, specialized skills, clinical judgment, and specialty development capacity), 23 second-grade indicators, and 87 third-grade indicators. The weights of the six first-grade indicators were .221, .149, .192, .209, .160, and .069, respectively. Conclusions: The core-competence system framework includes six core competencies, which represent the main characteristics of primary nurse specialists in diabetes care who are highly recommended by experts. It is important to keep in mind that this is only a theoretical framework and thus must be further tested in clinical practice settings in China.

1. Wang, R. H.(2017).Psychological care for patients with diabetes-Present and future.The Journal of Nursing Research,25(2),86-89.
   連結：
2. Aljamal, M. S.,Ashcroft, D.,Tully, M. P.(2016).Development of indicators to assess the quality of medicines reconciliation at hospital admission: An e-Delphi study.International Journal of Pharmacy Practice,24(3),209-216.
3. American Association of Diabetes Educators(2011).Competencies for diabetes educators: A companion document to the guidelines for the practice of diabetes education.Chicago, IL:Author.
4. Australian Diabetes Educators Association(2008).National core competencies for credentialled diabetes educators.Canberra, Australia:Author.
5. Bermudez-Tamayo, C.,Besançon, S.,Johri, M.,Assa, S.,Brown, J. B.,Ramaiya, K.(2017).Direct and indirect costs of diabetes mellitus in Mali: A case–control study.PLoS ONE,12(5),e0176128.
6. Cabral, D.,Katz, J. N.,Weinblatt, M. E.,Ting, G.,Avorn, J.,Solomon, D. H.(2005).Development and assessment of indicators of rheumatoid arthritis severity: Results of a Delphi panel.Arthritis and Rheumatism,53(1),61-66.
7. Chan, W. F.,Bond, T. G.,Adamson, B.,Chow, M.(2016).Identifying core competencies of infection control nurse specialists in Hong Kong.Clinical Nurse Specialist,30(1),E1-E9.
8. Douglass, E.,Ruddle, G.(2009).Implementation of the NHS knowledge and skills framework.Nursing Standard,24(1),42-48.
9. Fan, L.,Xi, S. H.(2011)。Study on the construction of core competency evaluation index system for emergency specialized nurses。Chinese Journal of Nursing，46(2)，144-146。
10. Gattinger, H.,Leino-Kilpi, H.,Hantikainen, V.,Köpke, S.,Ott, S.,Senn, B.(2016).Assessing nursing staff's competences in mobility support in nursing-home care: Development and psychometric testing of the Kinaesthetics Competence (KC) observation instrument.BMC Nursing,15(1),65.
11. Gibson, F.,Soanes, L.(2000).The development of clinical competencies for use on a paediatric oncology nursing course using a nominal group technique.Journal of Clinical Nursing,9(3),459-469.
12. Guariguata, L.,Whiting, D. R.,Hambleton, I.,Beagley, J.,Linnenkamp, U.,Shaw, J. E.(2014).Global estimates of diabetes prevalence for 2013 and projections for 2035.Diabetes Research and Clinical Practice,103(2),137-149.
13. Guo, X. H.(2005).Practical medical investigation and analysis techniques.Beijing, China:People's Medical Publishing House.
14. Hicks, D.(2010).Competency in practice: Are you fit for purpose?.Journal of Diabetes Nursing,14,44-46.
15. International Diabetes Federation(2017).IDF diabetes atlas-8th edition.Brussels, Belgium:Author.
16. Kalb, K. A.(2008).Core competencies of nurse educators: Inspiring excellence in nurse educator practice.Nursing Education Perspectives,29(4),217-219.
17. Ogurtsova, K.,da Rocha Fernandes, J. D.,Huang, Y.,Linnenkamp, U.,Guariguata, L.,Cho, N. H.,Makaroff, L. E.(2017).IDF diabetes atlas: Global estimates for the prevalence of diabetes for 2015 and 2040.Diabetes Research and Clinical Practice,128,40-50.
18. Trend, U. K.(2011).An integrated career and competency framework for diabetes nursing.London, England:SB Communications.
19. Whiting, D. R.,Guariguata, L.,Weil, C.,Shaw, J.(2011).IDF diabetes atlas: Global estimates of the prevalence of diabetes for 2011 and 2030.Diabetes Research and Clinical Practice,94(3),311-321.
20. Wu, L. P.(2011).Anhui, China,Anhui Medical University.
21. Xu, Y.,Wang, L.,He, J.,Bi, Y.,Li, M.,Wang, T.,2010 China Noncommunicable Disease Surveillance Group(2013).Prevalence and control of diabetes in Chinese adults.JAMA,310(9),948-959.
22. Yang, W.,Lu, J.,Weng, J.,Jia, W.,Ji, L.,Xiao, J.,China National Diabetes and Metabolic Disorders Study Group(2010).Prevalence of diabetes among men and women in China.The New England Journal of Medicine,362(12),1090-1101.
23. Yao, H.(2012)。Shanghai City, China，The Second Military Medical University。