Endocrine Abstracts

Background: There are a variety of growth hormone delivery devices (GHDD) available to children requiring growth hormone (GH) therapy. Many paediatric endocrine nurses can offer patients and their families a choice of the products that are available, which can sometimes be overwhelming. However, factors such a licenced clinical indications have to be considered, as well as cost. This study explored nurses viewpoints on GHDD.

Aim: The purpose of this project was to explore whether other factors should be considered when exploring choice of GHDD.

Methods: Participating nurses (N=10) attended an interactive training session on all of the GHDD. Subsequently, each nurse was given a box of marketing materials for each GHDD, including training materials, patient information literature and DVDs. The nurses were given five case study scenarios on different conditions, and were advised to work in pairs. In their groups, the nurses were asked to feed back on their choice of GHDD, detailing why they had chosen that specific device, utilising a problem based learning approach. Themes were extrapolated using thematic analysis.

Results: Nurses had a variety of devices to choose from (N=11): three groups had chosen different devices (N=3) apart from two groups had chosen the same device. Influencing themes that emerged included: knowledge of patients learning difficulties, social and housing implications, child’s body composition, child friendly device design, and ease of use. Cost was also discussed, but was not the deciding factor for a final decision.

Conclusions: Themes that emerged from the study demonstrate that the nurses’ clinical judgement and prior knowledge of the patient’s needs is an intrinsic factor to consider when implementing patient choice in GHDD.

Clinical Implications: Further research needs to be conducted on a larger scale to examine nurses’ thoughts and opinions on the different GHDDs available, and the need to remain conscious of underlying issues which may not be obvious or apparent to the child and family. From this, a reduced number of choice of devices can therefore be demonstrated to children and their families, thereby giving the nurse more time to focus on the most appropriate devices.