Endocrine Abstracts

Background: Patients and carers encounter a range of diabetes multi-disciplinary team (MDT) members. Patients in focus groups have indicated that nurses are more approachable than doctors¹, and the presence of specialist nurses in the MDT improves glycaemic control². Nurses are perceived to be the core providers of diabetes care but this has not been quantified, nor have the perceived roles of other members of the MDT been explored.

Methods: In June 2019, an online survey was sent to the primary contact of all children with diabetes in our centre. The ten-question survey examined the influence of different MDT members and the perceived roles of each member.

Results: Of 82 returned surveys, most (87%) were completed by a carer and 11% by the child with diabetes (2% unanswered). Specialist nurses were reported to be the most frequent point of contact by 95% of participants overall, but among patient participants 22% reported the doctor as the most frequent contact. When listing MDT members, nurses (98%), doctors (77%), dietitians (51%), and psychologists (34%) were most frequently named. Nurses were described as the most important source of support (85%) and help with diabetes control (73%). In the descriptive section, participants had a varied understanding of the role of administrators, dietitians, and psychologists. Specialist nurses were strongly associated with being a first point of contact, helping with day to day issues, and ‘advice,’ ‘support’ and ‘help’ were frequently used to describe their role. Doctors were associated with ‘control,’ ‘targets,’ and ‘HbA1c’ as well as oversight, maintenance, and monitoring.

Discussion: This is the first quantitative data confirming that participants perceive nurses to be of primary importance in the MDT, despite some fluidity between the roles of doctor and nurse in practice. Disappointingly, administrators, dietitians, and psychologists were less often listed as core members of the MDT and diabetes teams should work to actively promote their role. In addition, these results emphasise the continued need for medical staff to consider their patients holistically and work in partnership with them.

References

1. Hawthorne et al. The experiences of children…Diabetic Medicine.2011 Sep; 28(9): 1103–1108.

2. O’Hagan et al. Glycemic control…Diabetes Care.2010 Aug 1; 33(8): 1724–1726.