The Effect of Telenursing on the Pain and Fear of Insulin Injection
Condition: Nurse's Role
Study type: Interventional

Summary: 
      Aim: The aim of the study is to examine the effects of nursing follow-up with telenursing on
      the pain and fear factors related to self-injection testing in diabetic individuals who are
      started on insulin therapy for the first time.

      Materials and Methods: The research was implemented in a randomized controlled experimental
      design. The sample consisted of 70 individuals with diabetes who started insulin therapy for
      the first time in the diabetes polyclinic of a state university hospital in Istanbul between
      17 February and 15 November 2022. Individuals who will start insulin therapy for the first
      time are directed to the diabetes polyclinic. Insulin Injection Application to all patients
      in the diabetes polyclinic. In line with the Patient Education Content, the ability to
      administer insulin, the ability to monitor blood glucose levels, medical nutrition therapy,
      exercise, etc. applied after the training given on the subjects. Data were collected with the
      Patient Information Form, Diabetic Self-Injection and Fear of Testing Questionnaire Form
      (D-SFIQ), Insulin Injection Evaluation Form. Patients assigned to the intervention group were
      given telehealth service for three days for fear of self-injection and testing.
    

Detailed description: 
      The sample of the study consisted of 70 patients who met the inclusion criteria and agreed to
      participate. Insulin therapy was evaluated according to the inclusion criteria and those who
      agreed to participate in the study. 19 doctors and 2 nurses work in the diabetes polyclinic.
      Individuals who will start insulin therapy for the first time after a doctor's examination
      are referred to the diabetes polyclinic. The history of the patients who come to the diabetes
      polyclinic is taken by the diabetes nurse and their physical examination is performed. In the
      diabetes polyclinic, all patients are taught by the diabetes education nurse, the ability to
      administer insulin, the ability to monitor blood glucose levels, medical nutrition therapy,
      exercise, etc. subjects are taught. After the training, the patients are called for control
      seven days later. However, a nursing follow-up is not applied during this process until it
      comes to control again. In our study, all patients were given training on insulin
      administration and testing by subcutaneous route using the Insulin Injection Application
      Patient Education Content, accompanied by a diabetes polyclinic nurse. In line with the
      content of the training, it was applied in the form of explaining to all patients with the
      subcutaneous injection application model, answering the questions of the patients or their
      relatives with the question-answer method, monitoring the patient while practicing on the
      model by the researcher, and repeating the training in line with the needs. After the
      training, all patients who accepted to participate in the study were recorded with the
      Patient Information Form, as well as their individual characteristics and information about
      the disease and treatment characteristics. D-FISQ was applied by the face-to-face interview
      method. The application of the study was continued according to the groups to which they were
      assigned by randomization (Figure 3.1).

      Experimental group intervention Patients who were randomly assigned to the intervention group
      were informed about the method of the study. The patient was informed that participant would
      be called before blood glucose measurement and insulin injection for three days to monitor
      his fear of self-injection and testing. Insulin injection application training was repeated
      on the first day. Telephone calls made within the scope of tele-health service were recorded
      in the Telephone Interview Form. During the phone interviews, the questions that the patients
      wanted to ask were answered. The topics that the patients most frequently asked for support
      are listed in Table 1. The participant was asked to fill in the Insulin Injection Evaluation
      Form according to his experience during the three-day home treatment process. At the end of
      the three-day meeting, the tele-health service was terminated. D-FISQ was repeated to the
      patients when they came to the hospital for control.

      Control group intervention Patients who were randomly assigned to the control group were
      informed about the method of the study. Telehealth service in the control group was not
      applied. The participant was asked to fill in the Insulin Injection Evaluation Form according
      to his experience during the three-day home treatment process. D-FISQ was repeated to the
      patients when they came to the hospital for control.
    

Intervention name(s): Telenursing
Intervention type(s): Other
Intervention description(s): Patients who were randomly assigned to the intervention group were informed about the method of the study. The patient was informed that he would be called before blood glucose measurement and insulin injection for three days to monitor his fear of self-injection and testing. Insulin injection application training was repeated on the first day. Telephone calls made within the scope of tele-health service were recorded in the Telephone Interview Form. During the phone interviews, the questions that the patients wanted to ask were answered. He was asked to fill in the Insulin Injection Evaluation Form according to his experience during the three-day home treatment process. At the end of the three-day meeting, the tele-health service was terminated.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: telenursing, diabetes, pain, fear