Name: Florence Sharkey @FloSharkey
Scholarship type: FNF Research Scholarship 2019-2023 (extended)
Publication title: Managing diabetes and dementia, a challenging duo: a scoping review. Practical Diabetes Career Journey
Publication link (open access): https://wchh.onlinelibrary.wiley.com/doi/10.1002/pdi.2469
This paper aims to describe experiences and challenges when managing diabetes along with dementia from the perspectives of those living with these conditions, their informal carers and health care professionals.
The scoping review included studies published within the last 10 years (2012–2022) from EBSCO Research Databases: CINAHL, Health Business, Soc Index, ERIC, Medline, Information Science & Technology Abstracts and a review of reference lists. Three hundred and fifty-six papers were identified of which 11 studies met the inclusion criteria that focused on the experiences of managing the comorbidities of diabetes and dementia.
Six papers focused on the implications of those individuals diagnosed with both conditions, four on implications for their informal carers (unpaid), two included both the individuals and their informal carers. There was one study that reported experiences of health care professionals.
Individuals faced extraordinary challenges managing both conditions to perform activities of self-care such as taking medications, monitoring glucose levels, healthy eating, exercising and attending appointments. Informal carers reported that caring for both conditions was burdensome, sometimes overwhelming and they wanted more support from family and patients health care providers.
This scoping review revealed that many individuals and their informal carers were struggling with the impact of these comorbid conditions. Challenges such as lack of information and support were evident but there were few examples of solutions to improve diabetes management in those with dementia. To provide holistic care we need to integrate knowledge and skills from the areas of diabetes, mental health and social care. There is very little information relating to the experiences of health care professionals who work with those living with these conditions.
What I learned, and the support I got, through the FNF Scholarship has added to my knowledge base and helped to develop my role as Principal Investigator on the scoping review and to develop my leadership skills. Some of the key things the Scholarship provided me with were: an enhanced understanding of engaging and participating with key stakeholders within the Trust and externally with university colleagues in collaborating with the development of the project; an enhanced understanding of critical reading of the research literature, study design, data collection and analysis and interpreting data, writing up a report of the project and publishing; and learning how to apply qualitative/quantitative research methods.
It also taught me the importance of sharing ideas and learning with other colleagues internally and externally; and ensured that I completed Research Governance processes, reflecting on my own experience during the process, as a part of the process.
And it supported me in applying new knowledge and skills in Research and Quality Improvement to benefit others in supporting further projects in partnership with Trusts and universities.
The publication process remained daunting, even though I had some experience. However this time I was the lead for the academic study. To understand more about the publication process I attended an FNF webinar on ‘Writing for Publication’ which was helpful. I learnt the importance of choosing a journal that is relevant to my topic and following the journal guidance; and reaching out to the editor when I was unsure, was beneficial. Collaborating with my Scholarship mentor, Professor Vivien Coates (Nursing and Practice Research, Ulster University), has provided me with a deeper understanding of the publication process and dealing with rejection when my paper was initially not accepted by a journal. The importance of staying focused and remembering ‘what is the story I want to tell’.
When the paper was published, I had a feeling of accomplishment, a burst of joy in realisation that my hard work was worthy in this field of existing research. I was elated.
Based on the literature findings, I was inspired to write a second paper which has now been accepted for publication: ‘The challenges and successes of managing diabetes mellitus and dementia: a nursing overview’.
Following the first publication on the scoping review, I have been contacted by international conference organisers to present. September 2023, I presented a poster presentation at the Early Career Researcher Showcase Event at Coleraine Campus, Ulster University, Northern Ireland and at the Palliative Care Research Forum Northern Ireland Conference, ‘Living for Today, Planning for Tomorrow’, Stormont Hotel, Belfast in which I was awarded Poster Competition Prize.
I have applied for further funding to promote implementation so the publications are not the end of this story.
Ideally the review will provide sufficient preliminary data to inform a robust PhD proposal. Although it is a small-scale study, I would want to deliver a project that has the potential to improve the experiences of those with dementia and diabetes and their informal carers.
Florence is a Lecturer at the School of Nursing and Paramedic Science at Ulster University. She is originally from County Galway in Ireland and from a nursing family, with her sister and brother also going into nursing.
After undertaking her nurse training in England she worked in various roles, later focusing on providing palliative care in both a hospital and then a community setting. She then moved to Northern Ireland working first in palliative care and later as a Practice Education Facilitator implementing Nursing and Midwifery Council Standards to Support Learning and Assessment in Practice and as an Associate Lecturer with Open University and Lead Nurse for Research and Development, Western Health & Social Care Trust.
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