DIABETES

Telecoaching programme for type 2

diabetes control: a randomised
clinical trial
Hérica Cristina Alves de Vasconcelos, José Claudio Garcia Lira Neto, Márcio Flávio
Moura de Araújo, Gerdane Celene Nunes Carvalho, Carla Regina de Souza Teixeira,
Roberto Wagner Júnior Freire de Freitas, Marta Maria Coelho Damasceno

T
he epidemic of type 2 diabetes and the traditional
model for managing this disease are proving costly ABSTRACT
and time consuming for health professionals, as Background: people with diabetes have a high risk of developing micro and
well as being ineffective, especially because of the macrovascular complications that increase treatment costs and shorten
therapeutic inertia that may result in a reluctance life expectancy. Telecoaching programmes can improve short-term control
on the part of both patients and professionals to change or to of diabetes and reduce disease burden. Aims: to analyse the effect of a
progress with established treatment (Wild et al, 2016). In this health telecoaching programme in the control of type 2 diabetes. Methods:
regard, interventions aided by health-related technologies that a pragmatic clinical trial was carried out. Thirty-one patients with type 2
use ‘telehealth’ have been highlighted as an economical and diabetes were divided into control and intervention groups. The control group
effective alternative for controlling the disease, which involves received usual nursing care, and those in the intervention group received
clinical and laboratory conditions (Wayne et al, 2015). usual care and telecoaching for 24 weeks. Findings: the intervention group
Understood as the remote provision of interactive diagnostic improved: measurements of abdominal circumference, systolic and diastolic
and consultation services, telehealth can be provided using blood pressure and body mass index; variables related to glycaemic control
a variety of systems for the long-term management and (fasting venous glucose and glycated haemoglobin/HbA1c); and high-density
control of type 2 diabetes. The best known of these are web lipoprotein levels. Conclusion: the data indicate that telecoaching is an
conferencing, text messaging (SMS) and coaching via telephone effective tool for diabetes management. It is recommended that the study
calls (telecoaching). Used in different scenarios, telecoaching should be developed to include more people and run over the long term.
aims to support changes in health behaviour that are aligned Key words: Diabetes  ■ Telecoaching  ■ Telehealth ■ Patient support
with self-determined targets to reduce complications as well
as long-term physical and mental problems associated with the
disease (Odnoletkova et al, 2016a; Oskman et al, 2017).
Studies into telecoaching for glycaemic control in type 2 diabetes
have reported divergent findings, so there is no consensus nor a
sufficient level of evidence to indicate whether this strategy lowers
Hérica Cristina Alves de Vasconcelos, Department of Nursing,
blood glucose levels significantly, aiding in the metabolic control of Federal University of Ceará, Fortaleza, Ceará, Brazil
the disease and, consequently, reducing possible complications that
José Claudio Garcia Lira Neto, Department of Nursing, Federal
the disease can cause over time (Wayne and Ritvo, 2014; McGloin
University of Ceará, Fortaleza, Ceará, Brazil
et al, 2015; Quinn et al, 2016; Oskman et al, 2017).
Moreover, in Brazil—a country the size of a continent with Márcio Flávio Moura de Araújo, Department of Nursing,
University of International Integration of Afro-Brazilian Lusophony,
widespread social and economic problems—there is a clear lack
Redenção, Ceará, Brazil
of studies regarding the use of telecoaching in the metabolic
control of type 2 diabetes. In addition, telecoaching in the Gerdane Celene Nunes Carvalho, Department of Nursing, Federal
University of Ceará, Fortaleza, Ceará, Brazil
north-east region of Brazil, which has a high prevalence of
diabetes, has not yet been described in the literature. Carla Regina de Souza Teixeira, Department of Nursing,
The aim of this study was to analyse the effects of a health University of São Paulo, Ribeirão Preto, São Paulo, Brazil
coaching programme, provided via telephone, in the clinical Roberto Wagner Júnior Freire de Freitas, Department of Family
© 2018 MA Healthcare Ltd

and laboratory control of people with type 2 diabetes. Health, Oswaldo Cruz Foundation, Fortaleza, Ceará, Brazil
Marta Maria Coelho Damasceno, Department of Nursing,
Method Federal University of Ceará, Fortaleza, Ceará, Brazil
This was a pilot study, a randomised and pragmatic clinical trial, Accepted for publication: September 2018
conducted with adults of both sexes with type 2 diabetes, treated

British Journal of Nursing, 2018, Vol 27, No 191115

 at a primary healthcare unit (PHCU) in the city of Fortaleza Among the main reasons for participants leaving the study
in Brazil. The study was carried out from October 2013 to were: missing three appointments to collect samples for
May 2014. The study was approved by the Human Research laboratory analysis; incorrect telephone number provided; and
Ethics Committee of the Federal University of Ceará (opinion telephone calls unanswered after three attempts.
report 255.646) and is registered on the Brazilian Clinical Trials The control group received only routine care according
Registry Platform (TRIAL: RBR-29GJ42). to the institution’s protocol provided by the PHCU’s doctors
The PHCU was selected because it serves a significant number and nurses. The intervention group, in turn, was composed of
of people with diabetes, in addition to being a main primary patients who, in addition to routine care, received a programme
care centre. At the time of the study, it served a population of of guidance/coaching on the disease via telephone calls made
600 adults with type 2 diabetes. After the sampling calculation by a researcher nurse. The telephone calls were designed to
for pilot studies, 120 people were approached to take part. provide guidance, motivate individuals and encourage them to
Individuals were recruited during nursing consultations for adhere to the therapeutic regimen for the disease.
people with diabetes. Although 84 people agreed to take part Twelve biweekly telephone contacts were made over a period
in the study, only 31 completed all stages of the study, which is of 24 weeks, addressing topics related to: the pathophysiology
the final [Link], 15 were randomised to the control of the disease, the main types of diabetes, the action of drugs
group, and 16 to the intervention group (Figure 1). used, insulin therapy, the need to promote healthy eating habits,
The following patients were considered eligible for the study: the benefits of regular physical activity, and foot care to prevent
those who have had type 2 diabetes for at least one year; are ulcers. Guidance on the main complications and how to manage
literate; are aged 18 years or over; had a telephone number several of them was also provided. All guidance was based on
(landline or mobile); and were able to attend the face-to-face scientific evidence, and no changes in medication were made
stages of the study. Those who had had limb amputations or with any of the participants.
reported renal insufficiency, blindness, severe cardiovascular Therapeutic communication strategies were used, such as
disease or uncontrolled hypertension were excluded. knowing how to listen, speaking when necessary, providing
openings for patients to ask questions, showing respect and
interest, and allowing enough time in the conversation to
Calculated sample maintain the patient’s attention to what was being discussed
108 participants and subsequent follow-up on the proposed plan.
54 CG/54 IG
Anthropometric, clinical or laboratory data were measured
Increase of 10% three times. The first time was at initial patient contact in the
119 participants PHCU, after they had signed the consent form to participate in
59 CG/60 IG the research, to have a baseline for future comparisons during
6 months
of recruitment and after the [Link] second set of measurements were
84 participants made in the 12th week, and the third after the intervention, in
(70% of the sample) the 24th week. Face-to-face contact was scheduled for a new
Measurement of anthropometric
and laboratory data anthropometric measurements, blood pressure measurements
48 excluded participants and blood sample collection for laboratory testing. Different
36 participants dates were scheduled for individuals in both groups to avoid
Randomised
any contact bias between participants. Each patient was given
(36 participants) three opportunities to attend each of the face-to-face stages, and
anyone who failed to show up for any of the three scheduled
appointments was discontinued from the research. Measurements
were made by nurses during the nursing appointment.
18 participants 18 participants
The anthropometric data were: weight and height for
CG IG
calculating body mass index (BMI) (Pereira et al, 2014);
abdominal circumference (AC) (International Diabetes
Intervention
Federation, 2005; Figueiredo et al, 2008); waist and hip
12 calls in 24 weeks
circumference to determine waist-hip ratio (WHR) (World
Health Organization, 2000). Blood pressure was measured,
Measurement of anthropometric and laboratory and values of systolic blood pressure (SBP) >130 mmHg and
and other data collection
diastolic blood pressure (DBP) >80 mmHg were considered
high (Brazilian Cardiology Society, 2010; Brazilian Diabetes
15 participants 16 participants Key Society (BDS), 2014). Laboratory tests included: fasting venous
© 2018 MA Healthcare Ltd

CG IG CG: control group glucose (FVG), glycated haemoglobin (HbA1c), total cholesterol
IG: intervention group (TC), low-density lipoprotein (LDL), high-density lipoprotein
Final sample – 31 participants (HDL), and triglycerides (TGL).
To determine the values of FVG, HbA1c, TC, LDL, HDL
Figure 1. Flowchart of participants involved in the study and TGL, a venous blood sample was collected by a trained

1116 British Journal of Nursing, 2018, Vol 27, No 19

 DIABETES

employee belonging to a company contracted exclusively for Table 1. Demographic characteristics

laboratory collections and biochemical analyses.A blood sample
was taken, of which 4 ml was used for the HbA1c test and 3.5 ml CG (n=15) IG (n=16)
Sociodemographic variables p
for serum gel testing. The methods used for the analysis were: n % n %
hexokinase for FVG; high-performance liquid chromatography
Sex
for HbA1c; and enzymatic colorimetric for TC, LDL, HDL and
TGL. The patients were instructed to fast for 12 hours before Female 10 41.7 14 58.3 0.220*
the appointment at the PHCU.
Male 5 71.4 2 28.6
Regarding laboratory tests, reference values recommended
by the BDS (2014) were used. Accordingly, the following Education
were classified as high: FVG>7.21 mmol/litre; HbA1c≥7%; Elementary school 9 47.3 10 52.7
TC≥5.17  mmol/litre; LDL≥2.586  mmol/litre; and
Secondary school 5 50.0 5 50.0 0.990†
TGL≥ 1.693 mmol/litre. For HDL, values ≤1.163 mmol/litre
were considered inadequate. Higher education 1 50.0 1 50.0
The statistical measures of frequency, mean and standard
Marital status
deviation were calculated. Comparisons of means before and
after were performed using Student’s t-tests for paired data. Married 5 35.8 9 64.2
The association analysis between independent variables was Single 3 75.0 1 25.0
performed using the non-parametric c2 tests and the Fisher-
Widower 3 60.0 2 20.0 0.667†
Freeman-Halton exact test, and the association between
dependent variables by McNemar’s test. Inferential analyses Civil union 2 50.0 2 50.0
with values of p<0.05 were considered statistically significant.
Divorced 2 50.0 2 50.0
The data were processed using SPSS software 20.0.
With whom the participant lives
Results Children 3 42.9 4 57.1
The study was completed by 31 participants, of whom 15 were
Other family members 4 80.0 1 20.0
in the control group and 16 in the intervention group. Ages
were in the range of 44–85 years, with means of 59.6 years Domestic partner 4 33.3 8 66.7
(control group) and 60.9 years (intervention group). Table 1 0.272†
Alone 1 100.0 – –
shows the sociodemographic characteristics of the participants.
Regarding the disease, patients in the control group had lived Children and domestic partner 3 60.0 2 40.0
with it for 1–20 years, with a mean time of 8.67 years (SD=6.39). Other family members and domestic partner – – 1 100.0
In the intervention group, the range of time since diagnosis
Economic class
was 1–20 years, with a mean period of 10 years (SD=8.48).
Oral antidiabetic drugs were the predominant treatment in B1 1 100.0 – –
both groups.
B2 2 40.0 3 60.0
Table 2 shows the intra- and inter-group comparisons (mixed
effects) of the means of the variables BMI,AC,WHR, SBP and C1 2 28.6 5 71.4 0.522†
DBP. The intra-group analysis was performed using Student’s C2 7 58.3 5 41.7
t-test for paired data, while Student’s t-test for independent
data was used for the inter-group analysis. D 3 16.6 3 16.6
*Fisher’sexact test, †Likelihood ratio test
Discussion CG: control group, IG: intervention group

In this study, the effect of a telecoaching programme on the

clinical and laboratory control of people with type 2 diabetes group (p=0.03), and HbA1c in the control group/intervention
was [Link] results showed that participants who received group (p=0.048/p=0.052) were significant.
telecoaching during the 24-week study improved their Studies with similar aims have shown that telecoaching
measurements of AC (98.56 to 95.75; p=0.001), SBP (130.25 provides a rapid improvement in the blood sugar levels of
to 125.87; p=0.171), DBP (72.12 to 71.12; p=0.640) and BMI people with type 2 diabetes, and suggested that because of the
(29.99 to 29.96; p=0.764). They also saw improvements in connectivity established between patients and the healthcare
variables related to glycaemic control: FVG (7.925 to 7.162; provider by using the telephone, there is a greater adoption
p=0.378) and HbA1c (8.0 to 7.21; p=0.052), as well as in HDL of healthy behaviours that boost proper control of the disease,
© 2018 MA Healthcare Ltd

(1.165 to 1.191; p=0.59). with specific benefits to cost savings and significant results for
Despite the variety of the results, it was possible to show people’s quality of life (Wayne et al, 2015; Oksman et al, 2017;
that only changes in BMI in the control group (p=0.014), AC Walker et al, 2017).
in the intervention group (p=0.001), SBP in the control group A randomised clinical trial conducted in Belgium, which
(p=0.042), SBP in both the control group and the intervention sought to analyse the cost-effectiveness of a nurse’s coaching

British Journal of Nursing, 2018, Vol 27, No 191117

 Table 2. Intra-group and inter-group comparison of the means of the variables body mass index, abdominal circumference, waist–hip ratio
and systolic and diastolic blood pressure
Intra- and BMI AC WHR SBP DBP
inter-group
comparison Mean SD p Mean SD p Mean SD p Mean SD p Mean SD p

CG before 29.87 5.25 99.46 15.15 0.87 0.89 137.24 22.72 77.22 9.99
0.014 0.151 0.591 0.042 0.649
CG after 30.23 5.29 101.86 11.46 0.88 0.52 141.06 23.66 76.4 8.88

IG before 29.99 5.82 98.56 11.94 0.87 0.73 130.25 19.51 72.12 8.21
0.764 0.001 0.182 0.171 0.640
IG after 29.96 6.04 95.75 13.06 0.88 0.64 125.87 13.94 71.12 8.42

CG before 29.87 5.25 99.46 15.15 0.87 0.89 137.24 22.72 77.22 9.99
0.95 0.86 0.91 0.36 0.13
IG before 29.99 5.82 98.56 11.94 0.87 0.73 130.25 19.51 72.12 8.21

CG after 30.23 5.29 101.86 11.46 0.88 0.52 141.06 23.66 76.40 8.88
0.92 0.17 0.96 0.03 0.10
IG after 29.96 6.04 95.75 13.06 0.88 0.64 125.87 13.94 71.12 8.42

CG: control group, IG: intervention group, SD: standard deviation

Table 3. Intra-group and inter-group comparison of averages of laboratory data* regarding the control of type 2 diabetes
Intra- and FVG HbA1c TGL TC LDL HDL
inter-group
comparison Mean SD p Mean SD p Mean SD p Mean SD p Mean SD p Mean SD p

CG before 6.274 2.328 6.9 1.31 1.923 0.944 4.766 1.237 2.796 0.905 1.151 0.265
0.705 0.048 0.90 0.42 0.30 0.98
CG after 6.656 2.728 7.33 1.73 1.892 1.044 4.489 1.126 2.604 0.787 1.149 0.327

IG before 7.925 3.491 8.0 2.14 1.566 0.703 4.396 1.485 2.511 1.158 1.165 0.287
0.378 0.052 0.11 0.46 0.90 0.59
IG after 7.162 2.421 7.21 1.19 1.831 0.815 4.562 1.171 2.530 0.926 1.191 0.280

CG before 6.274 2.328 6.9 1.31 1.923 0.944 4.766 1.237 2.796 0.905 1.151 0.265
0.13 0.09 0.23 0.45 0.46 0.89
IG before 7.925 3.491 8.0 2.14 1.566 0.703 4.396 1.485 2.511 1.158 1.165 0.287

CG after 6.656 2.728 7.33 1.73 1.892 1.044 4.489 1.126 2.604 0.787 1.149 0.327
0.59 0.82 0.85 0.86 0.82 0.72
IG after 7.162 2.421 7.21 1.19 1.831 0.815 4.562 1.171 2.530 0.926 1.191 0.280

*Fasting venous glucose, glycated haemoglobin, triglycerides, total cholesterol, low-density lipoprotein and high-density lipoprotein
CG: control group, IG: intervention group, SD: standard deviation

programme for diabetes, showed that such intervention is highly Regarding blood pressure, in the intervention group there
cost-effective and significantly improves the quality of life of were reductions in the mean of both SBP and DBP after the
people with poorly controlled type 2 diabetes (Odnoletkova et al, telephone contacts. Mean SBP in the intervention group showed
2016b). However, despite the results, telecoaching is not supported a decrease of 4.3 mmHg; the decrease in SBP was significantly
everywhere, and the literature still shows the use of telecoaching more in some cases (Nocella et al, 2016).
to support glycaemic control for people with type 2 diabetes is Regarding DBP, although there was also a decrease in
varied (Blackberry et al, 2013; Eakin et al, 2014). the mean in the intervention group, the difference was only
Regarding the anthropometric data associated with the 1 mmHg. Unlike what occurred with SBP, most of the studies
accumulation of fat, the results show that the values of both selected for this discussion found DBP fell (McGloin et al, 2014;
BMI and AC were reduced in the intervention group, in line Odnoletkova et al, 2016c).
with other studies of the same nature (Carallo et al, 2015).The Control of diabetes is related to control of blood pressure
opposite effect was found in a study developed in Iran, which since people with high blood pressure are susceptible to one of
showed an increase in BMI values after 3 months of telecoaching the main comorbidities associated with type 2 diabetes—arterial
(Lashkari et al, 2013). However,WHR, an index of adiposity that hypertension—which increases the rate of complications and
© 2018 MA Healthcare Ltd

predicts cardiometabolic complications and serves as an indicator hospital admissions.

for changes in the glycaemic and lipaemic variables of people Laboratory data analysis showed that, with the exception of
with and without diabetes, showed an increase in the results TC and LDL, all indices (FVG, HbA1c, TGL and HDL) had
of the present study, albeit small (mean 0.87 to 0.88; p=0.182 positive results, indicating the benefits the 24-week telecoaching
in the intervention group and p=0.591 in the control group). intervention for managing type 2 diabetes. Studies on this

1118 British Journal of Nursing, 2018, Vol 27, No 19

 DIABETES

subject have targeted glycaemic control, leaving aside modifiable

factors related to type 2 diabetes, such as the lipid profile. KEY POINTS
A study conducted in Norway with an objective similar ■■ Interventions aided by health-related technologies such as telehealth can
to that of this study, with 120 patients monitored for 1 year, be an economical and effective alternative for controlling disease.
showed reductions in HbA1c and weight, and found that older ■■ Telehealth can be provided through a variety of systems for long-term
people tended to adhere more closely to the guidelines provided management and control of type 2 diabetes, including web conferencing,
by telecoaching (Holmen et al, 2014). In turn, researchers in text messaging and telecoaching by phone.
Italy found that a programme of telephone interventions with
■■ A telecoaching programme for diabetes provided by a nurse is highly cost-
people with type 2 diabetes who received no other intervention
effective and significantly improves the quality of life of people with poorly
proved to be effective in reducing HbA1c, BMI and LDL
controlled type 2 diabetes.
levels, and was as effective as outpatient [Link] authors
emphasised that, provided in addition to the usual care, the ■■ Telephone interventions are not only effective in controlling metabolic or
telephone intervention programme would achieve maximum weight variables, but are also cost-effective because they reduce outpatient
effects (Carallo et al, 2015). visits, hospital admissions and spending on laboratory tests for monitoring
Other findings in the literature indicate that telecommunication the disease.
tools used in the control of type 2 diabetes show positive results in
the short and long term. Moreover, telephone interventions are
not only effective in controlling metabolic or weight variables, term. This study was carried out by nurses; such practice can
for example, but are also cost-effective by reducing outpatient be increasingly encouraged in this professional class, increasing
visits, hospital admissions and spending on laboratory tests for the scope of nurses’ action to promote the health of people
monitoring the disease (Odnoletkova et al, 2015; 2016b; 2016c). with long-term conditions. BJN
Likewise, the use of telecoaching facilitates the management of
complex groups and reduces the time it takes for practitioners Acknowledgment: we would like to thank the Brazilian National Council
to monitor patients with higher rates of absence from outpatient for Scientific and Technological [Link] study originates from
care (Menon et al, 2017). the doctoral dissertation of Hérica Cristina Alves de Vasconcelos, titled
However, some authors stress that to achieve the success of ‘Control of diabetes mellitus type 2: analysis of an intervention program
telecoaching (and related interventions) in the monitoring of with information on the disease via telephone calls’.
people with type 2 diabetes or other long-term conditions, it is
important to identify the barriers that hinder their application Declaration of interest: HCAV conducted this project as part of her
(Peng et al, 2016). PhD in nursing at the Federal University of Ceará. No competing
Among studies discussed here, some of the most relevant relate interests are declared by other authors.
to individual motivation to follow the guidelines and advice
provided, the perception of short- and long-term improvement Brazilian Cardiology [Link] Brazilian guidelines for hypertension. Arq
Bras Cardiol. 2010; 95(1): 1–51. [Link] (accessed 4
through the achievement of goals and the engagement of the October 2018) [guidelines in Portuguese].
professional or group that accompanies these patients in daily, Brazilian Diabetes Society. Guidelines from the Brazilian Diabetes Society:
2013–2014; 2014. [Link] (accessed 4 October
weekly or monthly care, as well as sharing with family, friends 2018) [guidelines in Portuguese].
or colleagues and the support received by them. Blackberry ID, Furler JS, Best JD et al. Effectiveness of general practice based,
The limitations of the study relate to its nature as a pragmatic practice nurse led telephone coaching on glycaemic control of type 2
diabetes: the Patient Engagement and Coaching for Health (PEACH)
clinical trial and its small sample. pragmatic cluster randomised controlled trial. BMJ. 2013; 347:f5272.
[Link]
Carallo C, Scavelli FB, Cipolla M et al. Management of type 2 diabetes
Conclusions mellitus through telemedicine. PLoS One. 2015; 10(5):e0126858. https://
The results show a reduction in clinical (AC, BMI, SBP and [Link]/10.1371/[Link].0126858
DBP) and laboratory variables (HDL, FVG and HbA1c) in Eakin EG, Winkler EA, Dunstan DW et al. Living well with diabetes: 24-month
outcomes from a randomized trial of telephone-delivered weight loss and
the intervention group. The data indicate that telecoaching is physical activity intervention to improve glycemic control. Diabetes Care.
an effective tool to decrease HbA1c levels, which is important 2014;37(8):2177–2185. [Link]
Figueiredo RC, Franco LJ, Andrade RCG et al, 2008. Obesity and its relationship
in diabetes management. It is recommended that the study with cardiovascular risk factors in a Japanese-Brazilian population. Arq Bras
is developed to include more people and run over the long Endocrinol Metabol. 2008; 52(9):1474–1481 [article in Portuguese]

CPD reflective questions

■■ How would you implement a telecoaching system?
© 2018 MA Healthcare Ltd

■■ Would telecoaching be effective for acute as well as long-term conditions?

■■ What degree of nurse training would be required to implement a telecoaching programme?
■■ How does 1:1 telecoaching compare with group education in terms of cost effectiveness and outcomes?

British Journal of Nursing, 2018, Vol 27, No 191119

 Holmen H, Torbjørnsen A, Wahl AK et al. A mobile health intervention for Optimizing diabetes control in people with type 2 diabetes through
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[Link]/10.2196/mhealth.3882 effectiveness analysis for a tele-based health coaching program for chronic
International Diabetes Federation. 2005. The IDF consensus worldwide disease in primary care. BMC Health Serv Res. 2017; 17(1):138. https://
definition of the metabolic syndrome. Brussels: IDF. [Link] [Link]/10.1186/s12913-017-2088-4
y7kg3ra8 (accessed 4 October) Peng W,Yun S, Holtz BE. Exploring the challenges and opportunities of
Lashkari T, Borhani F, Sabzevari S, Abbaszadeh A. Effect of telenursing (telephone health mobile apps for individuals with type 2 diabetes living in rural
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McGloin H, Timmins F, Coates V, Boore J. A case study approach to the Pereira DCR, Araújo MFM, Freitas RWJF, Teixeira CRS, Zanetti ML,
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Support and care for patients About the book

with long-term conditions Fundamental Aspects of

Providing support and care for individua
ls with a long-term condition is an essential
health care. Over 15 million people feature of modern
in England currently have a long-term
these numbers will continue to rise. condition, and it is predicted that
Treating the range of long-term condition

Long-Term Conditions
will therefore play an important role s that affect the population
for health professionals. This book is
Fundamental Aspects of Long-Term Conditions

conditions, exploring the key principle an essential guide to long-term

s of practice, skills and policy. The chapters
as stand-alone chapters, or the book in this book can be read
can be read in sequence. Full referenc
es are provided.
Like other books in this series, Fundame
ntal Aspects of Long-Term Conditio

Helen McVeigh
basis from which both student nurses ns provides a succinct, useful
and adult nurses can extend their knowled
ge and skills.
About the author
Helen McVeigh is a Senior Lecturer
in Primary Care at De Montfort Universi
District Nurse. She has over 20 years
experience of working in Primary Care
ty Leicester. She is a qualified
Edited by Helen McVeigh
This book should make you think about how you can make a difference
city practices. working in both rural and inner

in the lives of those managing with a long term

Other titles in the Fundamenta
l Aspectscondition.
of Nursing series: It should enable
Children & Young Peoples Nursing Procedur
you to take a holistic perspective
Community Nursing
Complementary therapies
in the care,
es
management and support
Nursing Adults with Respiratory Disorders
Nursing the Acutely Ill Adult

of these patients. Finding Information

Mental Health Nursing
Pain Assessment & Management
Palliative Care Nursing 2nd edition
Research for Nurses
Series Editor: John Fowler

 Essential guide to long-term conditions, exploring the key principles

of practice, skills and policy

 Part of the successful Fundamental Aspects of Nursing series

 Each chapter presents learning points, using a reflective approach

*Low cost for landlines and mobiles

 Case history examples included to illustrate issues discussed

Edited by Helen McVeigh

ISBN 1-85642-392-1

ISBN-13: 978-1-85642-392-2; 234 x 156 mm; paperback; 280 pages; publication 2010; £24.99
© 2018 MA Healthcare Ltd

9 781856 423922
Fundamental Aspects of Nursing series
[Link]

Order your copies by visiting FA LTCs [Link] 1

or call
[Link] +44 (0) 333 800 1900* 18/1/10 12:38:13

1120 British Journal of Nursing, 2018, Vol 27, No 19

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