Self‐management of diabetes is encouraged; however, it is not an easy task and requires a good understanding of the disease. To determine how to improve the self‐management abilities of diabetes in people with an intellectual disability (ID), this study explored the knowledge and understanding of diabetes held by a select group of adults with diabetes. The group was made up of 14 adult New Zealanders (eight males and six females; age range 23–69 years) with type 1 diabetes (n = 6) and type 2 diabetes (n = 8). They and their nominated key informants were interviewed. Blood sugar levels (gained from using hemoglobin A1c (HbA1c) tests) were obtained on all participants. HbA1c levels ranged from 5.4% to 12.3%. The participants fell into three categories of understanding diabetes: (1) those who had a good understanding of the disease; (2) those who had some knowledge but their actual understanding was limited; and (3) those who demonstrated only a very basic knowledge. It was found that all of the adults were actively engaged in the self‐management process, and all appeared to have some understanding of the role of diet, blood sugar levels, and exercise in the management of their disease. Support from others was important in this process, even for those adults who had a good understanding of the disease. Diabetes significantly impacted the adults' lives, and in some cases, prevented them from living independently. When interviewed, the adults suggested strategies to assist with self‐management such as the use of a “buddy” system to encourage exercise. Authors concluded that adults with ID can be engaged in self‐management of their diabetes. However, it is important that they continue to receive education and support throughout their lives and that time be spent with each individual to identify how to provide the best education and support. Peer‐led education and user‐friendly resources are recommended to achieve lifelong education and support.

The incidence of diabetes in people with an intellectual disability, although unknown, is indicated to be higher than the general population. Given the challenges individuals with intellectual disability may face, this population is often dependent upon key workers to manage their health and well-being. One aim of a wider study on the self-management of diabetes by people with intellectual disability was to explore how key workers supported their self-management. That aim was the focus of this paper. Between 2009 and 2010, 17 staff from five residential intellectual disability services and two supported independent living services within New Zealand, consented to a semi-structured interview. Transcripts of the interviews were analysed using Thomas' General Inductive Approach. Three overarching themes emerged; having knowledge and understanding, being lifestyle police and ensuring future well-being. While knowledge, skills and perspectives varied, all participants were committed to ensuring that the lifestyle of the person concerned was compatible with the management of their diabetes. A range of perspectives existed between the expectations they had of themselves, colleagues and the individual with diabetes. There was an identified need for initial and ongoing education of permanent and casual staff and the people themselves with diabetes in collaboration with health and disability services to build confidence and promote self-management practices. In so doing, the impacts of this long-term condition may be reduced and the health outcomes improved for people with intellectual disability.

The health system in New Zealand and Australia requires health practitioners to prepare for the challenge of long-term conditions. Wagner's 1998 Chronic Care Model advocates a move away from the traditional acute model of primary health care to a model that addresses the long-term episodic nature of chronic disease. Nurse case management has been developed over the last 2 decades as a means to coordinate health services for people with long-term conditions. This meta-synthesis combines the results of 15 qualitative research studies that have a similar research question regarding peoples' perceptions of nurse case management. The research synthesises the experiences of people with long-term conditions on the quality of care under a nurse case management model of primary health care. Over 1000 people were represented across the studies, and the results suggest that people had a high degree of confidence and trust in their nurse case manager, were better able to manage their health conditions with nurse case management support, and had better access to appropriate health care. This research suggests that nurse case management is an effective model of care and may contribute to improved quality of life and better health care for those with long-term health conditions.

This article explores the ethical questions that were central to a qualitative study of the parenting experiences of parents with an intellectual disability. The study was located in three cities in New Zealand and involved 19 parents who have an intellectual disability. It considers three aspects of the research process, all of which involve significant ethical matters that need to be addressed throughout the research process. The first concerns issues around the construction of knowledge. Here fundamental issues such as who controls knowledge and knowledge production are explored. Building on the first issue, the second focuses on the significance of relationships in research and explores the factors that contribute to effective research relationships. The final theme explores social change in research and the role of the participant and researcher in this change process. The article provides a critical reflection on research practice by foregrounding common ethical concerns and poses some of the possible responses to these concerns so that research remains authentic and protects the interests of all participants. These involve seeking clarity around research aims and processes from the participants and others who have an interest in the research and its potential outcomes. . Jackie Sanders has twenty years' experience in health and social service planning and management. Her interests are the study of diverse groups of children and families, evaluation and planning for social service delivery and the development of new models of practice. Brigit Mirfin-Veitch has been a researcher with the Donald Beasley Institute, Dunedin, New Zealand since 1994. Brigit has a strong interest in deinstitutionalization and also conducts research in the area of health education with women with intellectual disabilities and has a commitment to work that increases the opportunity for women to have better access to health information. Jenny Conder is a Senior Lecturer in Nursing at the Otago Polytechnic and Senior Researcher with the Donald Beasley Institute, Dunedin, New Zealand. Jenny has a long history in both the fields of intellectual disability and child and family health nursing. Her recent research has focused on parents with an intellectual disability and health issues for people with an intellectual disability.

No abstract