BackgroundPatient and public involvement in diabetes research is an international requirement, but little is known about the relationship between the process of involvement and health outcomes.ObjectiveThis realist review identifies who benefits from different types of involvement across different contexts and circumstances. Search strategies Medline, CINAHL and EMBASE were searched to identify interventions using targeted, embedded or collaborative involvement to reduce risk and promote self‐management of diabetes. People at risk/with diabetes, providers and community organizations with an interest in addressing diabetes were included. There were no limitations on date, language or study type.Data extraction and synthesisData were extracted from 29 projects using elements from involvement frameworks. A conceptual analysis of involvement types was used to complete the synthesis.Main resultsProjects used targeted (4), embedded (8) and collaborative (17) involvement. Productive interaction facilitated over a sufficient period of time enabled people to set priorities for research. Partnerships that committed to collaboration increased awareness of diabetes risk and mobilized people to co‐design and co‐deliver diabetes interventions. Cultural adaptation increased relevance and acceptance of the intervention because they trusted local delivery approaches. Local implementation produced high levels of recruitment and retention, which project teams associated with achieving diabetes health outcomes.Discussion and ConclusionsAchieving understanding of community context, developing trusting relationships across sectors and developing productive partnerships were prerequisites for designing research that was feasible and locally relevant. The proportion of diabetes studies incorporating these elements is surprisingly low. Barriers to resourcing partnerships need to be systematically addressed.

The aim of the study was to understand the variability of Norwegian staff's attitudes towards patients with urinary incontinence across years and place of work, age and education levels. The Incontinence Stress Questionnaire-Staff Reaction (Norwegian version) (ISQ-SR-N) was used to measure staff's reactions and feelings towards patients with urinary incontinence. A cross-sectional survey design was used to gather self-reported data. The research sites were five nursing homes, three home care districts and medical and surgical wards at a university hospital. Of the 745 staff invited, 535 (72%) returned the questionnaire. Staff members working in long-term care units were older than staff members working in acute care units. Most of the registered nurses worked in acute care, whilst most of the nursing assistants worked in long-term care. Stepwise regression analysis identified education, working in a medical/surgical units, and the interaction of education and working in a medical unit to be most predictive of attitudes. Nursing assistants had more positive attitudes than registered nurses. Working in medical/surgical units predicted the most negative attitudes. Only 15.2% of the variability of attitudes can be explained by the predictive variables.

The WHOQOL-bref might be too comprehensive to identify associations between specific symptom-related factors. Alternatively, our results indicate that LUTS suggestive of BPH and LUTS-associated factors are not very important determinants of QOL.

OBJECTIVE To investigate how quality of life (QoL) components measured by given instruments direct the QoL perspective in treatment studies of lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). METHODS Computer searches were conducted in Medline, CINAHL and Psychinfo; MeSH terms covering QoL and surgical treatments for BPH and LUTS were combined for the search. The analysis was based on a framework linking components of QoL to patient outcome. RESULTS Of the 74 papers meeting the inclusion criteria, 48 were published in 1997–2001, showing the increase of interest of the topic. Most of the papers reported the change in QoL by a one‐item scale, whilst only a few reported results from several of the components in the QoL concept. Some papers regarded the change in general health status or parts of health status as changes in QoL. Functional status and symptoms, and the bother of symptoms, were often regarded as indicators of a change in QoL. CONCLUSION These analyses show an increasing interest in measuring QoL after surgery for LUTS and BPH. In most of the studies analysed, the batteries of instruments selected were too narrow in scope to study the complexity of QoL. Most papers are based on instruments sensitive to change, but the reports do not distinguish the basic assumptions for understanding relationships important in QoL research and as a result, the reason for change is open to question.

Aims To identify diabetes specific patient safety domains that need to be addressed to improve home care of older people; to assess research from primary studies to review evidence on patient safety in home care services for older people with diabetes. Design An integrative review. Data Sources Domains for patient safety in diabetes home care settings were identified by conducting two searches. We performed searches in: CINAHL, Medline, Embase, and Cochrane Library for the years 2000–2017. Review Methods The first search identified frameworks or models on patient safety in home care services published up to October 2017. The second search identified primary studies about older people with diabetes in the home care setting published between 2000–2017. Results Data from the 21 articles populated and refined 13 predetermined domains of patient safety in diabetes home care. These were used to explore how the domains interact to either increase or reduce risk. The domains constitute a model of associations between aspects of diabetes home care and adverse events. The results highlight a knowledge gap in safety for older persons with diabetes, influenced by e.g. hypoglycaemia, falls, pain, foot ulcers, cognitive impairment, depression, and polypharmacy. Moreover, providers’ inadequate diabetes‐specific knowledge and assessment skills contribute to the risk of adverse events. Conclusion Older persons with diabetes in home care are at risk of adverse events due to their reduced ability to self‐manage their condition, adverse medication effects, the family's ability to take responsibility or home care service's suboptimal approaches to diabetes care.