Needs assessment for developing a train-the-trainer educational program to improve healthcare professionals’ knowledge and skills in older diabetes care

Objectives: In Denmark, 15 % of people with diabetes are over 70 years old, and the proportion is expected to rise by 14 % over the next decade. Older people often require intensive diabetes care due to physical limitations, comorbidities, and cognitive decline. Yet, many healthcare professionals lack confidence and skills in managing diabetes care for this population. Notably, 85 % of healthcare assistants reports a need for extensive education within diabetes care. This study aimed to explore the educational needs of healthcare professionals related to providing diabetes care for older people in nursing homes and home care units to inform the development of a train-the-trainer program to address identified needs.

Methods: A qualitative explorative study, drawing on the first phase of a design thinking approach was conducted among 30 administrators, nurses, and healthcare assistants at the home care unit and four nursing homes. Data were collected through 150 hours of field observations, five semi-structured interviews, and six focus groups, and analysed using systematic text condensation.

Results: We identified substantial knowledge gaps among healthcare professionals regarding diabetes care for older people, particularly in balancing effective care with older peoples' self-determination. Our findings revealed a use of stigmatising language, which may adversely affect the interaction between the healthcare professionals and the older people with diabetes. Moreover, we found a lack of effective interdisciplinary collaboration among the healthcare professionals.

Conclusion: It is crucial to enhance diabetes education for healthcare professionals in long-term care, incorporating content related to clinical knowledge, ethical issues, and person-centered care, to provide high-quality diabetes care for vulnerable older people.