Problem

With the development of economy, the prevalence of diabetes mellitus has been rapidly increasing in the worldwide, especially in some developing countries and regions.The report of IDF in 2011 indicated that the number of diabetics globally has been reached in 366 million,while diabetes mellitus has become a challenging public health problem at the twenty-first century.,which will become a burden of economy in the worldwide. China , one of the five largest number of diabetics,will face an ordeal than before. Professor Yang pointed out in her article which had been published in NEJM 2010,that the prevalence of diabetes mellitus in China has been reached in 9.7% and the number of diabetics has been reached up to 92.4million.The number of diabetics has become a heavy load for a developing country ,which not only impose huge economic burden on the society but also bring the unprecedented pressures to professionals who go in for diabetes management ,care and therapy. By now, diabetes mellitus is an incurable disease, the patients need continuous management and treatment once they are diagnosed with diabetes,and diabetes management itself is also a key factor for treatment effect. Therefore, many countries in the world pay more attention on improving the management of diabetes in order to achieve the best therapeutic effect. It is well known that Diabetes education and clinical care are the two cornerstones of diabetes management, its quality directly affects the quality of patients self-management and confidence. The global increase in the prevalence of diabetes leads to increased demand for diabetes professionals, of course,this demand is not only in quantity but also in the quality of management. In clinical practice, the key persons to provide diabetes care involves doctors, nurses and nutritionists. However, considering the job nature and the work distribution, nurses play a pivotal role in diabetes education, management and clinical care.,thus, how to train and use of diabetes specialist nurses in diabetes management and care have attracted much attention nowadays. Taking American for an example ,fifty years ago, she has realized the importance and began to focus on cultivating diabetes educators .In the 80s, she set up a specialized accrediting agency responsible for the assessment of diabetes educator qualifications and audit. For nearly 60 years she has gained rich experience in training diabetes educators ,the association of American Diabetes Educators (AADE) actively organize, coordinate and establish a system of diabetes educators’ training and evaluation, and set up a special evaluation institution "National Diabetes Educator Certification Board (NCBDE)" to guarantee the quality of clinical care and management of diabetic patients. In Europe, taking UK for an example, developed country did the same as that of American , also pay more attention on the cultivation of diabetes specialist nurses, and have successively set up the " National Diabetes Nursing Knowledge And Skills Framework" "An Integrated Career and Competency Framework for Diabetes Nursing" and a series of standards and principles about the quality of care and nursing personnel qualification accreditation in the past decade. We can draw such conclusion from United States, Britain clinical practice that diabetes specialist nurses’ knowledge and skill is the core factor which affect the quality of patient care and self-management. Therefore , we have reasons to believe that it is suitable for China .So , it is urgent that we took action setting up core competence framework for diabetes nursing , on the one hand, it can guide diabetes nurses how to plan their professional development,and offer the reference for training diabetes nursing, on the other hand , it will lay the foundation for further diabetes nurses certification. Nowadays ,there is no fundamental frameworks in China,and lack of scientific and complete evaluation standard to evaluate the professional qualification of diabetes specialist nurses. Therefore, this study want to establish a core competence framework for diabetes specialist nursing in order to satisfy the demands of clinical practice and to provide career development direction and work instructions for care professionals.

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