The Influence of Nurses’ Work Environment and Patient-Centered Care Practices on Glycated Hemoglobin

In this cross-sectional study of 292 type 2 diabetics and their 49 family nurses in Portugal, we have examined the relationship between the nursing work environment and the implementation of patientcentred care practices, and between these practices and the glycated hemoglobin (HbA1c). For this purpose, we used the Structural Equations Model (SEM) in order to test these relationships. The clinical supervision and resource adequacy as assessed by “The Practice Environment Scale of the Nursing Work Index (PES–NWI)” had a direct and positive effect on the quality of patient-centered care as measured by “Diabetes Education Process (DEP)”, which in turn had a negative and direct effect on the gold standard outcome of diabetes (HbA1c). For the sample under study, it has been shown that the care environment affects the development of clinical care practices centered on the patient and that these practices affect the results on patients with diabetes.