Acceptability of a self-management support intervention for people living with type 2 diabetes to promote a person-centered approach by nurses: A qualitative study

Abstract

BackgroundThe diabetes guidelines recommend that healthcare professionals adopt a person-centred approach when they support the self-management of people living with type 2 diabetes. However, nurses seem to have difficulty implementing this approach in their clinical practice. The Person-Centred Approach Diabetes Self-Management Support is an individual intervention to promote the adoption of a person-centred approach among nurses who intervene with people living with type 2 diabetes having self-management difficulties. The intervention includes a tool, the Needs Map, which starts the encounter from the person's needs, concerns, and beliefs and targets intervention strategies according to these factors. ObjectivesTo explore the acceptability of the Person-Centred Approach Diabetes Self-Management Support as an intervention for nurses to support adults living with type 2 diabetes. DesignA qualitative descriptive interpretative approach. SettingsTwo local community service centers in Quebec (Canada) that already provide self-management education and support to people living with type 2 diabetes. ParticipantsTen adults living with type 2 diabetes with self-management difficulties and two nurses. MethodsEach adult met the same nurse twice during a 30-minute individual self-management support session in which the nurse used the new intervention, one to three months apart. Various methods of data collection were used: individual interviews, focus group, and dyadic interviews with persons living with diabetes and nurses as well as observation of self-management support sessions and collection of the Needs Maps elaborated in those encounters. FindingsThe results suggest that the person-centred intervention is generally well accepted by persons and nurses. Five main themes stand out in relation to acceptability: positive experience (feeling listened to and considered, and not feeling judged), consistent with personal values (placing the person at the heart of the intervention), having to adapt to a new way of doing things (ability increases with practice), requires cognitive and emotional effort (questioning oneself, experiencing difficult emotions, and losing one's usual bearings), and more effective than usual interventions (promoting adoption of person-centred approach, relevance of the visual aspect, raising awareness, and mobilising toward action). ConclusionThe intervention seems to have led to the adoption of a person-centred approach by nurses. It would be relevant to explore in future studies if it persists over time and can lead to lasting tangible effects on person self-management as well as various parameters of their health, including their quality of life.