Abstract
AimTo describe how diabetes nurses in primary care experience the process of learning to practise the person‐centred counselling approach Guided Self‐Determination among adults with type 2 diabetes.DesignA descriptive qualitative design.MethodData were collected in 2014–2015 by means of individual interviews with four diabetes nurses at two points in time. The data were analysed using qualitative content analysis.ResultsThree themes that reflect nurses’ processes in learning to use the Guided Self‐Determination approach were identified: (1) from an unfamiliar interaction to “cracking the code”; (2) from an unspecific approach to a structured, reflective, but demanding approach; and (3) from a nurse‐centred to a patient‐centred approach. The overall findings indicate that the process of learning to practise Guided Self‐Determination increased the nurses’ counselling competence. Moreover, the nurses perceived the approach to be generally helpful, as it stimulated reflections about diabetes management and about their own counselling practices.
Highlights
Type 2 diabetes mellitus (T2DM) is undoubtedly one of the most important health challenges of the 21st century (IDF, 2015)
The analysis indicates that diabetes nurses (DNs) in their learning process compared their earlier experiences in diabetes care with the new Guided Self-Determination (GSD) approach and, in turn, reflected on the advantages and disadvantages of each
Our findings indicate that the DNs appreciated that the GSD method allowed them to listen more and give patients opportunities to become more active and responsible in their diabetes management, even though this meant losing control over the direction of the consultation
Summary
Type 2 diabetes mellitus (T2DM) is undoubtedly one of the most important health challenges of the 21st century (IDF, 2015). PCC refers to a philosophy that understands patients as equal partners in planning, developing and assessing care rather than focusing on the disease (de Silva, 2014; Olsson, Jakobsson Ung, Swedberg, & Ekman, 2013) From this perspective, PCC focuses on consultations where health professionals use counselling methods to activate and motivate person to become partners in healthcare decisions (Coulter et al, 2015; Olsson et al, 2013). The method was developed and tested among adults with difficulties related to their type 1 diabetes to promote empowerment, decision-making and motivation for diabetes management (Zoffmann, 2004). It consists of seven consultations using several structured reflection sheets. Reported effects in randomized controlled trials (RCT) show significant increases in perceived competence, autonomous motivation and quality of life, as well as decreased HbA1c, emotional distress and motivation among adults with type 1 diabetes (Zoffmann & Lauritzen, 2006; Zoffmann et al, 2015), but no effect was found among men (Zoffmann et al, 2015)
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