Abstract
BackgroundGlobally, most countries face a common challenge by moving toward a population-based structure with an increasing number of older people living with chronic conditions such as type 2 diabetes. This creates a considerable burden on health care services. The use of digital tools to tackle health care challenges established views on traditional nursing, based on face-to-face meetings. Self-management is considered a key component of chronic care and can be defined as management of the day-to-day impact of a condition, something that is often a lifelong task. The use of a screening instrument, such as the Self-Management Assessment Scale (SMASc), offers the potential to guide primary health care nurses into person-centered self-management support, which in turn can help people strengthen their empowerment and self-management capabilities. However, research on self-management screening instruments is sparse, and no research on nurses’ experiences using a digitalized scale for measuring patients’ needs for self-management support in primary health care settings has been found.ObjectiveThis paper describes diabetes specialist nurses’ (DSNs) experiences of a pilot implementation of the SMASc instrument as the basis for person-centered digital self-management support.MethodsThis qualitative study is based on observations and interviews analyzed using qualitative content analysis.ResultsFrom the perspectives of DSNs, the SMASc instrument offers insights that contribute to strengthened self-management support for people with type 2 diabetes by providing a new way of thinking and acting on the patient’s term. Furthermore, the SMASc was seen as a screening instrument with good potential that embraces more than medical issues; it contributed to strengthening person-centered self-management support, and the instrument was considered to lead both parts, that is, DSNs and patients, to develop together through collaboration.ConclusionsPerson-centered care is advocated as a model for good clinical practice; however, this is not always complied with. Screening instruments, such as the SMASc, may empower both nurses and patients with type 2 diabetes with more personalized care. Using a screening instrument in a patient meeting may also contribute to a role change in the work and practice of DSNs.
Highlights
A need for structural changes in health care systems has emerged due to demographic changes and an increasing number of older people with chronic diseases such as type 2 diabetes (T2D), hypertension, chronic obstructive pulmonary disease, and asthma [1,2,3]
The Self-Management Assessment Scale (SMASc) was seen as a screening instrument with good potential that embraces more than medical issues; it contributed to strengthening person-centered self-management support, and the instrument was considered to lead both parts, that is, diabetes specialist nurse HbA1c (DSN) and patients, to develop together through collaboration
DSNs expressed various feelings, and from their narratives, 4 identified themes describing their experiences of using the SMASc instrument were identified and labeled: A screening instrument with good potential, Embraces more than medical issues, Strengthen person-centered self-management support, and Both parts develop through collaboration
Summary
A need for structural changes in health care systems has emerged due to demographic changes and an increasing number of older people with chronic diseases such as type 2 diabetes (T2D), hypertension, chronic obstructive pulmonary disease, and asthma [1,2,3]. Most countries face a common challenge by moving toward a population-based structure with an increasing number of older people living with chronic conditions such as type 2 diabetes. This creates a considerable burden on health care services. The use of a screening instrument, such as the Self-Management Assessment Scale (SMASc), offers the potential to guide primary health care nurses into person-centered self-management support, which in turn can help people strengthen their empowerment and self-management capabilities. Research on self-management screening instruments is sparse, and no research on nurses’ experiences using a digitalized scale for measuring patients’ needs for self-management support in primary health care settings has been found
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