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

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Summary

Introduction

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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