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Diabetes specialist nurses' perceptions of their multifaceted role
Umeå University, Faculty of Medicine, Department of Nursing.
Umeå University, Faculty of Medicine, Department of Nursing. (Arcum)
Umeå University, Faculty of Medicine, Department of Nursing.
Umeå University, Faculty of Arts, Department of culture and media studies.ORCID iD: 0000-0002-6544-3211
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2012 (English)In: European Diabetes Nursing, ISSN 1551-7853, E-ISSN 1551-7861, Vol. 9, no 2, 39-44 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to explore diabetes specialist nurses' (DSNs') perceptions of their professional role in diabetes care.

Exploratory interviews were used to elicit DSNs' perceptions of their professional role. Twenty-nine DSNs working in 23 primary health care centres in northern Sweden were interviewed in focus groups. Data were analysed using qualitative content analysis.

The DSNs described their profession as encompassing five major roles: ‘expert’, ‘fosterer’, ‘executive’, ‘leader’, and ‘role model’. Challenges interpreted as role ambiguities included feeling uninformed, fragmented, resigned, pressed for time, and self-reproachful.

The profession of DSN was interpreted as multifaceted, with various roles and role ambiguities. Patient-centred care and empowerment, which are recommended in diabetes care, can be difficult to achieve when DSNs experience role ambiguity.

Lack of clarity about role demands and difficulty in reconciling different roles may have a negative impact on DSNs' attitudes in clinical encounters and could inhibit patient-centred care. The development of the DSN profession requires improved awareness of the DSN's professional role in the clinical encounter, not only to improve the care of patients with diabetes, but also to retain these professionals.

Place, publisher, year, edition, pages
Maney Publishing, 2012. Vol. 9, no 2, 39-44 p.
Keyword [en]
Diabetes specialist nurse, patient-centred care, professional role, role ambiguity
National Category
URN: urn:nbn:se:umu:diva-61554DOI: 10.1002/edn.204OAI: diva2:570605
Available from: 2012-11-20 Created: 2012-11-20 Last updated: 2016-06-13Bibliographically approved
In thesis
1. Proximity and distance: challenges in person-centred care for diabetes specialist nurses in primary health care
Open this publication in new window or tab >>Proximity and distance: challenges in person-centred care for diabetes specialist nurses in primary health care
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Närhet och distans : utmaningar i personcentrerad vård för diabetessjuksköterskor inom primärvården
Abstract [en]

Background Type 2 diabetes demands self-management over time, to maintain health and reduce the risk for diabetes complications. However, despite efforts, many persons with type 2 diabetes are not reaching the treatment targets. In diabetes, person-centred care and group education are recommended. Diabetes specialist nurses (DSNs) working in primary healthcare have an important role in supporting patients with type 2 diabetes in their self-management to adapt to the demands of the disease in everyday life. Therefore, it is important to explore the DSNs’ professional role and their experiences of practising person-centred care. The overall aim of the thesis was to explore the professional role of DSNs in primary healthcare, and to describe their experiences of person-centred diabetes care.

Methods The thesis includes three studies with qualitative, and one with a quantitative, approach. Data collection consisted of focus group interviews, individual interviews, observations, and questionnaires. Qualitative content analysis and statistics were used in the analysis. In studies I and II, 29 and 31 DSNs participated, respectively. In study III, 10 DSNs and 44 persons with type 2 diabetes participated. Lastly, in study IV, 10 DSNs participated.

Results The results in the thesis showed that DSNs have a complex and multifaceted professional role that entails striving to be an expert, a fosterer, a leader, an executive, and a role model, which they found challenging. The DSNs perceived high job demands, such as decision-making and learning. The thesis also showed that the interaction between DSNs and persons with type 2 diabetes shifted from empowerment to authority struggles during group support sessions based on person-centred care. The experience of person-centred care was described as enriching, but DSNs also expressed ambivalence, related to an altered professional role.

Conclusion There is a desire by DSNs to be close to persons with type 2 diabetes, although they have several challenges to fulfil, which makes it difficult to uphold a relation with proximity; thus, distance is also present. Even though person-centred care is recommended in healthcare, and despite DSNs’ efforts to practise PCC, the result of this thesis shows that it also implies an altered professional role for DSNs that has to be addressed.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2013. 63 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1593
Diabetes specialist nurse, professional role, self-management support, type 2 diabetes, caring relation, power relation, person-centred care
National Category
Research subject
Caring Sciences
urn:nbn:se:umu:diva-80908 (URN)978-91-7459-735-6 (ISBN)
Public defence
2013-10-25, Vårdvetarhusets Aula, Vårdvetarhuset, Umeå Universitet, Umeå, 09:00 (Swedish)
Diabetes intervention in Västerbotten, DIVA 2
Available from: 2013-10-03 Created: 2013-09-27 Last updated: 2013-10-03Bibliographically approved

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Boström, EvaIsaksson, UlfLundman, BeritEgan Sjölander, AnnikaHörnsten, Åsa
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