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Role clarity and role conflict among Swedish diabetes specialist nurses
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 Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
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2013 (English)In: Primary care diabetes, ISSN 1878-0210, Vol. 7, no 3, 207-212 p.Article in journal (Refereed) Published
Abstract [en]

AIM: To explore diabetes specialist nurses (DSNs)' perceptions of their role in terms of clarity, conflict and other psychosocial work aspects.

METHODS: A cross-sectional study was conducted among DSNs in a county in northern Sweden. The DSNs answered the Nordic Questionnaire of Psychological and Social Factors at Work (QPS Nordic) about psychosocial aspects of their work. Statistical analysis compared DSNs with a reference group of different health professionals. Correlations between role clarity, role conflict, and other variables were analysed.

RESULTS: The DSNs perceived more, and higher, job demands, including quantitative, decision-making and learning demands, but also more positive challenges at work compared with the reference group. Role clarity correlated with experiences of health promotion, perception of mastery, co-worker support, and empowering leadership, while role conflict correlated with quantitative and learning demands.

CONCLUSIONS: The DSNs perceived high demands but also positive challenges in their work. Their role expectations correlated with several psychosocial work aspects. It is important that DSNs should be presented with positive challenges as meaningful incentives for further role development and enhanced mastery of their work.

Place, publisher, year, edition, pages
Elsevier, 2013. Vol. 7, no 3, 207-212 p.
Keyword [en]
Diabetes specialist nurse, role clarity, role conflict, psychosocial work aspects
National Category
URN: urn:nbn:se:umu:diva-80709DOI: 10.1016/j.pcd.2013.04.013ISI: 000324965700005PubMedID: 23768659OAI: diva2:651145
Available from: 2013-09-24 Created: 2013-09-24 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, EvaHörnsten, AsaLundman, BeritStenlund, HansIsaksson, Ulf
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