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Interaction between diabetes specialist nurses and patients during group sessions about self-management in type 2 diabetes
Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
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2014 (Engelska)Ingår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 94, nr 2, s. 187-192Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: The aim of this study was to explore the interaction between diabetes specialist nurses (DSNs) and patients with type 2 diabetes (T2D) during group sessions about self-management.

Methods: Ten DSNs and 44 patients were observed during group sessions about self-management, and thereafter the observations were analyzed using qualitative content analysis.

Results: The interaction was characterized by three themes: becoming empowered, approaching each other from different perspectives, and struggling for authority. The interaction was not a linear process, but rather a dynamic process with distinct episodes that characterized the content of the sessions.

Conclusion: It is important to achieve an interaction that is patient-centered, where the DSN is aware of each patient's individual needs and avoids responding to patients in a normative way. A satisfying interaction may strengthen patients' self-management, and also may strengthen the DSNs in their professional performance.

Practice implications: Authority struggles between patients and DSNs could be a prerequisite for patients to become autonomous and decisive in self-management. DSNs might benefit from an increased awareness about this issue, because they can better support patients if they do not perceive authority struggles as threats to their professional role.

Ort, förlag, år, upplaga, sidor
Elsevier, 2014. Vol. 94, nr 2, s. 187-192
Nyckelord [en]
Diabetes specialist nurse, interaction, patient, self-management, type 2 diabetes
Nationell ämneskategori
Endokrinologi och diabetes
Identifikatorer
URN: urn:nbn:se:umu:diva-80901DOI: 10.1016/j.pec.2013.10.010ISI: 000331923700007PubMedID: 24268676Scopus ID: 2-s2.0-84892806949OAI: oai:DiVA.org:umu-80901DiVA, id: diva2:651906
Projekt
Diabetes intervention in Västerbotten , DIVA 2
Anmärkning

Originally included in thesis in manuscript form. 

Tillgänglig från: 2013-09-27 Skapad: 2013-09-27 Senast uppdaterad: 2022-03-22Bibliografiskt granskad
Ingår i avhandling
1. Proximity and distance: challenges in person-centred care for diabetes specialist nurses in primary health care
Öppna denna publikation i ny flik eller fönster >>Proximity and distance: challenges in person-centred care for diabetes specialist nurses in primary health care
2013 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Alternativ titel[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.

Ort, förlag, år, upplaga, sidor
Umeå: Umeå Universitet, 2013. s. 63
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 1593
Nyckelord
Diabetes specialist nurse, professional role, self-management support, type 2 diabetes, caring relation, power relation, person-centred care
Nationell ämneskategori
Omvårdnad
Forskningsämne
omvårdnadsforskning med medicinsk inriktning
Identifikatorer
urn:nbn:se:umu:diva-80908 (URN)978-91-7459-735-6 (ISBN)
Disputation
2013-10-25, Vårdvetarhusets Aula, Vårdvetarhuset, Umeå Universitet, Umeå, 09:00 (Svenska)
Opponent
Handledare
Projekt
Diabetes intervention in Västerbotten, DIVA 2
Tillgänglig från: 2013-10-03 Skapad: 2013-09-27 Senast uppdaterad: 2018-06-08Bibliografiskt granskad

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Boström, EvaIsaksson, UlfLundman, BeritHällgren Graneheim, UllaHörnsten, Åsa

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