Acceptability of a self-management support intervention for people living with type 2 diabetes to promote a person-centered approach by nurses: A qualitative study

2021 ◽  
Author(s):  
S. Lafontaine ◽  
P. Bourgault ◽  
E. Ellefsen
Keyword(s):  
Type 2 Diabetes ◽  
Qualitative Study ◽  
Self Management ◽  
Management Support ◽  
Support Intervention ◽  
Person Centered Approach

scholarly journals Using the Self-Management Assessment Scale for Screening Support Needs in Type 2 Diabetes: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Ulrika Öberg ◽  
Carl Johan Orre ◽  
Åsa Hörnsten ◽  
Lena Jutterström ◽  
Ulf Isaksson
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Primary Health Care ◽  
Qualitative Study ◽  
Screening Instrument ◽  
The Self ◽  
Self Management ◽  
Management Support ◽  
Primary Health

BACKGROUND Globally, 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. OBJECTIVE This 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. METHODS This qualitative study is based on observations and interviews analyzed using qualitative content analysis. RESULTS From 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. CONCLUSIONS Person-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.

scholarly journals Barriers and enablers to sustaining self-management behaviours after completing a self-management support intervention for type 2 diabetes: a protocol for a systematic review and qualitative evidence synthesis

2021 ◽  
Vol 4 ◽  
pp. 129
Author(s):  
Márcia Carvalho ◽  
Pauline Dunne ◽  
Dominika Kwasnicka ◽  
Molly Byrne ◽  
Jenny McSharry
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Behaviour Change ◽  
Qualitative Studies ◽  
Self Management ◽  
Qualitative Evidence Synthesis ◽  
Management Support ◽  
Support Intervention ◽  
Barriers And Enablers

Background: Attendance at self-management support interventions is associated with improved outcomes for people with type 2 diabetes. However, initial improvements are often not sustained beyond one year, which may be a result of difficulties in sustaining positive changes made to self-management behaviours. The aim of this systematic review is to synthesise qualitative research on the barriers and enablers to sustaining self-management behaviours following completion of a self-management support intervention for type 2 diabetes. Methods: The review will use the “best fit” framework synthesis method to develop a new conceptual model of sustained behaviour change in type 2 diabetes. MEDLINE (Ovid), EMBASE (Elsevier), CINAHL (EBSCO), PsycINFO (Ovid), SCOPUS, ProQuest Dissertations and Theses, WorldCat and Open Grey will be searched to identify primary qualitative studies. A parallel search will be conducted in Google Scholar to identify relevant theories for the development of an a priori framework to synthesise findings across studies. Methodological limitations of included studies will be assessed using an adapted version of the Critical Appraisal Skills Programme tool for Qualitative Studies. A sensitivity analysis will be conducted to examine the impact of studies with methodological limitations on synthesis findings. Confidence in the synthesis findings will be assessed using the GRADE-CERQual tool. Screening, data extraction, methodological limitation assessment, synthesis and GRADE-CERQual assessment will be conducted by one author with a second author independently verifying a randomly selected 20% sample. Discussion: This review will develop a new model of sustained behaviour change in type 2 diabetes self-management. The findings can be used to inform the development of new interventions or revision of existing interventions to better support sustained engagement in type 2 diabetes self-management behaviours.

scholarly journals What follow-up care and self-management support do patients with type 2 diabetes want after their first acute coronary event? A qualitative study

2014 ◽  
Vol 8 (3) ◽  
pp. 195-206 ◽  
Author(s):  
Marise J. Kasteleyn ◽  
Kees J. Gorter ◽  
Anne L. van Puffelen ◽  
Monique Heijmans ◽  
Rimke C. Vos ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Qualitative Study ◽  
Coronary Event ◽  
Self Management ◽  
Management Support ◽  
Acute Coronary Event ◽  
Follow Up Care

scholarly journals Using the Self-Management Assessment Scale for Screening Support Needs in Type 2 Diabetes: Qualitative Study

JMIR Nursing ◽  
10.2196/16318 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e16318
Author(s):  
Ulrika Öberg ◽  
Carl Johan Orre ◽  
Åsa Hörnsten ◽  
Lena Jutterström ◽  
Ulf Isaksson
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Primary Health Care ◽  
Qualitative Study ◽  
Screening Instrument ◽  
The Self ◽  
Self Management ◽  
Management Support ◽  
Primary Health

Background Globally, 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. Objective This 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. Methods This qualitative study is based on observations and interviews analyzed using qualitative content analysis. Results From 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. Conclusions Person-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.

scholarly journals Digital Person-Centered Self-Management Support for People With Type 2 Diabetes: Qualitative Study Exploring Design Challenges

JMIR Diabetes ◽  
10.2196/10702 ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. e10702
Author(s):  
Robyn Schimmer ◽  
Carljohan Orre ◽  
Ulrika Öberg ◽  
Karin Danielsson ◽  
Åsa Hörnsten
Keyword(s):  
Type 2 Diabetes ◽  
Digital Health ◽  
Work Practice ◽  
Current Work ◽  
Self Management ◽  
Substantial Part ◽  
Management Support ◽  
Design Decisions ◽  
Ehealth Service

Background Self-management is a substantial part of treatment for patients with type 2 diabetes (T2D). Modern digital technology, being small, available, and ubiquitous, might work well in supporting self-management. This study follows the process of developing a pilot implementation of an electronic health (eHealth) service for T2D self-management support in primary health care. The use of digital health, or eHealth, solutions for supporting self-management for patients with T2D is increasing. There are good examples of successful implementations that can serve as guides in the development of new solutions. However, when adding person-centered principles as a requirement, the examples are scarce. Objective The objective of this study was to explore challenges that could impact the design of a person-centered eHealth service for T2D self-management support. The study included data collection from multiple sources, that is, interviews, observations, focus groups, and a Mentimeter (interactive presentation with polling) survey among stakeholders, representing various perspectives of T2D. Methods A user-centered design approach was used to exploratively collect data from different sources. Data were collected from a workshop, interviews, and observations. The different data sources enabled a triangulation of data. Results Results show that user needs related to an eHealth service for person-centered T2D self-management support are multifaceted and situated in a complex context. The two main user groups, patients and diabetes specialist nurses, express needs that both diverge and converge, which indicates that critical design decisions have to be made. There is also a discrepancy between the needs expressed by the potential users and the current work practice, suggesting more attention toward changing the organization of work to fully support a new eHealth service. Conclusions A total of three overarching challenges—flexible access, reducing administrative tasks, and patient empowerment—each having a significant impact on design, are discussed. These challenges need to be considered and resolved through careful design decisions. Special attention has to be given to the patient user group that could greatly impact current work practice and power structures at the primary care unit. A need for further studies investigating patient needs in everyday life is identified to better support the implementation of technology that does not give specific attention to organizational perspectives but instead approach design with the patient perspective in focus.

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