Collegian | 2021
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
Abstract
Abstract Background The diabetes guidelines recommend that healthcare professionals adopt a person-centred approach when they support the self-management of people living with type 2 diabetes. However, nurses seem to have difficulty implementing this approach in their clinical practice. The Person-Centred Approach Diabetes Self-Management Support is an individual intervention to promote the adoption of a person-centred approach among nurses who intervene with people living with type 2 diabetes having self-management difficulties. The intervention includes a tool, the Needs Map, which starts the encounter from the person s needs, concerns, and beliefs and targets intervention strategies according to these factors. Objectives To explore the acceptability of the Person-Centred Approach Diabetes Self-Management Support as an intervention for nurses to support adults living with type 2 diabetes. Design A qualitative descriptive interpretative approach. Settings Two local community service centers in Quebec (Canada) that already provide self-management education and support to people living with type 2 diabetes. Participants Ten adults living with type 2 diabetes with self-management difficulties and two nurses. Methods Each adult met the same nurse twice during a 30-minute individual self-management support session in which the nurse used the new intervention, one to three months apart. Various methods of data collection were used: individual interviews, focus group, and dyadic interviews with persons living with diabetes and nurses as well as observation of self-management support sessions and collection of the Needs Maps elaborated in those encounters. Findings The results suggest that the person-centred intervention is generally well accepted by persons and nurses. Five main themes stand out in relation to acceptability: positive experience (feeling listened to and considered, and not feeling judged), consistent with personal values (placing the person at the heart of the intervention), having to adapt to a new way of doing things (ability increases with practice), requires cognitive and emotional effort (questioning oneself, experiencing difficult emotions, and losing one s usual bearings), and more effective than usual interventions (promoting adoption of person-centred approach, relevance of the visual aspect, raising awareness, and mobilising toward action). Conclusion The intervention seems to have led to the adoption of a person-centred approach by nurses. It would be relevant to explore in future studies if it persists over time and can lead to lasting tangible effects on person self-management as well as various parameters of their health, including their quality of life.