Evaluation of a patient centred intervention aiming at supporting self management among patients with type 2 diabetes.
In order to manage to live with type 2 diabetes patient have to balance between controlling and being controlled by their illness. Patients do not change lifestyle because they achieve information about the advantage with the change. Patients need time to negotiate about what this lifestyle changes involves to integrate illness and self management.
A patient centered approach implies that healthcare professionals listen to the patients and investigate their own needs and motives that can effect positively on lifestyle changes and metabolic measurements. A patient centered attitude among health care professionals can provide inner motives for patients to make lifestyle changes and the disease eventually becomes easier to manage. Increased knowledge about patients’ integration of illness and self-management is important in order to support and speed up this process. This could lead to an improved metabolic control and also decrease diabetes-related complications. The aims of this PhD-project are to examine the effects of a patient centered intervention focusing on empowerment and to describe the illness integration process from novice to reaching a turning point in self-management in type 2 diabetes.
The aims of this project are to examine the effects of a patient centered intervention focusing on empowerment and to describe the process of integration of illness and self management in type 2 diabetes. The design is a longitudinal randomised control study running over five years. Both qualitative and quantitative methods are used. Nine of 28 health care centers (HCC) within Västerbotten (Public medical service) are participating and one HCC from Härnösand consisted an external control group. 200 patients participated in the study based upon a randomization to either group support, individual support or control. The intervention groups consisted of six consultations, telephone check-ups every month in six months and lastly personal telephone consultation twice a year in 5 years with their ordinary diabetes nurse. The patients receive their regular check-ups with their doctors and nurses ones a year as usually. Narrative interviews are annually perfomed among 18 patients to follow the integrational process. Laboratory test and questionnaires measuring patients’ wellbeing and self-management learning are used. A patient centered intervention focusing on both HbA1c and qualitative aspects are unusual in nursing research and may provide answers to questions about lacking evidence for traditional patient education.