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Primary care nurses struggle with lifestyle counseling in diabetes care: a qualitative analysis

BACKGROUND: Patient outcomes are poorly affected by lifestyle advice in general practice. Promoting lifestyle behavior change require that nurses shift from simple advice giving to a more counseling-based approach. The current study examines which barriers nurses encounter in lifestyle counseling to...

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Autores principales: Jansink, Renate, Braspenning, Jozé, van der Weijden, Trudy, Elwyn, Glyn, Grol, Richard
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2889883/
https://www.ncbi.nlm.nih.gov/pubmed/20500841
http://dx.doi.org/10.1186/1471-2296-11-41
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author Jansink, Renate
Braspenning, Jozé
van der Weijden, Trudy
Elwyn, Glyn
Grol, Richard
author_facet Jansink, Renate
Braspenning, Jozé
van der Weijden, Trudy
Elwyn, Glyn
Grol, Richard
author_sort Jansink, Renate
collection PubMed
description BACKGROUND: Patient outcomes are poorly affected by lifestyle advice in general practice. Promoting lifestyle behavior change require that nurses shift from simple advice giving to a more counseling-based approach. The current study examines which barriers nurses encounter in lifestyle counseling to patients with type 2 diabetes. Based on this information we will develop an implementation strategy to improve lifestyle behavior change in general practice. METHOD: In a qualitative semi-structured study, twelve in-depth interviews took place with nurses in Dutch general practices involved in diabetes care. Specific barriers in counseling patients with type 2 diabetes about diet, physical activity, and smoking cessation were addressed. The nurses were invited to reflect on barriers at the patient and practice levels, but mainly on their own roles as counselors. All interviews were audio-recorded and transcribed. The data were analyzed with the aid of a predetermined framework. RESULTS: Nurses felt most barriers on the level of the patient; patients had limited knowledge of a healthy lifestyle and limited insight into their own behavior, and they lacked the motivation to modify their lifestyles or the discipline to maintain an improved lifestyle. Furthermore, nurses reported lack of counseling skills and insufficient time as barriers in effective lifestyle counseling. CONCLUSIONS: The traditional health education approach is still predominant in primary care of patients with type 2 diabetes. An implementation strategy based on motivational interviewing can help to overcome 'jumping ahead of the patient' and promotes skills in lifestyle behavioral change. We will train our nurses in agenda setting to structure the consultation based on prioritizing the behavior change and will help them to develop social maps that contain information on local exercise programs.
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spelling pubmed-28898832010-06-23 Primary care nurses struggle with lifestyle counseling in diabetes care: a qualitative analysis Jansink, Renate Braspenning, Jozé van der Weijden, Trudy Elwyn, Glyn Grol, Richard BMC Fam Pract Research article BACKGROUND: Patient outcomes are poorly affected by lifestyle advice in general practice. Promoting lifestyle behavior change require that nurses shift from simple advice giving to a more counseling-based approach. The current study examines which barriers nurses encounter in lifestyle counseling to patients with type 2 diabetes. Based on this information we will develop an implementation strategy to improve lifestyle behavior change in general practice. METHOD: In a qualitative semi-structured study, twelve in-depth interviews took place with nurses in Dutch general practices involved in diabetes care. Specific barriers in counseling patients with type 2 diabetes about diet, physical activity, and smoking cessation were addressed. The nurses were invited to reflect on barriers at the patient and practice levels, but mainly on their own roles as counselors. All interviews were audio-recorded and transcribed. The data were analyzed with the aid of a predetermined framework. RESULTS: Nurses felt most barriers on the level of the patient; patients had limited knowledge of a healthy lifestyle and limited insight into their own behavior, and they lacked the motivation to modify their lifestyles or the discipline to maintain an improved lifestyle. Furthermore, nurses reported lack of counseling skills and insufficient time as barriers in effective lifestyle counseling. CONCLUSIONS: The traditional health education approach is still predominant in primary care of patients with type 2 diabetes. An implementation strategy based on motivational interviewing can help to overcome 'jumping ahead of the patient' and promotes skills in lifestyle behavioral change. We will train our nurses in agenda setting to structure the consultation based on prioritizing the behavior change and will help them to develop social maps that contain information on local exercise programs. BioMed Central 2010-05-25 /pmc/articles/PMC2889883/ /pubmed/20500841 http://dx.doi.org/10.1186/1471-2296-11-41 Text en Copyright ©2010 Jansink et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research article
Jansink, Renate
Braspenning, Jozé
van der Weijden, Trudy
Elwyn, Glyn
Grol, Richard
Primary care nurses struggle with lifestyle counseling in diabetes care: a qualitative analysis
title Primary care nurses struggle with lifestyle counseling in diabetes care: a qualitative analysis
title_full Primary care nurses struggle with lifestyle counseling in diabetes care: a qualitative analysis
title_fullStr Primary care nurses struggle with lifestyle counseling in diabetes care: a qualitative analysis
title_full_unstemmed Primary care nurses struggle with lifestyle counseling in diabetes care: a qualitative analysis
title_short Primary care nurses struggle with lifestyle counseling in diabetes care: a qualitative analysis
title_sort primary care nurses struggle with lifestyle counseling in diabetes care: a qualitative analysis
topic Research article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2889883/
https://www.ncbi.nlm.nih.gov/pubmed/20500841
http://dx.doi.org/10.1186/1471-2296-11-41
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