Perceptions of healthcare professionals and people with type 2 diabetes on emotional support: a qualitative study

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a demanding condition that impacts the person living with the condition physically and psychologically. Promoting emotional support is a key strategy to improve diabetes care. AIM: To explore the views and experiences of people with T2DM and healthcare professionals (HCPs) on emotional support in diabetes care, and identify barriers and facilitators to the provision of emotional support in clinical practice. DESIGN & SETTING: A qualitative study in England with data collected from four focus groups. METHOD: Focus group discussions were conducted with people with T2DM (n = 10) and HCPs (n = 10). The analysis was informed by the framework method and principles of the constant comparative approach. RESULTS: Emotional support was lacking in diabetes primary care, and there was a need to normalise the emotional impact of T2DM. Barriers to emotional support included: lack of HCP confidence to discuss emotional issues; lack of counselling training; and time constraints in consultations. Inappropriate use of the word ‘depression’ creates a sense of taboo for those experiencing emotions other than depression. CONCLUSION: Consensus between the two target groups indicated a strong need to integrate emotional support in diabetes care, and the need to support and train HCPs in addressing psychosocial aspects of T2DM. Shared language is recommended across diabetes services to appropriately refer to wellbeing. Addressing barriers and considering ways to incorporate emotional management in diabetes consultations is recommended, includings introducing HCP training to increase confidence and enhance counselling skills.