About me as a person not only the diseasepiloting Guided Self-Determination in an outpatient endometriosis setting Introduction: Endometriosis is a chronic disease affecting 5-10% of women in the reproductive age. Despite surgical and medical treatment, many women struggle with pain, infertility, sexual dysfunction, depression, distress and reduced workability, affecting their overall quality of life. The usual follow-up procedures may not support the women's self-management of this condition. Therefore, person-centred empowerment-based approaches are needed. Aim: To assess if the implementation of the Guided Self-Determination method targeted women with complex endometriosis appeared feasible and supported selfmanagement. Methods: Guided Self-Determination was offered to 10 outpatients with complex endometriosis. Each of the women had five conversations based on prefilled diseasespecific reflection sheets. A qualitative evaluation was conducted in 2016-2017 covering semi-structured, telephone interviews and focus group interviews, which were analysed using thematic analysis. Additionally, we assessed if the women changed the self-reported questionnaires, Endometriosis Health Profile 30 and the Patient Activation Measure from before and after the conversations. Results: We identified four themes: feeling alone with the disease; establishing a meaningful relationship with healthcare professionals in a traditional hospital setting; person-specific knowledge facilitated new behaviours and; accepting a chronic conditionthe beginning of a process. All dimensions of the Endometriosis Health Profile 30 and the Patient Activation Measure appeared to improve at two weeks and so did almost all the dimensions of Endometriosis Health Profile 30 after 1 year. Conclusions: The implementation of the Guided Self-Determination method appeared feasible and the women developed self-management skills in relation to endometriosis and its symptoms. This was achieved by increasing insight into their needs and behaviours and gaining new knowledge about the disease itself. The before-and-after assessment suggested benefit of the intervention, but this should be further tested in a randomised trial.

Aim The aim of the study was to investigate nurses' skill acquisition in Guided Self‐Determination according to the Dreyfus model of skill acquisition and Patricia Benner's studies based on the same model. Background Globally, person‐centred care is acknowledged as an essential aspect of quality in health care. To succeed with person‐centred care methods and skills are necessary. Guided Self‐Determination is a person‐centred method developed in the field of nursing. The method represents a new way of skill acquisition requiring knowledge of how skills are acquired, unfolded and best supported in Guided Self‐Determination. Design Qualitative interview study. Method From January 2019 to August 2019, 16 nurses were interviewed about their experiences of learning and using Guided Self‐Determination in three different gynaecological settings: cancer, endometriosis and sexual abuse. The study was registered with the Danish Data Protection Agency (file no.: VD‐2018‐445, I‐Suite no.: 6700). Results The spectrum in Guided Self‐Determination acquisition skills ranged from following schematical procedures in a rigorous way to an extended understanding of exploring and supporting the person‐centred concept. Two main themes were identified: Elements in the transition of knowledge from theory to practice and Aspects associated with Guided Self‐Determination skill acquisition. Conclusions Nurses practised Guided Self‐Determination at different levels. Quantity of practising Guided Self‐Determination was not the only aspect determining rapid progression. The Dreyfus model lacked several explanatory components of skill acquisition, such as personal dispositions, preferences, motivation, personal values and context.

Person-specific evidence was developed as a grounded theory by analyzing 20 selected case descriptions from interventions using the guided self-determination method with people with various long-term health conditions. It explains the mechanisms of mobilizing relational capacity by including person-specific evidence in shared decision-making. Person-specific self-insight was the first step, achieved as individuals completed reflection sheets enabling them to clarify their personal values and identify actions or omissions related to self-management challenges. This step paved the way for sharing these insights and challenges in a relationship with a supportive health professional, who could then rely on person-specific evidence instead of assumptions or a narrow disease perspective for shared decision-making.Trust in the evidence encouraged the supportive health professional to transfer it to the interdisciplinary team. Person-specific evidence then enhanced the ability of team members to apply general evidence in a meaningful way. The increased openness achieved by individuals through these steps enabled them to eventually share their new self-insights in daily life with other people, decreasing loneliness Nursing Inquiry.