Advice-Giving Styles by Finnish Nurses in Dietary Counseling Concerning Type 2 Diabetes Care

Abstract

Dietary advice-giving is an important part of dietary counseling in diabetes care and prevention. The strategies of advice-giving, however, have not been explicated and the qualitative characteristics of conversations in diabetes counseling have remained mainly unstudied. This article describes the styles in which nurses responsible for diabetes counseling in Finnish primary care practices offer dietary advice for patients with recently diagnosed type 2 diabetes or impaired glucose tolerance. The data consisted of 55 videotaped naturally occurring counseling sessions between 18 patients and five nurses and were analyzed using typology as an analyzing method. Four different styles of dietary advice-giving were recognized from the speech episodes concerning dietary behavior: recommending, persuasive, supportive, and permitting styles. Recommending style of advice-giving is recognized to be the dominant style that has arisen from the data and, actually, it seems to be the starting point in advice-giving practices. The other styles were used rarely, which suggest that the nurses rely upon quite a narrow selection of communication strategies that helps them to control the topics and the situation, although patient-centered counseling is strongly demanded nowadays. On the basis of our results we suggest that health professionals may need to become more aware of their advice-giving practices in routine situations through conscious effort of self-evaluation. A more detailed analysis of interpersonal conversations during counseling sessions is also needed as it may offer valuable information to promote patients' self-management skills by facilitating observation of conversational elements recognized to be successful in diabetes counseling.

Effective Nurse Communication With Type 2 Diabetes Patients

“…Of the included 13 studies, 7 studies used an observational design using videotaping or audiotaping, 4 of which coming from a Finnish research group using an observational data set from one large study (Karhila, Kettunen, Poskiparta, & Liimatainen, 2003; Kettunen, Poskiparta, Kiuru, & Kasila, 2006; Kiuru, Poskiparta, Kettunen, Saltevo, & Liimatainen, 2004; Poskiparta, Kasila, & Kiuru, 2006). Two studies used interviews or focus groups with nurses (Adolfsson et al, 2004; Jansink, Braspenning, van der Weijden, Elwyn, & Grol, 2010), and another 2 articles used questionnaires (Jallinoja et al, 2007; Woodcock & Kinmonth, 2001).…”

“…Nurses’ lack of communication skills are identified in self-reported studies, both through interviews (Jansink et al, 2010) and questionnaires (Jallinoja et al, 2007), and in observational studies (Karhila et al, 2003; Kiuru et al, 2004; Koopman-van den Berg & van der Bijl, 2001; Poskiparta et al, 2006; Sibley et al, 2011). Having insufficient knowledge about physical activity and diet recommendations may hamper effective communication.…”

The spread and uptake of diabetes prevention programs around the world: a case study from Finland and Australia

“…To overcome this barrier required dedication from key stakeholders in the regional health care management and support from the research team.Another such factor was the nature of the intervention program. While the structure and ready-made materials lowered the threshold for adoption, the facilitators discovered that it requires a different kind of preparation than the rather professional-driven individual counselling nurses were used to giving [37], and required specific interactive skills that they did not necessarily feel they mastered adequately. To solve these problems, the role of the program dietician was extended from support in dietary issues to more general support to facilitators.…”

“You Must Adhere Strictly to the Time and Days of Intake”: Medical Advice and Negotiations of Medical Authority in Nigerian HIV Consultations

“…In professional-client encounters, advice-giving is unidirectional; it is normatively initiated by the professional to the client (cf. Kawashima 2010;Kiuru et al 2004). Thus, the conduct of the professional is taken as a point of departure for the exploration of this interactional practice, as is the tendency for understanding the different trajectories in institutional interactions (cf.…”