Learning to practise the Guided Self-Determination approach in type 2 diabetes in primary care: A qualitative pilot study

Abstract

AimTo describe how diabetes nurses in primary care experience the process of learning to practise the person‐centred counselling approach Guided Self‐Determination among adults with type 2 diabetes.DesignA descriptive qualitative design.MethodData were collected in 2014–2015 by means of individual interviews with four diabetes nurses at two points in time. The data were analysed using qualitative content analysis.ResultsThree themes that reflect nurses’ processes in learning to use the Guided Self‐Determination approach were identified: (1) from an unfamiliar interaction to “cracking the code”; (2) from an unspecific approach to a structured, reflective, but demanding approach; and (3) from a nurse‐centred to a patient‐centred approach. The overall findings indicate that the process of learning to practise Guided Self‐Determination increased the nurses’ counselling competence. Moreover, the nurses perceived the approach to be generally helpful, as it stimulated reflections about diabetes management and about their own counselling practices.

Dropout From an eHealth Intervention for Adults With Type 2 Diabetes: A Qualitative Study

“…This theory proposes that in order to foster autonomous motivation for engagement in activities, it is important to support individuals’ basic psychological needs for autonomy, relatedness, and competence [ 21 ]. The GSD intervention aims to support diabetes self-management by empowering self-determined goal-setting and competence-building [ 22 , 23 ]. The intervention is described in more detail in the Methods section.…”

Reconfiguring clinical communication in the electronic counselling context: The nuances of disruption

“…This study is extending on an earlier published study about how diabetes nurses in primary care experienced the process of learning to practise the intervention Guided Self-Determination in face-to-face consultations among people with type 2 diabetes (Oftedal, Kolltveit, Zoffmann, Hörnsten, & Graue, 2017). In this current study, we move from face-to-face consultation to Guided Self-Determination in an electronic format with the purpose of developing knowledge about what may be needed to support nurses in shifting health intervention communications into the electronic format.…”

“…Malterud, Siersma, and Guassora () emphasize that a study with clear and focused dialogue between researcher and participants requires fewer participants to offer sufficient data material than a study with an unclear or vague communication. In our study, the researcher (BCHK) has interviewed the participants in an earlier study (Oftedal et al, ) and has thus, already established contact and trust in the dialogue. In addition, the researcher has knowledge of both the diabetic work at GP and the GSD intervention.…”

“…Previous systematic review reveals the need for eHealth interventions based on a theoretical framework that would provide appropriate patient‐tailored feedback from healthcare professionals (Pal et al, ). A recent study, using a theory‐driven intervention, shows that diabetes nurses (DNs) experienced this Guided Self‐Determination (GSD) intervention for type 2 diabetes as a constructive counselling method for stimulating patients’ reflections and motivation for diabetes management (Oftedal et al, ). Based on these findings, we, in this current study, adapted the GSD approach to an asynchronous eHealth intervention based on written communication.…”

“…The median duration of their experience in diabetes care was 7 years (ranging from 4 ‐ 22 years). Three of the four DNs had formal postgraduate education in diabetes care (60 ECTS) and all had been trained in the GSD method (Oftedal et al, ). However, none of the DNs had been trained in GSD on an eHealth platform.…”