An ethnographic investigation of healthcare providers’ approaches to facilitating person-centredness in group-based diabetes education

Nana Folmann Hempler, Susanne Reventlow, Gitte Wind

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    Abstract

    Aim
    To investigate approaches among healthcare providers (HCPs) that support or hinder person‐centredness in group‐based diabetes education programmes targeting persons with type 2 diabetes.

    Methods
    Ethnographic fieldwork in a municipal and a hospital setting in Denmark. The two programmes included 21 participants and 10 HCPs and were observed over 5 weeks. Additionally, 10 in‐depth semi‐structured interviews were conducted with patients (n = 7) and HCPs (n = 3). Data were analysed using systematic text condensation.

    Results
    Hindering approaches included a teacher‐centred focus on delivering disease‐specific information. Communication was dialog based, but HCPs primarily asked closed‐ended questions with one correct answer. Additional hindering approaches included ignoring participants with suboptimal health behaviours and a tendency to moralize that resulted in feelings of guilt among participants. Supporting approaches included letting participants set the agenda using broad, open‐ended questions.

    Discussion
    Healthcare providers are often socialized into a biomedical approach and trained to be experts. However, person‐centredness involves redefined roles and responsibilities. Applying person‐centredness in practice requires continuous training and supervision, but HCPs often have minimum support for developing person‐centred communication skills. Techniques based on motivational communication, psychosocial methods and facilitating group processes are effective person‐centred approaches in a group context.

    Conclusion
    Teacher‐centredness undermined person‐centredness because HCPs primarily delivered disease‐specific recommendations, leading to biomedical information overload for participants.
    Original languageEnglish
    JournalScandinavian Journal of Caring Sciences
    Volume32
    Issue number2
    Pages (from-to)783-792
    Number of pages10
    ISSN0283-9318
    DOIs
    Publication statusPublished - 2018

    Keywords

    • disease, health science and nursing

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