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

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@article{b6039e0d2b174d4a971ed27e2f5a2c77,
title = "An ethnographic investigation of healthcare providers' approaches to facilitating person-centredness in group-based diabetes education",
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.",
keywords = "communication skills, diabetes, ethnographic fieldwork, group-based patient education, healthcare providers' skills, person-centred methods, person-centredness, qualitative methods, self-management",
author = "Vibeke Stenov and Hempler, {Nana Folmann} and Susanne Reventlow and Gitte Wind",
year = "2018",
month = "6",
day = "1",
doi = "10.1111/scs.12509",
language = "English",
volume = "32",
pages = "783--792",
journal = "Scandinavian Journal of Caring Sciences",
issn = "0283-9318",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "2",

}

RIS

TY - JOUR

T1 - An ethnographic investigation of healthcare providers' approaches to facilitating person-centredness in group-based diabetes education

AU - Stenov, Vibeke

AU - Hempler, Nana Folmann

AU - Reventlow, Susanne

AU - Wind, Gitte

PY - 2018/6/1

Y1 - 2018/6/1

N2 - 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.

AB - 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.

KW - communication skills

KW - diabetes

KW - ethnographic fieldwork

KW - group-based patient education

KW - healthcare providers' skills

KW - person-centred methods

KW - person-centredness

KW - qualitative methods

KW - self-management

UR - http://www.scopus.com/inward/record.url?scp=85054145093&partnerID=8YFLogxK

U2 - 10.1111/scs.12509

DO - 10.1111/scs.12509

M3 - Journal article

VL - 32

SP - 783

EP - 792

JO - Scandinavian Journal of Caring Sciences

JF - Scandinavian Journal of Caring Sciences

SN - 0283-9318

IS - 2

ER -

ID: 55563668