A Canadian Cross-Sectional Survey on Psychosocial Supports for Adults Living With Type 1 or 2 Diabetes: Health-Care Providers' Awareness, Capacity and Motivation

Nichols, Jennica; Vallis, Michael; Boutette, Stephanie; Casey, Carolyn; Yu, Catherine

doi:10.1016/j.jcjd.2017.09.004

Cited by 12 publications

(18 citation statements)

References 34 publications

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“…From the perspective of the conference participants, challenges in integrating psychosocial support into routine diabetes care pertain to the patient-provider relationship, the organization and the community, which is also consistent with previous research [4][5][6][7][8][9][10][11].…”

Section: Discussionsupporting

confidence: 81%

Integrating psychosocial support into routine diabetes care: perspectives from participants at the Self‐Management Alliance meeting 2016

et al. 2018

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Aims To identify challenges and solutions to integrating psychosocial support into routine diabetes care from the perspective of stakeholders with expertise in diabetes self‐management education and support. Methods Ninety‐four people attended the annual international Diabetes Self‐Management Alliance meeting in 2016, which included plenary sessions and workshops on self‐management education, support and prevention. One workshop focused on how to integrate psychosocial support into routine diabetes care; this was run four times consecutively, allowing all conference participants to attend the workshops in groups of 20–25 people. Results Challenges and solutions associated with integrating psychosocial support into routine diabetes care concern the patient–provider relationship, the healthcare system and the community. Challenges identified were: lack of time, skills and resources to deal with psychological well‐being; a culture of patient blame and care expectations; the complexity of person‐centred assessment of psychological issues; and the substantial healthcare system focus on productivity and biomedical indicators. Lack of involvement of local communities and of inclusion of social determinants of health were also highlighted as challenging. Solutions identified were more patient–provider dialogue; more training and better skills among care providers; system incentives for psychosocial outcomes; and targeting social determinants of health and involvement of family and peers. Conclusions From the perspective of international stakeholders with an expertise in diabetes self‐management and support attending the conference in Denmark, substantial new incentives and systematic cultural changes are needed in healthcare systems to integrate psychosocial support into routine diabetes care, as recommended in international guidelines.

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Section: Discussionsupporting

confidence: 81%

Integrating psychosocial support into routine diabetes care: perspectives from participants at the Self‐Management Alliance meeting 2016

et al. 2018

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“…This result supports previous findings showing that nurses' behaviours in TPE were more oriented towards assessing and advising, that is towards medical tasks, which they master, than towards collaborative goal-setting and emotional management (Duprez et al, 2018;Elissen et al, 2013;ter Maten-Speksnijder, Dwarswaard, Meurs, & van Staa, 2016;Westland et al, 2018) where they feel less competent (Nichols, Vallis, Boutette, Gall Casey, & Yu, 2018). Nevertheless, healthcare professionals recognize the great importance of addressing psychosocial issues for optimal TPE (Nichols et al, 2018), but still lack adequate and effective training for this (Duprez, Vandecasteele, Verhaeghe, Beeckman, & Van Hecke, 2017 (Lelorain et al, 2017). In this particular context, even high emotional skills may not be enough to obtain a sense of authentic relatedness.…”

Section: Discussionsupporting

confidence: 90%

“…Thus, the fulcrum of motivation and sense of competence in TPE resides in nurses' and nursing assistants' general ability to handle their emotions and those of patients. This result supports previous findings showing that nurses' behaviours in TPE were more oriented towards assessing and advising, that is towards medical tasks, which they master, than towards collaborative goal‐setting and emotional management (Duprez et al, ; Elissen et al, ; ter Maten‐Speksnijder, Dwarswaard, Meurs, & van Staa, ; Westland et al, ) where they feel less competent (Nichols, Vallis, Boutette, Gall Casey, & Yu, ). Nevertheless, healthcare professionals recognize the great importance of addressing psychosocial issues for optimal TPE (Nichols et al, ), but still lack adequate and effective training for this (Duprez, Vandecasteele, Verhaeghe, Beeckman, & Van Hecke, ).…”

Section: Discussionsupporting

confidence: 89%

Nurses' and nursing assistants' emotional skills: A major determinant of motivation for patient education

Lelorain

Bachelet

Wortel

et al. 2019

Journal of Advanced Nursing

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Aims To explore professionals' (i.e. nurses and nursing assistants) motivation for Patient Education according to their emotional skills. Design A cross‐sectional study using a convenience sample of professionals completing self‐reported questionnaires assessing their general emotional skills and their Patient‐Education‐related sense of competence, autonomy and relatedness, according to the theory of basic psychological needs. Methods Professionals from 27 French hospitals working in various departments completed paper and web‐based questionnaires between January 2015 ‐ May 2017. Mediation analyses were performed controlling for the already known variables associated with motivation for patient education. Results Usable questionnaires (N = 185) were analysed. Professionals' emotional skills were associated with their motivation for Therapeutic Patient Education both directly and indirectly (i.e. partial mediation) via a higher sense of competence in Patient Education. Among the covariates, professionals who had received a high‐level training in Patient Education, those with a high recognition of their work in patient education and nurses (compared with nursing assistants) were the most motivated. Conclusion Professionals' emotional skills are the mainstay of their motivation for Patient Education. Training should aim to develop these skills so that professionals can manage their own emotions better (e.g. frustration when faced with non‐motivated patients) and those of patients (e.g. discouragement) and thus effectively support patient self‐management. Impact The study addressed nurses' and nursing assistants' motivation for patient education. Their emotional skills were directly and indirectly – via a higher sense of patient‐education‐related competence – associated with higher motivation. Training for professionals should therefore develop their emotional skills.

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“…The HCPs were aware of many of the self-care struggles experienced by people with Type 2 diabetes and recognized the impact this had on self-esteem and diabetes self-efficacy, which echoes that of previous work with HCPs [16,19,20]. HCPs also recognized that psychological support in diabetes services was valuable to support self-management, particularly at the point of diagnosis, which also aligns with previous work [25]; however there was a degree of dissonance as to when it would be most helpful to provide such support.…”

Section: Discussionmentioning

confidence: 54%

“…Diabetes HCPs recognize the importance of psychosocial support in diabetes care, but in reality, the majority feel apprehensive about engaging in conversations about psychological issues [19,20]. A key prerequisite of starting a conversation about the emotional challenges underpinning diabetes self-care is being able to notice these in daily practice.…”

Section: Introductionmentioning

confidence: 99%

Exploring the perceptions of emotional distress among couples living with Type 2 diabetes and among diabetes healthcare providers, and consideration of support needs

2019

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Aims To compare the emotional distress experienced by people with Type 2 diabetes with the perceptions of their partners, and to explore the perceptions of healthcare providers and how these differ from the perceptions and experiences of couples living with Type 2 diabetes regarding their support needs. Methods A purposive sample of people with Type 2 diabetes and their partners was recruited through Diabetes UK media outlets and support groups, while healthcare providers were recruited through hospital and diabetes education teams. Inductive thematic analysis was conducted. Results Seven people with Type 2 diabetes and six partners took part in separate semi‐structured interviews and seven healthcare providers took part in focus groups. Themes emerged regarding unique psychological struggles for people with Type 2 diabetes: ‘sense of restriction’; ‘disempowerment’; and ‘acceptance of diabetes’. For partners the themes of ‘feeling responsible’ and ‘need for greater involvement’ emerged. Common themes arising from people with Type 2 diabetes, partners and healthcare providers highlighted diabetes‐related stresses: ‘self‐care struggles’ and ‘perceived need for appropriate psychological support’. A key theme drawn from healthcare providers was ‘perceived professional barriers to psychological support’, which captures concerns related to providing emotional support in clinical practice. Conclusions People with Type 2 diabetes, partners, and healthcare providers share a common understanding of the emotional stresses of living with Type 2 diabetes, but also experience diabetes differently depending on their role and responsibilities. All face barriers that need to be considered to ensure that emotional support in diabetes is meaningful and feasible in routine practice.

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A Canadian Cross-Sectional Survey on Psychosocial Supports for Adults Living With Type 1 or 2 Diabetes: Health-Care Providers' Awareness, Capacity and Motivation

Cited by 12 publications

References 34 publications

Integrating psychosocial support into routine diabetes care: perspectives from participants at the Self‐Management Alliance meeting 2016

Integrating psychosocial support into routine diabetes care: perspectives from participants at the Self‐Management Alliance meeting 2016

Nurses' and nursing assistants' emotional skills: A major determinant of motivation for patient education

Exploring the perceptions of emotional distress among couples living with Type 2 diabetes and among diabetes healthcare providers, and consideration of support needs

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