Implementation of Person-Centered Methods in Group-Based Diabetes Education

Healthcare professionals’ (HCPs) skills in person-centeredness are pivotal for delivering successful diabetes self-management education and support (DSMES). Many HCPs favor person-centered methods as a concept but implementation in practice remains challenging. The main focus is on information about diabetes, complications, medications, diet and exercise. This study explored how HCPs implement new methods to facilitate person-centered DSMES in groups.

The study was guided by action research and divided into three phases (investigation, action, and pilot) using a variety of qualitative methods. In step one, observations were conducted across five educational settings including 49 persons with T2DM and 13 HCPs to explore HCPs’ person-centered skills. In step two, 14 HCPs collaborated in two workshops to develop new methods e.g., exercises and dialog tools to prompt discussions about psychosocial aspects of diabetes and to fit educational needs to both the individual and the group. In step three, we pilot-tested the methods using observations in three settings and interviewed 5 HCPs and 27 participants with T2DM. A final workshop was conducted to evaluate the methods. Systematic text condensation and hermeneutic analysis were used to analyze data.

Implementation of the methods was characterized by three categories. Some HCPs chose not to implement the methods because they conflicted with their usual practice relying on the biomedical model. Other HCPs agreed with the concept but was unable to structure the process, leaving participants uncertain about the aim. Finally, some HCPs succeeded with implementation promoting participants’ needs, reflections and discussions in groups.

Implementing methods to deliver person-centeredness is complex and requires systematic training of HCPs. The training should be structured stepwise incorporating techniques directed towards existing skills including ample time to train and reiterate skills.