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Does patient education facilitate diabetic patients’ possibilities to reach national treatment targets?: A national survey in Swedish primary health care
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Diabetes Nursing Research.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.ORCID iD: 0000-0003-3691-8326
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Diabetes Nursing Research.
2009 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 27, no 2, 91-96 p.Article in journal (Refereed) Published
Abstract [en]

Objective

To describe how patient education is arranged in Swedish primary healthcare (PHC) and to assess whether the type of patient education and individual goal setting have an impact on diabetic patients’ possibilities of reaching national treatment targets.

Design

A Swedish national survey.

Setting

Swedish PHC.

Subjects

Data from 485 primary healthcare centres (PHCCs) and 91 637 diabetic patients reported by the PHCCs to the National Diabetes Register in 2006.

Main outcome measures

Description of how patient education is arranged, HbA1c, body mass index, cholesterol, blood pressure, and physical activity.

Results

Of the PHCCs that reported how they performed the individual counselling, 50% reported checklist-driven counselling and 8% individualized counselling based on patients’ needs. A total of 105 PHCCs reported that they arranged group education. Of these, 67% used pre-planned programmes and 9% individualized the programme to the patients’ needs. The majority of PHCCs (96%) reported that they set individual goals (HbA1c, blood pressure, lipids, and lifestyle). A minority of the PHCCs (27%) reported that the patients were involved in the final decision concerning their goals. Individual goal-setting facilitated patients’ possibilities of reaching treatment targets. Goal-setting, list size of PHCCs, and personnel resources explained a variance of 2.1–5.7%. Neither individual counselling (checklist-driven or individualized to patients’ needs) nor group education had an impact on patients’ possibilities of reaching the targets.

Conclusion

The current study indicates that improvement is needed in patient education in PHC to facilitate diabetic patients’ possibilities of reaching national treatment targets.

Place, publisher, year, edition, pages
2009. Vol. 27, no 2, 91-96 p.
Keyword [en]
Diabetes mellitus, family practice, patient education, primary health care
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-97424DOI: 10.1080/02813430902759671ISI: 000266278900007PubMedID: 19247874OAI: oai:DiVA.org:uu-97424DiVA: diva2:172372
Available from: 2008-09-01 Created: 2008-09-01 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Patient Education for People with Type 2 Diabetes in Primary Health Care
Open this publication in new window or tab >>Patient Education for People with Type 2 Diabetes in Primary Health Care
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The general aim of this thesis was to evaluate different aspects of patient education for people with type 2 diabetes in Swedish primary health care.

The evaluation was conducted in a primary health care setting in central Sweden and in Swedish primary health care in its entirety. Seven centres in central Sweden had implemented the empowerment programme for patients with type 2 diabetes. Data on 16 care providers’ views on implementing the programme were collected in focus-group interviews. The effect and the patients’ experiences of the programme were evaluated in a randomized controlled trial (RCT) (n=101) and in individual interviews (n=28). In the RCT, 50 patients were assigned to the programme and 51 patients to routine diabetes care. The patients answered a 27-item questionnaire and BMI and HbA1c were measured, before the intervention and at one-year follow-up. Further, data from 485 primary health care centres with 91,637 diabetic patients were collected to evaluate patient education in Swedish primary health care in its entirety.

The care providers experienced conflicting roles in changing from expert to facilitator in the empowerment programme. The programme improved patients’ confidence in diabetes knowledge and contributed to their experience of self-control, while patients in the routine diabetes care experienced external control. Of the 485 centres, 50% reported having checklist-driven individual counselling and 8% that they individualized the counselling based upon patients’ needs. Most centres (>90%) set individual goals, but only one-third involved patients in the final decisions regarding their goals. Setting individual goals was found to have an impact on patients’ possibilities to reach national treatment targets.

In conclusion, the implementation of empowerment in patient education demands support to care providers in order to influence patients’ self-care. Furthermore, patients need to reflect upon necessary self-care changes and also set individual goals to facilitate the reaching of national treatment targets.

Place, publisher, year, edition, pages
Uppsala: Universitetsbiblioteket, 2008. 68 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 367
Keyword
Diabetes mellitus, empowerment, patient education, primary health care
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-9200 (URN)978-91-554-7254-2 (ISBN)
Public defence
2008-09-26, Samlingssalen, Psykiatricentrum, Centrallasarettet, Ing 29, Västerås, 13:15
Opponent
Supervisors
Available from: 2008-09-01 Created: 2008-09-01 Last updated: 2010-10-06Bibliographically approved

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Thors Adolfsson, EvaSmide, BibbiRosenblad, AndreasWikblad, Karin

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