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Understanding the job in a new way - a basis for development of competence in diabetes care
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. (Health Services Research)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. (Health Services Research)
2000 (English)In: Upsala Journal of Medical Sciences, Supplement, ISSN 0300-9726, Vol. 105, no 2, 161-169 p.Article in journal (Refereed) Published
Abstract [en]

Patients complain that doctors and nurses do not listen, and therefore a need to develop the patient encounter is at hand. Phenomenological theory has opened new ways to develop professional competence. If the idea holds that we express our understanding about our work through our actions, a change in understanding might further develop professional competence. This idea offers a new way to develop competence in diabetes health care service. The aim of this study was to map health care professionals' understanding of the patient encounter before and after an educational intervention that focused the way the health care professional experienced the encounter, and to describe how their understanding changed. Two general practitioners and two diabetes nurses participated. They were interviewed before and after the intervention. The intervention comprised 4-5 sessions during which they together with a tutor reviewed their videotaped consultations with different persons with diabetes. The tutors' role was to make interventions that could alter the persons understanding of the diabetes consultation through questioning. The interviews were analysed using phenomenographic method. The results show that the professionals changed their ways of experiencing the encounter after the intervention. They started to question their way of working, focused the patient's learning process and became interested in how to stimulate it.

Place, publisher, year, edition, pages
2000. Vol. 105, no 2, 161-169 p.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health Care Research
Identifiers
URN: urn:nbn:se:uu:diva-53443ISI: 000168299700013PubMedID: 11095112OAI: oai:DiVA.org:uu-53443DiVA: diva2:81353
Available from: 2008-10-17 Created: 2008-10-17 Last updated: 2017-12-04Bibliographically approved
In thesis
1. Gaining Professional Competence for Patient Encounters by Means of a New Understanding
Open this publication in new window or tab >>Gaining Professional Competence for Patient Encounters by Means of a New Understanding
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Swedish health care is currently facing problems, such as lack of financial resources, staff shortage and dissatisfaction among patients and professionals. Patients’ dissatisfaction was the point of departure for the present study, and one approach dealing with this problem was investigated. It was hypothesised that a patient-centred perspective could offer a possible solution. The aim of the study was to explore health care professionals’ and medical students’ understanding of their professional role and the patient encounter. A further goal was to determine whether these understandings could be developed by educational interventions. Students and professionals have been either interviewed or responded to a survey about their professional role and the patient encounter. Qualitative analysis was used. One group- and one individualised intervention were carried out. The participants’ understandings of their professional role were taken as the starting point for learning. The results showed that a minority of medical students and professionals in diabetes care had incorporated a patient-centred perspective. Nurses in telephone advisory services recognised the patients’ needs, but experienced conflicting demands of being both carer and gatekeeper. A non-optimal match between patients’ needs and what professionals understand as their role could cause some of the problems. Competence development could be achieved by taking the participants understanding of the professionals’ role and of the patient encounter as a starting point for reflection. The results have implications for changes in organisation and education in health care, to optimise outcomes of care. Time for reflection, mentoring and professional development is needed.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2002. 91 p.
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1145
Keyword
Medical sciences, competence development, diabetes care, educational interventions, medical students, patient encounters, phenomenography, phenomenology, professional role, telephone advisory services, MEDICIN OCH VÅRD
National Category
Medical and Health Sciences
Research subject
Health Care Research
Identifiers
urn:nbn:se:uu:diva-1975 (URN)91-554-5297-3 (ISBN)
Public defence
2002-05-14, Rudbecksalen, Uppsala, 13:15
Opponent
Available from: 2002-04-22 Created: 2002-04-22 Last updated: 2010-06-16Bibliographically approved

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Holmström, IngerRosenqvist, Urban

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