Främjande av egenvård för patienter med typ 2-diabetes inom primärvården - diabetessjuksköterskans upplevelser

Sammanfattning: ABSTRACT Background: The incidence of type 2 diabetes is increasing worldwide. Early intervention in form of medication, advice on self-management and lifestyle changes is necessary to avoid complications. Few Swedish studies are made on the diabetes nurse’s views on promotion of self- management. Purpose: To examine the diabetes specialist nurse’s experience of promoting self-management to patients with type 2 diabetes in primary care.   Method: A qualitative explorative study where eight diabetes nurses were interviewed. The interview guide consisted of semistructed questions concerning the promotion of self-management. Results: The diabetes nurse’s role in promoting patient self-management is significant, if resources are available in the form of adequate time for the patient and good team work. Best results are achieved when the diabetes nurse serves as a good coach by; building mutual trust, giving support and commitment, maintaining the exchange of knowledge through regular two-way communication and by being available. Organisational hold backs constitute a bottleneck for promotion of self-care. They are characterized by; limited resources which compel unsatisfactory priorities, political control by “Vårdvalet” and lack of diabetes teams.  Limitations of the patient may work against self-management by patient denial of the disease or physical limitations that complicate physical activity. Conclusion: Sufficient resources are required so that the diabetes nurse can conduct good diabetes care in accordance with the National Board guidelines. Key words:  type 2 diabetes, primary care, diabetes specialist nurse, self-management, patient education