Focus on functioning in person-centered nurse-led diabetes care:an exploration of views of patients and healthcare providers, in particular the nursing profession, on person-centered diabetes care and patient factors affecting health outcomes

Type 2 diabetes (DM2) is one of the most common chronic condition. DM2 is strongly related to obesity and less exercise. DM2 is characterized by elevated blood glucose levels, which can lead to serious complications. Medication is often required to prevent complications. A healthy lifestyle and coping with DM2 in everyday life is just as important. To support patients, a person-centered care approach is recommended. Not only the condition but the whole person is central in this. The aim of this thesis is to develop knowledge about person-centered diabetes care for application by primary care providers. Therefore, patients' and health care providers' views on person-centered diabetes care were explored. Patients were asked what helps or hinders them from actively participating in the diabetes consultation. This mainly concerned their health literacy and a trusting relationship with their healthcare provider. Nurses were asked which aspects of the patient's daily functioning they consider relevant in diabetes care. These turned out to be mainly biomedical factors and to a lesser extent psychosocial factors, such as assets or support from their employer. Furthermore, it turned out that shared decision-making, which is an important element of person-centered care, is not always applied by healthcare providers in the diabetes consultation. Finally, it was found that diabetes-related distress, patient`s health literacy and confidence to manage DM2, influence glycemic control. In order to optimize person-centered care, based on these findings, it is recommended that, in addition to disease and treatment, patients` functioning should also be taken as a reference point in diabetes care, including influencing environmental factors