A case study of the education process for diabetes self-management in a nurse-led centre in Hong Kong

Diabetes education is the corner-stone of diabetes care, but there has been limited investigation of the quality and characteristics of the diabetes education process in Hong Kong. This study aims to evaluate this process by adopting an embedded, single-case study design with multiple triangulation to examine a case – the education process for diabetes self-management in nurse-patient encounters. Two overarching themes of “control” and “concern” explain what happened in the education process, with nurses controlling and showing concern and patients submitting to the control and expecting genuine concern. The education process occurred within a relational context characterised by Chinese culture and the acute-care culture. Patients perceived self-management to be a part of their total life context and a positive nurse-patient relationship to motivate self-management. Patient outcomes were increased knowledge and improved glycaemic control, but no change in psychosocial self-efficacy after the education process. Findings highlight the positive aspects of nurses’ ability in expressing culturally appropriate concern and expertise in information-giving. The high relevance of the control/concern model to the cultural context is analysed, and one particular value of this model is its implications for a re-conceptualisation of the Western model of self-empowerment in a Chinese context where Confucianism has a strong influence on moral code based on human relations.