6533b86cfe1ef96bd12c8d3f

RESEARCH PRODUCT

Lifestyle counseling in type 2 diabetes prevention: a case study of a nurse's communication activity to produce change talk.

Marita PoskipartaTarja KettunenPäivi KiuruKirsti Kasila

subject

Counselingbusiness.industryCommunicationPerspective (graphical)Health BehaviorPublic Health Environmental and Occupational HealthPrimary health careLifestyle counselingSingle patientTask (project management)DilemmaNursingDiabetes Mellitus Type 2Tape RecordingMedicineHumansFemalesense organsHealth behaviorskin and connective tissue diseasesbusinessNurse-Patient RelationsExpansiveLife Style

description

As a case study, this article describes a nurse's communication activity, focusing on change talk during lifestyle counseling in primary healthcare. All videotaped counseling sessions with a single patient within a period of two years were transcribed verbatim. In the analysis, an emphasis was placed on the nurse's communication activity that produced change talk, how the nurse initiated change talk, and how the patient received it. The observations provide evidence that the dilemma of simultaneously maintaining professional authority and patient perspective leads to sensitivity in lifestyle counseling. Three categories of change talk were identified: rejected, restrictive, and expansive change talk. Producing change talk is a very demanding task for counselors. It is best produced when the nurse stays within the patient's frame of reference with a combination of reflective, change-inducing questions, encouraging assessments and conversational space. On the basis of our results, we suggest that nurses need training to identify and to encourage patients' change talk and to communicate flexibly according to patients' values during lifestyle counseling. In addition, in order to insist on change talk, we need to demonstrate how change talk could be carried out so that nurses could orient to it.

10.1515/cam.2006.002https://pubmed.ncbi.nlm.nih.gov/16808421