Interaction Between Patients With Type 2 Diabetes And Diabetes Nurse Specialists During Annual Check-Ups: A Study Using Video Recordings

Background : Patients with Type 2 diabetes are involved in lifelong treatment through annual diabetes check-up. Diabetes nurse specialists are in charge of these appointments which are meant to promote patient’s health, diabetes control as well as the recommended physical examination. Communication during the annual diabetes check-up depends on each party’s agenda or goals. The interaction structure during the annual check-ups by diabetes nurse specialists is rarely studied, though it is important for patients understanding. Objective: The aim of this study was to explain how the interaction was initiated and performed during the physical examination in annual diabetes check-ups.Methods: Applied conversation analysis was used in 20 video observations to describe verbal and nonverbal interaction between patients with type 2 diabetes and diabetes nurse specialists during the annual diabetes check-ups. Findings : Annual check-ups consisted of five phases: opening, health history, physical examination, conclusion and closing. Patients were generally the main actors. By recounting their health history they were able to set the agenda. The pattern changed to more passive participation during the physical examination which required mutual cooperation in order to create reliable outcomes. The informative value of check-ups varied depending on, the patients’ problems and the type of examination used, among other things. Practical implications: First professionals must be aware that routines of instruction to patients during physical examination procedures have an influence on patients’ understanding of measurement outcomes. Second, professionals should understand that even when there is no problems there can still be a subject for discussion about self-management. Third professionals need to be prepared to cope with embarrassing examination routines in order to enhance informative value.