A huge challenge in type 2-diabetes care is how to motivate patients towards health behaviour changes. In Denmark, the tendency is that nurses in general practice provide a large part of type 2 diabetes care. Observational studies support Self-determination Theory by finding autonomous motivation and perceived competence associated with improved HbA1c-levels in patients with type 2 diabetes. Hence, research is needed to develop and test interventions that are autonomy supportive. Aim To develop a training course for practice-nurses in autonomy support in patients with type 2 diabetes, and to evaluate the effect on patient outcomes. Methods The development of the intervention was based on literature research and expert meetings. The intervention is evaluated in a cluster randomised controlled trial with 40 Danish general practices, * where nurses, before enrolment in the study, provided consultations to patients with type 2 diabetes, * and about 2500 patients with type 2 diabetes, identified in a Diabetes Database. The patients will be followed 15 months from nurse-participation in the course. Data will be obtained from registers and patient-questionnaires. The hypothesis is that patients with type 2 diabetes regardless of education level, age, and gender will benefit from the intervention.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
40
An interactive course consisting of 4X4 hours education in autonomy support over a 6 months period. The main-components in the course are 1) communication skills, 2) introduction to patient work-sheets and 3) a quick up-to-date knowledge about treatment recommendations of type 2 diabetes. Furthermore, the nurses in the intervention-practices receive a half an hour support-visit 4-5 months after the end of the course.
Department of General Practice, School of Public Health, Aarhus University
Aarhus, Denmark
HbA1c
Collected from registers (historical data - not measured as a part of this study)
Time frame: Last measurement within 12 months before - and 15 months after nurse participation in the course
HDL-cholesterol
Collected from registers (historical data - not measured as a part of this study)
Time frame: Last measurement within 12 months before - and 15 months after nurse participation in the course
LDL-cholesterol
Collected from registers (historical data - not measured as a part of this study)
Time frame: Last measurement within 12 months before - and 15 months after nurse participation in the course
Perceived autonomy support (HCCQ)
Modified health care climate quastionaire (Self-determination Theory)
Time frame: 15 months from nurse participation in the course
Type of motivation (TSRQ)
The treatment self-regulation quastionaire (Self-determination Theory)
Time frame: 15 months from nurse participation in the course
Perceived competence (PCS)
perceived competence scale (Self-determination Theory)
Time frame: 15 months from nurse participation in the course
Total-cholesterol
Collected from registers (historical data - not measured as a part of this study)
Time frame: Last measurement within 12 months before - and 15 months after nurse participation in the course
Self-rated health (SF-12)
Time frame: 15 months from nurse participation in the course
Problem Areas In Diabetes scale (PAID)
Time frame: 15 months from nurse participation in the course
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