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Conflicts within and between patients and health professionals characterised poorly controlled diabetes

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Q What are the conflicts experienced between patients with diabetes and poor glycaemic control and health professionals? How do they approach problem solving?

DESIGN

Grounded theory.

SETTING

A Danish university hospital.

PARTICIPANTS

11 patients ⩾18 years of age (range 18–63 y) who had diabetes for ⩾1 year and were admitted to hospital because of poor glycaemic control (glycated haemoglobin concentration ⩾8%); and 8 nurses with ⩾1 year of experience in a specialised diabetes unit (range 1–17 y).

METHODS

1 patient-nurse conversation was audiotaped at the beginning and at the end of the hospital stay. Each nurse also taped a discussion with a doctor, dietician, or another nurse, without the patient present. Researchers listened to the tapes of all 3 conversations and then conducted semistructured interviews with patients after discharge, with nurses, and again with patients 6 months after discharge. Constant comparative analysis was applied to the taped conversations and interviews in 4 steps: coding, critical comparison of the most solid and insistent categories until saturation was reached, comparison across data sources to explore and confirm links between …

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Footnotes

  • For correspondence: Dr V Zoffmann, Department of Nursing Science, University of Aarhus, Aarhus, Denmark. vz{at}sygeplejevid.au.dk; vz{at}nursingscience.au.dk

  • Sources of funding: Danish Health Insurance Foundation, Novo Nordisk Fonden, Ely Lilly, and the Danish Nurses Organisation.