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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 concepts, and comparison of theoretical ideas and connections that emerged in the previous steps.

MAIN FINDINGS

The core category of “keeping life and disease …

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