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Practitioners' actions inhibited patient participation in self care decision making

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QUESTION: How do people with long standing type 1 diabetes mellitus manage self care decision making and relationships with practitioners?


Grounded theory, guided by symbolic interactionism.


Vancouver, British Columbia, Canada.


22 Caucasian adults (mean age 43 y, 64% women) with type 1 diabetes of ≥15 years' duration (mean 30 y) who nominated themselves or were nominated by their physicians as expert self care managers (ie, able to make trustworthy decisions about self management and to maintain good glycaemic control).


Data were collected from audiotaped think aloud periods, in which participants described their self care decision making over three 1 week periods; individual interviews held before and after think aloud periods; and a 2 hour focus group interview at the study conclusion. Transcripts of think aloud periods were used to develop interview prompts. All transcripts were analysed using constant comparative …

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  • Source of funding: BC Health Research Foundation.

  • For correspondence: Dr B Paterson, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada. paterson{at}