title: Quality assessment of practice nurse communication with type 2 diabetes patients.
abstract: OBJECTIVE
  Nurse self-management support for type 2 diabetes patients may benefit from applying theory-based behavior change counseling. The 5As model was used to assess if, and how, nurses applied the five key elements of self-management support in standard care.
  
  
  METHODS
  Seven practice nurses audio-recorded consultations with 66 patients. An existing instrument for assessing counseling quality was used to determine if the 5As were applied. Applied As were compared with quality criteria, to provide an in-depth assessment.
  
  
  RESULTS
  In almost every consultation, nurses assessed health behaviors, and arranged a follow-up meeting. However, nurses advised behavior change in less than half of the consultations, while setting goals and assisting patients to overcome barriers were used even less. Comparing applied As with quality criteria revealed several issues that could be improved.
  
  
  CONCLUSIONS
  Nurses consistently discussed health behaviors with patients, but important elements of self-management support were not applied.
  
  
  CONCLUSIONS
  Self-management support may benefit from training nurses in performing assessments that form the base for specific advice, setting goals, and addressing barriers to behavior change. Nurses also have to learn how to combine being medical expert and behavioral counselor. Clarifying both roles to patients may facilitate communication and establishing a collaborative relationship.
authors.affiliation: Strategic Communication, Wageningen University, Wageningen, The Netherlands. Electronic address: bob.mulder@wur.nl.
authors.forename: Bob C
authors.initials: BC
authors.lastname: Mulder
authors.affiliation: Strategic Communication, Wageningen University, Wageningen, The Netherlands. Electronic address: m.vanbelzen@outlook.com.
authors.forename: Milou
authors.initials: M
authors.lastname: van Belzen
authors.affiliation: Strategic Communication, Wageningen University, Wageningen, The Netherlands. Electronic address: annemarike.lokhorst@wur.nl.
authors.forename: Anne Marike
authors.initials: AM
authors.lastname: Lokhorst
authors.affiliation: Strategic Communication, Wageningen University, Wageningen, The Netherlands. Electronic address: ceesvwoerkum@gmail.com.
authors.forename: Cees M J
authors.initials: CM
authors.lastname: van Woerkum
mesh_terms: D003142:Communication; D003376:Counseling / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D015438:Health Behavior; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology*; D011320:Primary Health Care; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012648:Self Care; D014743:Videotape Recording
chemical_list: D007004:Hypoglycemic Agents
keywords: Nurse communication; Self-management support; The 5As model; Type 2 diabetes mellitus