title: A nurse-led interdisciplinary approach to promote self-management of type 2 diabetes: a process evaluation of post-intervention experiences.
abstract: OBJECTIVE
  Self-management of type 2 diabetes through diet, exercise and for many medications, are vital in achieving and maintaining glycaemic control in type 2 diabetes. A number of interventions have been designed to improve self-management, but the outcomes of these are rarely explored from a qualitative angle and even fewer through a process evaluation.
  
  
  METHODS
  A process evaluation was conducted using a qualitative design with participants randomized to an intervention. Seventy-three people living with type 2 diabetes and hyperglycaemia for a minimum of 1 year, randomized to one of two interventions (n = 34 to an education intervention and n = 39 to an education and acceptance and commitment therapy intervention) completed stage one of the process evaluation, immediately following the intervention through written feedback guided by open-ended questions. A purposive sample of 27 participants completed semi-structured interviews at 3 and 6 months post intervention. Interview data were transcribed and data analysed using a thematic analysis.
  
  
  RESULTS
  The majority of participants described an increase in knowledge around diabetes self-management and an increased sense of personal responsibility. Participants also described changes in self-management activities and reflected on the challenges in instigating and maintaining change to improve diabetes management.
  
  
  CONCLUSIONS
  The complexities of implementing change in daily life to improve glycaemic control indicate the need for ongoing support post intervention, which may increase and maintain the effectiveness of the intervention.
authors.affiliation: School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia.
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Whitehead
authors.affiliation: Centre for Postgraduate Nursing Studies, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Marie T
authors.initials: MT
authors.lastname: Crowe
authors.affiliation: Department of Psychology, University of Canterbury, Christchurch, New Zealand.
authors.forename: Janet D
authors.initials: JD
authors.lastname: Carter
authors.affiliation: Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand.
authors.forename: Virginia R
authors.initials: VR
authors.lastname: Maskill
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Dave
authors.initials: D
authors.lastname: Carlyle
authors.affiliation: School of Health Sciences, University of Stirling, Stirling, UK.
authors.forename: Carol
authors.initials: C
authors.lastname: Bugge
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Chris M A
authors.initials: CM
authors.lastname: Frampton
mesh_terms: D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology / Q000628:therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006943:Hyperglycemia / Q000523:psychology / Q000628:therapy; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D009726:Nurses; D010348:Patient Care Team / Q000458:organization & administration*; D010353:Patient Education as Topic / Q000379:methods*; D012648:Self Care / Q000379:methods* / Q000523:psychology
keywords: evaluation; experience