What processes of change are elaborated during an experiential educative counselling based on the patient centred care (PCC) model with type 2 diabetes patients in general practice ?
Résumé
• Educative counselling have to favour processes of change needed for the improvement of clinical criteria in type 2 diabetes patients. Their efficacy is identical to those of oral antidiabetics on intermediate criteria (1% decrease in HBA1c) but not on morbi-mortality. • Research question: Which processes of change are built during an educational approach based on a patient centred approach in type 2 diabetes patients in General Practice? • Qualitative phenomenological research with transtheorical model of change (Prochaska) triangulation • Educational patient centred approach including, after a purposive sampling, ten type 2 diabetic patients • Intervention : active listening and understanding of patients' perspectives (lived experience, beliefs, expectation, preference) + explanation on diabetes + adapted hygieno-dietetic counselling with an objective of common ground. • Main outcome measures assessed at 3 months : quantitative (weight and HBA1c) and qualitative (satisfaction, achievement of objectives) • Analysis of processes of change from patients' verbatims (NVivo 9) • To stimulate patients' reflexivity , self-evaluation and decisional balance • To highlight and support experiential cognitivo-emotional (Consciousness raising, dramatic relief, environmental reevaluation, self reevaluation, self liberation) and behavioural (Helping relationships, stimulus control, counter-conditioning, reinforcement management) processes of change • To promote strategies reinforcing the feeling of self-efficacy by lived-experiences
Domaines
Sciences de l'Homme et Société
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