Supporting change in a complex reality: a qualitative study of specialist nurses' perceptions of counselling patients at risk of type 2 diabetes.
Specialist nurses face significant barriers in providing effective dietary counselling for diabetes prevention, highlighting the need for better organizational support and cultural competence training.
Where it sits
this study against the rest of the evuzamitide corpusSummary and findings
This qualitative study explored specialist nurses' perceptions of providing dietary advice to patients at risk of type 2 diabetes in Swedish primary health care. It identified themes related to patient-centered strategies, cultural influences, and organizational challenges. Nurses reported barriers such as limited consultation time and low patient motivation.
Abstract
<h4>Background</h4>Specialist nurses in primary health care play a key role in supporting individuals at risk of type 2 diabetes to adopt healthier eating habits. Although dietary counselling is central to prevention, limited knowledge exists on how nurses experience providing individualized advice that considers gender, cultural background, and patients' everyday contexts.<h4>Objective</h4>To explore specialist nurses' perceptions of delivering individualized dietary advice to patients at risk of type 2 diabetes, with attention to gender, culture, and contextual factors.<h4>Design</h4>Qualitative study based on semi-structured interviews.<h4>Setting and participants</h4>Specialist nurses in Swedish primary health care were recruited through snowball sampling. Data were collected between August and November 2025.<h4>Methods</h4>Data were analysed using qualitative content analysis according to Graneheim and Lundman.<h4>Results</h4>Four themes and 12 subthemes described how specialist nurses applied patient-centered strategies, considered gendered and multicultural influences, encountered clinical and motivational challenges, and expressed a need for enhanced organizational and educational support. Nurses emphasized empathy, small-step goal setting, and person-centered communication. However, limited consultation time, low patient motivation, socioeconomic constraints, and cultural complexity hindered effective counselling. Participants highlighted the need for cultural competence training, accessible and updated resources, and stronger organizational support.<h4>Conclusion</h4>Effective dietary prevention requires that specialist nurses have sufficient time, appropriate tools, and organizational support to tailor advice to patients' everyday lives. Despite strong commitment, structural, cultural, and motivational barriers limit the effectiveness of prevention efforts. Strengthening organizational structures, improving access to culturally adapted resources, and adopting collaborative care models may enhance diabetes prevention in clinical practice.
Background
This study addresses the role of specialist nurses in providing dietary counselling to individuals at risk of type 2 diabetes, focusing on the challenges of tailoring advice to diverse patient backgrounds. Previous research highlights the importance of dietary changes in diabetes prevention, but little is known about how nurses navigate cultural and gender-specific factors in their counselling practices.
Methods
The study employed a qualitative design using semi-structured interviews with specialist nurses in Swedish primary health care. Participants were recruited through snowball sampling, and data were collected from August to November 2025. The analysis was conducted using qualitative content analysis according to Graneheim and Lundman.
Results
The study identified four main themes and 12 subthemes related to the delivery of dietary advice. Nurses used patient-centered strategies, considered gender and cultural influences, and faced clinical and motivational challenges. Barriers included limited consultation time, low patient motivation, and cultural complexity. Participants expressed a need for cultural competence training and stronger organizational support.
Interpretation
The findings suggest that while nurses are committed to providing individualized dietary advice, structural and motivational barriers limit their effectiveness. Compared to prior literature, this study highlights the specific challenges faced in multicultural settings. The effect size of these barriers is not quantifiable but appears significant in practice. The study implies that enhancing organizational support and cultural competence could improve diabetes prevention efforts.
Key findings
- Four themes and 12 subthemes identified.
- Nurses emphasized empathy and small-step goal setting.
- Limited consultation time and low patient motivation were barriers.
- Cultural complexity hindered effective counselling.
- Need for cultural competence training and stronger organizational support.
Limitations
- Qualitative study with subjective perceptions.
- Snowball sampling may introduce selection bias.
- Findings may not generalize beyond Swedish primary care.
- No quantitative data on intervention effectiveness.