چکیده (انگلیسی):

Background:Lifestyle counselling is a pivotal aspect of diabetes care. But general practitioners (GPs) often have
problems in finding their role in patients’ weight management. The aims of this study were to investigate the experiences
of type 2 diabetes patients with lifestyle counselling from their GPs and to explore how patients’ preferences regarding
counselling are embedded in the context of self-management and wider cultural aspects of nutrition.
Methods:Narrativeinterviewswereconductedwith35peoplewithtype2diabetesagedbetween35and77years.
The interviews were transcribed verbatim and analysed using the thematic framework method.
Results:Many patients had a strong feeling of personal responsibility for weight reduction as integral to diabetes
self-management but found it difficult to integrate the changes their disease requires into their self-management
activities. They attached great importance to their GPs’ advice on diet. While some patients appreciated direct
communication, others regarded dramatic pictures as either unhelpful or offending. A serious problem was the
incompatibility of the dietary recommendations with daily life resulting in a reluctance to adjust the whole diet
to the needs of diabetes care.
Conclusions:Ambivalence towards patient self-management and tensions between the necessary changes to
patients’ lifestyles and their culture, makes the GP’s role difficult and full of conflict. Instead of focusing exclusively on
the guidelines of diabetes management and provision of information, GPs should explore the patients’ capabilities of
self-management through open communication and accept their patients’ wishes to protect nutrition as part of their
culture.