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Diabetes Educ. 2013 Nov-Dec;39(6):811-9. doi: 10.1177/0145721713504471. Epub 2013 Sep 30.

Goal setting with type 2 diabetes: a hermeneutic analysis of the experiences of diabetes educators.

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Washington State University, Spokane, Washington (Dr Fleming, Ms Boyd, Dr Kynast-Gales, Dr Ballejos, Ms Malemute, Dr Armstrong Shultz, Dr Vandermause)



The purpose of this study was to explicate and interpret common experiences of diabetes educators (DEs) with patient goal setting for patients with type 2 diabetes in diabetes education.


Transcripts (n = 10) from semi-structured interviews were analyzed using a hermeneutic phenomenological approach to more deeply explore the accounts of DEs' goal setting with patients with type 2 diabetes.


The overarching pattern that emerged was "Striking a Balance," which subsumed 4 subthemes: Applying Theoretical-Practical Principles When Setting Goals, Identifying Idealistic-Realistic Expectations, Creating Patient-Educator-Centered Plans, and Readying-Living With Goal Setting. The pattern, "Striking a Balance," revealed a common meaning of DEs as experiences requiring balance and nuance in goal setting with patients.


The results of this study combined with the tenets of the self-determination theory can provide the DEs with real-life exemplars and a theoretical framework to encourage their patients to self-manage, increase intrinsic motivation, and improve adherence related to their lifestyle changes and glycemic control. DEs, as facilitators of change, can implement these changes with flexible and reciprocal activities with their patients. The DEs owned these activities and they are: "building the bond," "sharing the session," "readying for change," "sending them home," and "bringing them back."

[Indexed for MEDLINE]

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