Bakgrund: Antalet personer med diabetes i världen ökar. Det har blivit en global epidemi. Risken för dödsfall bland människor med diabetes, är ungefär dubbelt så stor, som för människor i samma ålder utan diabetes. Diabetes typ 2 (DT2) är den vanligaste typen av diabetes. Inom hälso- och sjukvården används alltmer motiverande samtal (MI) som behandlingsmetod för livsstilsrelaterade problem som till exempel: kost, motion alkohol och tobak. Syfte: Syftet med studien var att beskriva hur sjuksköterskans användning av MI påverkar livsstilsförändringar hos personer med DT2 och deras upplevelse av behandlingen. Metod: En litteraturöversikt. Resultat: MI som behandlingsmetod gav flera positiva hälsoeffekter. Det framgick bland annat genom en sänkning av HbA1c. Även kunskapsnivån gällande livsstilsförändringar ökade efter MI-behandling. Vid användning av MI stärktes personens inneboende motivation till förändring. Slutsats: MI är en relativt ny metod som ännu inte fått stor genomslag inom diabetesvården. MI ger positiva hälsoeffekter som till exempel sänkt HbA1c. Deltagarna blev mer motiverade och medvetna om sitt eget ansvar för att göra livsstilsförändringar. Mer forskning om MI för personer med DT2 behövs. / Background: The number of people in the world with diabetes is on the rise. It has become a global epidemic. The mortality risk among people suffering from diabetes is about twice as large, then for people in the same age without diabetes. Diabetes type 2 (DT2) is the most common form of diabetes. Motivational interviewing (MI) as a method of treatment, has a growing use within the health care sector and is applied to lifestyle related issues such as alcohol, tobacco, diet and exercise. Aim: The aim of the study was to describe how the nurse’s use of MI affect life-style changes in people with DT2 and their experience of the treatment. Method: A literature review. Result: MI, used as a treatment gave several positive health benefits. It showed among other things that HbA1c was lowered. Also the level of knowledge regarding lifestyle changes increased after MI treatment. The use of MI strengthened the person’s intrinsic motivation of change. Conclusion: MI is a relatively new treatment method that still hasn’t received a greater impact within the diabetic health care. MI shows positive health benefits such as a lowered HbA1c. The participants became more motivated and aware of their own responsibility to make life-style changes. More research is needed concerning MI for people with DT2.

Bakgrund: Livsstilsförändringar kombinerat med medicinsk stöd utgör grundläggande element i behandlingen av typ-2 diabetes. Varje individ är unik, vilket innebär att anpassningen av livsstilsförändringar vid  typ-2 diabetes kan skilja sig åt från person till person på grund av deras individuella behov och utmaningar. Diabetes är en av de vanligaste folksjukdomarna och har en betydande påverkan på utvecklingen av konsekvenser, vilka kan leda till allvarliga utfall, och det har även en betydande inverkan på människors ekonomiska, sociala och psykiska välbefinnande. Syfte: Syftet var att beskriva patienternas upplevelse av livsstilsförändringar vid typ -2 diabetes. Metod: Denna litteraturöversikt baserades på elva ursprungliga artiklar, alla utförda med kvalitativ metod och hämtade från databaserna Cinahl Complete och PubMed, vilka sedan inkluderades i resultaten. Dataanalysen grundade sig på Fribergs metodologiska beskrivning (Friberg, 2022). Resultat: Resultatet var indelat i fyra teman. Upplevelser i samband med diagnos och livsstilsförändringar, Upplevelser av kostförändringar, Upplevelser av fysisk aktivitet, Upplevelser av kunskap och motivation vid livsstilsförändringar. Efter att ha fått diagnosen typ-2 diabetes delade deltagarna i studien med sig av både positiva och negativa känslor samt erfarenheter relaterade till livsstilsförändringar. Å ena sidan upplevde de det som en utmaning att genomföra dessa förändringar, men å andra sidan fann de motivation i medvetenheten om de potentiellt allvarliga konsekvenser som sjukdomen kan medföra vid utebliven behandling. Slutsats: Deltagarna framhöll betydelsen av att få stöd från sjukvårdspersonalen för att känna sig motiverade och redo att genomföra livsstilsförändringarna. Den ansvariga sjuksköterskan bör säkerställa att patienterna erhåller det stöd och den individuellt anpassade utbildningen om egenvård vid typ-2 diabetes som behövs, eftersom patienterna själva bär en stor del av ansvaret för att förbättra sitt hälsotillstånd. / Background: Lifestyle changes combined with medical support are essential elements in the treatment of type-2 diabetes. Each individual is unique, which means that the adaptation of lifestyle  changes in type-2 diabetes may vary from person to person due to their individual needs and challenges. Diabetes is one of the most common chronic diseases and has a significant impact on the development of consequences, which can lead to serious outcomes, and it also has a significant impact on people´s economic, social, and mental well-being. Aim: The purpose was to describe patients' experience of lifestyle changes  in type-2 diabetes. Method: This literature review was based on eleven original articles, all conducted with a qualitative method and retrieved from the databases Cinahl Complete and PubMed, which were then included in the results. The data analysis was based on Friberg´s methodological description (Friberg, 2022). Results: The result was divided into four themes. Experiences related to diagnosis and lifestyle changes, experiences of dietary changes, experiences of physical activity, experiences of knowledge and motivation in lifestyle changes. After receiving the diagnosis of type-2 diabetes, the participants in the study shared both positive and negative emotions and experiences related to lifestyle changes. On the hand, they experienced it as a challenge to implement these changes, but on the other hand, they found motivation in the awareness of the potentially serious consequences that the disease can have if left untreated. Conclusions: The participants emphasized the importance of receiving support from healthcare professionals to feel motivated and ready to implement lifestyle changes. The responsible nurse should ensure that patients receive the support and individually tailored education on the self-care for type-2 diabetes that is needed, as patients themselves bear a significant responsibility for improving their health condition.

Bakgrunn: I senere år har det blitt en økende oppmerksomhet på forebygging av sykdom gjennom helsefremmende tiltak i forhold til livsstilsendring. Allmennprakitiserende leger er viktige samarbeidspartnere. Studier viser at en relativt liten del av befolkningen mottar slik rådgivning. Mål: Studiet hadde til hensikt å beskrive de ulike erfaringene allmennpraktiserende leger med å arbeide som folkehelsearbeidere med et helsefremmende perspektiv med fokus på livsstilsintervensjon. Metode: Studiet benyttet en kvalitativ og fenomenografisk tilnærming for innsamling og analyse av data. 26 allmennpraktikere ble strategisk valgt (kjønn, alder, arbeidserfaring, kommunestørrelse). Data innsamlet i 2007 fra seks fokusgrupper med utgangspunkt temaene livsstilsendring, motivasjon, pasienterfaringer og legenes egne erfaringer på området. Resultat: Tre deskreptive kategorier framkom; (A) Dramatisk inngripen, (B) En travel hverdag og (C) Det gylne øyeblikk med to respektive fire underkategorier. I kategorien A fremkom det at allmennlegene oppfattet livsstilsintervensjon som et vanskelig område å diskutere med pasienten, og var opptatt av maktrelasjonen i forhold til pasienten. Mange av dem oppga usikkerhet i forhold til en slik oppgave. I kategori B beskrev legene utenforliggende årsaker som de oppfattet begrenset intervensjon i forhold til levevaner. I kategori C beskrev legene hvordan de griper fatt i de gode situasjonene for intervensjon. Gjennom en syntese av resultatene foreslås en modell for praksisendring. Konklusjon: Den norske fastlegeordningen skaper et ”kjøper/selger forhold” mellom lege og pasient, noe som uheldigvis kan bidra til uklare maktrelasjoner. Mange av legene i studiet manglet kunnskap om folkehelse og helsefremmende perspektiv i sitt daglige arbeid. Modellen som beskrives, fokuserer på synergieffekten mellom behovet for å avgjøre hvilken prosess som reelt resulterer i helsefremmende arbeidet og en identifisering av de prosesser som legene annerkjenner som ”gylne øyeblikk”. Modellen kan benyttes som en diskusjon i nye fokusgruppediskusjoner med mål, å endre praksis mot et mer helsefremmende perspektiv. / Background: In recent years attention have increased on disease prevention and health promotion through lifestyle intervention. General practitioners (GPs) are important partners in this effort. Different studies indicate that relatively few GP-patient-populations receive this type of advice. Aim: The aim of this study was to describe GPs various experiences of working within the field of public health and especially from a health promotion perspective with focus on life style interventions Methods: The study used a qualitative and phenomenographic approach to collecting and analyzing data. Twenty six GPs were strategically selected (gender, age, work experience, sizes of communities). Data was collected in 2007 from six focus group developed on the basis of lifestyle changes, motivation, patient experiences, and GPs’ own experience with these subjects. Findings: Three categories emerged: (A) Dramatic intervention, (B) Busy workday, and (C) The golden moment. In category A, the GPs describe how they experience lifestyle intervention as a difficult theme to discuss with their patients. They were concerned about the risk of disrupting the balance imbalance of power, thereby depreciating the patients. In category B, the GPs describe ulterior causes for limitations in intervention-strategy towards lifestyle changes. Category C describes how GPs seize the opportunity provided by optimal moments for intervention. Synthesizing the focus group results yielded a model for modifying current health promotion practice. Conclusion: The Norwegian medical system uses a listing system to assign patients to a specific physician, a practice that gives the doctor/patient relationship an element of “purchase and sale” that unfortunately may influence the balance of power between GP and patient. Most GPs lacked sufficient knowledge of public health and health promotion in their daily work. The model described in this thesis focuses on the synergistic effects between the need to determine which processes actually result in health promotion and further identifying those processes GP recognizes as “Golden moment.” The model described here can be used as a point of departure for new focus group discussions aiming to modify medical practice towards health promotion perspectives. / <p>ISBN 978-91-85721-81-8</p>

Background: Diabetes mellitus type 2 is a common disease that is increasing globally. A healthy lifestyle can stunt the progression on the disease. Self-care is an important part of the treatment. Dietand physical activity are essential factors in treatment of diabetes. Healthcare workers can support knowledge of the disease, motivate and encourage the patients to enhanced self-care and a life-stylechange. Aim: The aim of this literature study was to describe the experience of persons diagnosed with diabetes mellitus type 2 regarding self-care. Method: Through a qualitative literature review based on ten scientific articles retrieved from PubMed and Cinahl, the aim of the study was answered. Result: Three main themes were identified. Experience of self-care during lifestyle changes, experience of self-care support and reasons hindering self-care. Conclusion: Tin summary, the results show that there are more obstacles for people diagnosed with diabetes to perform self-care. Obstacles like work, family and socioeconomic circumstances can affect life quality so much that, when in severe condition, self-care is negatively affected. Introduction of lifestyle changes and medication were experienced as difficult which could lead to deterioration of mental health. Better support and more knowledge would facilitate self-care in this patient group.