Table 2.

Challenges nurses faced in managing empowering patient education

Condensed meaning	Subcategory (N = number of descriptions)	Main category
Child/family not familiar to the nurse	Lack of information and expertise (N = 7)	Management and leadership challenges
Only limited experience of diabetes education in the diagnostic phase
Not enough information on the empowering patient education process
Being not sure of one’s ability to include all the details of empowering patient education
Wondering if educating differently from colleagues
Interruptions during education caused by colleagues seeking advice	Lack of vital resources (N = 4)
Education took place in a room with other families and without patient privacy
Lack of appropriate demonstrative material for school-age children
Teaching the traditional blood monitoring education	Nurse-centered education in practice (N = 6)	Ambivalence with traditional and empowering patient education
Not discussing objectives with the family, but knowing they should be communicated
Tendency to teach all parents in the same way
Using partly non-interactive teaching in which only the child tested blood glucose
Tendency to dominate the discussion
Education should be based more on the child and parents’ needs	Identification of the need for child- and family-centered education (N = 6)
Child and parent participation should be increased by listening to them and negotiating with them
Child not taking the disease seriously	Child as passive participant (N = 2)	Challenges of child or parent’s situation
Child is quiet and refusing to measure blood glucose
Parent not being present enough and unwilling to listen to anything	Parents suffering from shock (N = 4)
Parents remain passive and not able to receive or utilize any information
It is difficult to judge from parents’ behavior if they understood anything