Box 2.

Person-centred care in practice.

Dermot has lived with type 2 diabetes for 7 years. Shortly after diagnosis, he was referred to a structured education programme, which not only helped him understand his condition better and what could lie ahead, but also the changes he could make to prevent these problems (support for self-management).

At times, he has experienced feeling ‘down’. He doesn’t think this was due to his health or diabetes, but these did make it harder. Talking through his frustrations with his diabetes team was helpful and he also accessed peer support through the local voluntary group. Hearing that others had gone through similar things was very affirming (emotional and psychological support).

Dermot was aware that his diabetes control has been creeping up a little over recent years and was mindful of the potential risks associated with this. When he received his diabetes test results prior to his care planning appointment, he was disappointed to see that his HbA1c had increased a bit further. In discussion with his diabetes nurse at that appointment, he established that his goal was to try to feel better and stay healthy. Together they were able to establish that weight loss and improving his diabetes control were central to this and developed an action plan for this (care planning).

A few months on, Dermot was struggling to make the changes he would like, so he worked with his diabetes nurse, who supported him to think through his motivations for change, to start to make some small changes and gain some momentum (health coaching).

Following this, he was able to lose some weight, but the diabetes control did not improve as much as he had hoped. Following discussions with his diabetes team, and the use of a decision aid to consider his potential options, he decided that the appropriate next step was to start insulin (shared decision making).

He started insulin in the local group and found the education and information that he received here, along with the peer support from others in a similar position, was very powerful in motivating him to make the best use of the insulin. Over subsequent months, he gained the skills and confidence to adjust the insulin doses himself, and to make ongoing changes around weight loss, and was delighted that he achieved the improvements he was aiming for (support for self-management).