Diabetes Care from Diagnosis: Effects of training in patient-centred care on beliefs, attitudes and behaviour of primary care professionals

In a randomised trial, general practitioners and nurses in 21 practices wer e trained in patient-centred consulting and use of materials for people wit h Type 2 diabetes (GPs 0.5 days; nurses 1.5 days; two optional follow-up ha lf-days). Twenty practices formed the comparison group. Professional belief s, attitudes and behaviour were measured (pre-trial, close-of-course and en d-of-trial), supported by patient reports of nurse behaviour (141 trained: 108 comparison patients, 1 year after diagnosis). A total of 49 practice nu rses responded (29 trained; 20 comparison). Trained nurses rated relative i mportance of patient-centred to professional-centred care as greater than c omparison nurses. Trained nurses became less keen on the approach during th e trial, and perceived time constraints persisted. Patients diagnosed later in the study were less likely to recognise intervention materials. Trained nurses rated delivery of important aspects of care and satisfaction with s tyle of care as lower than comparison nurses, but patients were more positi ve about delivery of care from trained than comparison nurses. Although nur ses rated patient-centred care as important, whether or not they had been t rained as part of the trial, the short, generalisable training programme si gnificantly reduced nurse perceptions of their ability to deliver it. Nonet heless, patients reported that important aspects of diabetes care were deli vered more if their nurses had been trained in patient-centred consulting. This raises issues concerning measurement scales completed by trained profe ssionals. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.