Consulting about lifestyle change: Evaluation of a training course for specialist diabetes nurses

The National Service Framework (NSF) for Diabetes highlights the importance of sharing decision making with patients when helping them to adopt and maintain a healthy lifestyle. It was felt that this shift in focus with the development of a more patient-centred approach would require the teaching of new skills to health care professionals. The Communication Skills Unit in Cardiff worked with the local Diabetes Unit to design a training programme that allows professionals to develop their skills in behaviour change counselling. The nurse specialists in the Diabetes Unit were very involved in talking to patients about lifestyle issues, and yet they had little or no previous communication skills training. A pilot course was designed, in which four audiotaped simulated consultations were conducted before and after two seminars led by an expert in behaviour change counselling. The consultations were carried out in six nurses' normal clinical settings to ensure a truer representation of a normal consultation. The results showed that initially most participants were using a didactic and nurse-centred approach when offering lifestyle advice. Following the course, all the nurses were using skills that were more aligned with behaviour change counselling, and interviews afterwards revealed that the course was acceptable and enjoyable. This pilot study provides the rationale for paying closer attention to practitioner skill acquisition before examining the efficacy of behaviour change counselling for improving lifestyles among those with chronic diseases like diabetes. Copyright © 2003 John Wiley & Sons, Ltd.