different information forums, such
as literature and web-pages; as one
of the participants said: ‘Immediately
I got a diagnosis, I went to the library
and borrowed a thick book about diabetes
mellitus,’ (interview 7).
Supportive relationships were
one of the coping resources.
Participants said that they receive
encouraging, listening and social
support from their private relationships
with family members, other
next of kin, and friends. In particular,
family members’ contribution to having
a purpose in life was highlighted:
‘Without my family and my wife I probably
wouldn’t be alive,’ (interview 9).
Families also had a crucial role in
relation to everyday life: ‘Since I got
this diagnosis, the wife has tried to cook
healthier food for all of us,’ (interview 9).
The support from close family
members, such as spouse, friends
and children, was an important
resource in daily living, i.e. cooking
low-fat food, participating in the
appointments with diabetes nurse
and creating shared exercise routines.
‘I have friends; just a while ago
one called and asked if I wanted to go out
and enjoy afternoon coffee. We have this
group of men and we talk about everything,’
(interview 4). However, close
relationships were sometimes relatively
burdensome by nature: ‘When
my wife became ill, I got tired of looking
after my disease,’ (interview 11).
In addition to the above, participants
said that activities were also a
form of coping. Activities helped to
steer thinking away from the illness
and gave patients with diabetes
alternative ways in which to relax:
‘Different activities and culture events,
such as going to music concerts, open-air
theatres and just walking in the forest
help me to carry on,’ (interview 5).
Support provided by the nurse
was seen as the final form of coping
resources. This was a major
resource in coping with diabetes,
especially when there was carerelated
tiredness. Trustworthiness
and a shared sense of humour with
the nurse were featured in relation
to supportive relationships. Regular
counselling appointments played a
key role, especially during difficult
times: ‘Support from the nurse is the
thing. I wish the nurses would have the
strength to empower us and the hurry
would go away; today it’s important to
find a good nurse,’ (interview 15).
The content and form of counselling
The counselling provided by nurses
promoted diabetes patients’ participation
in planning their treatment
and in improving their balance of
care. There were some implications
that the counselling provided did
not pay sufficient attention to diabetes
patients’ resources, which
prompted some to consider the use
of counselling to be partly inadequate.
There were no direct discussions
on patients’ resources. As one
diabetes patient remarked: ‘I didn’t
notice that resources were asked about or
paid attention to in any way,’ (interview
8). On the other hand, the
diabetes patients themselves did not
introduce the matter of resources
into active discussion: participants
considered that the nurses should
have enough courage to ask directly
about their coping resources.
Guidance that supported nutritional
changes was described as a
positive way to change lifestyles.
Diabetes patients were motivated to
learn from the guidance when they
saw the differences – for example,
in their blood glucose levels.
Guidance was most useful when it
was regular. Some diabetes patients
felt a sense of guilt when they were
unable to obey the nurse’s instructions.
As one patient said: ‘I can’t
blame anyone else, it has to be me. If I
would have been stronger, I wouldn’t
have relapsed,’ (interview 5). In such
cases, diabetes patients felt that it
was important to meet the nurse.
Information was the main content
of counselling. Participants