Implementing Lifestyle Counselling Into Secondary Type 2 Diabetes Care: Perspectives From Diabetes Nurses

Aim: To explore the implementation of lifestyle counselling in secondary type 2 diabetes mellitus care from the perspective of diabetes nurses. Design: An exploratory qualitative study. Methods: Semi-structured interviews were conducted with diabetes nurses in a hospital setting. Data were analysed through inductive thematic analysis by two independent coders. Results: The findings are structured around two main categories: the current role of lifestyle in consultations and nurses' perspectives on the future of lifestyle counselling. Diabetes nurses consider lifestyle an essential component of care but face numerous barriers to discussing it effectively. Key challenges include limited expertise, a lack of practical guidelines, time constraints, patient motivation, and the patient-provider relationship. Nurses prioritise raising awareness, educating, and providing brief personalised advice, while comprehensive lifestyle coaching is beyond their scope. They emphasise the importance of multidisciplinary collaboration to ensure a holistic approach that incorporates multiple lifestyle factors and individual circumstances. Nurses also recognise the potential of eHealth, anti-obesity medication, and novel insulin pumps to support lifestyle changes. Conclusions: Lifestyle counselling is complex and influenced by various factors. Efforts should focus on specialised training, actionable guidelines, and interdisciplinary collaboration. Advances in medicine and technology offer additional opportunities to enhance patient support. Implications for the Profession and/or Patient Care: The role of diabetes nurses should focus on raising awareness, providing education, and offering brief, personalised lifestyle advice. Nurses need the knowledge and skills to identify lifestyle needs and receive an overview of appropriate referral options. Impact: Training programmes should be developed to enhance nurses' competence and confidence in providing lifestyle guidance. Interdisciplinary collaboration must be strengthened both within hospitals and at the regional level. Policymakers should develop practical guidelines encompassing all lifestyle dimensions and providing clear referral pathways to specialised professionals and interventions. Reporting Method: This study adhered to the COREQ criteria. Patient or Public Contribution: No Patient or Public Contribution.