Advice-giving styles by finnish nurses in dietary counseling concerning type 2 diabetes care.

Dietary advice-giving is an important part of dietary counseling in diabetes care and prevention. The strategies of advice-giving, however, have not been explicated and the qualitative characteristics of conversations in diabetes counseling have remained mainly unstudied. This article describes the styles in which nurses responsible for diabetes counseling in Finnish primary care practices offer dietary advice for patients with recently diagnosed type 2 diabetes or impaired glucose tolerance. The data consisted of 55 videotaped naturally occurring counseling sessions between 18 patients and five nurses and were analyzed using typology as an analyzing method. Four different styles of dietary advice-giving were recognized from the speech episodes concerning dietary behavior: recommending, persuasive, supportive, and permitting styles. Recommending style of advice-giving is recognized to be the dominant style that has arisen from the data and, actually, it seems to be the starting point in advice-giving practices. The other styles were used rarely, which suggest that the nurses rely upon quite a narrow selection of communication strategies that helps them to control the topics and the situation, although patient-centered counseling is strongly demanded nowadays. On the basis of our results we suggest that health professionals may need to become more aware of their advice-giving practices in routine situations through conscious effort of self-evaluation. A more detailed analysis of interpersonal conversations during counseling sessions is also needed as it may offer valuable information to promote patients' self-management skills by facilitating observation of conversational elements recognized to be successful in diabetes counseling.