115 Professional theme 2: Lacking effective strategies Common strategies not always work Trying to simplify Taking over responsibility Difficult explanation Not using resources Patients not listening HCPs competencies Repetitive strategies Simple language does not always lead to self-management HCPs report that they sometimes take over the responsibility although they think it is better to leave that to the patient HCPs report that they sometimes explain too much HCPs offer help resources but patients are not using them HCPs report that despite explaining poor health behaviors to patients they do not change them HCPs feel they lack competencies to support patients with LHL HCPs repeat information over and over but it does not help Emphasis on medical information Favoring medical over other information Addressing emotions Lifestyle as a topic Explaining the condition HCPs admit thaty they explain medical information in detail while other topics might need more attention HCPs might need to adress emotions more in consultations HCPs think lifestyle might need more attention in consultations The best way to explain CKD is difficult for HCPs Problems with tailoring of strategies Adaptation of communication Paternalism Case-to-case Speaking the same language Patients learning style Overcoming social desirability Create a trusting relationship Adaption of communication style regarding suspected patient needs is a challenge HCP dont want to invade in patients' autonomy, but it happens Difficulties with acting patient-centred, meeting individual needs Both literally and figuratively: when patient and HCP are not able to bridge their viewpoints or language problems Some patients 'learn by doing' and HCPs have more difficulties to support this style HCPs don't know how to support patients in being honest instead of answering what they think the HCP wants to hear HCPs perceive a relationship as important, but sometimes find that more difficult when patients do not self-manage well Limited use of beneficial strategies Asking the patient questions Avoiding teach back method Actionable information Follow-up Including support network Postive messages Summarizing main messages Visualization If HCPs identify if the patients understand by asking questions HCP feel hesitation to apply teach back method If HCPs feel they succeed in giving clear, goal-oriented advice If HCPs ask the patient what goals they want to achieve and follow it up in the next appointment Experiences with cooperating with the patients’ social network If HCPs motivate patients with positive feedback and messages If HCPs summarize all information of a consultation Use of images, video's, drawing to explain information Ideas for improvement Being on one (hierarchy) level Write down questions Using life aims Coaching Non-verbal communication Peer support Clear stepwise instructions Need for training of HCPs Patients preparation Applying strategies to comfort the patient and bridging feelings of hierarchy Encouraging to write down questions before/during consultations Motivating people by referring to aims that people have in daily life and how self-management can support these aims Acting as a coach and monitoring progress closely might be a strategy to motivate patients Overcoming HL problems in the interaction with patients by being sensitive to nonverbal behavior; Peer support is being mentioned as a strategy to improve selfmanagement HCPs mention that sometimes patients with LHL follow instructions very good Preferred way and topics for training to learning new HL skills HCPs say it would help if ptients can prepare consultations
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