Ohjaajien toiminta elintapamuutosten tukemisessa tyypin 2 diabeteksen ehkäisyn ryhmäohjauksessa

Abstract

The purpose of the study was to describe the supervisors’ action in the support of changing one’s living habits in two weight management groups in the type 2 diabetes prevention program. The data consists of 17 video-recorded 90-minute “Small decision a day” weight management group counselling sessions of two groups with 10 and 20 participants in the years 2004-2005. The supervisors’ talk was analyzed with the deductive analysis from five teaching perspectives including theirs beliefs, intentions and actions. The transtheoretical change model and the participants’ talk were analyzed with the inductive analysis. Quantitative methods were used to give more information about the counselling sessions. The results show that the transmission perspective was the most dominating followed by the apprenticeship perspective. The developmental perspective consisted of self-assessment and was nearly as dominating as the apprenticeship perspective. The supervisors changed the emphasis from the lesson- focused type to the participant-centered counselling. The need for the change and the objectives were continually connected to new information. The apprenticeship perspective consisted of physical exercise where the participants were also given individual advice. The self-assessment was supported with focused questions, comments, advice, positive feedback, encouragement, comfort and other linguistic methods by the supervisors. The supervisors adapted to the challenge of the change according to the participants’ resources. Mostly, the supervisors supported the awareness of participants and their self-assessment, the re-assessment of the environment and follow-up. The time used in the sessions and participation in the groups were quantified. Further research could concentrate on participants’ experiences in group counseling, the outcome expectations, the objectives and the role of peers, and also the factors of physical and psychosocial environment in the change, physical exercise intervention and web counseling.