Patients' perception of disease and experience with type 2 diabetes patient education in Denmark

Patient education programmes for a range of chronic conditions are widely implemented, but studies have shown that not all participants benefit equally from the patient education programmes.

To explore differences in how persons with diabetes experience diabetes-related patient education programmes.

Qualitative in-depth interviews were conducted with eleven participants 6 months after participation in patient education. Using thematic analysis, we identified three themes: programme elements, interactions between participants and the role of facilitators. We used Alonzo's theory of Everyday Illness Behaviour and reported restrictions in daily activities to categorise seven participants as 'healthy' and four as 'ill' and compare their experiences of patient education.

Although all participants identified information on diet and exercise as the most beneficial programme element, healthy participants found this information easy to understand and apply to make healthy changes in their daily lives. Ill participants found the information difficult to understand and were much less likely to implement related changes. Healthy participants valued social interactions occurring during interactive programme components such as weigh-in sessions, physical exercise and cooking classes. In contrast, ill participants did not value these social interactions. Healthy participants also tended to view programme facilitators more positively. Regardless of disease status, participants found it motivating to compare their health status to that of participants they perceived as more ill than themselves.

Patient education experiences differ according to self-perceived disease status. Programme facilitators should be sensitive to the possibility that participants who are more ill may be less likely to perceive patient education as beneficial and implement new behaviours. Knowledge about factors leading to differences in patient experiences of chronic disease self-management education programmes is essential for the development of programmes that benefit all patients. Future research should explore the value of programmes differentiated for participants with different levels of health.