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Table 3 Talking about success (a) Suzanne, specialist nurse, diabetes, London

From: “Was that a success or not a success?”: a qualitative study of health professionals’ perspectives on support for people with long-term conditions

Excerpts are presented in the order they arose in the interview
Interviewer: … can I ask for some examples or case histories from your experience, to illustrate what your idea of success might look like?
Participant: Oh, gosh, right, yeah. So I mean… I guess that can vary enormously from the type of clinics that we’re doing. So for instance, in an antenatal clinic… success is a healthy live baby and healthy mum… And then, of course… somebody with a chronic condition where you’re just supporting them living with the condition… We, of course, as health professionals, want someone to have as best HbA1C to reduce the risk of complications in the long term, as well as to be able to live a happy, healthy life, as it were… The people we get are more and more complex… We’re never going to achieve the ideal HbA1C for everyone… So if we can even just chip away and support them to live better with their diabetes we’re hopefully doing something to support them in a positive way…
Interviewer: … Can you think of some examples, again from your own experience, to illustrate what an unsuccessful partnership with a patient might look like?
Participant: I think one where there’s no connection, or where the patient probably isn’t at the right place to have a discussion about managing their diabetes, for whatever reason… We do have consultations where we think “Oh that didn’t go very well”… when you feel like you’re not getting very far with someone for whatever reason
Interviewer: … So thinking about the things you’ve said… can we think about how we might define the concept of success?
Participant: Gosh, yeah, that is so hard, isn’t it? Because the concept of success, I suppose, is about… the people with diabetes that had long term outcomes, the effect on the NHS, all those sort of things … What you really want to achieve is to be able to support someone to self-manage their diabetes so that they do not get (or they reduce the risk of getting) long term complications… And that’s success. But success on a day-to-day basis is about chipping away, and having a long term - and motivating people to take some action about their diabetes…
Interviewer: … Do you think patients would agree with how we’re defining success here?
Participant: Well no, not necessarily. Because success – another success could be for instance [with someone who is] having a really hard time with their blood glucose swinging all over the place [that] they have much more stable blood glucose levels that enables them to feel more confident about living their life without the risks of feeling unwell in the morning because their blood sugars are high, or having hypos in the middle of work situations, which are incredibly embarrassing… So that would be incredible success for an individual. That would be success for us, too, but then we’re always wanting more, aren’t we… for the long-term risks of complications?