The effectiveness of “Diabetes Theatre”, an educational workshop of diabetes care, on its theatre staffs toward empowerment: a qualitative study

Problem

Every choice of diabetes patient about diet, exercise, and pills are essential to their own care of diabetes. Therefore, “Empowerment approach” is considered one of the most suitable ways for diabetes care. In order to spread empowerment approach in Japan, “Diabetes Theatre (DT)” was developed. DT is an educational workshop for health care professionals (HCPs) who are audiences. The audiences watch plays about common communication problems in diabetes care and discuss what is the problem of that communication, paying attention to the relationship with patients. This allows each of the HCPs audiences to reflect their own relationship with patients and improve the communication. In DT, “Theatre staffs” are also HCPs who make scenarios, prepare for DT, and perform at DT. The aim of this study is to explore what theatre staffs learn through DT.

Approach

We interviewed 11 theatre staffs (3 doctors, 5 nurses, 2 nutritionists, 1 clinical technologist) of a DT held at Kobe city in Japan in November 2012. Participants were recruited through convenience sampling and we obtained the approval by documents. We asked them what they felt about the experience of the DT and what kind of change happened about their daily communication with patients after that. The transcripts were analysed using a qualitative data analysis method called “Steps for Coding and Theorization (SCAT)”.

Findings

Using SCAT, what the theatre staffs learned through DT were sorted into 3 categories: 1) Factors leading to awareness, 2) Awareness of the relationship with patients, 3) Changes led by the awareness. We showed some concepts in each category: 1) experience at DT putting themselves in patients’ shoes, experience at DT paying attention more to what patients think, similarity of DT to the reality, 2) awareness of their unconsciously repeated one-sided behaviors to patients, awareness of their attitude paying attention just to disease and not to patients themselves or patients’ background, 3) listening to patients story more carefully, paying attention to patients themselves, acceptance of patients as a whole person, compassion for patients, goal setting by patients.

Consequences

The concepts of category 3) are true for the key concepts of empowerment. Thereby, the finding articulates the HCPs theatre staffs learn to get empowerment approach through DT. Like the process from 2) to 3), we found that HCPs’ awareness of their unconsciously one-sided attitude led to their empowerment and compassion for patients which would allow them to improve the quality of their relationship. Such awareness is only brought about from their own experience, and DT was the one of effective programs which brings those experience like category 1). Therefore, DT is valuable for its HCPs theatre staffs, and we hope such a program will become more widespread for better and compassionate communication between HCPs and patients.