Clinicians must avoid “telling off” or “blaming” patients with diabetes, according to a new guide that highlights the importance of using the right words when interacting with those with the disease.
The guide – launched by NHS England and several charities – emphasises the “enormous power” of the language used by clinicians and the profound impact on patients with diabetes – good and bad.
“How we interact with those living with diabetes is fundamental to the management of their condition”
Using the right language when talking or writing to someone – or communicating without actually saying anything via body language – can “lower anxiety, build confidence, educate and can help to improve self-care”, noted the document.
“Conversely, poor communication can be stigmatising, hurtful and undermining of self-care and have a detrimental impact on clinical outcomes,” said the introduction to the guide, which was written by two people with diabetes.
The Language Matters guide was developed in partnership by NHS England with seven other organisations and charities, including Diabetes UK and type 1 diabetes charity the Juvenile Diabetes Research Foundation (JDRF).
The document has been launched to coincide with Diabetes Week, which runs from 11 to 17 June. It urges nurses and other healthcare professionals to be more empathetic, understanding and encouraging and less “disapproving”, “judgmental” and “threatening”.
“Small words can have a big impact – especially when someone is struggling with their type 1 diabetes”
The guide also emphasises the need to use language that is “free from judgement or negative connotations” and, in particular, try to avoid “scolding” or “telling off” patients.
In addition, nurses should “avoid language which attributes responsibility – or blame – to a person for the development of their diabetes or its consequences”.
“Judging, blaming or shaming a person who is experiencing the consequences of diabetes is common,” states the guide, which says health professional should steer clear of describing patients as “non-compliant” or criticising their food choices and eating habits.
It highlights the need to look out for words and phrases said by patients that may indicate “diabetes distress”, when people are struggling to cope with the daily demands of managing diabetes.
For example, this might include someone saying something like “I hate diabetes” or that it is a “big effort” to control what they eat.
“Phrases such as these said in a clinical encounter may be traditionally considered by health professionals as ones that show ‘denial’, ‘lack of motivation’ or ‘non-compliance’,” said the guidance.
“They are sometimes met with the reaction that the people with diabetes should ‘just get on with it’ or at best, a sign that someone is ‘not ready’ to engage with their diabetes,” it said.
“It’s important we make sure that people talking about diabetes feel safe to explore the issue”
However, Dr Partha Kar, associate national clinical director for diabetes at NHS England, stressed that using the right language in such situations could make all the difference.
“How we interact with those living with diabetes is fundamental to the management of their condition – the tone and words used – all have a bearing on how they look after their diabetes,” he said.
“Language Matters provides useful advice on things such as alternatives to commonly used phrases which may cause offence to some – it is a practical handbook for healthcare professionals, designed to be used and referred to in a clinical setting, rather than sit on a shelf,” he said.
Karen Addington, UK chief executive of JDRF, also emphasised the importance of using the right words.
“Healthcare professionals do an amazing job. But small words can have a big impact – especially when someone is struggling with their type 1 diabetes,” she said.
Diabetes UK chief executive Chris Askew acknowledged it could be hard to start “tricky conversations” about managing and living with diabetes and hoped the Language Matters guide would help.
“It’s important we make sure that people talking about diabetes feel safe to explore the issue, and that first and foremost that they are being treated and respected as a human being,” he said.
“Positive conversations can open the door to better care, better treatment at school and in the workplace and a better quality of life for everyone,” he added.