Table of Contents
Type: Coursework | Subject: Nursing | Level: Undergraduate | Word Count: ~2,400 words
This model coursework was produced by an Essays UK specialist as reference material for learning purposes only. For support in this field, see our nursing writing support.
Overview: This model undergraduate coursework explores how person-centred care can be applied to the nursing management of an adult with Type 2 diabetes. Using recognised frameworks and an illustrative case study, it examines shared decision-making, self-management support, psychosocial awareness and cultural sensitivity, together with the barriers that can undermine person-centred practice.
Person-centred care has become a defining principle of contemporary nursing, repositioning the patient from a passive recipient of treatment to an active partner in their own health. For people living with long-term conditions such as Type 2 diabetes mellitus (T2DM), this shift is particularly significant, because day-to-day management depends far more on the patient’s own choices than on episodic clinical intervention. This coursework examines how person-centred care can be applied to the nursing management of an adult with T2DM. It is presented as a model example to illustrate how an undergraduate nursing student might structure a theoretically informed, practice-focused discussion.
The discussion begins by defining person-centred care and situating it within recognised theoretical frameworks and professional standards, most notably the Person-Centred Practice Framework developed by McCormack and McCance and the Nursing and Midwifery Council (NMC) Code. A short, anonymised case study of a fictional patient is then introduced to ground the analysis in a realistic clinical context. Using this case, the coursework explores four interrelated dimensions of person-centred diabetes care: shared decision-making, support for self-management, attention to the psychological and social context, and cultural sensitivity. Finally, it considers the barriers that can undermine person-centred practice and reflects on the implications for the nursing role. Throughout, the aim is to demonstrate how person-centred values translate into concrete, defensible nursing actions.
Person-centred care is widely understood as an approach that treats people as individuals, respects their rights and preferences, and builds a therapeutic relationship grounded in mutual trust and shared power. The Health Foundation summarises this as care that is coordinated, personalised and enabling, recognising the person rather than the condition as the organising focus of care. The World Health Organization similarly frames people-centred services as those organised around the comprehensive needs of people rather than around individual diseases.
Theoretically, much nursing scholarship draws on the Person-Centred Practice Framework articulated by McCormack and McCance. This framework identifies several interdependent domains: the prerequisites of the nurse, such as professional competence and well-developed interpersonal skills; the care environment, including supportive organisational systems and shared decision-making structures; person-centred processes, such as working with the patient’s beliefs and values and engaging authentically; and person-centred outcomes, such as involvement in care and a sense of wellbeing. The framework is valuable because it makes explicit that person-centredness is not simply a matter of individual kindness; it depends equally on the culture and systems within which care is delivered.
Earlier theoretical roots can be traced to Kitwood’s work on personhood, which argued that recognising the individual’s unique identity, history and perspective is central to humane care. Entwistle and Watt extend this thinking through a capabilities approach, suggesting that person-centred care should actively support patients’ ability to understand, deliberate and act in relation to their own health. These positions are reinforced by professional regulation. The NMC Code requires nurses to prioritise people, to listen and respond to their preferences and concerns, and to empower them to share decisions about their care. Person-centred care is therefore not an optional philosophy but a professional and ethical obligation. For the purposes of this coursework, it is defined as a collaborative, individualised approach in which the nurse works in partnership with the patient to understand their values, priorities and circumstances, and to support informed, self-directed management of their condition.
To illustrate how these principles apply in practice, this coursework uses a fictional case study. In line with the NMC Code’s requirements on confidentiality, the patient described here is entirely illustrative and does not represent any real individual; all clinical details are invented for teaching purposes.
The patient, referred to as Mr Hughes, is a 58-year-old man diagnosed with Type 2 diabetes approximately three years ago. He attends a routine review at a community diabetes clinic. His most recent (illustrative) HbA1c result is 69 mmol/mol, above the individualised target of around 53 mmol/mol that had previously been agreed, indicating that his blood glucose control has deteriorated. He is prescribed metformin but reports that he sometimes forgets doses. Mr Hughes works long and irregular shifts as a delivery driver, lives with his wife, and describes limited time for cooking or exercise. He mentions, almost in passing, that he feels “fed up” with diabetes and worried about developing complications after a relative lost their sight to the condition.
This case presents a familiar clinical picture in which the biomedical data, a rising HbA1c and inconsistent medication-taking, cannot be understood in isolation from the person’s circumstances, emotions and priorities. A purely disease-focused response might simply intensify medication. A person-centred response, by contrast, seeks first to understand why control has slipped and what matters most to Mr Hughes before negotiating a plan with him. The following sections use his case to explore four dimensions of person-centred diabetes care.
Person-centred diabetes care can be understood through four interrelated dimensions, each of which translates the theory outlined above into practical nursing action. These are explored in turn below and summarised later in this section.
Shared decision-making is a cornerstone of person-centred care and is strongly emphasised in NICE guidance on the management of Type 2 diabetes in adults, which advises that treatment targets and plans should be agreed with the individual rather than imposed. In Mr Hughes’s case, this begins with an open, unhurried conversation that explores his understanding of his condition, his concerns and his goals. Rather than presenting a rising HbA1c as a failure, the nurse can frame it as shared information to be interpreted together.
Collaborative goal-setting involves negotiating targets that are both clinically appropriate and personally meaningful. NICE recognises that HbA1c targets should be individualised, taking account of factors such as the person’s circumstances, preferences, risk of hypoglycaemia and any other conditions. For a man working irregular shifts, a realistic, stepwise goal agreed with him may be more effective than an ambitious target he feels unable to meet. The nurse might, for example, explore small, achievable changes, such as linking medication to an existing daily routine to improve consistency. A useful structure for this partnership is the “house of care” model promoted within the NHS, which positions care planning as a collaborative conversation supported by organisational systems, with the engaged, informed patient at its centre.
Decision aids and teach-back techniques can be used to check understanding and ensure that any decision is genuinely informed. Crucially, shared decision-making also means respecting Mr Hughes’s right to make choices the clinician might not favour, provided he has the information to do so. This reframes the nurse’s role from directing behaviour to supporting autonomy. By involving Mr Hughes as an expert in his own life, the nurse increases the likelihood that the agreed plan is realistic, owned by the patient and therefore sustainable.
Because the majority of diabetes care is self-care, supporting self-management is central to person-centred practice. Bodenheimer and colleagues argue that effective self-management support moves beyond traditional didactic patient education towards building the patient’s confidence and problem-solving skills, often described as self-efficacy. The nurse’s task is not simply to transmit information but to help Mr Hughes develop the knowledge, skills and confidence to manage his condition day to day.
Structured education programmes are an important resource here. NICE recommends that adults with Type 2 diabetes and their families are offered a structured education programme at or around the time of diagnosis, with ongoing reinforcement. Established UK programmes such as DESMOND are designed to help people understand their condition and make informed lifestyle choices. The nurse can explore with Mr Hughes whether he has previously been offered such education and, if so, what he found useful or difficult, recognising that his shift pattern may have prevented attendance. A person-centred approach would then seek flexible alternatives, such as digital or evening sessions, rather than treating non-attendance as non-compliance.
Self-management support also involves practical, individualised problem-solving. For Mr Hughes, this might include discussing realistic dietary adjustments that fit a driver’s working day, strategies to remember medication, and recognition of the signs of deteriorating control. Setting collaborative, specific and measurable goals, and reviewing them at subsequent appointments, helps to maintain momentum and demonstrates that his effort is valued. Importantly, self-management support is not about transferring responsibility and then attributing poor outcomes to the patient. The language of “compliance” is increasingly regarded as inconsistent with person-centred values because it implies obedience rather than partnership; a person-centred nurse instead asks what support Mr Hughes needs to manage his condition within the context of his life.
Mr Hughes’s comment that he feels “fed up” is clinically significant and should not be overlooked. Diabetes is associated with a considerable emotional burden, sometimes described as diabetes distress, and with an increased risk of low mood and anxiety. Diabetes UK highlights the importance of attending to emotional and psychological wellbeing as an integral part of diabetes care rather than an optional extra. A person-centred nurse therefore responds to this cue, gently exploring how Mr Hughes is feeling and what lies behind his frustration.
His fear of complications, prompted by a relative’s loss of sight, is a further important element. Rather than dismissing or amplifying this fear, the nurse can acknowledge it, provide accurate information, and use it, if Mr Hughes wishes, as a source of motivation framed positively around what he can do to protect his health. This illustrates the person-centred process of working with the person’s beliefs and values. The social context is equally important. His irregular shift work, time pressures and home life all shape what is realistic for him. Recognising these social determinants prevents the nurse from setting unachievable expectations and opens the possibility of practical support, such as signposting to peer support, involving his wife if he wishes, or adjusting appointment times. Person-centred care here means seeing Mr Hughes as a whole person embedded in a particular life, not as an isolated set of blood results.
Person-centred care must also be responsive to culture, identity and health literacy. Dietary advice, in particular, needs to be tailored to a person’s cultural background, food preferences and budget if it is to be relevant and achievable; generic guidance that ignores these factors is unlikely to be followed. The nurse should therefore explore Mr Hughes’s usual diet and preferences rather than prescribing a standardised plan.
Health literacy, the degree to which a person can obtain, understand and use health information, is a further consideration. Varying levels of health literacy mean that information must be communicated clearly, free of jargon and checked for understanding, for example through the teach-back method. Written or digital materials should be accessible and, where necessary, available in the person’s preferred language or format. Attending to these factors is not peripheral; it is essential to equity. If care is designed only around the assumptions of the clinician, it risks being less effective for those whose circumstances, culture or literacy differ. By actively adapting communication and advice to Mr Hughes’s individual context, the nurse upholds the NMC Code’s requirement to treat people as individuals and to avoid making unwarranted assumptions.
| Person-Centred Dimension | Example of Nursing Action in Mr Hughes’s Case |
|---|---|
| Shared decision-making | Agree an individualised, realistic HbA1c goal together; link medication to an existing daily routine. |
| Self-management support | Offer flexible structured education; build confidence and problem-solving skills for everyday management. |
| Psychological and social awareness | Explore his frustration and fear of complications; adjust expectations to fit his shift work and home life. |
| Cultural sensitivity and health literacy | Tailor dietary advice to his preferences and budget; use teach-back to confirm understanding. |
Although person-centred care is widely endorsed, several barriers can undermine it in practice. Time is among the most significant. Meaningful shared decision-making and exploration of a person’s circumstances require longer consultations than are often available in busy clinics, and organisational pressures can push practice back towards a quicker, task-focused model. McCormack and McCance’s framework is useful precisely because it reminds us that the care environment, including staffing and systems, either enables or constrains person-centred practice.
Professional culture can also present obstacles. A traditional, paternalistic model in which the clinician is the expert and the patient a passive recipient remains influential, and language such as “compliance” reflects it. Shifting towards partnership requires both individual reflection and cultural change. Unequal power within the consultation, differences in health literacy and communication barriers can further limit genuine participation if they are not actively addressed. For the patient, factors such as low confidence, competing life demands, financial constraints and emotional distress can all reduce engagement, which is why psychological and social awareness matters so much. Finally, there is a risk that person-centred care is interpreted superficially as simply being pleasant, rather than as a substantive redistribution of information and decision-making power. Recognising these barriers is itself part of person-centred practice, because it prompts nurses and organisations to put in place the conditions, adequate time, supportive systems, a reflective culture and accessible communication, that allow person-centred values to be realised rather than merely stated.
For nursing practice, the case of Mr Hughes demonstrates that person-centred care is both an attitude and a set of skills. It requires the nurse to listen actively, to communicate without jargon, to negotiate rather than instruct, and to interpret clinical data within the fuller picture of a person’s life. These are capabilities that undergraduate nurses can deliberately develop through reflection, supervision and practice.
The approach also reframes what counts as a successful consultation. Success is not simply a lower HbA1c achieved through intensified medication, but a plan that Mr Hughes understands, agrees with and feels able to follow, alongside attention to his emotional wellbeing. This is consistent with the person-centred outcomes described by McCormack and McCance, such as involvement in care and a feeling of wellbeing. Finally, the analysis underlines that person-centred care depends on supportive systems as much as on individual practitioners. Advocating for adequate consultation time, accessible education and joined-up services is therefore part of the professional nursing role. In this way, the nurse acts not only as a clinician but as an advocate for care that genuinely places the person at its centre.
This coursework has examined how person-centred care can be applied to the nursing management of an adult with Type 2 diabetes. Drawing on recognised frameworks, including the Person-Centred Practice Framework and the NMC Code, it has argued that person-centredness means working in partnership with the patient to understand their values and circumstances and to support informed self-management. Using the illustrative case of Mr Hughes, the discussion showed how shared decision-making, structured self-management support, attention to the psychological and social context, and cultural and health-literacy awareness combine to produce care that is both clinically sound and genuinely individualised.
The analysis also recognised that person-centred care faces real barriers, from limited time to entrenched professional culture, and that overcoming them requires change at both individual and organisational levels. For a long-term condition such as Type 2 diabetes, where outcomes depend so heavily on everyday self-care, person-centred nursing is not a luxury but a clinical necessity. By treating people as partners and experts in their own lives, nurses can support more effective, more equitable and more humane diabetes care. As a model example, this coursework illustrates how such an argument can be constructed and evidenced for an undergraduate assignment.
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