Communicating cardiovascular risk to persons with type 2 diabetes remains difficult, and the core challenge is 'striving to enhance cardiovascular risk awareness in persons with type 2 diabetes while balancing responsibility and uncertainty.'
Key Findings
Results
A core category capturing HCP challenges in CVD risk communication was identified as 'Striving to enhance cardiovascular risk awareness in persons with type 2 diabetes while balancing responsibility and uncertainty.'
This core category was derived from constructivist grounded theory analysis of individual interviews with 14 healthcare professionals (HCPs) in primary care.
The core category reflects the dual challenge of making CVD risk understandable and meaningful for patients while managing professional responsibility and uncertainty.
Four sub-categories were identified that describe the HCPs' work processes related to this core challenge.
Results
HCPs reported navigating a complex assessment of cardiovascular risk as a distinct component of their work.
This was identified as one of four categories describing HCP work in CVD risk communication.
HCPs recognized significant responsibility for cardiovascular risk communication.
HCPs simultaneously experienced uncertainty about how to assess patients' individual CVD risk.
Results
HCPs reported struggling to communicate cardiovascular risk in a pedagogical way.
This was identified as the second of four categories describing HCP work.
HCPs must go beyond education to build trust and understanding.
HCPs must balance encouragement with demands when communicating risk to patients.
Results
HCPs described trying to build a trusting relationship while simultaneously highlighting the severity of the disease.
This was identified as the third of four categories describing HCP work in CVD risk communication.
The tension between building rapport and conveying disease seriousness was a distinct challenge identified by participants.
A more person-centred approach was identified as essential to improving risk communication.
Results
Diabetes specialist nurses reported experiencing professional isolation, limited medical support from physicians, and a lack of shared responsibility within the diabetes care team.
Diabetes specialist nurses specifically described 'feelings of professional isolation.'
Nurses reported 'limited medical support from physicians' in the context of CVD risk communication.
A lack of shared responsibility within the diabetes care team was identified as a problem.
HCPs also requested sufficient organisational resources as part of a fourth category: 'experiencing loneliness and requesting organisational changes.'
Methods
The study was conducted using constructivist grounded theory methodology with 14 HCPs in primary care.
Data were collected through individual interviews with 14 HCPs.
All participants worked in primary care settings.
The COREQ checklist was used for reporting.
No patient or public contribution was included in the study design.
What This Means
This research suggests that healthcare professionals (HCPs) working in primary care face significant and multi-layered challenges when trying to explain cardiovascular (heart disease) risks to people living with type 2 diabetes. Through in-depth interviews with 14 primary care professionals, researchers found that HCPs feel a strong sense of responsibility to help patients understand their heart disease risks, but they also feel uncertain about how to accurately assess each patient's individual risk and how to convey that information in a way that is clear and motivating rather than overwhelming or confusing.
The study also found a notable issue with teamwork: diabetes specialist nurses, who often take the lead in patient education, reported feeling professionally isolated. They described receiving limited support from physicians and felt that responsibility for communicating cardiovascular risk was not shared equitably across the care team. This lack of collaboration and organizational support was a recurring concern, with HCPs calling for better resources and clearer team structures to help them do their jobs more effectively.
This research suggests that improving how heart disease risk is communicated to diabetes patients requires more than just providing HCPs with better information or tools. It points to the need for a more person-centred approach that goes beyond standard health education — one that prioritizes building trust with patients, balancing honest conversations about disease severity with encouragement, and fostering stronger teamwork and organizational support within primary care settings.
Stenlund A, Hellström Ängerud K, Lilja M, Otten J, Jutterström L. (2026). Primary Healthcare Professionals' Perspectives on Cardiovascular Risk Communication to Persons With Type 2 Diabetes: A Grounded Theory Study.. Nursing open. https://doi.org/10.1002/nop2.70828