Abstract
The purpose of this study was to quantify emotional responses, including trust and blame, of people with diabetes, when exposed to problem words.
People with diabetes experience words that are judgmental and based on blame.1 Language guidance papers have been developed in multiple countries, because negative messages can be harmful to people with diabetes.2 A recent integrative review synthesized studies on communication and diabetes outcomes and concluded that negative messages can lead to diabetes distress, decreased health behaviors, and poor health outcomes. On the other hand, positive or supportive messages can lead to positive health behaviors.3
Trust is associated with engagement in health behaviors and better health outcomes.4 People with diabetes have reported being more likely to listen to and collaborate with health professionals they trust.1
This study employed a semantic differential scale to measure emotional responses to problem words and phrases in people with diabetes.5 Participants rated eleven problem words or phrases on a scale from “trusting” to “not trusting” and from “encouraged” to “blamed.”
A total of 217 adults with diabetes (type 1, n = 107; type 2, n = 110) completed the semantic differential. Participants with type 1 diabetes tended to be younger and have had diabetes longer than those with type 2 diabetes.
Participants with type 1 diabetes reported feeling the least trusting when they heard or saw the words “failed,” “what did you do wrong” and scare tactics such as “you could end up blind or on dialysis.” Participants with type 2 diabetes felt the least trusting when they saw or heard “should,” “what did you do wrong,” or “failed.” For participants with type 1 diabetes, the following words or phrases led to feeling blamed: “what did you do wrong,” “failed,” “uncontrolled,” scare tactics, “in denial,” “should,” and “noncompliant.” Most participants with type 2 diabetes felt blamed when they read “what did you do wrong,” scare tactics, “failed,” “in denial,” “should,” “uncontrolled,” and “noncompliant.”
Problem words are commonly and unconsciously spoken, and written in the EHR, by nurses regarding people with diabetes. People with diabetes feel not trusting and blamed when they hear and read these messages, which can, in turn, lead to decreased health behaviors and negative health outcomes, Nurses, therefore, have an opportunity to learn about the impact of words and change the messages they send through spoken and written language.
Notes
References:
1. Dickinson JK. The experience of diabetes-related language in diabetes care. Diabetes Spectr. 2018;31(1):58-64.
2. Dickinson JK, Guzman, SJ, Maryniuk MD, O’Brian CA, Kadohiro JK, Jackson RA, D’Hondt N, Montgomery B, Close KL, Funnell MM. The use of language in diabetes care and education. Diabetes Care. 2017;40:1790-1799.
3. Dickinson JK, Posesorski RE, Djiovanis SG, Brady VJ. Impact of negative or stigmatizing language on diabetes outcomes: An integrative review. Sci Diabetes Self Manag Care. 2024;50(2):167-178.
4. Birkhauer J, Gaab J, Kossowsky J, et al. Trust in the health care professional and health outcome: A meta-analysis. PLoS One. 2017;12(2):e0170988.
5. Dickinson JK, Guzman SJ, Wooldridge JS. The emotional impact of negative language in people with diabetes: A descriptive study using a semantic differential scale. Sci Diabetes Self Manag Care. 2017;49(3):193-205.
Sigma Membership
Mu
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Global Leadership, Health Equity or Social Determinants of Health, Patients with Diabetes, Negative Words Impact on Patients
Recommended Citation
Dickinson, Jane K.; Guzman, Susan J.; and Wooldridge, Jennalee, "Trust, Blame, and the Words Nurses Use" (2025). International Nursing Research Congress (INRC). 104.
https://www.sigmarepository.org/inrc/2025/presentations_2025/104
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Trust, Blame, and the Words Nurses Use
Seattle, Washington, USA
The purpose of this study was to quantify emotional responses, including trust and blame, of people with diabetes, when exposed to problem words.
People with diabetes experience words that are judgmental and based on blame.1 Language guidance papers have been developed in multiple countries, because negative messages can be harmful to people with diabetes.2 A recent integrative review synthesized studies on communication and diabetes outcomes and concluded that negative messages can lead to diabetes distress, decreased health behaviors, and poor health outcomes. On the other hand, positive or supportive messages can lead to positive health behaviors.3
Trust is associated with engagement in health behaviors and better health outcomes.4 People with diabetes have reported being more likely to listen to and collaborate with health professionals they trust.1
This study employed a semantic differential scale to measure emotional responses to problem words and phrases in people with diabetes.5 Participants rated eleven problem words or phrases on a scale from “trusting” to “not trusting” and from “encouraged” to “blamed.”
A total of 217 adults with diabetes (type 1, n = 107; type 2, n = 110) completed the semantic differential. Participants with type 1 diabetes tended to be younger and have had diabetes longer than those with type 2 diabetes.
Participants with type 1 diabetes reported feeling the least trusting when they heard or saw the words “failed,” “what did you do wrong” and scare tactics such as “you could end up blind or on dialysis.” Participants with type 2 diabetes felt the least trusting when they saw or heard “should,” “what did you do wrong,” or “failed.” For participants with type 1 diabetes, the following words or phrases led to feeling blamed: “what did you do wrong,” “failed,” “uncontrolled,” scare tactics, “in denial,” “should,” and “noncompliant.” Most participants with type 2 diabetes felt blamed when they read “what did you do wrong,” scare tactics, “failed,” “in denial,” “should,” “uncontrolled,” and “noncompliant.”
Problem words are commonly and unconsciously spoken, and written in the EHR, by nurses regarding people with diabetes. People with diabetes feel not trusting and blamed when they hear and read these messages, which can, in turn, lead to decreased health behaviors and negative health outcomes, Nurses, therefore, have an opportunity to learn about the impact of words and change the messages they send through spoken and written language.
Description
The messages nurses use with people who have diabetes has been historically judgmental and blaming. People with diabetes are less likely to engage in health care and health behaviors when they lack trust in nurses. In this study, people with both type 1 and type 2 diabetes consistently rated problem words and phrases as making them feel not trusting and blamed. Because messages influence outcomes in people with diabetes, nurses can learn about and make changes to the language used in diabetes.