Pilot Study of Flow and Meaningfulness as Psychological Learning Concepts in Patient Education: A Short Report


Background: The aim of this pilot study was to explore patient experiences of meaningfulness and flow related to group based patient education in type 2 diabetes. Meaningfulness and flow are underexposed as psychological learning concepts in patient education, and the ambition of this study was to investigate the applicability of these concepts of positive psychological theory in a patient education setting. Methods: This pilot study combines participating observation of group based patient education and 8 qualitative interviews with 4 patients with type 2 diabetes. Meaning condensation was used as an analytical tool to identify themes. Preliminary results: When the teaching activities were experienced as engaging for the patients and/or when they stimulated flow, it was due to 1) the perceived relevance of the activities, 2) the acquisition of new knowledge and 3) the feeling of importance in relation to life with diabetes. However, patients only reported a few activities and situations that indicated flow states. A sense of meaningfulness occurred when the patients experienced a sense of community and connectedness, which they obtained from being together with the other patients in the patient education setting. Patients experienced that there was a clear, comprehensive and structured plan for the education programme which was followed. This stimulated their experiences of meaningfulness and flow.

Share and Cite:

Nicic, S. , Nørby, K. , Johansen, C. & Willaing, I. (2014). Pilot Study of Flow and Meaningfulness as Psychological Learning Concepts in Patient Education: A Short Report. Psychology, 5, 566-571. doi: 10.4236/psych.2014.56066.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Antonovsky, A. (1979). Health, Stress, and Coping. London: Jossey-Bass Publishers.
[2] Antonovsky, A. (1987). Unraveling the Mystery of Health: How People Manage Stress and Stay Well. San Francisco, CA: Jossey-Bass Publishers.
[3] Antonovsky, A. (1998). Ch.1: The Sense of Coherence: An Historical and Future Perspective. In Stress, Coping, and Health in Families: Sense of Coherence and Resiliency (pp.3-20). London: SAGE Publications.
[4] Baumeister, R. F., & Vohs, K. D. (2002). The Pursuit of Meaningfulness in Life. In C. R. Snyder, & S. J. Lopez (Eds.), Handbook of Positive Psychology (pp. 608-618). Oxford: Oxford University Press.
[5] Celano, C. M., Beale, E. E., Moore, S. V., Wexler, D. J., & Huffmann, J. C. (2013). Positive Psychological Characteristics in Diabetes: A Review. Current Diabetes Report, 13, 917-929.
[6] Cooper, H., Booth, K., Fear, S., & Gill, G. (2008). A Trial of Empowerment-Based Education in Type 2 Diabetes—Global Rather than Glycaemic Benefits. Diabetes Research and Clinical Practice, 82, 165-171.
[7] Csikszentmihaly, M., & Csikszentmihalyi, I. (1988). Optimal Experience: Psychological Studies of Flow in Consciousness. Cambridge: Cambridge University Press. http://dx.doi.org/10.1017/CBO9780511621956
[8] Csikszentmihalyi, M., & LeFevre, J. (1989). Optimal Experience in Work and Leisure. Journal of Personality and Social Psychology, 56, 815-822. http://dx.doi.org/10.1037/0022-3514.56.5.815
[9] Csikszentmihalyi, M. (1996). Creativity: Flow and the Psychology of Discovery and Invention. New York: Harper Collins Publishers.
[10] Csikszentmihalyi, M. (1997). Finding Flow: The Psychology of Engagement with Everyday Life. New York: Basic Books.
[11] Csikszentmihalyi, M., Abuhamdeh, S., & Nakamura, J. (2005). Flow. In Handbook of Competence and Motivation (pp. 598-608). New York: The Guilford Press.
[12] Csikszentmihalyi, M. (2007). The Psychology of Engagement with Everyday Life. Virum: Dansk Psykologisk Forlag.
[13] Csikszentmihalyi, M. (2008). The Psychology of Optimal Experience. Virum: Dansk Psykologisk Forlag.
[14] Davies, M. J., Heller, S., Skinner, T. C., Campbell, M. J., Carey, M. E., Cradock, S., Dallosso, H. M., Daly, H., Doherty, Y., Eaton, S., Fox, C., Oliver, L., Rantell, K., Rayman, G., & Khunti, K. (2008). Effectiveness of the Diabetes Education and Self-Management for Ongoing and Newly Diagnosed (DESMOND) Programme for People with Newly Diagnosed Type 2 Diabetes: Cluster Randomised Controlled Trial. British Medical Journal, 336, 491-495.
[15] Delle Fave, A. (2009). Optimal Experience and Meaning: Which Relationship? Psychological Topics, 18, 285-302.
[16] Ellis, S. E., Speroff, T., Dittus, R. S., Brown, A., Pichert, J. W., & Elasy, T. A. (2004). Diabetes Patient Education: A Meta-Analysis and Meta-Regression. Patient Education and Counselling, 52, 97-105.
[17] Gary, T. L., Genkinger, J. M., Guallar, E., Peyrot, M., & Brancati, F. (2004). Meta-Analysis of Randomized Educational and Behavioral Interventions in Type 2 Diabetes. Diabetes Educator, 29, 488-501.
[18] Glaser-Zikuda, M., & Mayring, P. (2005). Enchancing Enjoyment in Learning at School. In F. Pons, D. Hancock, L. Lafortune, & P. Doudin (Eds.), Emotions in Learning (pp. 101-119). Aalborg: Aalborg Universitetsforlag.
[19] Kensiger, E. A. (2004). Remembering Emotional Experiences: The Contribution of Valence and Arousal. Reviews in the Neurosciences, 15, 241-252.
[20] Khunti, K., Gray, L. J., Skinner, T., Carey, M. E., Realf, K., Dallosso, H., Fisher, H., Campbell, M., Heller, S., & Davies, M. J. (2012). Effectiveness of a Diabetes Education and Self-Management Programme (DESMOND) for People with Newly Diagnosed Type 2 Diabetes Mellitus: Three Year Follow-Up of a Cluster Randomised Controlled Trial in Primary Care. British Medical Journal, 344, Article ID: e2333. http://dx.doi.org/10.1136/bmj.e2333
[21] Kvale, S. (1996). Ch. 11: Methods of Analysis. In Interviews—An introduction to Qualitative Research Interviewing (pp. 193-199). California: Sage Publications.
[22] Nakamura, J., & Csikszentmihalyi, M. (2002). The Concept of Flow. In C. Snyder, & S. Lopez (Eds.), Handbook of Positive Psychology (pp. 89-105). New York: University Press.
[23] Newman, S., Steed, L., & Mulligan, K. (2004). Self-Management Interventions for Chronic Illness. The Lancet, 364, 1523-1537. http://dx.doi.org/10.1016/S0140-6736(04)17277-2
[24] Norris, S., Engelgau, M. M., & Narayan, K. M. V. (2001). Effectiveness of Self-Management Training in Type 2 Diabetes. Diabetes Care, 24, 561-587. http://dx.doi.org/10.2337/diacare.24.3.561
[25] Schiøtz, M., Bøgelund, M., Almdal, T., & Willaing, I. (2012). Discrete Choice as a Method for Exploring Education Preferences in a Danish Population of Patients with Type 2 Diabetes. Patient Education and Counselling, 87, 217-225.
[26] Yi-Frazier, J. P., Hilliard, M., Cochrane, K., & Hood, K. K. (2012). The Impact of Positive Psychology on Diabetes Outcomes: A Review. Psychology, 3, 1116-1124. http://dx.doi.org/10.4236/psych.2012.312A165
[27] World Health Organization (2010). Global Status Report on Noncommunicable Diseases 2010: Description of the Global Burden of NCD’s, Their Risk Factors and Determinants. Geneva: World Health Organization.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.