Diabetes education to provide the necessary self-management skills

Wilson, V. | 2021 | Diabetes education to provide the necessary self-management skills | British Journal of Community Nursing | Vol. 26 | No. 4 | https://doi.org/10.12968/bjcn.2021.26.4.199

Abstract

Diabetes is a chronic health condition requiring patients to provide 95% of their own care. Having control over this condition and the self-care behaviours necessary for good diabetes self-management can be achieved with patient empowerment and effective diabetes education. The patient must perceive that they have this level of control to maintain good diabetes self-management, enabling prevention or delay of diabetic complications. Currently, there are 3.9 million people who have been diagnosed with diabetes in the UK, 90% of whom have Type 2 diabetes. However, there has also been a rise in prevalence of Type 1 diabetes in recent years – caused by autoimmune disease rather than lifestyle factors. The number of individuals now living with diabetes exerts a huge toll on the NHS and community healthcare resources, making it crucial that patients manage their condition as well as possible to reduce the human and healthcare costs of treating diabetes complications.

We can provide a copy of this article to Rotherham NHS staff, just contact the Library for the paper

Follow-Up Support for Effective type 1 Diabetes self-management (The FUSED Model)

Full reference: Campbell, F., et al. |2018| Follow-Up Support for Effective type 1 Diabetes self-management (The FUSED Model): A systematic review and meta-ethnography of the barriers, facilitators and recommendations for sustaining self-management skills after attending a structured education programme| BMC health services research| 18|1| 898|https://doi.org/10.1186/s12913-018-3655-z

Researchers from ScHARR (School of Health and Related Research) are part of a research team that has looked at a series of qualitative studies that identify factors that inform and influence people’s self management behaviours following attendance of strucutred education sessions. It is anticipated that their findings will be used to inform the design of more effective support; with the reserachers presenting ten recommendations abstracted from the papers reviewed to provide a model for a programme of individualised and responsive follow-up support.

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Abstract 

Background

People with type 1 diabetes who attend structured education training in self-management using flexible intensive therapy achieve improved blood glucose control and experience fewer episodes of severe hypoglycaemia. However, many struggle to sustain these improvements over time. To inform the design of more effective follow-up support we undertook a review of qualitative studies which have identified factors that influence and inform participants’ self-management behaviours after attending structured education and their need for support to sustain improvements in glycaemic control.

 

Methods

We undertook a meta-ethnography of relevant qualitative studies, identified using systematic search methods. Studies were included which focused on participants’ experiences of self-managing type 1 diabetes after attending structured education which incorporated training in flexible intensive insulin therapy. A line of argument approach was used to synthesise the findings.

 

Results

The search identified 18 papers from six studies. The studies included were judged to be of high methodological quality. The line of argument synthesis developed the Follow-USupport for Effective type 1 Diabetes self-management (FUSED) model. This model outlines the challenges participants encounter in maintaining diabetes self-management practices after attending structured education, and describes how participants try to address these barriers by adapting, simplifying or personalising the self-management approaches they have learned. To help participants maintain the skills taught during courses, the FUSED model presents ten recommendations abstracted from the included papers to provide a logic model for a programme of individualised and responsive follow-up support.

 

Conclusions

This meta-ethnography highlights how providing skills training using structured education to people with type 1 diabetes does not necessarily result in participants adopting and sustaining recommended changes in behaviour. To help people sustain diabetes self-management skills after attending structured education, it is recommended that support be provided over the longer-term by appropriately trained healthcare professionals which is responsive to individuals’ needs. Although developed to inform support for people with type 1 diabetes, the FUSED model provides a framework that could also be applied to support individuals with other long term conditions which require complex self-management skills to be learned and sustained over time.

The full article is available to read from BMC Health Services Research

Family support among older persons in diabetes mellitus self-management

Results of new study highlight the importance of family support in diabetes mellitus self-management in older persons | BMC Geriatrics

Background
The aging process has functional consequences for older persons, such as degenerative processes of the pancreas resulting in diabetes mellitus. The increasing age of the population will eventually lead to increasing health problems of older persons, including diabetes mellitus. Diabetes mellitus is a chronic disease that requires long-term care through self-management. Diabetes self-management in older persons is influenced by family support as the main support system. This study aimed to explore perceived family support by older persons in diabetes mellitus self-management.

Methods
This study applied descriptive phenomenology method. The data were collected through in-depth interviews. There were nine older persons with diabetes mellitus as participants. Data consisted of in-depth interview recordings and field notes. Data were transcribed and analyzed using Colaizzi’s method.

Results
The results identified that family support as perceived by older persons included daily activity assistance, assistance with obtaining health services, food preparation, financial support, attention, guidance, and problem solving. The response to family support was pleasure as expressed by the older persons.

Conclusions
Physical and economic limitations were a significant hindrance to self-management of diabetes mellitus in older persons; therefore, they require family support to optimize their independence. The results of this study highlight the importance of family support in diabetes mellitus self-management in older persons.

Full reference: Niko Dima Kristianingrum et al. | Perceived family support among older persons in diabetes mellitus self-management BMC Geriatrics | 2018, 18 (Suppl 1) :304 | published 19 December 2018