The burden diabetes presents multiple challenges to clients and their families. With this in mind, we need to consider the way we deliver health services and how we are supporting and communicating with our clients, their families and communities.
In diabetes self management, the empowerment approach has become the hallmark of all chronic disease management models. It is obvious that people do not necessarily act, learn or change their behaviour simply on a “prescribed” therapy. Actual behaviour change is more complex, and the self-care practices associated with managing diabetes is even more so. Using an empowerment approach, an individual can make informed decisions and act based on their awareness of possible consequences. This process is the gold standard of practice and has been widely accepted. In order to be successful, clients are required to learn a body of knowledge, coping skills and essential self-management skills which require ongoing reinforcement and support. The development of behaviour-change goals and their implementation is one of the most difficult tasks in learning to live well with diabetes. They require ongoing support as they make changes towards a healthier lifestyle. Support can include many different activities, takes place in many different settings and is facilitated by individuals from many different disciplines. Each profession brings a unique perspective and contribution to the educational and support process.
Given the complex nature of diabetes, an interprofessional team approach is known to be essential for diabetes management. Within their scope of practice, diabetes educators often spend more time than general practitioners and have more specialized skills in consolidating the client’s knowledge and skills regarding eating plan, physical activity, self-monitoring, medication usage, initiation and support with insulin therapy and training in foot care. Research shows when diabetes self-management education is provided by diabetes educators, improvements in self-care practices, glycemic control, lipid profiles and blood pressure result in a reduced risk and progression of diabetes complications. A study completed by Gucciardi et al., explored the implementation processes of integrating specialized diabetes teams – specifically nurses and dietitians – into primary care in Southern Ontario. The educator team saw patients for half hour each or together to assess the client’s level of diabetes self-care, diabetes knowledge and lifestyle habits. Individualized education, treatment priorities and action care plans were developed to assist the client with subsequent follow up visits to review client’s goals and needs. The educators provided immediate management support to clients, such as adjustment recommendations for medications/insulin, which produced greater adherence to self-care recommendations. Clients reported feeling comfortable and confident after their interactions with the educators. They also reported shifts in their attitudes and behaviours after meeting the team and expressed their appreciation for the educators’ time and support which improved their understanding of their diabetes and their confidence in their treatment plans and abilities to self-manage.
Evidence continues to document the importance of educator teams to best support people living with diabetes. Why is this effective? Because it improves the client’s outcomes.
Image: Diabetes Canada
Journal article: Implementing specialized diabetes teams in primary care in Southern Ontario – https://www.sciencedirect.com/science/article/pii/S1499267115005547