Diabetes Self Care Program (7 steps to success)

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  • Diabetes Self Care Program (7 steps to success)
    • Background
    • Program philosophy and theoretical framework
    • Program aims
    • Participant target group
    • Program facilitators
    • Conducting the program
    • Evaluation
    • Marketing
    • References
  • Introductory module
  • Healthy eating module
  • Being active module
  • Monitoring module
  • Taking medications module
  • Problem solving module
  • Healthy coping module
  • Reducing risks module
  • Program Survey

Diabetes Self Care Program (7 steps to success)

1.6 Conducting the Program

The DSCP should be conducted within accepted standards of practice for diabetes educators. This includes ensuring appropriate documentation for each client entering the program including: written referrals; client consent forms; an individual client assessment; a record of the interventions they receive; the outcomes of the interventions; and communication with other practitioners.

Because the DSCP is conducted within a group environment, this does not negate the accepted standard of care whereby an individual assessment of participant’s learning outcomes is conducted and acted upon.

The DSCP has been developed as a group program but can be used in one to one education sessions. Group programs have been demonstrated to be effective in improving diabetes outcomes (fasting blood glucose, HbA1c, diabetes knowledge, systolic blood pressure, body weight and the requirement for diabetes medication) ¹¹.

The recommended number of participants for a group is between three (3) people with diabetes and a maximum of twelve (12) people. Significant others should be encouraged to attend and where they do so, should be encouraged to participate actively in the group activities. DSCP module outlines and their associated tools may be used by diabetes educators to guide individual consultations.

The DSCP consists of:

• An introductory module
• Seven modules based on the seven self care behaviours; and

The DSCP focuses on the development of self care skills. The imparting of information is not the aim of the DSCP other than to provide the information necessary to facilitate the development of self care behaviours. Active engagement of the participants is an essential underpinning of the DSCP. The DSCP is learner centred, meaning that the DSCP:

• Lets learners know why something is important to learn
• Shows learners how to direct themselves through the information
• Relates the topics to the learner’s experiences
• Recognises that people will not learn until they are ready and motivated to learn
• Helps learners overcome inhibitions, behaviours, and beliefs about learning (changing behaviour).¹⁵

Learner centred approaches acknowledge the expertise of the learner and differ from didactic approaches where the teacher is the expert. It should be noted that employing a conversational style (question and answer) is not sufficient to achieve learner centred model of teaching/learning.

All modules make provision for an open ‘burning issues’ activity whereby participants identify questions they want answers to before they leave the session.

The intent of the modules is to activate participants by developing self awareness and developing self assessment and problem solving skills and mobilising those skills to adopt effective self care behaviours.

Introductory module

Participants deemed suitable for participation in the DSCP, based on an initial assessment (this can be made on the basis of information in a carefully constructed referral form or on the basis of a telephone interview), should attend the introductory module before attending other modules. The purpose of the introductory module is to:

• Provide a brief overview of diabetes
• Provide an opportunity for participants to explore feelings about living with a chronic condition
• Introduce the concept of diabetes self management within the context of overall diabetes care
• Introduce clients to the DSCP, including the challenge based philosophy
• Assist participants to understand their individual priorities through the use of a care plan
• Motivate participants to register for further modules
• Provide a further opportunity for the diabetes educator to assess client suitability for participation in a group program and their capacity for self care and make recommendations / arrangements for alternative services if required.

It is envisaged that the introductory module would need to be conducted on a regular basis to accommodate new referrals in a timely manner.

Self care behaviour modules

These seven modules are built around each of the self care behaviours:

• Healthy eating
• Being active
• Monitoring
• Taking medication
• Problem solving
• Healthy coping
• Reducing risks.

Based on their own priorities and readiness for change, clients choose which modules they want to attend and in what order.

Each of these modules starts with a recapitulation of participants care plan, explores how the particular behaviour impacts on various risk indicators and provides a range of activities for participants to assess their current behaviour. Participants are encouraged to take up the challenge of a self care ‘goal’ within a goal setting and problem solving context.

It is envisaged that each of the above modules would be conducted on a cyclical basis. Based on client demand, some modules may be conducted more frequently than other.

Each module includes:

• Indicators for referral to the referring practitioner or other health professionals
• A section for diabetes educators to complete that identifies local services (health service and community) that can support participants achieve goals or help facilitate self care behaviours.

Note: The ‘Problem solving’ module brings together the learning from other modules such as ‘Healthy eating’, ‘ Being active’ and ‘Monitoring’. Participants will gain the most benefit from this module if they have attended these other modules.

 

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