Health education relating to diabetes Ann MacLeod, RN, BScN, MPH.
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Transcript of Health education relating to diabetes Ann MacLeod, RN, BScN, MPH.
![Page 1: Health education relating to diabetes Ann MacLeod, RN, BScN, MPH.](https://reader036.fdocuments.in/reader036/viewer/2022083009/5697c0291a28abf838cd72dd/html5/thumbnails/1.jpg)
Health education relating to diabetes
Ann MacLeod, RN, BScN, MPH
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A. MacLeod. Fall 2002 2
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A. MacLeod. Fall 2002 3
One minute paper
Think of the last time you tried to adopt a healthier behaviour.
What motivated you to change?
What helped, what hindered?
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A. MacLeod. Fall 2002 4
Levels of Prevention
Primary - before a disease develops
Secondary - screening, early identification
Tertiary - preventing more serious complications from an identified condition
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A. MacLeod. Fall 2002 5
Stages of Change, Prochaska and DiClemente
Precontemplation
contemplation
preparation
action
maintenance
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A. MacLeod. Fall 2002 6
Precontemplation
“ it isn’t that they can’t see the problem, they can’t see the solution” “ I can’t be bothered trying to control my sugars.”
No intention to change behavior resistance to recognizing or modifying a
behavior
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A. MacLeod. Fall 2002 7
Patient and Nursing
“eating chocolate is the only pleasure I get” Patient may feel rebellion, need to share
info, demoralized, Dr will not spend time
Work on developing rapport “tell me about, …” encourage change to talk give factual, motivating information
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A. MacLeod. Fall 2002 8
Contemplation
“Knowing where you want to go but not quite ready”
know problem but not quite made commitment but within 6 months
weighing of pros and cons of problem, impact on others and solutions to it
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A. MacLeod. Fall 2002 9
Patient and Nursing
Guilt, profound ambivalence, procrastinator
here are the tools to make it easier for you provide networking “ here are the complications of uncontrolled
diabetes, but we can help you control them”
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A. MacLeod. Fall 2002 10
Preparation
Planning to change in next 30 days taking some small steps of cutting down
behavior, investigating some programs
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A. MacLeod. Fall 2002 11
Patient and Nurses
Decision to try on behavior “ I think I can control my diet, but I don’t know
how to give a needle. ”
LOC, self-efficacy, positive reinforcement, follow up visits, tools to help, iron out logistics
“how can I help?” “Can you show me how you use your glucometer and needles?”
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A. MacLeod. Fall 2002 12
Research studies
Researchers found that key is timing change to correct stage independent of treatment ie counselling, peer programs
for smoking success (@6mos) was - precontemplators 22% - contemplators 43% - preparation or action 76%
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A. MacLeod. Fall 2002 13
Action
Currently, practicing change but transition within last six months
a difficult time as takes energy but self-liberation and autonomy to change lives
“I am really working hard to change”
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A. MacLeod. Fall 2002 14
Patient and Nursing
Intense time with new behavior, high risk for relapse
lots of support, external recognition, follow up meetings, behavior change and long term benefits “what things are you seeing different” “ your sugars are being well controlled.”
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A. MacLeod. Fall 2002 15
Relapse
“tell me about what happened” “what were the elements of relapse” “reflect on what you valued to start in the
first place”
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A. MacLeod. Fall 2002 16
Maintenance
Work to prevent relapse and consolidate the gains beyond six months of action phase
“I may need some help right now to maintain changes”
development of alternate coping strategies
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A. MacLeod. Fall 2002 17
Patient and Nurses
Rewards still very important
“do you find it easier to maintain changes” “what ways to increase your activity are
working for you?” “ what are your rewards for keeping your
sugars regulated?”
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A. MacLeod. Fall 2002 18
Important Steps for Change
1. Clearly assess patient’s stage Nurse, “Tell me where you are at about
dealing with your diabetes.” 2. Tailor interventions accordingly
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A. MacLeod. Fall 2002 19
Enhancing Motivation
Elicit client’s concerns emphasize personal choice and
responsibility for future behavior treatment goals and strategies are negotiated
based on info and acceptability express and reflect client perceptions
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A. MacLeod. Fall 2002 20
Enhancing motivation cont’d
Positive reinforcement support continued exploration of the
problem and solutions reinforce goal identification and attainment help pt to move forward “How would like
things to turn out for you?”