ueda2013 diabetes in education-d.morsi
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Transcript of ueda2013 diabetes in education-d.morsi
Pathways and Targets in Diabetes Education
Planning Who Educates ? The Recipient Patient
* physician * understand
* Nurse * Self manage
* pharmacist * prevent
Education * Specialists: complications
Program - Diet * improve quality
Planner - exercise. of life
- foot care, etc
* Prof. Educator
* Volunteer
* Piers (in groups)
* Family member
( e.gother)
Diabetes Education
Diabetes Education = 50% of success
in management: control of diabetes
and prevention of its complications.
:Successful EducationIndicators of Some
- Less hospital admissions (esp. for
DKA , foot ulcers & hypoglyc.
Etc.).
- Less incidence of amputations
- More frequent good glycemic
controls ….
in Diabetes bjectives In planning the o Education
1- Decide the Target : to educate patients ,
physicians . nurses , or public (awareness )
then select the required objectives
2- Cover All Education Domains
a- knowledge
b- Skills
c- attitudes
3- Consider from which learner ‘s background
4- and , to achieve what level of competence
Consider ensuring the basic
competences in the Educator :
( physician , nurse , or other HC persons ,
professional educator , or pier ( precautions !!).)
1. Accurate knowledge of the contents(diabetes).
2. Professional Education skills (viz)
3. Performs as a member in the education Team
4. Beware of the biased educator !.
rBackground of The LearneConsider the
1. his General educational standard:,
(e.g. illiteracy)
2. his Specific knowledge about diabetes:
( not necessarily correlated with his general
education level……?
Knowledge accuracy in relation to the
duration of diabetes ?
- not necessarily nil at the onset …..
- and not necessarily satisfactory
after a long duration with diabetes .
).very frequently wrong or distorted (…...
- LearnerConsidering the background of the
.) (cont
3.his psychological status “stage of acceptance”
4.his diabetes stage : (controlled / uncontrolled/
complicated / handicapped ?)
5.his basic attitudes , perception and belief about
the cause of his diabetes, consequences ,
value of treatment, cost /benefit , slavery to
his specific habits (e.g. smoking).
Not concerned,
unlikely to benefit
from education
I am not sick 1- Denial
Mis-interprets the
informat. given.
Fails to remeber .
Why me? 2- Revolt
Ready to learn.
Demands to learn
OK , but I know
what to do
3-Bargain
readiness to learn at and Patient acceptance
states psycholigicaldifferent
Also ready to
learn
I am sick , I shall
take Rx,but shall I
be able to cope?
4- Depression
Most receptive :
attentive, ready to
discuss ,accepts
suggestions &
corrections
I shall live with it
……
5- Acceptance
Psychological acceptance and readiness to
learn (cont.)
V Aids in Pt Education-Pitfalls in the use of A
(Diet sheet, Handbooks , Pamphlets , Slides.
Video tapes , Self evaluation check lists ,
computer programs with Q & A, etc)
1. must be selected to meet the objectives and to
match the learner’s abilities.
2. avoid : too complex leaflets – long videos
(optimal is 7-10min with only 2-3 concepts)
contradictory information . or badly translated
material from foreign sources .)
3. should not be intended to replace and escape
from direct talking to people.
Specific Skills required in conducting
:certain education sessions
- In One-to-One Education:
(listen , motivate, individualize to stage,
not too much, reward more than blame,etc.)
- In Group Education:
- Size of the group.
- Group dynamics (+ve & -ve behaviours)
- Educate, not teach (active participation)
Pitfalls in diabetes education through the
Media (Mass Group Education)
- personal propaganda
- business promotions
- causing panic
- false news on premature studies
- individual advices to replace direct contact
with the physician ……….etc
The Uncompliant Patient resents
education:
Causes of uncompliance :
1- at the early stages of denial , protest & refusal
2- when slave to a habit ; smoking , exercise ,
eating……..
3- if adherent to his belief about the cause of
his diabetes
(cont ) UncomplianceCauses of
after repeated frustration and depression -4
failures to reach the set goals ;
- in body wt reduction
- in glycemic control parameters
or by social, economic stresstransient -5
intercurrent illness.
N:B: Therefore ,changing the attitude to
improve compliance should be
individualized after knowing its cause.
Indicators of the poor performance of
:the physicians as educators in Egypt patients their observations onindirectly, from
.un control glycemicHigh prev. of -1
e.g. parameters other related of Un control -2
hypertension, hyper-cholestrolemia.etc.
hospital admissionsof frequency High -3
for preventable complications ; DKA,
Hypoglyc , Foot infection., etc
poor or distortedFrom their patients’ -4
(e.g. about syringes , typesknowledge
of insulin etc. which means poor education ).
inCauses of failure The most Common
prespectiveeducation from patient
their cultural to unsuitable Objectives -1
background , attitudes, beliefs , psychological
)not individualizedstatus, stage of illness, etc.(
to the patient . not achievableObjectives
skillswithout proper educational Educators -2
and/or sufficient knowledge of the program
content (diabetes).
of The Main Causes of National inadequacy
in Egypt: ProgrammesEducation
1. Lack of a national coordination of education
programs in place and time, duplication
and mal - distribution .
2.Lack of professional skills of the Educators
3. Wrong planning in targets and in selection
of the suitable objectives.
(Education Parties ): benefit-cost. Poor 4
* minimal attendance
* false certification
* too short courses
Causes of National inadequacy of Education
(cont..): Programmes
5.Unsuitable content to audience (confusing
. theoreticalhigh teceducation with basic
knowledge ).
6. Lack of, poor quality or misleading
education material (e.g. badly translated
guide books biased by commercial interest.
7. Biased Education ( with conflicts of interest ,
business promoting and propaganda . .)
8. Lack of national collaboration to produce:
for education programlines -unified guide
.
studies evaluationup and follow . lack of 9
on the outcomes of education courses.
to specific accountability. Lack of 10
references and judgment authorities
Causes of National inadequacy of Education
): (cont..in Egypt Programmes