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Self-Management Education

Canadian Diabetes Association 2013 Clinical Practice Guidelines. Self-Management Education. Chapter 7 Helen Jones, Lori D Berard, Gail MacNeill , Dana Whitham , Catherine Yu. Self-Management Education (SME). A systematic intervention that involves active patient participation

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Self-Management Education

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  1. Canadian Diabetes Association 2013 Clinical Practice Guidelines Self-Management Education Chapter 7 Helen Jones, Lori D Berard, Gail MacNeill, Dana Whitham, Catherine Yu

  2. Self-Management Education (SME) A systematic intervention that involves active patient participation in self-monitoring and/or decision-making

  3. Key Points 2013 • Diabetes self-management education (SME) improves health parameters • SME should teach behaviours as well as knowledge and technical/problem-solving skills • SME should be patient-centred, tailored to the individual, use a variety of teaching methods and be regularly reinforced

  4. Knowledge is Power • Empowering patients through self-management education improves: • A1C • Quality of life • Weight loss • Cardiovascular fitness

  5. Basic Knowledge and Skills • Monitoring health parameters (including self-monitoring blood glucose [SMBG]) • Healthy eating • Physical activity • Pharmacotherapy and medication adjustment • Hypo-/hyperglycemia prevention/management • Prevention and surveillance of complications • Problem identification and solving

  6. Not Just Knowledge: Work on Behaviour! • Cognitive-behavioural interventions improve self-management and metabolic outcomes • They may involve: • Cognitive re-structuring • Problem-solving • Cognitive-behavioural therapy (CBT) • Stress management • Goal setting • Relaxation

  7. How should SME be delivered? Personal contact with healthcare workers Combination of group and individual sessions Combination of didactic and interactive Interdisciplinary team and/or peer-education

  8. SME must be Reinforced Regularly • Booking follow up sessions • Patient-educator contact between sessions • Automated or technology-based reminders

  9. Diabetes Education… Improved! • Collaborative and interactive • Patient-centred and individualized • Knowledge and technical skills, but also problem-solving skills • Repeatedly reinforced • Educational, psychological, and behavioural interventions and a variety of teaching methods

  10. Steps to Success

  11. Recommendation 1 • People with diabetes should be offered timely diabetes education that is tailored to enhance self-care practices and behaviours[Grade A, Level 1A ].

  12. Recommendation 2 • All people with diabetes who are able should be taught how to self-manage their diabetes [Grade A, Level 1A].

  13. Recommendation 3 • SME that incorporates cognitive-behaviouraleducational interventions, such as problem-solving, goal setting, and self-monitoring of health parameters, should be implemented for individuals with diabetes [Grade B, Level 2].

  14. Recommendation 4 • Interventions that increase patient participation and collaboration in healthcare decision-making, should be used by providers [Grade B, Level 2].

  15. Recommendation 5 • For people with type 2 diabetes, SME interventions should be offered in small-group and/or one-on-one settings, since both may be effective [Grade A, Level 1A].

  16. Recommendation 6 • In both type 1 and 2 diabetes, interventions that target families’ ability to cope with stress or diabetes-related conflict should be included in educational interventions when indicated [Grade B, Level 2].

  17. Recommendation 7 2013 • Technologically based home blood glucose monitoring systems may be integrated into SME interventions in order to improve glycemic control [Grade C, Level 3].

  18. Recommendation 8 2013 • Culturally-appropriate SME, which may include peer or lay educators, may be used to increase diabetes-related knowledge, self-care behaviours, and decrease A1C [Grade B, Level 2].

  19. Recommendation 9 2013 • Adding literacy and numeracy sensitive materials to a comprehensive diabetes management and education program may be used to improve knowledge, self-efficacy, and A1C outcomes for patients with low literacy [Grade C, Level 3].

  20. CDA Clinical Practice Guidelines http://guidelines.diabetes.ca – for professionals 1-800-BANTING (226-8464) http://diabetes.ca – for patients

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