Education for type 2 diabetes mellitus self-care: from compliance to empowerment

Antonio Pithon Cyrino; Lilia Blima Schraiber; Ricardo Rodrigues Teixeira

doi:10.1590/s1414-32832009000300009

Diabetes self-management: multiple technologies of self

Australian Journal of Primary Health ◽

10.1071/py03025 ◽

2003 ◽

Vol 9 (3) ◽

pp. 61 ◽

Cited By ~ 4

Author(s):

Dorothy H Broom

Keyword(s):

Chronic Conditions ◽

Service Providers ◽

Management Strategies ◽

Diabetes Type 2 ◽

Disease Status ◽

Self Management ◽

The Social ◽

The Individual

Self-management is now positioned as essential to the optimal management of many chronic diseases. Health promoters and service providers often acknowledge that some forms of self-management are difficult and demanding, and that health education must be appropriately tailored in order to enhance ?compliance?. These discourses may recognise that part of a person?s response to diagnosis arises from the individual?s personality and their social circumstances. However, less attention is paid to the social and personal effects of the variety of strategies people deploy in order to manage an ongoing condition. Self-management affects more than symptoms or disease status; it also shapes the subjectivity of the person, so different management strategies may mould different selves. The self-management of diabetes entails numerous daily practices, and produces several distinct ways of constructing an embodied diabetic self. In this article, I describe how a sample of adults living with diabetes type 2 manage their diabetes from day to day, and how those activities both arise from, and contribute to, distinctive subject positions. Appreciating the daily and dynamic character of self-management may also help service providers to facilitate an improved quality of life for people with chronic conditions.

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Aging and Chronic Illness in Language and Sexuality

The Oxford Handbook of Language and Sexuality ◽

10.1093/oxfordhb/9780190212926.013.35_update_001 ◽

2018 ◽

Author(s):

Elizabeth Peel ◽

Sonja J. Ellis

Keyword(s):

Social Sciences ◽

Public Health ◽

Type 2 Diabetes ◽

Chronic Illness ◽

Older People ◽

Chronic Conditions ◽

Health Issues ◽

Future Directions ◽

The Social

An aging demographic in Western societies as well as globally has made public health issues, such as dementia, subject to hyperbolic metaphor such as “tsunami” and “time bomb.” This chapter reviews the state of knowledge regarding language, sexualities, aging, and chronic illness. In particular, the discussion focuses on discursive research from across the social sciences that furthers understandings of older people’s lives and experiences. The chapter highlights research that has focused on ageism and chronic conditions impacting older people (specifically, dementia and type 2 diabetes), including empirical research on these conditions, and on manifestations of heterosexism and heteronormativity in these contexts. Using illustrative examples that emphasize the intersection of discourse and issues that relate to aging, the chapter foregrounds this area as an important element of language and sexuality scholarship. Last, future directions for the development of research focusing on these topics are indicated.

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Aging and Chronic Illness in Language and Sexuality

The Oxford Handbook of Language and Sexuality ◽

10.1093/oxfordhb/9780190212926.013.35 ◽

2018 ◽

Cited By ~ 1

Author(s):

Elizabeth Peel ◽

Sonja J. Ellis

Keyword(s):

Social Sciences ◽

Public Health ◽

Type 2 Diabetes ◽

Chronic Illness ◽

Older People ◽

Chronic Conditions ◽

Health Issues ◽

Future Directions ◽

The Social

An aging demographic in Western societies as well as globally has made public health issues, such as dementia, subject to hyperbolic metaphor such as “tsunami” and “time bomb.” This chapter reviews the state of knowledge regarding language, sexualities, aging, and chronic illness. In particular, the discussion focuses on discursive research from across the social sciences that furthers understandings of older people’s lives and experiences. The chapter highlights research that has focused on ageism and chronic conditions impacting older people (specifically, dementia and type 2 diabetes), including empirical research on these conditions, and on manifestations of heterosexism and heteronormativity in these contexts. Using illustrative examples that emphasize the intersection of discourse and issues that relate to aging, the chapter foregrounds this area as an important element of language and sexuality scholarship. Last, future directions for the development of research focusing on these topics are indicated.

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The social engagement framework for addressing the chronic-disease-challenge

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.678 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

T Alhambra-Borrás ◽

S S Tan ◽

S Macchione ◽

V Vasiljev ◽

O Zanutto ◽

...

Keyword(s):

Chronic Disease ◽

Social Engagement ◽

Chronic Conditions ◽

Healthy Lifestyle ◽

Self Care ◽

Cost Effective ◽

Self Management ◽

Perceived Effectiveness ◽

Post Intervention ◽

The Social

Abstract Background The Social Engagement Framework for Addressing the Chronic-disease-challenge (SEFAC) intends to empower citizens to self-manage chronic conditions by combining mindfulness, social engagement and ICT support. This study evaluates effects in terms of perceived effectiveness, utility, efficiency, sustainability and satisfaction with SEFAC intervention. Methods A prospective cohort study with 6-month pre-post design was conducted in Croatia, Italy and the Netherlands. A total of 270 citizens ≥50 and at risk of or with a chronic condition were recruited. Self-reported effects of SEFAC intervention were assessed post-intervention using 5-point Likert scale [Strongly disagree -Strongly agree] and overall satisfaction on a scale from 1-10. Results Post-intervention analyses of a preliminary sample of 98 participants showed the SEFAC intervention was effective. In particular, perceived effectiveness for stimulating the work towards a healthy lifestyle was found for: mindfulness training (63.3%; n = 62), social engagement (48%; n = 47) and ICT support (40.8%; n = 40). After the intervention, 57.1% participants (n = 56) reported having become more aware of moment-to-moment sensations, thoughts and emotions and being able to better accept them without getting lost in them. Most participants (73.5%; n = 72) found the intervention was beneficial (perceived utility). A total of 78.6% (n = 77) participants found it was worth the investment in time and effort (perceived efficiency) and 61% participants (n = 60) agreed the intervention led to sustainable changes/benefits that will last. Finally, satisfaction with the intervention was high overall (8.5 out of 10). Conclusions This is the first study to develop an intervention combining the concepts of mindfulness, social engagement and ICT support. By this combination, self-reported effects were satisfactory. We expect this intervention to be feasible and cost-effective to promote self-management and self-care of chronic conditions. Key messages This study provides an innovative intervention to promote self-management and self-care of citizens with chronic conditions. This is the first study to develop an intervention combining the concepts of mindfulness, social engagement and ICT support.

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Atividades de autocuidado em pessoas com diabetes mellitus tipo 2

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963.2019.241793 ◽

2019 ◽

Vol 13 ◽

Author(s):

Sinderlândia Domingas dos Santos ◽

Mariana Rodrigues da Rocha ◽

Ionara Holanda de Moura ◽

Raylane Gomes Paiva ◽

Thais Raiane da Silva Amorim ◽

...

Keyword(s):

Social Sciences ◽

Diabetes Mellitus ◽

Control Method ◽

Self Care ◽

Family Health ◽

Clinical Control ◽

The Social ◽

Care Activity ◽

Activity Questionnaire

Objetivo: analisar a frequência de atividades de autocuidado em pessoas com Diabetes Mellitus tipo 2 e sua associação com o controle clínico. Método: trata-se de um estudo quantitativo, analítico, em cinco Estratégias Saúde da Família, com 86 indivíduos. Coletaram-se os dados por meio de um formulário e um Questionário de Atividades de Autocuidado com o Diabetes. Analisaram-se os dados por meio do programa Statistical Package for the Social Sciences (SPSS) IBM®, versão 20.0. Resultados: observou-se, considerando o autocuidado, resultado satisfatório para a ingestão de doces e uso de medicamentos e insatisfatório para as demais atividades. Encontrou-se baixo percentual de tabagismo. Associou-se a frequência de atividades de autocuidado significativamente com tempo de diagnóstico, tipo de medicação e glicemia capilar. Conclusão: conduziram-se os resultados a um perfil de autocuidado insatisfatório que influencia no mau controle clínico do DM2. Permitiu-se, além disso, avaliar a importância do autocuidado no controle metabólico do DM2, servindo como subsídio para o desenvolvimento de estratégias de enfrentamento. Descritores: Diabetes Mellitus tipo 2; Autocuidado; Enfermagem; Comportamento; Controle; Atividades Cotidianas.AbstractObjective: to analyze the frequency of self-care activities in people with type 2 diabetes mellitus and their association with clinical control. Method: this is a quantitative, analytical study in five Family Health Strategies, with 86 individuals. Data was collected using a form and a Diabetes Self-Care Activity Questionnaire. Data was analyzed using IBM® Statistical Package for Social Sciences (SPSS), version 20.0. Results: it was observed, considering self-care, a satisfactory result for the ingestion of sweets and medication use and unsatisfactory for the other activities. A low percentage of smoking was found. The frequency of self-care activities was significantly associated with time since diagnosis, type of medication and capillary blood glucose. Conclusion: the results were led to an unsatisfactory self-care profile that influences poor clinical control of T2DM. It was also allowed to evaluate the importance of self-care in the metabolic control of DM2, serving as a subsidy for the development of coping strategies. Descriptors: Diabetes Mellitus Type 2; Self Care; Nursing; Behavior; Control; Activities of Daily Living.ResumenObjetivo: analizar la frecuencia de las actividades de autocuidado en personas con Diabetes Mellitus tipo 2 y su asociación con el control clínico. Método: este es un estudio cuantitativo y analítico en cinco Estrategias de Salud Familiar, con 86 individuos. Los datos se recopilaron mediante un formulario y un Cuestionario de Actividades de autocuidado como Diabetes. Los datos se analizaron utilizando el programa Statistical Package for the Social Sciences (SPSS) IBM®, versión 20.0. Resultados: se observó, considerando el autocuidado, un resultado satisfactorio para la ingestión de dulces y el uso de medicamentos e insatisfactorio para las otras actividades. Se encontró un bajo porcentaje de tabaquismo. La frecuencia de las actividades de autocuidado se asoció significativamente con el tiempo desde el diagnóstico, el tipo de medicamento y la glucosa en sangre capilar. Conclusión: los resultados condujeron a un perfil de autocuidado insatisfactorio que influye en el control clínico deficiente de la DM2. También se permitió evaluar la importancia del autocuidado en el control metabólico de DM2, sirviendo como un subsidio para el desarrollo de estrategias de afrontamiento. Descriptores: Diabetes Mellitus Tipo 2; Autocuidado; Enfermagem; Conducta; Control; Actividades Cotidianas.

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Peer support program (P-SUP) to strengthen self-management in patients with chronic conditions

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1122 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

L Giesen ◽

H Könnecke ◽

M Redaèlli ◽

D Simic ◽

M Heßbrügge ◽

...

Keyword(s):

Peer Support ◽

Support Groups ◽

Chronic Conditions ◽

Primary Outcome ◽

Hospital Admissions ◽

Self Management ◽

Artery Disease ◽

Telephone Coaching

Abstract Background Chronic care programmes (CCPs) ensure a standardised, evidence based and structured patient care. In Germany, CCPs are successful in improving quality of care and making care more patient-centred. Regarding self-management support, however, the programs only feature patient education and shared decisions on treatment goals. Peer support has proven to be a successful component in outpatient care to enhance self-management. The aim of this study is to support patients with type 2 diabetes and coronary artery disease in conducting successful self-management through a multimodal program. Methods This randomized controlled trial (RCT) is set up for 27 months and will include a study population of approximately 1800 patients, beginning in summer 2020. The primary outcome (PO) is the reduction of hospital admissions. In addition to the PO, secondary outcomes include motivational and knowledge-based aspects. Furthermore, health-competitive and health-economic data will be collected. The formative evaluation will review the processes for implementation. The central element of the intervention will be peer support groups, in which the group will participate in physical activities and educational lectures on nutrition, exercise or disease related knowledge. Additionally, a specially designed online platform, personalized feedback for patients on medical outcomes from their family doctors, and regular telephone coaching to increase intrinsic motivation and activation will be provided. Results In addition to the primary outcome (reduction of hospital admissions), increased motivation levels, improved quality of life and increased health literacy are expected. Conclusions This project, funded by the Federal Joint Committee (establishment of statutory health insurance funds and medical providers in Germany), can serve as a blueprint for future implementations of public health approaches and accessible care models for patients with chronic conditions. Key messages Peer support as a successful method to enhance self-management in patients with type 2 diabetes and coronary artery disease. A multimodal program, consisting of peer support groups, an online platform, personalized medical feedback and telephone coaching, aiming to improve quality of life in patients with chronic conditions.

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The impact of e-Health interventions on promoting Self-Care in Chronic Patients: an Umbrella Review

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1104 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

E Renzi ◽

G Gasperini ◽

V Baccolini ◽

C Marzuillo ◽

C De Vito ◽

...

Keyword(s):

Public Health ◽

Quality Of Life ◽

Chronic Conditions ◽

Self Care ◽

Health Interventions ◽

Self Management ◽

Improve Quality ◽

Umbrella Review ◽

Copd Patients

Abstract Background Promoting self-care is one of the most promising strategies to manage people with chronic conditions and to improve the Public Health System resilience. In this context, the use of e-Health could facilitate self-care promotion, assure continuity of care and save time. Methods We performed an umbrella review on Cochrane, Scopus, Medline, PsychInfo, CINAHL to analyse e-Health self-care promoting intervention in patients with Type- 2 Diabetes Mellitus (T2DM), Cardiovascular Diseases (CVD) and Chronic Obstructive Pulmonary Disease (COPD) compared to traditional intervention. AMSTAR-2 was used for quality appraisal. Results 10 systematic reviews were included for an amount of 376 RCTs and 3 quasi-experimental studies. All the e-Health interventions retrieved were categorized in 4 subgroups: Phone Reminder, Telemonitoring, Psychoeducational intervention supported by PCs/Apps and Combined Intervention. Nurses (271/379 studies) and physicians (149/379 studies) were the healthcare workers mostly involved in the administration of e-Health interventions. T2DM (5 reviews; 175 studies) and CVD (7 reviews; 164 studies) patients gained more progresses in self-management than COPD patients (3 reviews; 8 studies). E-Health appeared effective both in promoting self-management and disease awareness. Globally, all the e-Health interventions seemed to improve Quality of Life and clinical outcomes. Phone reminders were most effective to increase Medication Adherence. All Causes Mortality registered a positive effect through Telemonitoring. Hospital Admission and Cost-Efficacy were explored only by telemonitoring and it did not show differences with traditional intervention. Conclusions E-Health is an effective strategy to promote self-care in patients with chronic conditions and to improve quality of life and clinical outcomes. Further research is required to test e-Health intervention in COPD patients and to examine if there is different efficacy among e-Health subgroups. Key messages E-Health should be integrated in Primary Care strategies to improve Public Health systems resilience. Nurses, as frontline Primary Health Care workers, should be advised for e-Health administration.

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Evaluating the Effect of Knowledge, Attitude, and Practice on Self-Management in Type 2 Diabetic Patients on Dialysis

Journal of Diabetes Research ◽

10.1155/2016/3730875 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 12

Author(s):

Shima Ghannadi ◽

Atieh Amouzegar ◽

Parisa Amiri ◽

Ronak Karbalaeifar ◽

Zhale Tahmasebinejad ◽

...

Keyword(s):

Quality Of Life ◽

Microvascular Complications ◽

Glycosylated Hemoglobin ◽

Self Care ◽

Self Management ◽

Diabetic Patients ◽

Attitude And Practice ◽

Knowledge Attitude And Practice

Background.Type 2 diabetes is an increasingly common condition with several preventable microvascular complications such as kidney damage. Nephropathy is expensive to manage, especially as hospital dialysis treatment. Improving patients’ knowledge, attitude, and practice (KAP) toward their condition can achieve better control, delay complications, and improve their quality of life. This study evaluated the KAP and self-care behaviors of diabetic patients on dialysis and variables that affect it.Methods.This cross-sectional study was conducted at Shahid Beheshti academic hospitals of Tehran, Iran. Face-to-face interviews were held to fill five validated questionnaires: three evaluating KAP, one evaluating self-management, and one evaluating quality of life.Result.117 diabetic patients on hemodialysis (42 females) with mean (SD) age of68.70±9.26years were enrolled in the survey. The scores for patient’s KAP, self-care, and quality of life were59.90±11.23,44.27±8.35,45.06±12.87,46.21±10.23, and26.85±13.23, respectively. There was significant negative correlation between patients’ knowledge and attitude with their glycosylated hemoglobin level and their fasting blood sugar. There was significant correlation between patients’ knowledge and practice with their self-care activities.Conclusion.The present study suggests that patients’ KAP scores have a practical effect upon self-care behavior. This highlights the needs for effective diabetes education programs in developing countries like Iran.

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Historicism Now: Historiographic Ontology, Epistemology and Methodology Out of Bounds

Journal of the Philosophy of History ◽

10.1163/18722636-12341458 ◽

2021 ◽

pp. 1-30

Author(s):

Aviezer Tucker

Keyword(s):

Social Sciences ◽

Social Science ◽

Ultimate Reality ◽

Empirical Science ◽

Historical Event ◽

Applied Psychology ◽

The Social ◽

Transmission Of Information ◽

Self Knowledge ◽

Five Senses

Abstract This article examines historicism as the expansion of historiography beyond its bounds, analogous to Physicalism, Naturalism, Psychologism, and Scientism. Five senses of historicism are distinguished: Ontological Historicism claims ultimate reality is, and only is, historical. Idiographic historicism considers historiography an empirical science that results in observational descriptions of unique singular events. Introspective historicism considers the epistemology of historiography to be founded on self-knowledge. Scientistic historicism considers historiography an applied psychology or social science that can expand to overtake the social sciences. Methodological historicism extends the use of historiographic methodologies to unreliable or dependent evidence. The first four historicisms are inconsistent with historiography within bounds and implode. Methodological historicism describes proper historiographic methodologies that are applied out of their proper bounds, but are used in historiography based on the epistemology of testimony and the tracing of the transmission of information from historical event to historiographic evidence.

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The Effect of Cognitive Behavioral Therapy on Self-Management and Self-Care Behaviors of Type 2 Diabetes Mellitus Patients

Jurnal Keperawatan Soedirman ◽

10.20884/1.jks.2021.16.1.1569 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Jenny Marlindawani Purba ◽

Hanna Ester Empraninta

Keyword(s):

Diabetes Mellitus ◽

Cognitive Behavioral Therapy ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Behavioral Therapy ◽

Self Care ◽

Self Management ◽

Cognitive Behavior ◽

Type 2 Dm

Diabetes mellitus (DM) is the condition of metabolism affected by chronic hyperglycemia (the increase of glucose levels in the blood) caused by insulin secretion defect. One of the non-pharmacological therapies used to decrease the type 2 DM is cognitive behavioral therapy. The objective of the research was to identify the effect of Cognitive Behavior Therapy (CBT) on self management and self-care behaviors of type 2 DM patients. The research used a quasi-experimental method with a two-group pretest-posttest design. The samples were 70 respondents with 35 of them were in the intervention group and the other 35 were in the control group, taken by using a consecutive sampling technique. The data were gathered using the Diabetes Self-Management Questionnaires (DSMQ) and the Summary of Diabetes Self-Care Activities (SDSCA) questionnaires. The gathered data were analyzed by using paired t-test, and independent t-test. The results of the study showed that there were significantly differences of mean scores of self management and self care behaviors between intervention and control groups (t=13.24; p=0.00) and(t=14.63,p=0.00), respectively. It is recommended that cognitive behavior therapy can be used as one of the non-pharmacological therapiesto change self-care behaviors in type 2 DM patients.

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