Diabetes Education

ABOUT THE EDITOR Professor Trisha Dunning AM is Chair in Nursing, Deakin University and Barwon Health and a Clinical Nurse Consultant in Diabetes Education, Geelong, Australia. She is widely published in peer reviewed journals and non-peer reviewed publications, and is on the editorial boards and reviews panels of several health professional journals. Trisha also writes regular columns for The Australian Diabetes Educator and Diabetes Conquest. In addition, she is a highly experienced clinical nurse consultant having worked in the field for over 20 years.

List of Contributors xi

Foreword xiii

Preface xvii

Acknowledgements xxi

List of Tables, Figures and Boxes xxiii

List of Abbreviations xxvii

1 Brief Overview of Diabetes, the Disease 1
Trisha Dunning AM

Introduction 1

Overview of diabetes 1

Prevalence of diabetes 2

Overview of normal glucose homeostasis 2

Signs and symptoms of diabetes 3

Diabetes management and management aims 7

Long-term diabetes complications 8

Summary 9

References 9

2 The Journey of the Person with Diabetes 12
Jane Speight and Harsimran Singh

Introduction 12

Psychological factors: the role of beliefs and attitudes 14

Psychological factors: emotional reactions to diabetes 19

Social factors: influence of personal situation 21

Factors that affect illness/wellness behaviours 22

Summary 23

References 24

3 Teaching and Learning: The Art and Science of Making Connections 28
Trisha Dunning AM

Introduction 28

Purpose of diabetes education 29

Principles of learning and teaching 29

Learning theory 31

Laws of learning 32

Knowledge 32

Nudging 34

Learning and the brain 35

Memory 36

Keeping the brain fit: brain training 37

Brain training: mind-body fitness 38

Sleep: vital for learning and memory 39

His brain, her brain 39

Technology 40

Helping people learn: proactive strategies are more effective 41

Summary 46

References 46

4 Making Choices, Setting Goals 49
Timothy Skinner

Introduction 49

Why don ’ t people do what is best for them? 50

Self-regulation, goals and values 52

Behaviour-serving goals 53

Limited resources 56

SMARTER 58

Sleep 59

Summary 60

References 61

5 The Teacher: Moving from Good to Exceptional 62
Trisha Dunning AM

Introduction 62

Healing 63

Who is a teacher? 64

Attributes of a ‘good’ teacher 65

Moving from good to exceptional 67

Philosophy of diabetes care and education 67

Factors that influence philosophy 69

Therapeutic relationship 70

Listening 72

Know yourself 72

Wounded healer 74

Reflection 74

Being present in the moment 75

Self-care 75

Summary 76

References 76

6 People Do Not Always Speak the Same Language Even When They Speak the Same Language 78
Trisha Dunning AM

Introduction 78

What is language? 78

Components of language 80

Learning a language 81

The power of language 82

Body language 84

Culture 86

Exchanging information: a complex process 89

Language and attitude change 90

‘Voices’ 90

Narrative medicine 91

The value of reading fiction 91

Using writing in diabetes care 92

Education materials 94

Winnie the Pooh has the last word 94

References 95

7 Role and Use of Creative Arts in Diabetes Care 98
Jean-Philippe Assal and Tisiana Assal

Introduction 98

Medical identity 98

The four cardinal axes of healthcare delivery 99

Listening to patients and modes of self-expression 101

Promoting creativity 101

Painting as a process of transformation 101

The theatre of lived experience 106

Artistic expression favours communication 106

Two examples 107

Key learning 111

Art and therapeutic education 112

Summary 114

Recommended reading 115

8 Turning Points and Transitions: Crises and Opportunities 117
Trisha Dunning AM

Introduction 117

The seven ages of man 118

Common major life transitions 120

Neutral zone 122

A new beginning 122

Major life transitions 123

Signs a person may be entering or is in a life transition 125

Strategies to help people manage life transitions 125

Building resilience 127

References 131

9 Sharing Stories of the Journey: Peer Education 133
Gretchen A. Piatt, Rhonda Lee, Helen Thomasic, Norma Ryan and Millie Glinsky

Introduction 133

Empathy and sympathy 142

Empathy and social support 142

Empathy and patient relationships 143

References 147

10 Diabetes: A Lifetime of Learning 151
Michelle Robins

Introduction 151

The clinical experience 152

Learning styles 156

Be honest 159

Consistent and correct terminology 159

Simplifying complex concepts into easier to understand concepts 160

Using the individual ’ s knowledge and experience 161

‘Catchy’ phrases 161

Visual aids 162

Asking the right questions 163

Health literacy 164

Group education 166

Educating people with disabilities 169

Being flexible about where diabetes education is delivered 170

Cultural sensitivity and diabetes education 170

Be aware of language 172

Where to start 172

Chapter summary and key points 173

References 174

11 Medicine Self-Management: More than Just Taking Pills 177
Trisha Dunning AM

Introduction 177

Medicine self-management 178

Complementary and alternative medicines and therapies 181

‘Compliance’: to use or not to use, that is the question 183

People with diabetes’ perspective 184

HPs, especially prescribers and educators perspectives 186

Carers, particularly family members 186

Extent of non-compliance 187

Is there a relationship between medicine compliance and optimal health outcomes? 188

Factors that influence medicine compliance 190

How is compliance assessed/measured? 190

Quality use of medicines 194

QUM, diabetes educators and medicine management 194

Summary 196

References 197

12 The Advance of Health Information Technology: Travelling the Internet Superhighway 200
Kari Harno

Introduction 200

Internet and networks 200

Diabetes education 202

Diabetes management tools 205

Personal health tools and self-care 207

Summary 211

References 212

13 Leadership—Know Yourself: Influence Others 215
Trisha Dunning AM

Introduction 215

Leadership: a brief historical perspective 216

What is leadership and what/who is a leader? 218

Leader functions 220

Leadership philosophies, theories and models 220

Leadership styles 221

Leadership competencies and attributes 221

Leadership education and care of people with diabetes 224

Leadership in diabetes clinical care 225

Leadership in diabetes education 225

Leadership in diabetes research 225

What do diabetes educators think about leadership? 227

How can we grow diabetes education leaders? 228

Summary 229

Acknowledgements 230

References 230

Appendix 232

Index 235