Building Competency in Diabetes Education THE ESSENTIALS

CHANGES ACROSS THE LIFESPAN| 4-51

without judgment. Identifying positive and negative feelings and then exploring ways to deal with the negative feelings are good steps toward constructive goal setting. Establishing a trusting relationship between the patients and their families is important. Demonstrating genuine caring will help patients feel comfortable and willing to share their fears and feelings. This requires strong communication skills, feeling comfortable dealing with emotional issues and being able to acknowledge a patient’s limitations. Sometimes solutions may be handled within the context of usual self-management education; at other times, more specialized psychological services may be required. Coping Coping is the process of managing demands that are perceived as taxing or exceeding a patient’s resources (119). When demands are managed ineffectively, a person may experience feelings of powerlessness or make unhealthy choices to deal with the demands (119). The American Association of Diabetes Educators (AADE) has identified healthy coping as one of the seven key self-care behaviours for successful diabetes management (120). The person with diabetes experiences numerous physical demands, as well as psychological and social demands. Effectively coping with these demands requires “adaptation” skills involving concepts of motivation, self-efficacy, perceived control and coping styles (121). Although there is no universal set of definitions, coping styles may be categorized in the following ways (119,122): • Problem-focused: Cognitions and behaviours that manage the problem causing the stress. • Emotion-focused: Regulating the emotion and the distress; perceived control. • Avoidance coping: A form of escape. Using denial may be an effective coping mechanism for the short term, but it is generally not a long-term solution.