Building Competency in Diabetes Education THE ESSENTIALS

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been found to be effective for diabetes related stress and depressive symptoms, especially when delivered using newer technology (129,130). Regardless of the intervention, it is evident that diabetes educators and others can intervene to improve coping, emotional health and QOL in our patients. Being open, listening without judgement and being supportive are the key elements. Demonstrating respect and genuine caring for patients will help them share their innermost feelings and fears about the demands of living with diabetes. See Chapters 2 and 11 for more detail on these interventions. Support systems Family and significant others can either facilitate or impede effective coping with diabetes (131). When family members perceive it as their responsibility to learn about and participate in diabetes care out of concern, caring and respect for the patient with diabetes, and when communication about diabetes-related issues is open, successful coping is more likely. When family or significant others view diabetes as being “owned” by the person who has it, and/or when the patient is blamed for inconveniences associated with diabetes management, coping is far more difficult. The DAWN2 study highlights that even when family members want to participate in care, they are frequently unsure as to how to help (118). Working with families demands a number of approaches, including: • Obtaining the views of each member. • Understanding the nature of the relationships and bonds between members. • Determining the strengths of each member and the family as a unit. • Using these strengths to address any problems of diabetes management that arise. Determining roles and responsibilities for dealing with problems requires good knowledge of the family system and cooperation of the entire unit. In some cases, it is beneficial for the family and the patient to receive counselling. The Behavioural Diabetes Institute has some excellent resources for patients, family members and HCP coping with the emotions that diabetes can provoke (http://behavioraldiabetes.org/). Beyond family or kin supports, patients may develop and use other support networks. These networks may be available in the workplace, at school or in the community. Practice Tip: It is the educator’s role to assess the support the patient is receiving and assist in creatively supplementing it.