Building Competency in Diabetes Education THE ESSENTIALS

2-16 | CHAPTER 2

take action based on his or her awareness of possible consequences (30,43-45). This approach is based on the understanding that adult learners: • Are self-directed and responsible for themselves. • Have an inherent drive for growth and health. • Possess self-awareness.

Empowerment

• “Process designed to facilitate self-directed behaviour change”. • Helping patients discover and develop the inherent capacity to be responsible for one’s own life. • Philosophy: Patients have choices, control and consequences. • Goal: Informed choice (44,45).

Empowerment is not so much a type of intervention as it is a philosophy and process that guides an educator’s perspective regarding interventions (12,45). It involves a fundamental shift in the roles and responsibilities of both the patient and the health-care provider. The health-care provider must see the patient as an equal partner and be willing to accept that the patient has the ultimate control and power over decision-making. This shared decision- making approach ensures a greater individualization of goals, an equal exchange of information, and advocates for patient involvement in all aspects of their care (45,48). Adults are more likely to make and maintain behaviour changes if changes are personally meaningful and freely chosen (46). An empowering conversation has a very different approach recognizing that it is the person’s internal drive to change that must be nurtured. The key features of empowering interventions include the 5 As (47): • A cceptance (unconditional, positive regard)

• A ffect (exploring the emotional content of a problem) • A utonomy (decision-making by the person with diabetes)

• A lliance (providing help and information for informed decision-making) • A ctive participation (participation and active listening by both/all parties)