Building Competency in Diabetes Education THE ESSENTIALS

FOUNDATIONS OF DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT| 2-21

SELF-MANAGEMENT EDUCATION AND SUPPORT

Essential concept of SME and SMS Diabetes presents many challenges to patients and their families. Through studies, such as DAWN (Diabetes Attitudes, Wishes and Needs) and DAWN2, the burden of diabetes on the patient, their family and their community has been better understood (51,52). We realize that living well with diabetes requires a positive psychological approach and considerable stamina. Since diabetes is a chronic illness, it continues to present new challenges and changing requirements over time so patients need to be flexible and be able to adapt to change (10,12). To be successful, they are required to learn a body of knowledge, coping skills and essential self-management skills which require ongoing reinforcement and support (3,12). SME and SMS are processes that can be used to achieve the goal of living well with diabetes (12,35,53-56). SME involves the teaching-learning process designed to help patients, families and groups gain the knowledge, behaviours, attitudes and skills required for self-management. Planned educational experiences with a strong patient-provider collaborative approach have proven to be most effective in supporting the SME process (3,38,55,56). A diagnosis of diabetes generally involves significant changes in lifestyle behaviours and patients view such changes through unique perspectives. The development of behaviour change goals and their implementation is one of the most difficult tasks in learning to live well with diabetes. Patients require ongoing support as they make changes towards a healthier lifestyle. SMS is the integral component necessary to achieve and sustain behaviour change with the ultimate goal being successful self-management (12). SMS can include many diverse activities involving the extended community and beyond which influence the ability of the person with diabetes to continue in their self-management behaviours (3). SME and SMS for persons affected by diabetes takes place in many different settings and formats and is facilitated by individuals from many different disciplines. Each profession brings a unique perspective and contribution to the educational and support process.

In all circumstances, SME and SMS should be individualized, taking into consideration the type of diabetes, the patient’s ability, the patient’s motivation for learning and change, their cultural and literacy level and their preferences (3).