Building Competency in Diabetes Education THE ESSENTIALS

FOUNDATIONS OF DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT| 2-27

What have we learned? From the evidence, we can conclude that SME has had positive effects in a variety of settings, using a variety of techniques, with a variety of inclusive elements (67,73). Over time, we have moved from knowledge acquisition alone to a more holistic, integrated approach where strategies targeting behaviour change are recognized as essential to the process (61). We now know that educational, behavioural and psychosocial principles must be effectively incorporated into the practices of all providers of health care for individuals/populations with chronic disease (4,31,62,68). SME interventions should provide not only knowledge and self care skills training, but also facilitate the motivation and confidence to take action and improve one’s quality of life over the long term (1,2,12,47). To be effective, these interventions must be developed

Key Principles: (SME) interventions should: • Be collaborative and interactive

collaboratively within a patient-centred interprofessional team (10,74). The “shared decision-making approach” enables active participation by the patients and ensures consensus building by the HCP (1,2,48,75). SME interventions should be designed to address a patient’s physical, psychological, financial, spiritual and emotional needs, as well as his/her previous experiences and readiness to learn. They must be individualized to reflect the patient’s intentions and goals (3,10,49). We have also learned that interventions must be repeated and reinforced throughout the lifetime for the sustainability of any behaviour change (32,68,74,76,77). A further discussion of SMS will emphasize this reality.

• Be individualized to address a patient’s needs • Share knowledge, technical skills and problem-solving • Enhance self-care training skills • Facilitate motivation and confidence to take action and improve one’s quality of life • Be repeatedly reinforced

“The treatment of a disease may be entirely impersonal; the care of a patient must be completely personal” (78).

Process of SME With the publication of the 2013 Guidelines, there was a considerable effort to make these guidelines practical and applicable. This has been continued in the 2018 Guidelines. To this purpose, when investigating the HCP tools and patient resources on Diabetes Canada website (guidelines.diabetes.ca), you will see a wealth of information on SME and SMS. These tools are downloadable, adaptable and very valuable to you as a diabetes educator. Figure 3 outlines