Building Competency in Diabetes Education THE ESSENTIALS

SELF-MANAGEMENT EDUCATION & SUPPORT: PROGRAM DEVELOPMENT| 11-103

• Choice of therapy (e.g. insulin needed if on steroids).

Course of treatment for diabetes, past and current.

• Potential problems with self-management; beliefs patient/family holds regarding health and their self-management practices; barriers to change evidenced by past experiences. • Stage of readiness for these behaviours now; health beliefs about these behaviours. • Ability to perform these tasks, including psychomotor and cognitive ability. • Knowledge of self-adjustment guidelines. • Awareness of need for significance of complications surveillance data, especially microalbuminuria. • Level of education program and current understanding of diabetes and its management (even though a patient presents as capable and intelligent and states he or she has attended a SME program, a real knowledge deficit is likely if the program took place five to 10 years ago and little active learning has taken place since then. The person may not be aware of the potential for new options). • Stage of change: Is the individual resistant to education now? Was the education a positive or negative experience? Would group or individual education be preferable? • The simple act of asking these questions may raise awareness of the need and trigger future action. An area that is critical to assess is knowledge of symptoms and treatment for hypoglycemia. Initial assessment should explore this, at least at a basic level.

Monitoring practices and record-keeping of BG, blood pressure, A1C and other lab data, and patient use of data.

Use of medical and health related resources, including attendance at previous SME programs.

Information on hypoglycemic events, such as frequency, severity, symptoms,

perception, prevention, precipitating causes and treatment.

A1C = glycated hemoglobin; SME = self-management education