Therapeutic education of diabetic patients

Abstract

Therapeutic patient education is a patient-centred approach, focussed on patients' needs, resources, values and strategies. It allows patients to improve their knowledge and skills not only concerning their illness but also their treatment. It brings a better quality of life, a greater therapeutic compliance and a reduction in complications. The most difficult part of therapeutic patient education occurs when patients must change their behaviour. Motivational interviewing and cognitive-behavioural approaches contribute greatly here and allow both the preparation and support of patients during progressive 'step by step' change. The work on resistance to change is fundamental, and ambivalence when faced with the choice of a new way of life must be measured, discussed and negotiated. Patients become partners and we become 'coaches'. The negotiation of objectives must allow patients to choose their own strategies, which normally should cost them the least possible, psychologically, and bring them the maximum benefit. The efficiency of therapeutic patient education no longer needs to be proved: 80% less amputations over 10 years in diabetic patients; 50% maintenance of weight loss over 5 years, etc. In conclusion, therapeutic education is part of a humanistic medical approach centred on patients; it allows them to be active participants in their own treatment with the aim of improving their quality of life and therapeutic compliance, as well as reducing potential complications. Thus, health care professionals teach, inform, train, negotiate with, motivate and accompany patients in the long-term follow-up of their illness.

Needs and preferences for nutrition education of type 2 diabetic adults in a resource-limited setting in South Africa

“…The inaccuracy and deficiency in knowledge may be due to lack of specific and comprehensive education, as indicated by the patients, and poor understanding related to low literacy levels. Although knowledge by itself does not necessarily lead to improved self-care behaviours or outcomes (Norris et al 2001), an understanding of the disease, its course and treatment and how all these interact are pre-requisites for effective selfcare (Golay et al 2008;Persell et al 2004). Some studies have also demonstrated a positive relationship between disease knowledge and self-care behaviours (Van den Arend et al 2001;Persell et al 2004) and glycaemic control (Colleran, Starr & Burge 2003;Persell et al 2004).…”

Perfil epidemiológico e nível de conhecimento de pacientes diabéticos sobre diabetes e retinopatia diabética

“…Apesar de já existirem evidências de que a educação de pacientes diabéticos e seus parentes constitui um ponto fundamental tanto para encorajar rastreamentos mais regulares para RD quanto na prevenção e tratamento da RD (14,(19)(20)(21)(22)(23) , a maioria dos pacientes na nossa amostra relata que nunca havia recebido alguma informação ou palestra sobre diabetes de algum profissional de saúde, bem como não haviam recebido algum tipo de material informativo sobre DM. Uma grande parte da nossa amostra também nunca havia participado de programas de educação sobre DM.…”

Un nouveau programme en éducation thérapeutique : former des soignants pour favoriser la résilience des patients

“…Elle les a visionnées une première fois dans une visée exploratoire, à la recherche de critères lui permettant de construire la grille d'analyse des entretiens. Les grilles utilisées ont été validées et utilisées en éducation thérapeutique 18 2). La péda-gogue a visionné une deuxième fois tous les entretiens (12) et les a analysés avec cette nouvelle grille comprenant des items bio-psycho-sociaux, avec un accent particulier sur la recherche des ressources du patient.…”

“…Elle est centrée notamment sur les besoins, les connaissances et les compétences du patient, mais également sur ses ressources 2 . L'éducation thérapeutique du patient est appliquée pour des malades chroniques ; elle élargit l'approche biomédicale habituellement enseignée dans nos facultés par une approche systé-mique et psychosociale.…”