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Diabetes Patient Teaching Strategies
 

Diabetes Patient Teaching Strategies

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  • - With statistics like these, it is easy to see the great likelihood that you will care for many diabetic patients throughout your career. - The number of undiagnosed diabetics, especially striking. - Treating pre-diabetics with oral anti-diabetic agents has been shown to delay or prevent the onset of diabetic disease. - Early diagnosis and good disease management decrease burden.(American diabetes Association, 2012a)
  • Many of the individuals you will be caring for will be 65 or older(Smeltzer, Bare, Hinkle, & Cheever, 2008) The age of your patient is one of the things you should take into consideration, especially in the area of patient teaching. We have discussed the significance learning styles might have on the learning process. Literacy plays a part, one more reason we must vary our teaching and assessment methods (Redman, 2007)
  • - Many patients are anxious as a result of their initiate diagnosis. Much of this stems from lack of understanding. - It is important to assess what your patient already knows in order to dispel any misconceptions and to begin the learning process.
  • One of the advantages to having so many of your diabetic patients being adults is that many of them already know how they learn best. Don’t forget to ask! Try to be specific. Questions like: “do you prefer learning about things by reading, having them explained, watching a video, demonstration, manipulation of equipment?”
  • - Remember the video we saw about the visual learner. The woman used visual words “don’t see” “doesn’t look right”. - her eyes turned upward (Demonstrate here).http://www.youtube.com/watch?v=S-I2EL_K5pM
  • - Remember the video we saw about the Auditory learner (reiterate above phrases) used auditory-oriented words. - her eyes looked off to the side while she was considering the questions (Demonstrate here).http://www.youtube.com/watch?v=6ue3lleo-T8
  • - Remember the Kinesthetic learner in the video we saw. The gentleman was reassured when demonstration was offered by the salesperson.http://www.youtube.com/watch?v=A_on7l6WmFI
  • Having visual aids helps the visual learner remember information more readily. There is a tool used in many diabetes education settings called a conversation map. These maps use cartoon-type depictions to represent blood glucose levels. A balloon in the sky going higher or lower to represent BG levels. A no U-turn sign representing the necessity of lifelong diabetes management (Curry, 2011).
  • This is an example of a visual aid which has an example of a sliding scale (Huizinga et al., 2008). It also asks the patient to demonstrate understanding by determining a proper dose. This would be a useful tool for all patients, but would be especially appealing to a visual learner. In addition, this tool allows the patient demonstrate understanding by calculating the correct dosage.
  • - Again, this tool is useful for all patients, but would be especially helpful to the visual learner. - Visual learners do best with a “look and say” method (Dille, 2007). - Have patient verbalize the various injection sites as they point them out on the diagram for reinforcement of learning.Graphic: (Smart Nurse, 2011)
  • Begin presentation of information with a conversation or a teaching video. If written materials are being used, read these aloud to patient. It is helpful for these patients to participate in groups with conversation and idea-sharing. Brainstorming about possible barriers and/or questions with family members and nurse facilitate learning. To assess learning use a question and answers format. Have patient “teach back” the information to you.As Dawn said in lecture, it doesn’t always make sense to teach in a logical sequence. Might be nervous about self-injection, so it might make sense to get that out of the way.
  • http://ndep.nih.gov/resources/ResourceDetail.aspx?ResId=380Go to 2:35 in video to show value of visuals for teaching (National Diabetes Education Program, n.d).National Diabetes Education Program. (n.d.). Healthy eating with diabetes. Retrieved from http://ndep.nih.gov/resources/ResourceDetail.aspx?ResId=380
  • - You may have seen this format in some of the online teaching you have used as resources. Not only is the video made available, but the transcript is provided as well (Mayo Clinic, 2011). - In addition, the graphics provided are an animated representation well-designed for the lay-person. - (Go to 3/4point in video to show insulin deficiency representation) - I am one of the people who prefers to read the transcript first, then watch the video for reinforcement. I am more of a reader/visual learner, auditory methods are not my preference. As you may recall, there were relatively few in this class who were auditory learners. Hmmmm, is this meaningful?Mayo Clinic. (2011). Video: How diabetes affects your blood sugar. Retrieved from http://www.mayoclinic.com/health/blood-sugar/MM00641
  • http://www.youtube.com/watch?v=xrAIGLkSMlsEnvironment should be quiet and clean to minimize distractions. My sister uses this ad as a way to describe how easily distractible both she and my niece are. Both have tactile kinesthetic learning preferences.These learners should be well-rested, and well-fed. Frequent breaks will help with focus.
  • Mechanical manipulation of instruments appeal to this learner. Although all insulin-dependent diabetics will need to acquire this skill, the tactile/kinesthetic learner will benefit greatly from this activity. These learners benefit from seeing, touching and doing. (Demonstrate insulin administration)As Dawn said in lecture, it doesn’t always make sense to teach in a logical sequence. Might be nervous about self-injection, so it might make sense to get that out of the way.
  • - These are just two examples of the multitude of resources available.Know your population, and have resource suggestions availableEmphasize the importance of good disease management in prevention of complicationshttp://www.facebook.com/home.php#!/AmericanDiabetesAssociation http://community.diabetes.org/t5/I-Love-Someone-with-Diabetes/bd-p/caregivers?utm_source=Facebook&utm_medium=Post&utm_content=021613-caregiver-message-board&utm_campaign=COMM
  • - These are just two examples of the multitude of resources available.Know your population, and have resource suggestions availableEmphasize the importance of good disease management in prevention of complicationshttp://www.facebook.com/home.php#!/AmericanDiabetesAssociation http://community.diabetes.org/t5/I-Love-Someone-with-Diabetes/bd-p/caregivers?utm_source=Facebook&utm_medium=Post&utm_content=021613-caregiver-message-board&utm_campaign=COMM
  • The ADA has programs specifically tailored to cultural groups. These groups take into consideration specific groups risk factors and other challenges related to their culture (genetics, religion, diet, etc.)http://www.diabetes.org/in-my-community/programs/
  • - Discuss with class issues they might have encountered, and possible solutions.- Remind students that good patient education will empower their patients and increase the patient’s feelings of self-efficacy, ultimately resulting in better outcomes.

Diabetes Patient Teaching Strategies Diabetes Patient Teaching Strategies Presentation Transcript

  • Tools and Strategies for SuccessMarjorie ReillySenior PracticumSUNY DelhiNURS 403, 11070Cheryle Levitt
  • In the United States Thereare over 25 million people with diabetes (diagnosed) Thereare over 79 presently undiagnosed people with diabetes Diabetes and its costs over 218 billion dollars annually
  •  Over40 percent of newly-diagnosed diabetics are over 65 years old. Onein five Americans read below the fifth grade level. Manyilliterate individuals have either normal, or above normal intelligence. Theseare among the many challenges one may face in patient teaching,
  •  Anxiety with initial diagnosis May have misconceptions influencing anxiety Assess what your patient already knows Begin teaching immediately
  •  Askyour patient about their learning preferences Use teach-back methods in order to assess understanding
  • Watch for verbal and non-verbal clues Visual learners: - phrases like “ I see what you’re saying” - May look up and away when listening or considering something new.
  • Watch for verbal and non-verbal clues Auditory learners: - phrases like “ Doesn’t sound right to me, or I hear what you’re saying” - May look off to the side when listening or considering something new.
  • Watch for verbal and non-verbal clues Kinesthetic learners - Phrases like “Just doesn’t feel right” - Used hand gestures when speaking - May look down when listening or considering something new.
  •  Use pictures, graphs, videos and other visual aids Flash cards Encourage patient to take notes Conversation Map
  • Use visualtools likethisgraphicwhenteachinginjectionsites
  •  Teach the patient with a verbal narrative. Audio/Visual presentations. Read printed materials aloud. Group(family) instruction with discussion and brainstorming. Question and answer format.
  •  National Diabetes Education Program: Healthy Eating with Diabetes:http://ndep.nih.gov/resources/ResourceDetai l.aspx?ResId=380
  •  Format with both video and transcript. Graphic representations Good for all learners, especially visual and auditory. How Diabetes Affects Your Blood Sugar:http://www.mayoclinic.com/health/blood- sugar/MM00641
  •  Quiet, uncluttered environment.http://www.youtube.com/watch?v=xrAIGLkS Mls Well-rested, snack if needed for energy. Take frequent breaks (every 20 minutes) http://www.youtube.com/watch?v=xrAIGLkS Mls
  •  Demonstration with models that can be touched. Allowpatient to manipulate supplies, especially with insulin administration . Usea multi-sensory approach (seeing, touching, doing).
  • Encourage use of these tools:Facebook: http://www.facebook.com/home.php#!/Am ericanDiabetesAssociation
  • Encourage use of these tools: American Diabetes Association Message Boards: http://community.diabetes.org/
  • The American Diabetes AssociationResources and community tailored to specific target groups: African American Latino Asian/Pacific Islander Native American http://www.diabetes.org/in-my- community/programs/
  • Problems Time Constraints Limited Resources Health Literacy Limitations Solutions Start Patient Teaching Early Be Creative Enlist Family Members Use “Teach Back” method to ensure understanding
  • ReferencesAmerican Diabetes Association. (2012a). Diabetes statistics. Retrieved from http://www.diabetes.org/diabetes-basics/diabetes- statistics/Curry, A. (2011). Visual aids for diabetes education: Can teaching tools help people retain their lessons? Retrieved from http://forecast. diabetes.org/magazine/your-ada/visual-aids-diabetes-educationDille, B. (2007). Learning style Inventory. Retrieved from http://www.odessa.edu/dept/govt/dille/brian/courses/ 1100Orientation/LearningStyleInventory_survey.pdfHuizinga, M., Elasy, T., Wallston, K., Cavanaugh, K., Davis, D., Gregory, R., Fuchs, L., … Rothman, R. (2008). DNT sample questions. Retrieved from http://www.biomedcentral.com/1472- 6963/8/96/figure/F2?highres=yMayo Clinic. (2011). Video: How diabetes affects your blood sugar. Retrieved from http://www.mayoclinic.com/health/blood- sugar/MM00641
  • ReferencesNational Diabetes Education Program. (n.d.). Healthy eating with diabetes. Retrieved from http://ndep.nih.gov/resources/ ResourceDetail.aspx?ResId=380Redman, B. (2007). The practice of patient education: A case study approach (10th ed.). St. Louis, MI: Mosby-Elsevier.Smart Nurse. (2011). Locating subcutaneous injection sites. Retrieved fromhttp://smart-nurse.blogspot.com/2011/05/locating- Subcutaneous-injection-sites.htmlSmeltzer, S., Bare, B., Hinkle, J., & Cheever, K. (2008). Brunner & suddarth’s textbook of medical-surgical nursing (11th ed.). Philadelphia, PA: LippincottWilliams & Wilkins.