August, 2020
Diabetes is an incurable disorder in which an individual is required to make several self-management decisions on a daily basis and carry out complex self-care processes. Diabetes self-management support (DSMS) is a process in which an individual with diabetes is assisted by a nursing professional in putting into practice and maintaining the characteristics required to control his or her disease on a continuous basis (Brunisholz et al. 2014). The method of assistance offered can be psychosocial, behavioral, clinical, or educational, and a patient-centered approach is applied to ensure that the care is provided respectfully and the patient’s decisions and values control all clinical decisions. Despite having DSMS, there is diabetes self-management education (DSME), which is a continuous activity of simplifying the understanding, and the skills required for self-care during diabetes. The process includes the requirements, objectives, and personal life experiences with the disease and is managed through evidence-based research.
The main objective of DSME is to reinforce enlightened decision-making, problem-solving, self-care characteristics, and an active alliance with clinicians to improve clinical results and health outcomes (Powers & Marrero, 2016). In DSMS, there is shared decision making among the nurses, whether professional or in practice, which is a major element in patient-centered care, which gives rise to patient attitude and choices as well as provides information to enable full participation of the patient. Shared decision making has been proved to enhance clinical, behavioral, and psychosocial results for individuals with diabetes. Through the patient-centered approach, nurses are required to collaborate and effectively communicate with patients with diabetes. Through this approach, practice nurses obtain emotions, interpretation, and understanding through active asking open-ended questions and searching the aspiration to change in diabetes patients to support self-management. Moreover, practice nurses applying the approach assist the diabetes patient to have a better understanding of the options available and feel supported when making instructed self-management decisions.
American Diabetes Association (2016) states that diabetes care professionals should set out appropriate lifestyle reinforcement or pharmacological therapy for diabetes patients with no beneficial glucose levels, lipid management, or blood pressure. He suggests that nurses should apply strategies such as setting goals directly with the patient, recognizing barriers to care provided, consolidating evidence-based measures, as well as other nurses, healthcare providers, and pharmacists, have proved to maximize team behavior, thereby enhancing the care provided. There is also the strategy of increasing the functions of teams involved in diabetes management strategies such as revising care activities and eliminating financial barriers such as out of pocket costs. Additionally, there is a patient-centered medical home initiative that enhances results through organized basic care and provides new chances of diabetes care that is based on a team.
When offering support to diabetes patients, nurses mostly forget about utilizing family members as a resource to offer support. The strategy of involving family members and friends in DSME/S activities regularly can help improve the patient’s positive outcome (Wetherill et al. 2019). Family members can also assist in shared decision making, where they adjust the medication plan according to the requirements of the patient to improve the patient’s outcome. Though DSMS has included the issue of strategies to cover psychosocial problems and concerns, there should be more mental health measures needed to cover the critical stress related to diabetes, anxiety, and clinical depression.
There are board nursing standards that are required for diabetes self-management education. According to Beck et al. (2018), DSME system is required to choose a group of advisors who assist in quality assurance when nurses are in the process of educating the patients. This group of individuals should incorporate health professionals, individuals with diabetes, and the community, just to mention a few. Incorporating the small group of professionals in a DSME program ensures that the process applied by the nurse is patient-centered and responds to the patient's requirements as well as those of the community. There is also the standard that states that the DSME system is required to discover the diabetes educational requirement of the patients as well as recognize the resources compulsory to meet these requirements. DSME is a crucial element in the process of treating diabetes, but most of the patients with diabetes do not get proper diabetes education. Due to this, during the assessment period, nurses are required to identify if there are issues with receiving diabetes education. I was fascinated to find out that when a nurse is planning, implementing, and evaluating a diabetes self-management education, a supervisor is assigned to conduct the process. The supervisor has academics and experts in the preparation of incurable disease care and program management education. The healthcare professional acting as the supervisor will be of use if there is familiarity with the lasting activities of chronic disease management and with the diabetes management program.
Reference
American Diabetes Association. (2016). 1. Strategies for improving care. Diabetes care, 39(Supplement 1), S6-S12.
Beck, J., Greenwood, D. A., Blanton, L., Bollinger, S. T., Butcher, M. K., Condon, J. E., ... & Kolb, L. E. (2018). 2017 National standards for diabetes self-management education and support. The Diabetes Educator, 44(1), 35-50.
Brunisholz, K. D., Briot, P., Hamilton, S., Joy, E. A., Lomax, M., Barton, N., ... & Cannon, W. (2014). Diabetes self-management education improves the quality of care and clinical outcomes determined by a diabetes bundle measure—Journal of multidisciplinary healthcare, 7, 533.
Powers, M. A., & Marrero, D. (2016). Diabetes Self-management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. Diabetes Care 2015; 38: 1372-1382. Diabetes Care, 39(1), e17.
Wetherill, M. S., Williams, M. B., White, K. C., & Seligman, H. K. (2019). Characteristics of Households of People With Diabetes Accessing US Food Pantries: Implications for Diabetes Self-Management Education and Support. The Diabetes Educator, 45(4), 397-407.