A study to assess effectiveness of structured teaching program regarding self care management among diabetic patients attending Out Patient Department
A study to assess effectiveness of structured teaching program regarding self care management among diabetic patients attending Out Patient Department
Introduction
Diabetes management is vital for OPD diabetic patients and that STP effectiveness allows imperative success of diabetes centered management. Research will be in accordance to preliminary and comprehensive encounter of literature studies as it is a must for OPD patients and the rest of the team involved thus, achieving better sense of research process and approaches put into awareness and applicability domains. Thus, because of nature of chronic disease, management varies over time, with treatments adjusted according to changes in patient symptoms and fluctuations of disease process, acknowledge self-management education as an important aspect of diabetes care. Diabetes self-management programs facilitate acquisition by the patient of preventive or therapeutic health care activities, often in collaboration with health care providers. Self-management education programs emphasize the role of patient education in preventive and therapeutic health care activities and usually consist of organized learning experiences designed to facilitate adoption of health-promoting behaviors. Such programs usually are separate from clinical patient care, but are often run in collaboration with health care professionals as previous reviews have been limited to diabetes disease.
Background of the study
Medical care often fails to meet the needs of chronically ill patients, even in managed, integrated delivery systems. The medical literature suggests strategies to improve outcomes in these patients. Effective interventions tend to fall into use of evidence-based, planned care; reorganization of practice systems and provider roles; improved patient self-management support; increased access to expertise; and greater availability of clinical information. The challenge is to organize these components into an integrated system of chronic illness care whether STP adaptation can be done most efficiently and effectively in primary diabetes care practice rather than requiring specialized systems of care for OPD patients.
Statement problem
Structured diabetes teaching program/Structured teaching program (STP) might involve cornerstone of care for individuals with diabetes who want to achieve successful health related outcomes allowing in quality diabetes self-management education that can be implemented in diverse settings and will facilitate improvement in health care outcomes. The dynamic health care process obligates the diabetes community to review and possibly reconsider care standards to reflect advances in management knowledge and diabetes oriented care. The need to review and acquire research for STP in lieu to self care diabetes management applied for OPD patients, convened to review current structured teaching standards for appropriateness and health integrated basis, and to be sure STP ways are specific and achievable in care paths and OPD settings. Methodology used in conducting and reporting self management education programs varied widely. The lack of standard methods may hinder interpretation of summary data across diseases and programs, like STP, there may have limited the number of studies with extreme results as interesting to see whether aspects of STP for diabetes will be associated with care management assumptions as certain programs incorporating face to face teaching can be more effective; in-depth research observation should be considered when developing future STPs for diabetes care organization. Part of the rationale to combine studies will examine whether specific behavioral theories used in developing structured teaching programs accounting for diabetes management success. Thus, only few researchers described an underlying behavioral science model, such programs referring to behavioral framework cannot be in association with better OPD care outcomes.
Objectives
1. Critically review STP process and prepare evidence based review of the literature
2. Create and assesses usability of STP effectiveness for Diabetes Self-Management Care as appropriate as possible
3. Perform an initial analysis and review of current STP standards to identify OPD areas that need to be address for diabetes care plan
4. Collect input from OPD diabetic patients who utilize and receive STP in whatever manner
5. Critically review STP and perform review of the literature for diabetes care, education centered programs as well as new trends in diabetes care and management
6. The need to ensure quality and consistency with Diabetes Association Standards of Medical Care integrating STP effectiveness and assessment routes
Hypothesis
Conducting structured review of trials of STP programs for diabetes care, examining OPD care efficacy as whether specific features of STP are to be associated with better OPD based outcomes. Hypothesizing effectiveness of assessment of structured teaching programs if variations occur and characteristics of programs across diabetes care would have correlation with levels of effective realization. Hypothesizing that STP for self care diabetes management may be effective only for certain situations and to have basis and grounding support of the latter as self-management teaching have moderate benefit on important intermediate end points for diabetes patients the effective means of achieving STP will be put in careful assessment routes and outcome monitoring in accordance to theory and literature base.
Theoretical framework
STP may stress reinforcement and avoidance of self care management and activities, eliciting impeding care behaviors. Preliminary studies shows patients reinforcing others for care giving responses but show improve tolerance of teaching programs execution as being encouraged. Diabetes educators use theories anytime, even if they are not aware of it. To teach, one must have some assumptions about how people learn and what constitutes effective teaching. The purpose is to help diabetes educators interested in research and evaluation choose appropriate STP based theories put into description, explanation, prediction and control, as well as articulation and elaboration, reviewing how to use the teaching programs in every stage of research.
Review literature
Structured diabetes teaching and treatment programmes (STTP) are increasingly offered for patients with diabetes to improve metabolic control. Fritsche, Stumvoll, (1999 ) have “prospectively studied the long term-effect of STTP on metabolic control and knowledge of diabetes in patients with type 2 diabetes, differences in the mode of follow up as assessed”. The patients had significantly better knowledge of diabetes and diet 2 years after the program as father noted by the proponents (1999 ), STTP for patients with type 2 diabetes was effective in improving long-term glycaemic control and knowledge of diabetes along precise therapeutic goals and follow up instructions given to patient. There have been controlled study evaluated effect of 5 day teaching program for diabetic patients on their quality of life 1 and 2 years afterwards, three hundred and nineteen insulin-treated patients, of mean age and mean duration of the disease were followed up at reeducation sessions 1 and 2 years after the program (2004 ). There was group of 241 insulin-treated patients was followed up and served as control group, baseline and 1 and 2 years later, researchers have assessed patients’ well-being, using a standard 22-item questionnaire. There was significant increase in overall well-being of patients one and 2 years ( 2004 ) after the program, due to reduction in depression and anxiety and increase in positive well-being after 1 year and decrease in depression and increase in positive well-being after 2 years as compared to the control group. There was improvement in glycaemic control of the educated patients as compared to the control group demonstrated that structured patient education improves patients’ well being and 2 years after teaching program (2004 ).
Methods and methodology plan for data analysis
Searching medical databases concerning diabetes care, management, STP and other salient points for topic understanding to be identified by such relevant journals/articles being in consideration for review of STP and care management component, research outcomes will be evaluated into literature studies exclusively put in research knowledge, focusing diabetes care and management programs as diabetes educational program will have to be included to improve comparability of assessment and studies. Evaluating practicability and efficacy of structured treatment and teaching program for OPD diabetic patients in primary care. Physicians (n = 5) and office staffs as participated in a special training have to be contacted for survey based interview. A random sample of 4 offices which documenting data of patients who had received teaching in same period will be collected and evaluated. To abstract information regarding the following characteristics specific to STP, duration of teaching, number of sessions or contacts, background training of educators such as medicine, nursing, social work, health education, setting of structured teaching program (outpatient). Review each study to ascertain whether behavioral science model can be use in designing STP for diabetes care and management to include framework of cognitive behavior therapy in which STP effectiveness can be important research stature and record primary end point reported by researcher.
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