Diabetes Education Program Development Portfolio - Essay Example

Diabetes Educational Program Development Portfolio Introduction Many studies and surveys (World Health Organisation, International Diabetes Foundation; 2014; Diabetes Australia, 2013; Al-Nozha et al., 2004; Alqurashi et al., 2010) have indicated that Diabetes Mellitus (DM) is a major health issue, practically, in all countries of the world. It is well recognised that providing as much information as possible to the patients, and education in self-management are two important components of the treatment and management of this condition (American Diabetes Association, 2010). There are a number of approaches that can be used to improve and/ or foster patient education with regard to diabetes. All of them rely on evidence from previously conducted research as well as theories that have been established from previous research. This portfolio elaborates on an evidence-based approach for a diabetes educational programme, for the education of patients in the Al Qassim area in the Kingdom of Saudi Arabia. Program Outline This diabetes day program schedule will be used to cover the following diabetes knowledge areas of concern among patients: hypoglycaemia – its symptoms and management, hyperglycaemia – its symptoms and management, healthy lifestyle to promote better management of the disease. Aims of the day-program The main aim of the portfolio (day program) is to compile diabetes information materials that can be used by patients in a bid to improve on their diabetes knowledge and develop the ability to self-manage. The patient information will focus on the following sessions: Hypoglycaemia: This session will include information related to the following topics: introduction to what hypoglycaemia is and the symptoms and management of hypoglycaemia. The aim of including this information is to help learner patients be in a better position to manage their health issue and offer themselves self management for the achievement of better health care needs. Hyperglycaemia: This session will include information related to the following: what hyperglycaemia is and the symptoms and management of hyperglycaemia. The aim of including this information is to help boost the learner’s knowledge with regard to their health issue. Healthy lifestyle: This session will include information related to: physical activity and the need to eat healthy diets so as to maintain a controlled weight. These topics were chosen based on the results of a previously conducted priority-based questionnaire from which it was established that these topics were the most prioritized to be included in the portfolio. The table 1 presents the relevant results of the above-mentioned survey. Table 1: Priority scores from responses to a previous survey, on each of the diabetes education topics Suggested Teaching Method Percentage Score Points Scored Number of Participants Topic Use of multimedia 73 % 99 27 Introduction to type II diabetes Use of multimedia 91 % 123 27 Hypoglycaemic symptoms and management Use of multimedia 88 % 120 27 Hyperglycaemic symptoms and management Cooperative learning 75 % 102 27 Diabetes control Cooperative learning 87% 118 27 Healthy lifestyle Key The answers were scored on the following scale: Not a priority (1point); Low priority (2 points); Medium priority (3 points); High priority (4 points); Essential (5 points) Program Objectives The overall objectives of the program are to assist the learner patient in the following: 1. Knowing more about diabetes as a global health issue and the available treatment options. 2. The essence of nutritional management into lifestyle. 3. The need for physical activity into lifestyle. 4. The need for using the appropriate medication (s) safely. 5. How to monitoring blood glucose. 6. Detecting, preventing and treating acute complications that could arise from diabetes. 7. Detecting, preventing and treating chronic complications that could arise with diabetes. 8. Developing personal strategies to promote health and behaviour change. Objectives of the day-program The objectives of the overall day-program are to supply reasonable knowledge to the learner-patients, on three important elements of diabetes, namely hypoglycaemia, hyperglycaemia and life styles suitable for diabetic patients. They will also be provided with the knowledge and skills for self-management of their condition. The day-programme is divided into 3 separate sessions. The objectives of session 1 At the end of session 1, the learners should have a reasonable understanding of: 1. What is hypoglycaemia (drop in blood sugar level causing discomfort to the patient), 2. Situations that can cause hypoglycaemia. 3. To recognise symptoms of hypoglycaemia. 4. How to manage hypoglycaemia, when it occurs and how to avoid causative situations. 5. Available treatment options for hypoglycaemia 6. How to monitor their own blood glucose level, using the glucometer. Objectives of Session 2: At the end of the session, the learners should have sufficient knowledge in: 1. What is hyperglycaemia (uncontrolled rise in blood glucose)? 2. Situations that can cause hyperglycaemia. 3. Recognising symptoms of hyperglycaemia 4. Treatment of hyperglycaemia 5. Management of hyperglycaemia, and how to avoid situations that may lead to hyperglycaemia. 6. Self-monitoring of blood glucose level, using the glucometer. The objectives of session 3: At the conclusion of session 3, the learners should have gained sufficient information on: 1. How life-style changes can help in managing diabetes, or even reversing it. 2. How losing body weight, and avoiding obesity can help diabetics. 3. The physical activities that will help in this process. 4. Dietary habits suitable for diabetics 5. Special types of foods, and food preparation methods that can help diabetics. Content outline of the diabetes educational program portfolio Below is the content outline of the diabetes educational program that patients are to be educated with: Content Outline Comments Knowledge related to the symptoms and/ or management of Hypoglycaemia. These includes the following: The definition of Hypoglycaemia. Knowledge of all the possible propagators (causes) of Hypoglycaemia. Symptoms that are expected when a patient has Hypoglycaemia. What are the preventive and treatment options for Hypoglycaemia? This is another crucial topic that must be addressed in the diabetes educational program portfolio. This topic and/ or session seek to introduce and educate the patient with concepts that are related to Hypoglycaemia. For instance, the patient is introduced to the causes, signs, symptoms of Hypoglycaemia. Moreover, they are instructed on what to do when the symptoms appear, and are given the available options for the prevention of the escalation of the health issue. Knowledge related to the symptoms and/ or management of Hyperglycaemia. These includes the following: The definition of Hyperglycaemia Knowledge of all the possible propagators (causes) of Hyperglycaemia Symptoms that are expected when the patient has Hyperglycaemia. What are the preventive and treatment options of Hyperglycaemia? This is another crucial topic that must be addressed in the diabetes educational program portfolio. This topic and/ or session seek to introduce and educate the patient with concepts that are related to Hyperglycaemia. For instance, the patient is introduced to the causes, signs, symptoms of Hyperglycaemia. Moreover, they are instructed on what to do when the symptoms appear, and are given the options that are available in the prevention of the escalation of the health issue. Knowledge about living a healthy lifestyle through physical activity and/ or losing weight. This section seeks to inform and/ or provide the patient with more information about how they could eat healthy foods and maintain a healthy lifestyle through physical activity and losing weight if need be. Nutrition and/ or meal planning information which includes: The type of meals that the patient should take on a daily basis? This also includes information related to exchange meal plans, carbohydrate counting meal plans and constant carbohydrate meal plans. This section seeks to inform the patient more about their diet and what is suitable for them with regard to their type of diabetes health issue. Moreover, the patient is also introduced to the concept of diet exchange plans where they can be in a better position to arrange and rearrange their diet plans at their comfort. Teaching Plan Time Area of coverage Instructional techniques Duration 8:00 AM To 8:30 AM Registration Breakfast Using computer to register data 30 mins 8:30 AM TO 9:00 AM Welcome to diabetes day program & Introduction to diabetes mellitus Lecture using PowerPoint presentation 30 mins 9:00 AM TO 9:30 AM Hypoglycaemia symptoms and management Lecture using PowerPoint presentation 30 mins 9:30 AM TO 10:30 AM Practical session on managing Hypoglycaemia Using virtual community-based intervention 1 hour 10:30 AM TO 11:00 AM Break & snacks 11:00 AM TO 11:30 AM Hyperglycaemia symptoms and management Lectures using 30 mins 11:30 AM TO 12:30 PM Practical session on managing hyperglycaemia Workshop on Using glucometer 1 hour 12:30 PM TO 1:00 PM Break &Lunch 1:00 PM TO 3:00 PM Healthy lifestyle Cooperative learning: discussions with other diabetics and the dietician on the best diet for diabetics; training with a physical or exercise therapist for best exercises in losing or maintaining weight for diabetics. 2 hours 3:00 PM TO 4:00 PM Review of learning and evaluation 30 mints 4:00 PM TO 5:00 PM Graduation ceremony And Certificate Distribution 1 hour Group formation As part of the teaching plan, the patients will be divided into smaller groups, of 5 each. It is known that smaller groups give better results in learning outcomes, as compared to larger ones, with an average of 10 per group, the optimal size for patient education (DeYoung, 2003; Tang, Funnell & Anderson, 2006). In addition, smaller groups give a chance for better patient-educator interaction, and ensure that the patients are comfortable with asking questions about anything that they do not understand well. Linking the Programme to Theoretical Framework The design, implementation and the evaluation of the programme are guided by the chosen Learning theories, namely the adult learning theory and the humanistic theory developed by Maslow (1968). The concepts of these theories are incorporated into the portfolio because learning (diabetes self management knowledge) was all related to the patient – that is, learning about basic diabetes self management is the driving force that patients had in themselves. More importantly, Maslow (1968) termed this aspect as motivation based on the human instinct in a bid to achieve a set of needs which include: safety, psychological needs, love/belonging, esteem and self-actualisation. However, the most important needs that were projected in this portfolio were related to needs such as: safety – in the form of ensuring that optimal health has been achieved; self esteem – in the form of ensuring that a healthy lifestyle has been achieved through safe weight loss techniques and/ or engagement in physical activity so as to keep fit; self-actualisation – in the form of achieving the safety and self esteem needs. Moreover, adult learning in this instance also incorporates the aspect of setting friendly learning conditions where the learner can be in a position to participate in problem solving tasks as compared to being subjected to comprehensive knowledge involving tasks. As part of offering convenient problem solving scenarios in the self management strategy, the use of workshops and interactive learning through the use of Power Point slides have been implemented so as to offer an environment for better problem solving and communication in the form of discussions for the patients (Bastable, 2008). As noted by Quinn (2007), adult learners have different learning characteristics – some adults are fast learners while others are slow learners. As such, different frameworks are used in teaching and/ or disbursing information to the different categories of adult learners. This fact needs to be considered in the strategic planning, implementing as well as evaluating the knowledge disbursement to optimize the understanding of the information provided to the adult learner. Resources list Recommended texts and web links Alrubeen, K. (2014).Diabetes from A to Z. Alwbakan. Riyadh Diabetic Magazine. (2014) Diabetes University centre. SA Saudi Charitable Association of Diabetes. (2014). Diabetes. Web. Retrieved from: http://alsukkary.org.sa/ Evaluation strategies Evaluation is the process whereby the effectiveness, that is whether the relevant programme has made a value-added difference to the learners’ knowledge, is determined (Bastable, 2008). Such evaluation helps the educators too, in that it will enable the improvement of similar courses undertaken by the educator in the future. In this instance, the chosen evaluation strategy should be able to determine the success of the effective delivery of diabetes self management information to the patients. Accordingly, the Roberta Straessle Abruzzese (RSA) evaluation model (Abruzzese, 1992) will be chosen as appropriate for the purpose. The RSA model is comprehensive in that it enables evaluation of the 5 different components; total program, process, content, outcome and impact. Therefore, it evaluates both the educator as well as the course. Evaluation will be done in two different ways. As for the success of the learners acquiring the relevant knowledge – the outcome and impact, they will be evaluated during the practical segment of the course. Each learner will be required to perform the blood glucose analysis by him/herself, to the satisfaction of the instructor. They will also be tested verbally in a casual environment, on their relevant knowledge in hypoglycaemia, hyperglycemias and lifestyle changes. Considering that the learners are of advanced age, and also based on the principles of humanistic theory, it will be inappropriate to conduct a written test for these learners. Secondly, the effectiveness of the course will be evaluated through a tool developed for the purpose – a questionnaire (Appendix 1) filled out by the learners. The questionnaire includes items on the content, the process and the overall programme. It is designed, having in mind, the scope of the evaluation (Bastable, 2008; p. 561). In the present case, there are questions on the contents, whether the contents were suitable, the learning environment and those relating to the instructor and the quality of his/her teaching. Reflection on the process undertaken When reflecting on a process that has been completed, several questions need to be asked, including whether the most appropriate approach was used, whether the approach was based on the correct theoretical framework, appropriateness of the tools used, whether the desired results were achieved, and what lessons were learnt for use in the future. Additionally, it helps in examining the author’s own learning experiences, particularly in integrating theory and practice. Establishing diabetes self management learning outcomes for the patient as well as working with them towards achieving the set goals is a task that is dependent largely on the and needs and desire on the part of the patient, as much as the duty and enthusiasm of the educator. In the present exercise, setting up of the learning outcomes in the portfolio was not comprehensive, but limited, based on the patients’ feed-back to a point based questionnaire, according to which the outcomes to be achieved by the portfolio were related to the following topics: Hypoglycaemia symptoms and management; Hyperglycaemia symptoms and management; Healthy diet options for diabetics; Healthy lifestyle through physical activity and/ or losing weight. The Table 1 above indicates this information. Once the teaching plan is outlined, it will be implemented according to the adult learner theory and the humanistic theory by Maslow (1968). The adult learner theory is used in recognition of the fact that there are different types of learners – that is, those patients who are fast learners and those who take longer to understand the major concepts of the diabetes self management program. In addition, the theory by Maslow (1968) will act as a benchmark to optimally reveal the needs that these patients had to fulfil through their engagement in the programme. Some of the needs that were established included: safety, self esteem and self-actualisation. Lastly, the teaching methodologies to be implemented will be more appealing since the diabetes management workshops and the use of visuals in the workshops aids in better understanding as well as problem solving as compared to teaching more about theory to the elder patients. In conclusion, the evaluation – verbal tests during the practicals and the learners’ feedback from the evaluation tool, will suggest whether the process was effective in providing the patients with the required knowledge and skills to self manage their disease. Works Cited Abruzzese, R.S. (1992).Evaluation in Nursing Staff Development. In R.S.Abruzzese, Nursing staff development: strategies for success.St. Louis, Missouri, USA, Mosby-Year Book. American Diabetes Association. (2010). Standards of Medical Care in Diabetes.Diabetes Care, 33 [Suppl. 1], S11–S61. American Diabetes Association. (2014). Diabetes Basics.Web. Retrieved from: http://www.diabetes.org/diabetes-basics/ American Diabetes Association. (2014). Type 2.Web. Retrieved from: http://www.diabetes.org/diabetes-basics/type-2/ Al-Nozha, M. M., et al. (2004). Diabetes mellitus in Saudi Arabia.Saudi Medical Journal, 25(11), 1603–1610. Alqurashi, K. A., et al. (2010). Prevalence of diabetes mellitus in a Saudi community.Annals of Saudi Medicine, 31(1), 19–23. Bastable, S.B. (2008).Nurse as Educator. Jones & Bartlett Publishers: Masschusetts, USA. Brodison, S. (2010).Secrets to Effective Weight Loss. USA: Strategic Book Publishing Diabetes Australia. (December 2013).Diabetes Globally. Web. Retrieved from: http://www.diabetesaustralia.com.au/Understanding-Diabetes/Diabetes-Globally/ DeYoung, S (2003). Teaching strategies for nurse educators. Upper Saddle River, New Jersey: Prentice-Hall. Hollands, M. (2005).Diabetes Self-management Meals & Menus for 1 or 2. USA: Diabetes Self-management Books International Diabetes Foundation. (2014). Introduction – Key messages. Web. Retrieved from: http://www.idf.org/diabetesatlas/introduction Maslow, A. H. (1968). Some educational implications of the humanistic psychologies.Harvard Educational Review, 38(4), pp. 685–696. Ozcan, S., and Erol, O. (2007).Teaching and learning in diabetes: techniques and methods. Web. Retrieved from: https://www.idf.org/sites/default/files/attachments/article_554_en.pdf Poolsup, N., Suksomboon, N., & Rattanasookchit, S. (2009). Meta-analysis of the benefits of self-monitoring of blood glucose on glycemic control in type 2 diabetes patients: an update. Diabetes technology & therapeutics, 11(12), 775-784. Quinn, F. M. (2007). The principles and practice of nurse education, (5th edn). London: Nelson Thornes Limited. Stanley, K., and Crawley, C. (2007).Quick & Easy Diabetic Recipes for One. USA:American Diabetes Association Sharifirad, G., Entezari, M. H., Kamran, A., & Azadbakht, L. (2009).The effectiveness of nutritional education on the knowledge of diabetic patients using the health belief model.Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences, 14(1), 1. Tang, T.S., Funnell, M.M. & Anderson, R.M. (2006).Group education strategies for diabetes self-management. Diabetes Spectrum, 19(2).99-105. World Health Organisation (WHO). (2012). Diabetes.Web. Retrieved from: http://www.who.int/mediacentre/factsheets/fs312/en/ Read More