Importance of Diabetes Self-Care Education

To combat this situation ADA recommends Diabetes Self-Management Education (DSME) to provide information, skills, strengthening and empowering the patient with diabetes self-care (Arlington, 2017). Nurses and diabetes educators are encouraged to provide individual or group training to these individuals. Often due to the complexity of self-care, patients with diabetes experience, physical and mental stress. Some patients accept their chronic illness while some demonstrate no motivation for self-care. People who are noncompliant with their diabetes care are frequently hospitalized with abnormally high blood sugar or DKA.

Why some people ignore their condition? How can I help as a nurse to improve their experience and help them better manage their disease? It is important to give special consideration on the limitations that patients may be facing.

A study by Sarkar, Fisher, and Schillinger (2006) looked into low-income patients with diabetes and there were significant barriers to the diabetes management such as cost of treatment such as the cost of glucose test strips or medications, cultural belief, limited health literacy, poor knowledge of diabetes management, patient-physician communication problems, comorbid conditions such as depression or chronic pain, and lack of safe space to exercise and accessibility of fresh foods were identified. To successfully cope with this chronic disease a holistic approach should be considered. King's theory and Orem's model of self-care both were equally important to combat the barriers. The result shows that proper health education can lower diabetic related complication and increase patient's adherence to the regimen (Sarkar, Fisher & Schillinger, 2006).

Not only inpatient settings, outpatients' clinics, but home health is also a vital part in diabetes continuous care. Home health nurses encourage, motivates their homebound clients to take control of their disease and follow up. With proper coaching, guidance patient soon develops required skills to combat this disease. Many patients are afraid to ask questions, some are might not understand what self-care activities are. Instead of labeling them as "non-compliant" as a nurse it is my responsibility to take the time to fully assess the patient and them make an informed decision on patient's care plan. Also, just not the hospital stays, as to maintain and sustain treatment plan a nurse should help patients for follow up care.

In conclusion, it is recommended that diabetes self-care education has a dramatic impact on quality of life, lowering glycosylated hemoglobin levels, and delay or prevent complications. In our current practice, King's goal attainment theory and Orem's self-care deficit theory both are equally valuable. Patients see nurses/healthcare providers as a guide, expert. Nurses are leaders, a change agent. Patients rely on us to help educate them on their own health. One size might not fit all! As a nurse, it is our responsibility to assess patient care and depending on individual need and we should create an individualized nursing care plan.Based on an individual's priorities and situation nurses need to schedule follow up visits, reassess current goal and develop new goals of self-care. It is important to discuss and make aware to the patients of complications of poorly managed diabetes. As nurses, our job and responsibility not only centered around vigilant monitoring for physiological changes but also centered around educating our patients in self-care. It is nurse's responsibility to explore patients experience, frustrations with self-care, available resources and instill a seed of success in living with diabetes. Pt might not be ready on the first visit but to keep the door open always.

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