Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
The researchers are correct with this assumption. Nursing must
consider defining interventions that not only support a specific
educational method, but one that includes the individual’s
experiences. The researchers contend the difficulties diabetics
experience when trying to learn and maintain self-management
skills may be related to external conditions, which restrict responses
to their self-management. Directly applicable to rural, homebound
diabetics, are obstacles in their physical environment that inhibit
self-management. For example, the ability to move about in a
wheelchair could be confined to circumscribed areas because a
ramp was not available. Nurses must consider environmental factors
because these factors influence the course and outcome of a
person’s disease.
A new research paradigm in diabetes education was
suggested by Jack, Liburd, Vinicor, Brody, and McBride-Murry
(1999). The new paradigm would focus on a public health approach
aimed towards comprehensively viewing diabetic clients and their
challenges with diabetes self-management. The new paradigm could
be a positive influence on rural, homebound diabetics because it
may increase their visibility in the medical community.
Evidenced-based recommendations to improve outcomes of
older, adult education in diabetes and symptom management are
needed in nursing practice. Rutledge, Donaldson, and Pravikoff
(1999), reported their evidence-based recommendations of disease
management education programs must be tailored to self-care
management needs and capacities of the client. They believe client
education is the core to disease management, and the effectiveness
of educational strategies depends upon a therapeutic, collaborative
level of provider and client interaction. The authors contend that the
basic structure of successful, diabetes management programs is
built on mobilizing the patients as active participants and
collaborators in their health care. This is a worthwhile diabetes
intervention that appears based in the holistic care model and
applicable to the older client.
The patient and healthcare provider need to agree upon a
common goal, and elements of the plan must be adapted to the
patient’s lifestyle, preferences, and environment to promote patient
adherence. Undoubtedly, this is a vital component of adherence.
Eliciting clients’ preferences are best served by listening to the older
adult describe their experiences and offering choices based on what
is available and realistic.
Fundamental for consideration in the development of diabetes
education programs are: content, teaching method, and person
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