Diabetes in Communities

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68784/2/10.1177_014572178801400301.pd

Development of a Guide to Recommended Print Materials for Diabetes Patient Education

There are hundreds of current booklets, pamphlets, and manuals available for diabetes patient educa tion. Everyone, it seems, is writing them from large pharmaceutical com panies and publishing houses to small rural hospitals. A national review of those materials has led to the development of an an notated resource booklet entitled "Recommended Print Materials for Diabetes Patient Education, 1984. " This article discusses the overall results of the review and the methodology used in its formation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68926/2/10.1177_014572178401000311.pd

Screening for Diabetic Retinopathy in Communities

Twelve retinopathy screening clinics serving 489 diabetic patients were conducted in three Michigan communities as part of the outreach effort of the Michigan Diabetes Research and Training Center. Screening activities were initiated by local diabetes educators who conducted a program designed to promote detection of diabetic eye disease and increase patient and health care provider awareness of accepted ophthalmic evaluation guidelines. This experience suggests that retinopathy screening clinics can be successfully conducted if health care professionals in the community consider diabetic retinopathy to be a serious problem, one individual is willing to oversee the organizational aspects of the clinic, and an ophthalmologist with laser treatment capability is present or nearby. These clinics are effective in detecting diabetic eye disease and facilitating subsequent patient visits to an ophthalmologist for evaluation in accordance with national recommendations.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68539/2/10.1177_014572179201800205.pd

Diabetes Patient Education in The Office Setting

The diabetes patient education provided in ran domly chosen primary care physician offices in small and large com munities was compared with hospital-based patient education programs in those same communities. The office programs were usually physician-de livered, informal, and in terwoven with the clinical care offered. They usually did not include a sys tematic needs assessment, were not recorded, used educational materials sparsely, and often lacked evaluation. The time spent on education is approx imately 48 minutes per year per patient in the of fice setting. The study suggested several develop mental activities that might improve patient education in physician of fices where the majority of patients with diabetes receive most of their care.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/69027/2/10.1177_014572178601200307.pd

The Biggest Problem in Diabetes

An assessment of the big gest problem in diabetes care from the viewpoint of 115 health care profes sionals and 428 diabetic patients was obtained. There was substantial agreement by health pro fessionals and patients alike that diet and diet- related issues constituted the most difficult problem faced by persons with diabetes and by health professionals caring for those persons. These find ings may be important in organizing diabetes patient education and in the selection of research efforts within the overall field of diabetes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68782/2/10.1177_014572178601200107.pd

Development of a Guide To Recommended Audiovisual Materials on Diabetes, 1983

The task of reviewing and critiquing the hundreds of audiovisual programs available for diabetes education is an exceedingly time consuming and tedious activity. To assist the many users of educational audiovisual materials the Outreach Core of the Michigan Diabetes Research and Training Center undertook the review and critique of these programs. Based on specified selection and review cri teria, 35 programs have been chosen for inclusion in a booklet entitled "Recommended Audiovisual Re sources for Diabetes Education. " This booklet is available to any diabetes educator upon request.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68617/2/10.1177_014572178400900408.pd

Patient Knowledge Compared With National Guidelines for Diabetes Care

Data collected on a randomly selected group of 428 patients with insulin-dependent and noninsulin-dependent diabetes from 61 physician practices in eight Michigan communities were compared with national standards for diabetes patient knowledge. Comparisons were performed using a standardized Diabetes Knowledge Test (DKT) and selected items from the Diabetes Education Profile (DEP). Patient performance on these instruments was compared with corresponding items in the Ambulatory Care Facilities section of the Guide lines for Diabetes Care published by the American Diabetes Associ ation and the American Associ ation of Diabetes Educators. In general, insulin-dependent persons scored higher than noninsulin-dependent persons. Those taking insulin (whether insulin-dependent or not) scored higher than noninsulin-dependent persons whose regimen did not include insulin. The findings emphasize the need to subdivide any analysis of clinical diabetes or diabetes education into groups based on insulin use or nonuse.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/69139/2/10.1177_014572178801400312.pd

Evaluation of an Activated Patient Diabetes Education Newsletter

This study evaluated a monthly; activated patient newsletter sent to over 7000 patients in Michigan with diabetes. The newsletter provided concise and action-oriented information about diabetes care. Patients who had signed up to receive the newsletter during the first 4 months of the project (1863) were surveyed to determine how many patients found the newsletter helpful; 80% (1498) of the patients replied. Patients who found the newsletter most helpful were older, had lower incomes, and reported more corrtplications, less understanding of diabetes, and being in poorer overall health. They also were more likely to have non-insulin-dependent diabetes mellitus (NIDDM) than insulin-dependent diabetes mellitus (IDDM). We concluded that the activated patient newsletter is a useful public health/patient education intervention for persons with diabetes. Such a newsletter should be part of a coordinated system of ongoing patient care, education, screening, and social and psychological support.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68904/2/10.1177_014572179402000106.pd

The Diabetes Education Experience of Randomly Selected Patients Under the Care of Community Physicians

The purpose of this study was to describe the diabetes education and nutritional counseling received by patients under the active care of community physicians. The study population consisted of 440 patients with diabetes from the practices of 68 primary care physicians in eight Michigan communities. Fifty-eight percent of the sample reported having received diabetes education, and the mean number of years since the most recent education was 4.15 years. Sixty-six percent reported having seen a dietitian. Patients who had received diabetes education scored higher on a basic diabetes knowledge test (70% correct vs 60%) than patients who had not received diabetes education. From 1981 to 1991, a decline was observed in the percentage of patients who reported having received diabetes education (70% to 58%). Although patient education is an integral part of comprehensive diabetes care, too few patients are receiving it. Furthermore, diabetes education often results in less-than-optimal levels of knowledge. The situation has deteriorated over the past 10 years, and patients who are not on insulin typically are the least well served.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68590/2/10.1177_014572179402000506.pd

Development and Validation of the Diabetes Care Profile

To determine the reliability and the validity of the Diabetes Care Profile (DCP), an instrument that assesses the social and psychological factors related to diabetes and its treatment, two studies with separate populations and methodologies were conducted In the first study, the DCP was administered to, and physiologic measures collected from, individuals with diabetes being cared for in a community setting (n = 440). In the second study, the DCP and several previously validated scales were administered to individuals with diabetes receiving care at a university medical center (n = 352). Cronbach's alphas of individual DCP scales ranged from .60 to .95 (Study 1) and from .66 to .94 (Study 2). Glycohemoglobin levels correlated with three DCP scales (Study 1). Several DCP scales discriminated among patients with different levels of disease severity. The results of the studies indicate that the DCP is a reliable and valid instrument for measuring the psychosocial factors related to diabetes and its treatment.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67531/2/10.1177_016327879601900205.pd