Il modello della Group Care. Verso una teoria della formazione

To develop pedagogic interventions within a health care delivery context one needs to take into account the theory and practice of educating people, taken both as individuals and members of society. Current knowledge on the most appropriate methodologies to deliver education must be reconsidered. Pedagogy is key to harmonize such knowledge and, as such, stands up as a science in itself with its own epistemologic status. It allows to select what belongs to the field of education and what does not, within the realms of other disciplines. The clinico-pedagogic model of Group Care was developed within such framework, to harmonise pedagogical expertise and clinical needs with the ultimate aim of helping people with a chronic disease to retrace their own identity despite illness.La progettazione di interventi clinico ed educativi richiede una riflessione organica e critica sui problemi educativiovvero la teorizzazione di quei processi rivolti a educare, istruire e formare i soggetti, individualmente e socialmente intesi. Si tratta di rileggere le conoscenze e teorie in campo educativo e in secondo luogo le modalità di gestione dei processi educativi e formativi. Il ruolo della pedagogia è quello di armonizzare queste conoscenze in chiave educativa. Sulla base di un tale sistema di riferimento la pedagogia assume le caratteristiche di scienza autonoma con un proprio statuto epistemologico che le permette di operare scelte all’interno dei risultati di altre discipline fra ciò che è proprio del campo educativo e ciò che non le appartiene. In questo quadro di riferimento nasce il modello clinico educativo e assistenziale della Group Care che ha ripensato l’educazione in un contesto clinico con il fine di aiutare le persone a ritrovare una propria identità pur in presenza di una malattia

Vision-related quality of life and locus of control in type 1 diabetes: a multicenter observational study

AIMS: Diabetic retinopathy remains asymptomatic until its late stages but remains a leading cause of vision impairment and blindness. We studied quality of life and the ability to deal with the discomfort deriving from the presence of a chronic disease in patients with type 1 diabetes and different stages of retinopathy. METHODS: Multicenter collaborative observational study involving nine centers screening for retinopathy in different areas of Italy. The National Eye Institute 25-item visual functioning questionnaire and the locus of control tool were administered to 449 people with type 1 diabetes between February 2016 and March 2018. Socio-demographic and clinical data were collected. RESULTS: On multivariable analysis, severe retinopathy is associated with worse scores for general vision, ocular pain, near vision activities, distance vision activities, driving, color vision, peripheral vision and lower values of internal control, independently of visual acuity. Women had a perception of worse general health, distance vision activities and driving, and lower internal control and trust in others. Worse scores for visual-specific social functioning, visual-specific mental health, visual-specific role difficulties, visual-specific dependency and peripheral vision were associated with higher HbA1c levels. Fatalism increased with rising HbA1c levels. CONCLUSIONS: These results confirm that a gap exists between patients' knowledge and expectations on retinopathy and providers' expertise and assumptions. To bridge this gap, patient-centered education and engaging approaches may be more effective than simple information given during consultations