A modular approach to diabetes structured education: Effects on patient knowledge, self-efficacy, self-management and patient experience in diabetic kidney disease
Diabetic kidney disease (DKD) is a serious chronic complication of diabetes, associated with increased risk of cardiovascular disease, end stage kidney disease and mortality. Intensive management, incorporating dietary and lifestyle changes with pharmacological agents, has been shown to reduce associated risks of DKD. This requires multiple self-management (SM) actions to optimise risk factors including diabetes, hypertension and hyperlipidaemia. Diabetes structured education (DSE) is integral to diabetes management and research shows DSE is beneficial to knowledge, SM activities, and diabetes control (Dekain et al., 2009; Speight et al., 2010). However, little evidence exists in DSE focused on DKD, despite the increased risk of mortality associated with the condition and NICE guidelines (NICE, 2008; NICE, 2003) encouraging education to optimise management of diabetes and kidney disease. The aim of the research is to determine whether complication-specific DSE for DKD has an impact on SM, self-efficacy (SE), and knowledge related to DKD, and to identify what effect education has on participants. A mixed method approach, combining quantitative questionnaires and semi-structured qualitative interviews was utilised. A standalone education module specifically for adults with DKD was provided for participants, tailored to the needs of this distinct group. A single education module demonstrated positive changes in SM activities, specifically seeking information, asking questions regarding biomedical results and following suggestions to alter dietary and exercise habits. Improvements were also seen in knowledge related to DKD. Significant positive correlations were demonstrated between SM and SE outcomes related to seeking support and discussing worries with family and friends. Qualitative results identified that social support can have a negative or positive impact on participants depending on the nature of the support. It was also found that participants felt healthcare professionals did not inform them of their biomedical results. An education module specifically for DKD allows the information to be tailored to meet the needs of participants to a greater extend, which is in keeping with NICE guidelines (NICE, 2003). A single education session had a positive impact on participants demonstrated by improvements in DKD knowledge, SE and increased engagement in SM activities. Healthcare professionals can improve partnership with patients through the sharing of, and the significance of, biomedical information. This could have a benefit in reducing the health burden of DKD considering its morbidity and mortality risk.Diabetes Research Unit at the Countess of Chester Hospital NHS Foundation Trust, Cheshire and Wirral Partnership NHS Foundation Trust, Cheshire and Merseyside Allied Healthcare Professional Research Network, and Lily U
