I've just been reading through the Scope of Practice for Diabetes Educators. I didn't realize that the AADE7 were published in 2002 -- We should celebrate! The AADE7 are 7 years old :)
The following statement in the Scope of Practice caught my eye today...
"It is the position of the AADE that all educators should measure the AADE7 Self-Care Behaviors...at least twice: preintervention and postintervention. These behaviors are...
- healthy eating
- being active
- monitoring
-taking medications
-problem solving
-healthy coping
-reducing risks"
In my previous blog, I mentioned 'information overload' as a risk for the patient's ability to feel confident in diabetes management. I offer them a choice of one of the AADE7 as a starting point.
Will I ask each patient to return 6 times after the initial visit so that each of the AADE7 can be addressed individually in a visit? Some insurance companies will actually pay for additional visits if the doctor orders it. How many physicians believe that it takes at least 7 patient visits to gain the basic understanding of the self-care behaviors? I don't think that is the reality we live in. If I could choose the one self-care behavior from the AADE7 to focus on during the first visit, I believe it would be "problem solving". The problem solving skill must address the importance of accessing ongoing resources, such as the wonderful support groups that are available -- in our community, online, through magazines. Let the patient know they are not alone, that it takes a great deal of time to comprehend it all, that they should prominently post the AADE7 and remember to take each - one - step - at - a - time.
In the short time that we have with the patient in the 'insurance provided" education time slot, we focus on the survival skills - monitoring, taking medications, problem solving. No matter how I try to put it in small, understandable, blocks of information. If I ask the question "Are you feeling overwhelmed?", a majority of the patients respond, "Yes." I reassure them that it will take time to process this information and encourage them to ask me enough questions to feel confident in just one aspect of diabetes management. It is usually very difficult, they most frequently just want to know 'what can I eat' . Regarding monitoring and medications, I still hear a great deal of "My doctor said..." reverting to the 'acute care' health model belief that if I do as my doctor says, the disease will be well treated. The 'chronic care' health model of patient self-management does not seem to be well promoted by all physicians. I'm afraid if the doctor does not plant the idea in the patient's head, it will be much harder for them to comprehend it when they begin hearing it from the other health care providers.
Still -- handing them a copy of the AADE7 -- informing them that the best managed diabetes is the self-managed diabetes is a good starting place. I believe it is a message that should be shared with all of our physicians and with every patient visit.
AADE7 - repeat - repeat -repeat
The AADE website - Patient Education section, offers a 2 minute video for each of the behaviors:
http://www.diabeteseducator.org/DiabetesEducation/Patient_Resources/
which also refers them to the website:
www.mydiabetespartner.org
The dLife website has a nice link to each of the 7 self-care habits. You can make a print out to give to your patients, or if they have computer access, refer them directly to the website...
http://www.dlife.com/dLife/do/ShowContent/7_Self-Care_Habits/7_Self-Care_Behaviors.html
dLife.com
What do you think? Do you have additional website links for the AADE7?
Brenda
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