Diabetes Education Study Group

CHAIRMAN'S REPORT
Prof. Jean-Philippe Assal - September 1995

I should firstly like to thank Servier International for their continuing support of our Study Group without whom our activities would not take place. I should also like to address my thanks to Mrs. Lisbeth Vang our Honorary Secretary who has just completed the final year of her mandate, as well as Dr. Daniel Figuerola the Vice-President, Mrs. Sylvaine Clavel, Treasurer, Prof. Urban Rosenqvist continuing his activities with the DESG as Director of Educational Strategies and finally to Mrs. Melodie Käser who runs the Geneva secretariat.

This last year has seen the birth of further DESG publications and a workshop was held in October 1994, in Grimentz, Switzerland, to test the feasibility of the 5-Minute 'Survival Kit' before its final polishing for publication . These and other activities are listed below.

1. DESG Workshop, 8-13 October, 1994, Grimentz, Switzerland
A total of 40 participants, coming from 21 European countries, i.e. Albania, Belgium, Denmark, France, Hungary, Ireland, Italy, Lithuania, Malta, Morocco, Netherlands, Poland, Romania, Russia, Slovak Republic, Spain, Sweden, Switzerland, Turkey, UK, and Yugoslavia) attended this workshop. Among the items presented on the programme was the 'Survival Kit'. The nine topics covered in this document i.e. Prevention of Hypoglycemia, Intercurrent illness, Sickday rules and acetone, Meal Planning for Insulin Treated diabetes, Meal planning for Type II, Weight loss, Prevention of foot Iesions, Loss of pain sensation, Follow-up of eye problems, Pregnancy and diabetes were enacted by all participants working in small teams in order to observe the viability of a 5-minute education programme. These practical exercises showed the strengths and weaknesses of the health care team to pass a pertinent message to the patient in a restricted time. As a result of our practical findings, the 'Survival Kit' topics were further streamlined to be as concise as possible. Evaluation of the effect of 'survival' education was taken into consideration and debated.

The idea of helping patients to understand and acquire new skills was approached firstly by the discussion of several methods. One method was using the errors of patients in a positive way to favour understanding. To this end the 'DiabTrain' Model was presented by Dr. Jan Tehran and Prof. Urban Rosenqvist and all participants took part in practical exercises using this model. It was designed to help health care providers to understand in an easier way concepts such as:

- how does one learn?
- what is the role of a teacher who has to help a person to acquire new skills?

Each participant received a free copy offered by the DESG.

Empowerment of patients was discussed at length with a prior video showing of a film made by one of the 'Patient Education 2000' congress lecturers, Ms Cathy Feast, on this subject.

A discussion on, and the practicalities for, planning and running a workshop in their own setting within the year by the participants was also covered. They were each invited to present their ideas for a workshop, using what they had learned during the week.

Our workshop also covered such topics as round-table discussions on training health care providers and small group discussions on using the 'Metaplan' type approach. Practical exercises were also made by participants working in small groups in order to illustrate why seemingly simple exercises (which patients need to carry out) may be difficult. This was followed by group discussions, together with psychologists and specialists in education, in order to find ways to overcome these 'handicaps'.

2. PUBLICATION OF THE DESG 'SURVIVAL KIT'
Following the evaluation of the 'Survival Kit' during that workshop, the one-page handouts were honed down and then presented To Novo Nordisk AS in the kit form desired. These nine topics have now been printed by Novo and are available at the Novo stand in Stockholm. They will be distributed to key people in Europe and other countries around the world for further distribution. One working set of this kit will be distributed to all members of the GeneraI Committee.

The entire kit has been accepted for publication in 'Diabetic Medicine'. Translations in to several European languages have already been made and the Novo affiliates of those countries have been approached for publication purposes.

We are currently working on a second 'Survival Kit' for Type II diabetes.

3. PROCEEDINGS of 'PATIENT EDUCATION 2000' - An international Congress on the Treatment of Chronic Diseases, 1-4 June, 1994, Geneva, Switzerland
Members of the DESG may obtain a copy of the order form for the hardback version of the Proceedings from the secretariat of the DESG President. They also appear in VoI. 26 of Patient Education & Counseling, August 1995.

4. DESG TEACHING LETTER and the 'DIABTRAIN'
A Teaching Letter entitled: 'THE PATIENT'S TASK - NEW DEVELOPMENTS IN DIABETES EDUCATION - From classical to holistic approach' has now been written together with Prof. Urban Rosenqvist, Dr. Jan Tehran and myself. This has been distributed to all DESG members. The educational background of the 'DiabTrain' is described in that Teaching Letter.

5. Publication of New Teaching Letters
During the period 1995-1997 a series of new Teaching Letters will be prepared covering difficulties we all encounter under the three main topics of:

1. Quality of Life
2. Long Term Management of Type II Diabetes
3. Adherence to Treatment

6. Educational Posters
A new series of Educational Posters will be prepared. The poster on 'Teaching & Therapy' has already been made. Working copies were distributed during the 1 -day DESG Meeting held in Stockholm on Tuesday, 12 September. One large and one small copy of this poster will be distributed to members of the General Committee. Other topics such as 'Attitudes which imprison doctors and patients', 'Following a patient on a long-term basis implies...', 'Following a treatment for many years implies...', 'Relapse prevention', 'Helping patients to learn ' will follow.

The aim of these posters is to summarize through image the main concepts in therapy of chronic diseases which are very often difficult to describe in writing.

Meetings with specialists in the above mentioned fields are envisaged in the not too distant future to rationalize these projected projects.

7. Update of Previous Teaching Letters
Together with the sponsors, Servier International, we are currently updating the original Teaching Letters which were produced in 1988 covering such topics as: OraI agents, hypoglycemia, self-monitoring, foot care, etc., and these will be redistributed to DESG members in the near future.

8. DESG 1-day Meeting: Tuesday, 12 September, Stockholm, Sweden
A one-day meeting was organized by Prof. Urban Rosenqvist, the DESG Director of Educational Strategies, on 'New Trends in Diabetes Education - hands on the Iearning process'. Each participant received a booklet upon entering the meeting helping them to understand the exercises, exhibition and educational posters presented. There were 20 exercises and lectures to which all participants could actively participate. There were simultaneous video shows running all throughout the meeting showing specific clinical situations. The aim of the meeting was to present standard teaching and holistic learning. The Diabtrain model was also presented.

9. Future sponsorship of the DESG for 1995-1997
'Les Laboratoires Servier' have most generously accepted to sponsor this Study Group for the period 1995-1997. May we thank the directors Dr. Jean-Philippe Seta and Dr. Didier Halimi for their understanding and their support.

I would like to end this report by once again thanking Novo Nordisk for their sponsorship of the DESG over the past three years as well as for the publication of the English version of the Survival Kit after their mandate had finished, and in particular, Ms. Susanne Hayes for her personal support.

Prof. Jean-Philippe ASSAL
President, Diabetes Education Study Group
September, 1995