|
Winners of the 2002 DESG Awards |
|
|
|
|
Page 1 of 2 Best abstract on Therapeutic Patient Education presented during the 38th EASD Congress, Budapest, 2002:
Bernas, M, Taton, J: Balancing knowledge and motivation in constructing education programmes for Type 1 diabetic persons (Abstract No 981)
Chair and Department of Internal Medicine and Diabetology, Warsaw Medical University, Warsaw, Poland.
Background and Aims: Therapeutic education of patients with incurable, chronic disease is not a simple transfer of the information. This complicated process exerts a formative influence on all parties involved - patients, educators and people allegedly from outside - society.
Methods: Keeping in mind the ideas of personalistic, psychological mechanisms in shaping personality and behaviour through education as described above and, in addition, this particular experience, we have designed a programme oriented at stimulating primarily motivation. This programme became an object of observation and of experimental evaluation. This we attempted to achieve by comparing the outcomes and the results of 2 programmes implemented in the same organizational setting: 1. the programme more oriented toward increasing knowledge - PK, 2. the programme more oriented toward increasing motivation - PM. Methods used for the knowledge - oriented programme were: 30 min lectures and preprogrammed as educational units, reproducible, practical exercises in self - control, injection, adapting the insulin dose, diet composition and bread unit calculations, simulation of the sick day rules. In the motivation - oriented programme the educator had the task of incorporating into the knowledge - building activities such as for example the general, psychological aspects of the non - curable disease, the possibility of organizing the whole life around new values and possibilities, a new <> not a worse one - life without diabetes mellitus. The educators were instructed to build the alliance between the patient, the treatment team and the social group. Also during this programme two experiments in self - control were organized - the influence of a nutritional error on blood glucose (200 g of sweet cake) and of physical exercise on blood pressure (bicycle ergometer). Teaching. Both programmes were taught according to a basic, written syllabus. The programmes were taught at the diabetic school.
Results: By comparing the level of knowledge, before and after the knowledge - oriented programme, it was possible to calculate, that the average index of change in knowledge was 22. it means, that after the programme the number of patients with positive multiple choice tests went up from 2 to 24. at the same time the index of change in the motivation calculated in the same manner went up only by 2, that is from 6 to 8. the other group composed of 25 participants underwent in a similar diabetic school the motivation - oriented programme. After this type of education the index of change in the knowledge, calculated in the same way as described above, went from 4 up to 19, an increase of 15. the index of change for motivation went up at the same time from 5 to 23, an increase of 18. All these changes were statistically significant at the <> level of 0,05.
Conclusions: 1. Teaching according to the knowledge - oriented programme increased mostly knowledge. It did not correlate with an increase in motivation, meaning the readiness to put knowledge into practice. 2. Educating the diabetes mellitus type 1 patients according to the motivation - oriented programme was significantly more effective in increasing both knowledge and motivation.
|