Education for Life-Long conditions

Question 1

What must be combined with knowedge to evoke a bahavioural change in the patient?

Answer 1

Intention

Question 2

What is the national target for glycaemic control?

Answer 2

TYpe 1 diabetes - 6.5% (48 mmol/l)

Although a study in grampian showed that 94% of patients did not meet this target

This goes to show that education alone is not enough to bring about behavioural change in patients - needs intention

Question 3

What gets in the way of changing behaviour?

Answer 3

Emotional well-being

Motivation

Importance

Health beliefs

Experiences

Question 4

What are health beleifs?

Answer 4

Perceived:

Seriousness of problem

Effectiveness of treatment

Costs and benefits of following advice

Self-efficacy

Vulnerability to future problems

Impact of illness

Question 5

How do health beleifs impact you psychologically?

Answer 5

oAnxiety & Stress

oDepression & Low Mood

oAdjustment problems

oEating-related & body image difficulties

Question 6

How does stress affect diabetes?

Answer 6

Stress makes blood glucose levels rise

Cortisol kicks in = fight or flight system - raises energy for the body to survive and get away

Question 7

What are features of depression (may or may not relate to diabetes)?

Answer 7

Rumination

Reduced socialising

Sadness

Reduced motivation

Reduced enjoyable activities

Question 8

What are the incidence rates of people with depression who are diabetic?

Answer 8

20%

Question 9

What are the effects of anxiety?

Answer 9

Worry

Nausea

Reduced focus

Restlessness

Shaking

Muscular tension

Seating

Avoidance

Question 10

What is the incidence of GAD (generealised anxiety disorder) for diabetic patients and the public?

Answer 10

o~40% (~5% in population) but can be specific issue, e.g., hypo fear

Question 11

Clinicians are often interested with experiential avoidance - what does this mean?

Answer 11

Experiential avoidance (EA) has been broadly defined as attempts to avoid thoughts, feelings, memories, physical sensations, and other internal experiences—even when doing so creates harm in the long-run

Question 12

Why does the function of behaviour help us understand patients?

Answer 12

oBehaviour is idiosyncratic – people do the same thing for different reasons

Question 13

Experietaional avoidance in health-related behaviour:

Answer 13

Question 14

Understanding why we do something helps us change our behaviour: Give an example of this

Answer 14

Question 15

What is the difference between positive reinforcement and negative reinforcement?

Answer 15

Question 16

What does ABC stand for?

Answer 16

Something that existed before

Question 17

Look at an example of ABC

Answer 17

Question 18

How can we break well established habits?

Answer 18

•Stress reducing techniques

–Online self-help/psychology/mindfulness

•Involve key people in behaviour change

–Friends; family; HCP

• Use prompts – apps, alerts on phone
• Importance (0-10) if important will be motivated to change; if not important then unlikely to change
• Confidence in changing (0-10)

Question 19

What are the benefits of behaviour change?

Answer 19

Prevent disease

Improve management of disease

Improve quaity of life

Question 20

Why is behaviour described as idiosyncratic?

Answer 20

People behave the same way for different reasons