Education for Life-Long Conditions Flashcards
what things get in the way of behaviour?
emotional well-being
motivation
importance
health beliefs
experiences
most people ____ what they ______ __ but it doesnt always change their _______
most people know what they should do but it doesnt always change their behaviour
does education alone change behaviour?
There is hardly any evidence that ‘education’ alone can change behaviour
Have to support people through the process and help people find their own solutions to problems.
Knowledge – intention- change
knowledge doesnt necessarily mean behaviour, what is inbetween?
In between is intention which is effected by a huge range of things that we spoke about
Gap between knowledge and behavior which is often overlooked
Intention is what helps our patients make changes to their self management in the long term
what is insanity?
doing the same thing over and over again and expecting different results
what is living with diabetes like?
Diabetes is a complex disease
Controlling and managing diabetes can be a challenge for anybody living with the condition
Adjustment to diagnosis can be difficult as well as burnout
Diabetes is like a full time job where you get no holiday
Diabetes can be a difficult task to juggle
Everyone is different
What are the national targets for glycemic control?
Type 1 diabetes - 6.5% (48 mmol/l)
How achievable is the national targets for glycaemic contorol?
Setting realistic goals
similar to telling a kid at primary school to get 95% in every test that they do – impossible task
are we setting patients up to fail?
there are also current _________ challenges
technology
Whole Clinic HbA1c - Grampian:
Describe what is seen here
National guidelines sit at 6.5/ 48mol/L
We collected data in Grampian – a few years ago now
However you can see the distribution here – how many people actually achieve this target – 6th percentile which means more than 94% do not meet this target
As soon as we add anything to the mix including stress, which is very common – our targets seem bit redundant
6.5 is the target so Grampian levels not great
What are the levels of adolescents’ HbA1c like?
Similar for adolescents
50th percentile is 9.45
What is HADS?
Hospital Anxiety and Depression Scale
Describe the levels of secondary care HADS screening?
Here are the results of the screening
As you can see – anxiety and depression is very common in this population
~18% have clinical level problems
Include borderline: Anxiety = 30%; Depression = 20%
what are things that may affect a patients psychological wellbeing?
- Anxiety & Stress
- Depression & Low Mood
- Adjustment problems
- Eating-related & body image difficulties
(People often have another problem along side their diabetes such as the ones listed and this is common and they may self refer their self’s)
As soon as you add in ______ to diabetes the job gets a lot harder
stress
Stress makes blood glucose levels rise
Cortisol kicks in – function of fight or flight system – trying to raise energy for the body to survive and get away
what things can depression cause?
rumination (deep or considered thought about something)
fatigue
< socialising
sadness
< motivation
< enjoyable activities etc
what may bepression be linked to?
may or may not relate to diabetes
How much people that have diabetes have depresison?
Incidence rate of ~20% (5% in general public) - prevalence ~ same in types 1, 2 kids & adults
Do peole with depression often seek treatment?
Generally people reluctant to seek treatment
is relapse of depression common?
Relapse more common than not (50% in 2 years; 75% in 5 years) + 10-20% stay depressed
People with higher __________ scores tent to have higher _____
depression
HbA1c
what does anxiety & diabetes cause?
Worry
nausea
< focus
restlessness
shaking
muscular tension
sweating
avoidance
Symptom overlap problem often very important leads to inappropriate self-care behaviours
may or may not relate to diabetes
may have a fear of hypo so intentionally raise BG
What factors affects the ability of people with LTCs to engage in healthy behaviours?
Often health beliefs are not the same as the patient
May be hard to get them to change their behaviour
what are some percieved health beliefs?
Seriousness of condition
Effectiveness of treatments
Costs & benefits of following advice
Self-efficacy
Vulnerability to future problems
Impact of illness
