Required Readings - Midterm 1

Question 1

Diabetes requires what kind of management?

Answer 1

Self-management, which requires self-management education (SME)

Question 2

What does SME facilitate?

Answer 2

Individual decision making, improving knowledge, attitudes, self efficacy, healthy behaviours and improved clinical outcomes

Question 3

Define SME

Answer 3

Systematic intervention that involves active participation of the individual in self-monitoring in health parameters and/or decision making with the application of knowledge and skills

Question 4

What does evidence indicate about SME?

Answer 4

Advantageous for improving glycemic control, self-efficacy, self-care behaviours and reducing diabetic complications

Question 5

What are the basic knowledge and skills which encompass SME?

Answer 5

• Monitoring parameters
• Healthy eating
• Physical activity
• Pharmacotherapy
• Prevention and management of hypo/hyperglycemia
• Prevention and surveillance of complications

Question 6

How can the acquisition of knowledge be augmented in SME?

Answer 6

Through cognitive behavioural interventions

Question 7

What does CBI involve?

Answer 7

• Cognitive restructuring
• Problem solving
• Cognitive behavioural therapy
• Stress management
• Goal setting
• Relaxation techniques

Question 8

What does CBI do?

Answer 8

Recognize personal awareness and alteration of thoughts and emotions which are essential for behaviour change.

Question 9

What interventions appear to be the most effective?

Answer 9

Those that combine knowledge acquisition and self-care management

Question 10

What can decrease barriers to overall diabetes management?

Answer 10

Effective individual health-care provider education

Question 11

What can improve glycemic control, lips and BP?

Answer 11

Access to an interprofessional team for diabetes education

Question 12

What are some traits to address to successfully tailor SME?

Answer 12

• Type of diabetes
• Ability to learn
• Readiness for change
• Cultural and health beliefs
• Literacy level
• Socioeconomic background

Question 13

How can benefits of SME be sustained?

Answer 13

Through self-management support (SMS)

Question 14

Define SMS

Answer 14

Strategies that augment an individuals ability to self-manage their diabetes.

Question 15

How can SMS be delivered?

Answer 15

• Follow-ups
• Diabetes coaching
• Peer support/community health worker
• Support groups

Question 16

How else could SMS be delivered?

Answer 16

Email, telephone reminders, telehealth, internet

Question 17

How can SMS be tailored?

Answer 17

• Frequent follow-ups with diabetes educator, which could be done through the telephone.
• Community health worker in ethnically diverse populations
• Diabetes coaching for personalized support

Question 18

What is the overarching goal of SME and SMS?

Answer 18

Engagement in effective diabetes self-management

Question 19

What are the 3 key concepts of SME?

Answer 19

• Knowledge
• Skills
• Behaviour

Question 20

What are the 4 key concepts of SMS?

Answer 20

• Reinforcement
• Coaching
• Peers
• Community

Question 21

What is a shared concept between SMS and SME? What does it entail?

Answer 21

Patient centered, which must be done interactively

Question 22

SME is _____ while SMS is _____

Answer 22

collaborative

individualized

Question 23

What are the two kinds of nutrition interventions delivered by RDs?

Answer 23

Nutrition education and nutrition counselling

Question 24

What is nutrition education?

Answer 24

Provides the patient/client with information to improve knowledge and skills.

Question 25

What is nutrition counselling?

Answer 25

Involves more in-depth behaviour change strategies

Question 26

What two kinds of language is imparted in nutrition education?

Answer 26

1) Instruction/training to develop knowledge

2) Instruction/training to develop skills

Question 27

What are the 4 key steps in nutrition education? (CPET)

Answer 27

• Clearly communicate
• Prioritize nutrition issue
• Explain relationship of nutrition to diseases
• Tailor education to individual

Question 28

What is the ultimate goal of nutrition counselling?

Answer 28

For the patient to take responsibility for behaviour that improve their nutritional status to treat the existing condition and improve overall health

Question 29

What is the principle of cognitive-behavioural theory?

Answer 29

Behaviour is learned and is directly related to both internal and external factors.

Question 30

Application of CB theory in nutrition?

Answer 30

Focus on interventions which change the environment, and ways to change patterns of negative thinking

Question 31

Principle of the health belief model?

Answer 31

Predicts a persons decision about health-related behavioural changes and identifies the clients perceived ability to accomplish a behaviour change

Question 32

Application of health belief in nutrition?

Answer 32

May benefit from explanations of disease risks and link to diet or exploration of pros/cons

Question 33

Principle of social learning theory?

Answer 33

Builds on concepts of modelling, where people learn through people who are doing well

Question 34

Application of social learning theory in nutrition?

Answer 34

Share success stories, refer to support groups and engage clients in group classes

Question 35

Principle of stages of change?

Answer 35

Behaviour change occurs in stages of motivation as client moves through the 5 stages to take action

Question 36

Application of stages of change model in nutrition?

Answer 36

Tailor treatment interventions to clients stage of change

Question 37

What are ED’s?

Answer 37

Psychiatric conditions characterized by severe disturbances in eating behaviour that result in significant physiologic impairment and in some instances, death.

Question 38

What is AN characterized by?

Answer 38

Excessive dieting, severe weight loss and distorted body image with a pathological fear of being fat.

Question 39

What are the two sub-types of AN?

Answer 39

• Restricting type

- Binge eating/purging type

Question 40

How do restrictive-type AN lose weight?

Answer 40

Through dieting, fasting, or excessive exercise.

Question 41

How do binge/purging AN lose weight?

Answer 41

Self-induced vomiting, fasting, excessive exercise, misuse of laxatives, diuretics and enemas

Question 42

What is the most common binge/purging AN compensatory mechanism?

Answer 42

Self-induced vomiting

Question 43

Do most patients with AN lose their appetite?

Answer 43

No, they often experience profound hunger

Question 44

How is bulimia nervosa characterized?

Answer 44

Frequent episodes of binge-eating followed by inappropriate behaviours such as self–induced vomiting to avoid weight-gain.

Question 45

What is specific about the bulimia nervosa diagnostic criteria?

Answer 45

The episode of binge eating must be characterized by consumption during a relatively short period of time of an amount of large food, and a sense of lack of control

Question 46

What is important when defining a binge?

Answer 46

Understanding the context in which the food was consumed

Question 47

When is BN diagnosed?

Answer 47

When binge eating and compensatory behaviours occur at least once per week over a period of 3 months

Question 48

What does a binge result in?

Answer 48

Shame, unpleasant feelings of fullness and often triggers purging or other compensatory mechanisms

Question 49

BN patients are often of ____ weight

Answer 49

normal

Question 50

How is binge eating disorder defined?

Answer 50

Recurring episodes of eating significantly more food in a short period of time than most people would eat, with episode marked by feelings of lack of control.