When overcompliance means trouble

Diabetes Education: A Multidisciplinary Team Approach

Diabetes mellitus is one of the leading causes of mortality and morbidity in the United States, showing an incidence of over 14 million individuals, with the numbers increasing yearly. Current evidence suggests that maintaining normal blood glucose levels will result in preventing or lessening the degree of acute and chronic complications of diabetes. Therefore, because many of the complications of diabetes may be prevented or lessened by strict glycemic control, it is of the utmost importance that the individual with diabetes understand the roles of diet, exercise, and insulin/oral hypoglycemics in the management of his or her diabetes. This is an area in which diabetic education plays an important role. The properly educated individual with diabetes can learn to increase or decrease insulin, to change diet, or to modify exercise regimens based on results of home blood glucose-monitoring to achieve normoglycemia. This article discusses a multidisciplinary team approach to educating the diabetic patient. This involves using the skills of physicians, pharmacists, nurses, dieticians, and other health care professionals, as well as teaching tools such as diabetes patient assessment forms, diabetes education, and teaching documentation records. It should become clear from this discussion the active role that pharmacists can play as an important member of the diabetic education team.

Critical analysis of everyday self-care decision making in chronic illness

AIMS OF THE PAPER

The purpose of the paper is to (1) identify prevalent assumptions that underlie the traditional conceptualization of everyday self-care decision making and (2) contrast these with the findings of relevant research.

BACKGROUND/RATIONALE

Current understandings of self-care decision making in chronic illness tend to be extrapolated from knowledge gained in relation to one-time decisions, or decision making in contexts that are only superficially related to the complexity and pervasiveness of living with a chronic disease.

FINDINGS

The authors challenge the assumptions with which current understandings represent self-care decision making in chronic illness, using evidence from their research on what it is like to live with and manage the implications of having a chronic disease on an everyday basis.

CONCLUSIONS

The paper concludes with a call for a new conceptualization of self-care decision making in chronic illness which sufficiently addresses the unique and complex nature of such decisions.