Sustaining the benefits of structured education: Participants' experiences of receiving structured individual support during a programme (DAFNEplus) informed by behavioural science

IF 3.2 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetic Medicine Pub Date : 2024-05-31 DOI:10.1111/dme.15371

Ruth I. Hart, David Rankin, Paul M. Chadwick, Nicole de Zoysa, Simon Heller, Debbie Cooke, Jackie Elliott, Julia Lawton, the DAFNEplus study group

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引用次数: 0

Abstract

Aims

The DAFNEplus programme seeks to promote sustained improvements in glycaemic management by incorporating techniques from behavioural science. It includes five sessions of structured individual support delivered over 12 months following group education. As part of a broader evaluation, and to inform decision-making about roll-out in routine care, we explored participants' experiences of, and engagement with, that individual support.

Methods

We interviewed DAFNEplus participants (n = 28) about their experiences of receiving individual support and the impact they perceived it as having on their self management practices. We analysed data thematically.

Results

Participants described several important ways individual support had helped strengthen their self management, including: consolidating and expanding their understandings of flexible intensive insulin therapy; promoting ongoing review and refinement of behaviour; encouraging continued and effective use of data; and facilitating access to help from healthcare professionals to pre-empt or resolve emergent difficulties. Participants characterised themselves as moving towards independence in self management over the time they received individual support, with their accounts suggesting three key stages in that journey: ‘Working with healthcare professionals’; ‘Growing sense of responsibility’; and, ‘Taking control’. Whilst all portrayed themselves as changed, participants' progress through those stages varied; a few continued to depend heavily on DAFNEplus facilitators for advice and/or direction at 12 months.

Conclusions

While all participants benefited from individual support, our findings suggest that some may need, or gain further benefit from, longer-term, tailored support. This has important implications for decision-making about roll-out of DAFNEplus post-trial and for the development of future programmes seeking to bring about sustainable changes in self management practices.

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保持结构化教育的益处：参与者在一项以行为科学为依据的计划（DAFNEplus）中接受结构化个人支持的经历。

目的：DAFNEplus 计划旨在结合行为科学的技术，促进血糖管理的持续改善。该计划包括在小组教育后的 12 个月内提供五次有组织的个人支持。作为更广泛评估的一部分，并为在常规护理中推广该计划提供决策依据，我们探讨了参与者对个人支持的体验和参与情况：我们采访了 DAFNEplus 的参与者（n = 28），了解他们接受个人支持的经历以及他们认为个人支持对其自我管理实践的影响。我们对数据进行了专题分析：结果：参与者描述了个人支持帮助他们加强自我管理的几种重要方式，包括：巩固和扩展他们对灵活强化胰岛素疗法的理解；促进对行为的持续审查和改进；鼓励持续有效地使用数据；以及促进获得医疗保健专业人员的帮助，以预防或解决突发困难。参与者认为，在接受个人支持的过程中，他们在自我管理方面逐渐实现了独立，他们的叙述显示了这一过程中的三个关键阶段："与医护人员合作"；"责任感增强"；以及 "掌握控制权"。虽然所有参与者都认为自己发生了改变，但他们在这些阶段的进展各不相同；在 12 个月时，少数人仍然非常依赖 DAFNEplus 促进者的建议和/或指导：尽管所有参与者都从个人支持中获益，但我们的研究结果表明，有些人可能需要长期的、量身定制的支持，或从这种支持中进一步获益。这对试验后推广 DAFNEplus 的决策以及未来制定旨在持续改变自我管理方法的计划具有重要意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”