Ruth I. Hart, David Rankin, Paul M. Chadwick, Nicole de Zoysa, Simon Heller, Debbie Cooke, Jackie Elliott, Julia Lawton, the DAFNEplus study group
{"title":"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。","authors":"Ruth I. Hart, David Rankin, Paul M. Chadwick, Nicole de Zoysa, Simon Heller, Debbie Cooke, Jackie Elliott, Julia Lawton, the DAFNEplus study group","doi":"10.1111/dme.15371","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims</h3>\n \n <p>The DAFNE<i>plus</i> 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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We interviewed DAFNE<i>plus</i> participants (<i>n</i> = 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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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 DAFNE<i>plus</i> facilitators for advice and/or direction at 12 months.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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 DAFNE<i>plus</i> post-trial and for the development of future programmes seeking to bring about sustainable changes in self management practices.</p>\n </section>\n </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15371","citationCount":"0","resultStr":"{\"title\":\"Sustaining the benefits of structured education: Participants' experiences of receiving structured individual support during a programme (DAFNEplus) informed by behavioural science\",\"authors\":\"Ruth I. Hart, David Rankin, Paul M. Chadwick, Nicole de Zoysa, Simon Heller, Debbie Cooke, Jackie Elliott, Julia Lawton, the DAFNEplus study group\",\"doi\":\"10.1111/dme.15371\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aims</h3>\\n \\n <p>The DAFNE<i>plus</i> 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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We interviewed DAFNE<i>plus</i> participants (<i>n</i> = 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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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 DAFNE<i>plus</i> facilitators for advice and/or direction at 12 months.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>While all participants benefited from individual support, our findings suggest that some may need, or gain further benefit from, longer-term, tailored support. 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Sustaining the benefits of structured education: Participants' experiences of receiving structured individual support during a programme (DAFNEplus) informed by behavioural science
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.
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.”
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