A PRACTICAL MODEL OF DIABETES MANAGEMENT AND EDUCATION
A PRACTICAL MODEL OF DIABETES MANAGEMENT AND EDUCATION
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DOI：
10.2337/diacare.18.1.117
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发表时间：
1995-01-01
期刊：
影响因子：
16.2
通讯作者：
GLASGOW, RE
中科院分区：
文献类型：
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作者：
GLASGOW, RE
本文讨论了一个不断发展的概念模型糖尿病自我管理和病人教育。该模型包含三个主要层次或阶段：1）社会环境和背景因素，很少受到研究关注; 2）患者-医疗保健提供者的互动，自我管理行为和短期生理结果，构成了护理反馈系统的持续循环; 3）长期健康和生活质量结果，包括治疗糖尿病并发症的主要社会成本。讨论了这些水平中每个水平内因素的评估和干预影响，重点是适合所有患者的低成本全系统活动和较高成本的活动和资源（例如，糖尿病控制和并发症试验中的强化管理）。我希望这种糖尿病管理的系统方法可以帮助减少受害者的指责（无论受害者是不顺从的患者还是不敏感的提供者）。这种概念模型，如果实际导向，可能有助于加快发展，评估和传播的程序，促进病人和医疗保健团队遵守推荐的糖尿病护理指南。
This article discusses an evolving conceptual model of diabetes sell-management and patient education. The model contains three primary levels or stages: 1) social environment and contextual factors, which have received little research attention; 2) patient-health care provider interactions, self-management behaviors, and short-term physiological outcomes, which constitute an ongoing cycle of care feedback system; and 3) longer term health and quality-of-life outcomes, which include the major societal costs of treating diabetes complications. The assessment and intervention implications of factors within each of these levels are discussed, with emphasis on both low-cost system-wide activities appropriate for all patients and higher cost activities and resources (e.g., intensive management a la the Diabetes Control and Complications Trial) for appropriately targeted or higher risk patients. I hope that such a systems approach to diabetes management can help reduce victim blaming (whether the victim is the noncompliant patient or the insensitive provider). Such conceptual models, if practically oriented, may help accelerate the development, evaluation, and dissemination of programs that facilitate both patient and health care team adherence to recommended guidelines for diabetes care.