'Educator talk' and patient change: some insights from the DESMOND (Diabetes Education and Self Management for Ongoing and Newly Diagnosed) randomized controlled trial
'Educator talk' and patient change: some insights from the DESMOND (Diabetes Education and Self Management for Ongoing and Newly Diagnosed) randomized controlled trial
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DOI：
10.1111/j.1464-5491.2008.02492.x
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发表时间：
2008-09-01
影响因子：
3.5
通讯作者：
Oliver, L.
中科院分区：
文献类型：
--
作者：
Skinner, T. C.;Carey, M. E.;Oliver, L.
目的是为了确定是否差异的时间教育工作者在自我管理的教育计划期间交谈的参与者的报告信念的变化程度有关diabetes.Method教育工作者培训，以促进和非说教的方法，观察提供DESMOND自我管理计划的个人新诊断为2型糖尿病。观察员使用10秒事件编码来估计教育工作者在该计划的不同会议期间发言的时间。促进，而不是教学交付的目标，为每届会议的教育工作者的谈话设置。这些指标是根据先前的试点工作确定的。使用修订的疾病感知问卷（IPQ-R）和糖尿病疾病表征问卷（DIRQ），参与者完成了以下测量：感知糖尿病持续时间（时间轴IPQ-R），了解糖尿病（一致性IPQ-R），影响糖尿病的个人责任（个人责任IPQ-R），糖尿病的严重性（严重性DIRQ）和对日常生活的影响结果来自事件编码的数据表明，教育者说话更少，达到了少说教的目标，参与者报告的疾病信念发生了更大的变化。然而，教育工作者努力达到目标的大多数会议的program.Conclusion的时间量教育工作者在自我管理方案的谈话可能会提供一个实用的标记的教育过程的有效性，与较少的教育工作者谈话表示一个更方便/少说教的方法。这一发现为随后对全面质量发展框架的改进提供了信息，承认教育工作者需要持续的支持，以促进向正常教育方式的转变。
Aims To determine whether differences in the amount of time educators talk during a self-management education programme relate to the degree of change in participants' reported beliefs about diabetes.Method Educators trained to be facilitative and non-didactic in their approach were observed delivering the DESMOND self-management programme for individuals newly diagnosed with Type 2 diabetes. Observers used 10-s event coding to estimate the amount of time educators spoke during different sessions in the programme. Facilitative as opposed to didactic delivery was indicated by targets for levels of educator talk set for each session. Targets were based on earlier pilot work. Using the revised illness Perceptions Questionnaire (IPQ-R) and the Diabetes Illness Representations Questionnaire (DIRQ), participants completed measures of: perceived duration of diabetes (timeline IPQ-R), understanding of diabetes (coherence IPQ-R), personal responsibility for influencing diabetes (personal responsibility IPQ-R), seriousness of diabetes (seriousness DIRQ) and impact on daily life (impact DIRQ), before and after the education programme.Results Where data from the event coding indicated educators were talking less and meeting targets for being less didactic, a greater change in reported Illness beliefs of participants was seen. However, educators struggled to meet targets for most sessions of the programme.Conclusion The amount of time educators talk in a self-management programme may provide a practical marker for the effectiveness of the education process, with less educator talk denoting a more facilitative/less didactic approach. This finding has informed subsequent improvements to a comprehensive quality development framework, acknowledging that educators need ongoing support to facilitate change to their normal educational style.