An Audit of Diabetes Self-Management Education Programs in South Africa.
An Audit of Diabetes Self-Management Education Programs in South Africa.
复制标题
DOI：
10.4081/jphr.2015.581
复制
发表时间：
2015-11-17
影响因子：
2.3
通讯作者：
Housiaux M
中科院分区：
文献类型：
--
作者：
Dube L;Van den Broucke S;Dhoore W;Kalweit K;Housiaux M
糖尿病是全球疾病负担的重要贡献者。由于其治疗需要广泛的自我护理，因此广泛建议进行自我管理教育，特别是在资源有限的情况下。本研究旨在回顾南非糖尿病自我管理教育（DSME）的政策和实施现状，特别关注文化适当性。审计涉及审查政策文件和向公共和私营保健服务提供者和专家发出的半结构化问卷。44名受访者接受了采访。参考国际糖尿病联合会的糖尿病教育国际标准对文献进行分析。在Excel中输入数据并进行分析，以描述DSME计划和临时干预措施。检索到三个2型糖尿病指南和两个慢性病指南，但没有一个专门针对DSME。确定了五个结构化方案和22个临时干预措施。DSME主要由医生、护士和营养师提供，与支助团体等其他举措没有一贯的联系。健康教育材料主要是英文的，数量有限。南非的荒漠化和中小型企业在范围、内容和一致性方面受到限制，特别是在公共服务方面。A需要制定国家糖尿病教育课程和材料，并使其适应目标人口的社会经济背景、文化和识字水平。建议在国家政策和指导方针中处理荒漠化和中小型企业问题，以指导标准化方案的制定和实施。糖尿病是全球疾病负担的重要组成部分。发展中国家尤其感受到这一负担，因为这些国家资源有限，卫生系统必须同时应对传染性和非传染性疾病。虽然关于糖尿病自我管理教育的发展和实施的文献越来越多，但几乎所有的项目都来自发达国家。关于发展中国家糖尿病自我管理教育的现状知之甚少。通过关注南部非洲的糖尿病自我管理教育，本文为南非的政策制定者和决策者提供了信息，这些信息将有助于决定在何处以及如何干预糖尿病自我管理教育。该文件还通过提供糖尿病政策和糖尿病自我管理教育的建议，对其他发展中国家的决策者具有相关性。
Diabetes is a significant contributor to the burden of disease worldwide. Since its treatment requires extensive self-care, self-management education is widely recommended, particularly in resource limited settings. This study aimed to review the current state of policies and implementation of diabetes self-management education (DSME) in South Africa, with a specific focus on cultural appropriateness. The audit involved a review of policy documents and semi-structured questionnaires with providers and experts in public and private health services. Forty-four respondents were interviewed. Documents were analysed with reference to the International Standards for Diabetes Education from the International Diabetes Federation. Data were entered and analysed in excel to give a description of the DSME programs and ad hoc interventions. Three guidelines for Type 2 diabetes and two for chronic diseases were retrieved, but none were specifically dedicated to DSME. Five structured programs and 22 ad-hoc interventions were identified. DSME is mostly provided by doctors, nurses and dieticians and not consistently linked to other initiatives such as support groups. Health education materials are mainly in English with limited availability. DSME in South Africa is limited in scope, content and consistency, especially in the public services. A National curricula and materials for diabetes education need to be developed and adapted to the socio-economic context, culture and literacy levels of the target populations. It is recommended that DSME would be addressed in national policies and guidelines to guide the development and implementation of standardised programs. Diabetes significantly contributes to the global burden of disease. This burden is especially felt in developing countries, where resources are limited and the health system simultaneously has to deal with communicable and non-communicable diseases. While there is a growing body of literature on the development and implementation of diabetes self-management education, nearly all programs originate from developed countries. Very little is known about the current state of diabetes self-management education in developing countries. By focusing on diabetes self-management education in Southern Africa, the current paper provides policy makers and decision makers in South Africa with information that will help decide on where and how to intervene with regard to diabetes self-management education. The paper also has relevance for decision makers from other developing countries by providing recommendations on diabetes policies and diabetes self-management education.