Methodology and Therapeutic Education

Patient Education in the field of Diabetes Care has been centred for many years on the health care provider’s perspective. Recently more attention has been focused on the learner’s point of view, that is how does a person learn meaningfully. Most guidelines on the management of type 2 diabetes include dietary modification and physical activity goals, but it is important to consider only the type of interventions that can make a long-term difference. Several key models have reasonable evidence for their effectiveness: cognitive behavioral, motivational interview, trans-theoretical model based on the stages of change, behavior change counselling, social learning theory and empowerment, although not all of them have been successfully tested in diabetes care. There are three areas to be considered when looking at the core requirement of an effective lifestyle modification program: the first is that the program must be integrated in routine diabetes care. The second is the philosophical approach adopted by the health care professional. The third is how you do it, focusing on importance, confidence and competence. In order to have people develop the life skills required to prevent complications we must recognize that giving information is not only a pot filling exercise. Collaboration with the patient is essential in setting any education program and initially the view point must be considered. The model of behavior change is described and further concepts of theory and practice are explored, focusing on the concepts ‘learning and taking control’, rather than on ‘education and teaching’.