Nurse

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Nurses Role in Educating Patients with Diabetes
about Diet and lifestylesPresentation at the
International Conference on Health Promoting
Hospitals, May 25-28 .Moscow, Soviet
UnionVictoria Oladimeji (PhD, MA, MBA, BA, RGN,
RM)Lecture in Nursing with speciality in Health
PromotionCity UniversitySt Bartholomew School
of Nursing and Midwifery, Philpot StWhitechapel
London EC1 2EA Tel [phone]
020 7040 5887-Direct LineFax 020 7040 5811.
Email V.I.Oladimeji_at_city.ac.uk
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Abstract

• Education about diet and lifestyle is essential
  to delay the onset, or even prevent diabetes in
  those at risk of Type 2 diabetes and for the
  effective management of the condition in those
  with Types 1 and 2 diabetes.
• Nurses, in collaboration with dieticians are
  uniquely placed to provide this input and to
  ensure the integration of accurate and consistent
  dietary messages throughout hospital and
  community care teams. The aim is to provide those
  living with diabetes the information required to
  make appropriate choices on the type and quantity
  of the food which they eat as well as their
  lifestyles. The advice must take account of the
  individual's personal and cultural preferences,
  beliefs and lifestyle, and must respect the
  individual's wishes and willingness to change.
•  

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Introduction

• Education about diet and lifestyle is essential
  for effective management of diabetes. Nurses,
  are uniquely placed to educate patients because
  they spent more time with patients that any other
  professional.

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AIM

• The aim of education is to provide those living
  with diabetes with the information required to
  make appropriate choices on the type and quantity
  of the food which they eat as well as their
  lifestyles. It should cater for the specific
  needs of the individual.

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Objective

• To facilitate self-care and help the patient
  acquire new knowledge and skills to make informed
  choices about diet and lifestyle, and facilitate
  behaviour change.

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The steps in the Education Process
1/ Assessment of the situation, Data
collection.2/ Planning for action /Goal Setting.
3/ Implementation4/ Evaluation of progress and
outcomes. Mallik et al ( 1998)
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Assessment of Health status must incorporate the
entire bio psycho-social aspects within the
context of the environment.v       Health
beliefv       Personal habits sleep and wake
patterns v       Recreational patternsv      
Nutritional patternsv       Stress and coping
patternsv       Socio-economic statusv      
Environmental issuesv       Occupational health
patternsv       Self concept v       Cultural,
spiritual etcv       Family role and
relationshipsv       Sexualityv       Social
supportv       Emotional health    (Mallik et
al 1998)
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The process of dietary assessment provides an
opportunity to explain the types of dietary
changes needed and to explore how these may be
met.
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Educational goals must be outcome orientated and
there must be audit protocols to assess the
effectiveness of structured education, and of
behavioural change programmes and of clinical
management (Department of Health, 2001).
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Summary of content of educational package
DIET FRUITS/DAY VEGETABLES BROWN BREAD LOW FAT SPREAD URINE/BLOOD GLUCOSE/ CHOLESTEROL MONOTORING. SIGNS SYMPTOMS OF HYPO/HYPER GLYCAEMIA COMPLI CATIONS- EYES/HEART KIDNEYS NERVES ARTERIES BP lt140/90
WEIGHT CONTROL BMI lt30 REGULAR EXERCISE MEDICATION COMPLIANCE ALCOHOL
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Process

• Lifestyle and dietary education should be
  on-going interactive process between the patient
  and the professional, not a standard package
  which can be delivered to a patient in a single
  session.

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Strategies

• A variety of educational strategies, targeted at
  individuals or groups, via verbal, written or
  audio-visual forms of information can be used to
  expand and reinforce dietary messages and
  lifestyle change.

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The most important aspect is to match the type
and level of information to individual needs and
abilities.
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In the initial stages after diagnosis, people
may only be able to assimilate a very limited
amount of information. Those from ethnic
minority groups may need oral or written
information in their own language.
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Written information summarizing the key messages
which the patient can take home and refer to
later is usually essential.
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Regular follow-up is then essential to evaluate
the effectiveness of change and to continue the
learning process. Newly diagnosed patients and
those with special needs such as renal disease,
pregnancy, perceived poor practice or poor
knowledge should be seen more frequently.
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The frequency of follow-up depends on the
patient's ability, compliance, confidence, and
overall diabetic control.
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ConclusionDiabetes is a chronic disease that
requires people to make diet and lifestyle
choices on daily basis. Nurses role in
supporting patient through the process is
paramount.With advances in medicine and
technology, people can lead normal lives without
much restriction to food choices. Education about
self-management and skills in meal planning will
help in delaying the onset of complications of
diabetes.
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ReferencesDepartment of Health (2001) National
Service Framework for Older People. London
Department of Health.Mallik M. Hall C. Howard
D. (1998) Nursing Knowledge and Practice A
decision-making Approach London Bailliere
Tindall.