Anderson R M, Funnell M M
The Department of Medical Education, University of Michigan Medical School, Ann Arbor, Michigan (Dr Anderson)
The Michigan Diabetes Research and Training Center, University of Michigan, Ann Arbor, Michigan (Ms Funnell)
Diabetes Educ. 2000 Jul-Aug;26(4):597-604. doi: 10.1177/014572170002600405.
Recognizing that adherence and compliance are dysfunctional concepts is not a passing fad or the latest trend in behavioral approaches to diabetes care and education. Shifting from the acute-care/compliance-focused paradigm to an empowerment/collaborative approach requires a new vision of diabetes education and a new definition and enactment of the roles of educators and patients. Our practice is always an expression of our vision; therefore, if our vision is transformed, our practice will most likely change to reflect our vision. Eliminating the concepts of adherence and compliance makes it possible for our patients to discover and actualize their personal responsibility for their diabetes self-management. Also, it helps us to practice diabetes education as win-win collaboration among equals.
认识到依从性和顺从性是功能失调的概念,这并非一时的风尚或糖尿病护理与教育行为方法中的最新潮流。从以急性护理/依从性为重点的模式转向赋权/协作方法,需要对糖尿病教育有新的愿景,以及对教育者和患者角色的新定义和践行。我们的实践始终是我们愿景的体现;因此,如果我们的愿景发生转变,我们的实践很可能会随之改变以反映我们的愿景。摒弃依从性和顺从性的概念,使我们的患者能够发现并实现他们对糖尿病自我管理的个人责任。此外,这有助于我们将糖尿病教育实践为平等者之间的双赢合作。