Colagiuri R, Eigenmann C A
The Diabetes Unit - Menzies Centre for Health Policy, Victor Coppleson Building DO2, University of Sydney, NSW 2006, Australia.
Diabet Med. 2009 Apr;26(4):442-6. doi: 10.1111/j.1464-5491.2009.02700.x.
To develop a national evidence and consensus position on the desired goals, outcomes and indicators of diabetes patient education (DPE).
A mixture of qualitative and quantitative methods were used including: (i) literature reviews to identify existing definitions, issues and work in the area; (ii) interviews with key opinion leaders; (iii) focus groups with people with diabetes; (iv) a national survey of diabetes education service providers; (v) a systematic consultation process culminating in a national stakeholder forum.
Three overarching goals were identified as the main purpose of diabetes patient education: (i) optimal adjustment to living with diabetes, (ii) optimal health outcomes and (iii) optimal cost-effectiveness (for the individual and for society). Given the difficulty in attributing cause and effect between education and clinical or cost outcomes and that mechanisms already exist for collecting data on clinical endpoints and surrogate indicators, the development of education indicators concentrated on the goal of optimal adjustment to living with diabetes. Four key outcomes for this goal were listed in order as either directly attributable to DPE or in which DPE plays a discernable role: knowledge and understanding, self-determination, self-management and psychological adjustment.
The consensus position represents a sound evidence-informed platform on which diabetes education policy, programmes, data collection and research can be based. However, further work was required to test and make recommendations about applying potentially relevant psychometric tools to measure changes in the identified indicators.
就糖尿病患者教育(DPE)的预期目标、结果和指标制定一项全国性的循证共识立场。
采用了定性和定量相结合的方法,包括:(i)文献综述,以确定该领域现有的定义、问题和研究;(ii)与关键意见领袖进行访谈;(iii)与糖尿病患者进行焦点小组讨论;(iv)对糖尿病教育服务提供者进行全国性调查;(v)一个系统性的咨询过程,最终形成一个全国性的利益相关者论坛。
确定了三个总体目标作为糖尿病患者教育的主要目的:(i)对糖尿病生活的最佳适应;(ii)最佳健康结果;(iii)最佳成本效益(对个人和社会而言)。鉴于难以确定教育与临床或成本结果之间的因果关系,且已经存在收集临床终点和替代指标数据的机制,教育指标的制定集中在对糖尿病生活的最佳适应这一目标上。该目标的四个关键结果按顺序列出,要么直接归因于DPE,要么DPE在其中发挥可识别的作用:知识与理解、自主决定、自我管理和心理调适。
该共识立场代表了一个合理的循证平台,糖尿病教育政策、项目、数据收集和研究均可基于此。然而,需要进一步开展工作,以测试并就应用潜在相关的心理测量工具来衡量所确定指标的变化提出建议。