University of Missouri Institute for Data Science and Informatics, University of Missouri, Columbia, 5 Hospital Drive, Columbia, MO 65212, United States.
University of Missouri Institute for Data Science and Informatics, University of Missouri, Columbia, 5 Hospital Drive, Columbia, MO 65212, United States; Department of Health Management and Informatics, University of Missouri, Columbia, 5 Hospital Drive, Columbia, MO, 65212, United States.
Diabetes Metab Syndr. 2022 Sep;16(9):102582. doi: 10.1016/j.dsx.2022.102582. Epub 2022 Jul 30.
Diabetes self-management education and support (DSMES) can improve clinical and health outcomes of people with diabetes. However, DSMES has been underutilized because of many barriers. We aimed to develop a patient-centered educational aid, SEE-Diabetes (Support-Engage-Empower-Diabetes), that facilitates shared decision-making about DSMES between patient and provider during the follow-up visit. We investigated the information needs to inform the design of the SEE-Diabetes from the providers' perspective.
We conducted an online survey (N = 42) and three focus groups (N = 13) involving providers who have experience managing diabetes in older patients. Survey collected demographics and assessed knowledge of DSMES. During the subsequent focus groups, participants evaluated the Assessment and Plan section of three clinic notes of older people with diabetes. We also demonstrated the potential workflow of DSMES documentation using SEE-Diabetes during clinical practice.
The survey showed 60% of providers were familiar with DSMES. Focus group findings showed clinic notes should convey concise information at an appropriate reading level, numbered problems, and less medical jargon to improve the readability of clinic notes. Application of SMART (Specific, Measurable, Attainable, Relevant, Time-bound) goals was suggested to deliver effective diabetes self-care information.
Providers should consider adopting validated DSMES guidelines along with goal-setting strategies to provide patient-centered care. The research team will integrate the provider recommendations when we develop SEE-Diabetes.
糖尿病自我管理教育和支持(DSMES)可以改善糖尿病患者的临床和健康结果。然而,由于存在许多障碍,DSMES 的利用率一直不高。我们旨在开发一种以患者为中心的教育辅助工具,即 SEE-Diabetes(支持-参与-授权-糖尿病),以便在随访期间促进患者和提供者之间就 DSMES 进行共同决策。我们从提供者的角度调查了了解设计 SEE-Diabetes 所需的信息。
我们进行了一项在线调查(N=42)和三次焦点小组(N=13),参与者为有经验管理老年患者糖尿病的提供者。调查收集了人口统计学信息,并评估了对 DSMES 的了解。在随后的焦点小组中,参与者评估了 3 份老年糖尿病患者诊所记录的评估和计划部分。我们还展示了使用 SEE-Diabetes 在临床实践中进行 DSMES 文档记录的潜在工作流程。
调查显示,60%的提供者熟悉 DSMES。焦点小组的调查结果表明,诊所记录应传达简洁的信息,使用适当的阅读水平、编号问题和较少的医学术语来提高诊所记录的可读性。建议应用 SMART(具体、可衡量、可实现、相关、有时限)目标来提供有效的糖尿病自我护理信息。
提供者应考虑采用经过验证的 DSMES 指南以及目标设定策略,以提供以患者为中心的护理。研究团队将在开发 SEE-Diabetes 时整合提供者的建议。