1. Self-management in diabetes and care can be defined as the participation of patients in the course of treatment actively. Self-management comprises of “medical management” that suggests that patients take medications according to their dietary advice. It also consists of “behavioural management”, where patients develop new behaviours in place of their chronic disease. Emotional management is the patients are Activities to deal with the feelings of despair, fright and frustration because of the disease.
Most of the educators associated with diabetes and care prefer the participation of the patients in taking care of themselves. Self-management is not a misnomer in diabetes. This is an evolutionary process to develop awareness by learning to survive diabetes. Most of the daily care of diabetes is done by patients and their close members. Therefore it is important that proper self-care behaviours are integrated with the people (Dao et al. 2019). Healthy eating, monitoring of blood sugar, physically active, coping skills and so on are the essential skills that a person must have for self-management. These measures are useful for educators and also for clinicians for the treatment of patients. Preparing a self-report is the most effective approach to self-management.
The self-management activities that are taken by diabetes patients are the behaviours which can help manage the disease successfully on their own. With proper self-management strategies, a person can reduce the risks and lead a healthy life. Self-efficacy was developed by Albert Bandura, who is known for the “social learning theory”. Self-efficacy according to him is the belief in a person’s capabilities for reorganizing and executing the actions necessary for managing situations. This is the belief that a person has in his capability for performing a specific task. The confidence that one has in his abilities for having control over motivation, social environment and behaviour is self-efficacy.
The beliefs of a person about his capabilities are generally derived from previous experiences, any past performances, emotional arousal and verbal persuasion. Self-management of a person having diabetes involves working with the health professionals so that they can understand their condition and the treatment portions that are available to them. Working in partnerships with the doctors in the treatment of diabetes helps in reviewing any previous care plan and engaging in activities which can protect health (King et al. 2017). Self-management of a person having diabetes also means that he is working within the doctors so that the symptoms can be managed and the impact of the disease in relationships and emotions can be understood.
Self-management and self-care are directly related to each other. Self-efficacy can immediately improve motivation by improving behaviour by efficacy expectations. Indirectly, it can affect the motivation level by determining stability. Therefore self-efficacy is important for bringing a change in the self-management behaviour process. It is reported that about 98% of the care in diabetes is through self-management (McKittrick, and McKenzie, 2018). Self-monitoring and having control over diseases and engaging in physical activities are the ways that a person having diabetes can keep it under control.
Self-efficacy and self-management are related. The term is not a misnomer in diabetes. Having control and engaging in activities are the main principles of self-care. Humans have a predetermined behaviour and self-management system which can control their actions and thoughts. Therefore it can determine their outcomes and destiny. Self-efficacy is important in self-care as it determines the behaviour and changes the actions that one can take for surviving the disease and living a healthy life.
2. Self-management is crucial and also beneficial in patients having diabetes. Patients who have diabetes show dramatic improvements in the progress of their disease by involving in self-care and management. Self-care is also crucial in receiving positive outcomes in diabetes reception. Strictly fowling dietary routines and involving in physical activities and engaging in regular checkups with healthcare professionals can help regulate and prevent diabetes.
“The American Association of Clinical Endocrinologists” suggests that it is important for patients to be involved in their self-management. They must take part actively in their self-care and be knowledgeable about the activities. According to data presented by WHO, patients involved in self-management have shown success in treating and managing diabetes. “The American Diabetes Association” analyzed self-management education and identified that there was an increase in the complications for patients who did not know any tips for self-monitoring and did not practice any self-management (Morgan et al. 2015). Diabetes education is important and must be made into action for self-management practices for the total benefit of the patient.
Adherence to treatment in diabetes is important and the health educators in diabetes are expected to take care of patients and their concerns first. Diabetic patients are expected to follow several behavioural activities such as having a positive life cycle, changing in meals, physical activities, and proper medications and so on. Majority of diabetics can reduce their chances of complications by engaging in self-management activities. The role of a diabetic educator is important and is well recognized. A diabetic educator has the role to help people having diabetes to self manage their illness for preventing any complications. A diabetes educator provides with detailed information, motivation and support for self-managing the illness (Schofield et al. 2014).
A diabetes educator also helps in finding the balance between other health professionals. The “chronic care model” was developed by Wagner at the McColl Institute in the USA in 1998 (Warm, 2007). Thus is an organisational approach for taking care of people who have a chronic disease CCM is based in population and creates supportive and practical interactions between the patient and a care team. Important elements of health care systems are identified by the model. These elements are “health systems”, “delivery system design”, “clinical information systems”, “self management approach”. Change concepts are provided in the health elements that are used by teams for improving their efforts.
Health systems create an organisation which gives better and standardised care. Community resources are mobilised for patients. They are empowered and prepared for effectively managing their health. Delivery designs make sure that efficient and effective self-management is provided. Decision support is provided to clinicians for improving their care and making knowledge concerning recent scientific data. Clinical information systems are present in the model for organising information so that the health status and complications are monitored and reduced gradually. The CCM follows several principles for treating chronic diseases. It empowers people so that they can self manage their conditions (Wickramasinghe et al. 2013). It provides support to take care of them by giving effective medications and care. The care given to the patients with the help of this model is patient centred and gradually improves the health outcomes by suggesting a change in routine health care.
Self-management is crucial for diabetic patients. As the illness has no cure, self-treatment is considered as the best for avoiding any complications. A proper diet and working under strict regulations and consulting a health instructor are the easy ways of staying in control. the CCM is a model that can help these patients as it promotes self-care and coordinates necessary resources.
Dao, J., Spooner, C., Lo, W. and Harris, M. 2019, ‘Factors influencing self-management in patients with type 2 diabetes in general practice: a qualitative study’, Australian Journal of Primary Health, vol. 25, p. 303-309.
King, O., Nancarrow, S., Grace, S. and Borthwick, A. 2017, ‘Diabetes educator role boundaries in Australia: A documentary analysis, Journal of Foot and Ankle Research, vol. 1, no. 10, p.1-11.
McKittrick, R. and McKenzie, R. 2018, ‘A narrative review and synthesis to inform health workforce preparation for the Health Care Homes model in primary healthcare in Australia’, Australian Journal of Primary Health, vol. 24, p. 317-329.
Morgan, M. A., Coates, M.J.and Dunbar, J.A. 2015, ‘Using Care plans to better manage multimorbidity’, Australian Medical Journal, vol. 30; no. 8, p. 208-15
Schofield, D., Cunich, M. and Naccarella, L. 2014, ‘An evaluation of the quality of evidence underpinning diabetes management models: a review of the literature’, Australian Health Review, vol. 38, p. 495–505.
Warm, E.J. 2007, ‘Diabetes and the chronic care model: a review’, Current Diabetes Reviews, vol. 3, no. 4, p.219–225.
Wickramasinghe, L.K., Schattner, P., Hibbert, M.E., Enticott, J.C., Georgeff, M.P. and Russell, G. 2013, ‘Impact on of general practice management plans, team care arrangements and reviews, Medical Journal of Australia, vol.199, no. 4, p. 261-265
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