A PRACTICAL MODEL OF DIABETES MANAGEMENT AND EDUCATION

被引:98
作者
GLASGOW, RE
机构
[1] Oregon Research Institute, Eugene, OR
[2] Oregon Research Institute, Eugene, OR 97403
关键词
D O I
10.2337/diacare.18.1.117
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
This article discusses an evolving conceptual model of diabetes sell-management and patient education. The model contains three primary levels or stages: 1) social environment and contextual factors, which have received little research attention; 2) patient-health care provider interactions, self-management behaviors, and short-term physiological outcomes, which constitute an ongoing cycle of care feedback system; and 3) longer term health and quality-of-life outcomes, which include the major societal costs of treating diabetes complications. The assessment and intervention implications of factors within each of these levels are discussed, with emphasis on both low-cost system-wide activities appropriate for all patients and higher cost activities and resources (e.g., intensive management a la the Diabetes Control and Complications Trial) for appropriately targeted or higher risk patients. I hope that such a systems approach to diabetes management can help reduce victim blaming (whether the victim is the noncompliant patient or the insensitive provider). Such conceptual models, if practically oriented, may help accelerate the development, evaluation, and dissemination of programs that facilitate both patient and health care team adherence to recommended guidelines for diabetes care.
引用
收藏
页码:117 / 126
页数:10
相关论文
共 82 条
  • [1] ADAY LA, 1993, RISK AM HLTH HLTH CA, P260
  • [2] TELEPHONE MODEM ACCESS IMPROVES DIABETES CONTROL IN THOSE WITH INSULIN-REQUIRING DIABETES
    AHRING, KK
    AHRING, JPK
    JOYCE, C
    FARID, NR
    [J]. DIABETES CARE, 1992, 15 (08) : 971 - 975
  • [3] AMER DIABET ASSOC, 1993, DIABETES, V42, P1555
  • [4] ANDERSON B, 1980, PROFESSIONAL ED DIAB, P3
  • [5] EFFECTS OF PEER-GROUP INTERVENTION ON METABOLIC CONTROL OF ADOLESCENTS WITH IDDM - RANDOMIZED OUTPATIENT STUDY
    ANDERSON, BJ
    WOLF, FM
    BURKHART, MT
    CORNELL, RG
    BACON, GE
    [J]. DIABETES CARE, 1989, 12 (03) : 179 - 183
  • [6] ANDERSON BJ, 1993, ADV CHILD HLTH PSYCH, P167
  • [7] Anderson BJ, 1993, DEVELOPMENTAL ASPECT, P77
  • [8] AN UPDATED CORONARY RISK PROFILE - A STATEMENT FOR HEALTH-PROFESSIONALS
    ANDERSON, KM
    WILSON, PWF
    ODELL, PM
    KANNEL, WB
    [J]. CIRCULATION, 1991, 83 (01) : 356 - 362
  • [9] ANDERSON L A, 1990, Diabetes Care, V13, P66
  • [10] ANDERSON L A, 1989, Health Education Research, V4, P383, DOI 10.1093/her/4.3.383