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AVENA Y DIABETES 🥣🛑 5 ERRORES frecuentes al consumir AVENASelf-care initiatives in diabetes management -
We use this information to improve our site. Let us know if this is OK. You can read more about our cookies before you choose. Change my preferences I'm OK with analytics cookies. Living with a long term condition can be difficult and stressful. Whilst we all strive to provide optimal care for our patients the reality for those living with Type 1 diabetes is that on average, they will spend around hours with a healthcare professional every year.
Access to trusted information, resources and support is key to helping people to manage their condition. Arming people with the knowledge and skills to look after themselves, so they can prevent complications and deterioration is paramount. However, there is a lot of advice online when it comes to Type 1 diabetes and it can be hard for those newly diagnosed to know exactly where to turn and which sources to trust.
We hope that providing an online resource with all the useful links in one place will help people with Type 1 diabetes gain the knowledge and confidence to manage their condition.
The new Type 1 diabetes online resource is a simple and effective way for those newly diagnosed with Type 1 diabetes to learn about the disease and to understand how to manage it most effectively.
Many of them said they wanted to know where to access more information, how their diabetes may change throughout their lifetime and how to meet others with the same condition.
For example; how the disease may affect driving, going to university, exercise and sport and pregnancy. The site also includes links to psychological help and support three out of five people with diabetes living with diabetes experience emotional or mental health problems as a result of their condition.
Among other things, we wanted to find out whether people found what they were looking for, whether the information encouraged people to learn more about their diabetes and if the information provided on the site could avoid unnecessary contact with health professionals.
Ultimately we hope this resource and the corresponding upskilling will lead to a reduction in emergency admissions as well as unnecessary GP appointments.
We used a purposive sampling strategy to recruit participants with a range of experiences and characteristics [ 42 ] sex, age, ethnicity, duration of diabetes, educational attainment, income from the broader pool of cohort study participants.
We made the website available during each interview, in case the interviewee wanted to show the interviewer something on the website.
All interviews were audiotaped and transcribed verbatim [ 43 ]. Transcripts were inductively analyzed to identify emergent categories and themes using a constant comparative approach [ 44 ]. Coding was conducted independently by three team members with expertise in qualitative research methods CHY, JAP, SH [ 44 ].
After coding an initial subset of interviews, a preliminary coding framework was developed on the basis of the emerging analysis, with discussion and consensus amongst the analysts [ 45 ]; the framework was then iteratively tested and refined with subsequent interviews [ 44 ].
Thematic saturation was attained with 21 interviews [ 42 ]. NVivo software version 9 was used to assist with data management and retrieval. Techniques to ensure analytic rigour included use of multiple analysts, negative case analysis, and triangulation of the qualitative findings with the quantitative results [ 42 ],[ 44 ],[ 46 ].
The study was approved by the Research Ethics Boards of St. All participants gave written and verbal informed consent. Of the 98 participants recruited, 81 had complete data collection for at least two time points one before and one after the intervention was implemented and were included in the analysis.
The mean number of days on which users logged in during the study period was 8. The average frequency of use was 0. Increased use of the website during those weeks appeared to be driven by the blog. In general, website use appeared to parallel blog use, with users visiting the blog repeatedly during the same login or visit Figure 1.
Website login and blog use by week. Black bar: Number of logins per week. Grey bar: Number of blog views per week. Regarding site penetration, users viewed 6. Within the blog section of the website, there were a total of page views by 35 participants over the study period, with peaks at week 10 54 views , week 27 43 views , and week 30 53 views , corresponding to blog entries about the medication log, supplements and insulin, and foot and kidney care, respectively.
A total of 13 comments responding to the blog postings were submitted by five participants. These comments took the following forms: 1 responding to the blog agreement or disagreement ; 2 requesting help with or providing feedback on the website; 3 requesting help with self-management; 4 offering assistance, empowerment, and their own solutions including food recipes ; 5 self-reporting behaviour change; 6 sharing responses to medication; and 7 warning others about interactions with health care providers.
These users had a mean of 3. Self-efficacy: Despite a significant short-term increase in self-efficacy score immediately after implementation of the intervention 0. Self-efficacy, self-care, and diabetes distress nine months before and nine months after intervention implementation.
Reference categories used in the plot were as follows: female, mean age Self-care: The self-care score improved by 0. Self-care scores were positively correlated with age 0. Diabetes distress varied with age and sex: younger female participants had greater diabetes distress.
Seventy-three of the participants were included in the analysis of clinical outcomes. The other eight participants were excluded because of missing data for HbA1c, blood pressure, LDL-C, or weight within 90 days of the self-efficacy data or because no data were obtained after implementation of the intervention.
The intervention had no effect on HbA1c, blood pressure, LDL-C, or weight in either the unadjusted or the adjusted models Table 2. At the nine-month follow-up after implementation of the intervention, there was no difference between users and non-users in terms of self-efficacy 0. Twenty-one individuals Table 1 participated in an interview.
The sample consisted of White and Asian men and women of various ages, duration of diabetes, educational attainment, and employment status, who used computers frequently and were comfortable with using the internet.
Additional themes will be the focus of future publications. The following four themes are considered here: 1 barriers and facilitators of website use; 2 patterns of website use, including the role of the blog in driving site traffic; 3 general feedback on website characteristics; and 4 potential mechanisms for the effect of the website on self-efficacy, behaviour change, and diabetes distress.
Representative quotes for each theme appear in Table 3. In particular, participants reported feeling frustrated with the uncontrolled nature of their disease, and the collection of self-monitoring information that showed a lack of metabolic control exacerbated this frustration Table 3 ; 1d.
Similarly, some participants said that they were sometimes overcome with a sense of futility. They perceived that regardless of their actions, some outcomes such as dialysis were inevitable Table 3 ; 1e ; hence, they saw no value in learning about the disease or in trying to self-manage the disease or use the website.
Others were limited by poor computer or internet access and said they would prefer a mobile solution Table 3 ; 1g. Finally, some participants noted that the onerous process for correcting error in log entries discouraged them from using the self-management tools Table 3 ; 1h.
In contrast, other website characteristics appeared to encourage users to visit and return. Similarly, routinization of the online experience appeared to routinize use of the internet for certain aspects of health care.
Rather than browsing at random, users said they were goal-directed: when they had a specific concern, they focused on that area of the website Table 3 ; 2a. For example, one participant was initially motivated to visit and subsequently continued to visit the foot care section of the website because of her foot symptoms Table 3 ; 2b.
Participants also commented that they used the website to gauge the urgency of their concerns and to try to obtain immediate answers to their questions Table 3 ; 2b. We explored potential reasons for the unexpected finding that the blog was the most frequently accessed tool and appeared to drive website usage.
participating in a discussion thread. However, this was not a universal sentiment, and some participants felt uncomfortable with and disconnected from the blog Table 3 ; 2c,ii. Participants perceived that the website was accurate, comprehensive Table 3 ; 3a , and easy to navigate Table 3 ; 3b.
Deeper exploration of the data regarding patterns of use and website features uncovered factors that might account for these quantitative findings. For example, rather than returning to the site to revisit and review items, some participants reported that they printed items of interest from the website and subsequently referred to these paper copies Table 3 ; 4a.
The use of reminder emails also had an effect. Participants reported that these emails not only prompted them to return to and log into the website, but also encouraged them in their own self-management Table 3 ; 4b.
Although she did not subsequently login to the website to record these behaviours, she did continue to record them on paper. We found that a self-management website for patients with type 2 diabetes led to no improvement in self-efficacy, diabetes distress, or clinical outcomes over the study period.
However, there was an improvement in self-care a secondary outcome , and the group that used the website experienced significantly lower diabetes distress than those who did not use it. Despite a user-centred design process and an increase in the frequency of blog posting from weekly to twice weekly, use of the website as ascertained by login records was limited.
Our interviews revealed that both patient-related factors e. competing health and life concerns, a sense of futility and website-related factors e.
requirement for login, limited computer or internet access limited use of the website. These qualitative findings have confirmed the importance of website features such as the reliability and authoritativeness of information [ 47 ], as well as the use of blogs [ 15 ] and reminders [ 48 ] for continued engagement of users.
Our data also suggest that mobile devices are a potential avenue through which to improve accessibility and use of a self-management site. However, as with web-based technology, a systematic approach to development, testing, implementation, and evaluation of mobile health technology is warranted.
Although such technologies are proliferating, with over applications related to diabetes alone, their usability and clinical effectiveness are variable [ 53 ], and concerns exist regarding their effectiveness and safety, as well as the security of personal health information [ 54 ].
Our findings regarding user engagement with web-based technology echo those for mobile technology: an evaluation of 10 mobile diabetes applications emphasized the importance of user-centred design, an engaging interface, and context-driven use [ 55 ].
Competing health concerns were identified as a barrier to web-based self-management. depression , which in turn directly affects self-management ability and competes for time and attention [ 56 ].
For example, patients with a greater number of comorbidities placed a lower priority on diabetes and had worse diabetes self-management ability [ 57 ]. Future interventions should consider strategies, such as shared decision-making and priority-setting, to empower patients with multiple comorbidities to optimize their self-care [ 58 ].
For example, a patient may identify mood management as a priority, which is key to subsequent self-care.
Finally, our results may be extrapolated to other chronic diseases. In particular, our finding of the need for tailored content and peer support, balanced with concerns regarding information reliability and confidentiality, is applicable to other strategies for managing chronic disease.
For example, a systematic review of the benefits and limitations of social media in the context of chronic disease identified benefits increased interaction and social support, tailored and accessible information and limitations quality concerns and lack of reliability, confidentiality, and privacy [ 59 ] to those we identified.
Similarly, our finding of a reduction in diabetes distress in conjunction with no improvements in clinical outcomes echoes findings from intervention strategies targeting other chronic diseases.
For example, another systematic review examining the effect of social media on psychological and physical outcomes in chronic disease found a relatively large body of evidence demonstrating psychological benefit 19 identified studies but limited evidence for physical outcomes 4 identified studies [ 60 ].
This study was limited by its non-randomized design. However, we employed a repeated-measures design that permitted reliable assessment of baseline self-efficacy.
Although our primary outcome self-efficacy was a non-clinical outcome, it is a validated predictor of patient behaviour change and clinical outcomes [ 18 ],[ 20 ],[ 24 ],[ 25 ]. The infrequency of website use likely limited the effect of this intervention, but we obtained valuable insights regarding mediators of website use through our individual interviews.
The qualitative evaluation was conducted by individuals who were also involved in developing the intervention, which created a potential for bias; however, we guarded against this bias by including individuals who were not involved in designing the website as members of the qualitative analytic team and by having three coders.
As such, we were able to obtain and report critical feedback that participants openly shared. Study strengths include the use of multiple repeated measures, the use of validated outcomes, dual coding of all transcripts, and triangulation of the qualitative findings with the quantitative results [ 42 ],[ 44 ],[ 46 ].
Increasing use of the World Wide Web by consumers for health information and ongoing revolutions in social media are strong indicators that consumers are welcoming and demanding a new era of technology in health care.
However, full potential of this technology is hindered by limited uptake and high attrition rates. Our research findings have shed light on these limitations by identifying characteristics associated with website use and attrition and suggesting strategies to reduce website attrition as a way to potentially optimize clinical outcomes.
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We thank Jovita Sundaramoorthy and Carolyn Gall-Casey of the Canadian Diabetes Association for their input and feedback related to project design. We also thank Kevin Thorpe for his invaluable input into the choice of methods for the statistical analysis. The study was funded by the Canadian Institutes of Health Research CIHR Knowledge to Action Operating Grant funding reference number KAL SE Straus is supported by a Tier 1 Canada Research Chair.
Li Ka Shing Knowledge Institute, St. Department of Medicine, University of Toronto, Toronto, ON, Canada. Dhalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. Applied Health Research Centre, St.
Medindia » Articles » Lifestyle » Self-Care Practices in Diabetes Self-care initiatives in diabetes management. Diabetes mellitus DM is a inltiatives progressive metabolic disorder characterized by hyperglycemia initiativee to im in Refreshing hydration beverages release, Energize your body and mind naturally Self-care initiatives in diabetes management or both. Diabetes Performance recovery supplements was believed to maangement a disease occurring mainly in developed countries, but recent findings reveal a rise in number of new cases of type 2 DM in developing countries with an earlier onset and associated complications. Diabetes-associated complications can lead to chronic morbidities and mortality. World Health Organization WHO estimates that more than million people are affected with DM worldwide. This number is likely to double in number by without any intervention. Diabetes self-care is an evolutionary process of improving knowledge or awareness in the social surroundings by figuring out how to cope with the complex nature of diabetes. Self-care initiatives in diabetes management Medical Informatics and Decision Making Gut health maintenance 14Self-cwre number: Cite initiatiges article. Metrics details. Management of diabetes mellitus is ,anagement and involves controlling multiple risk factors that may lead to complications. Given that patients provide most of their own diabetes care, patient self-management training is an important strategy for improving quality of care. Web-based interventions have the potential to bridge gaps in diabetes self-care and self-management.
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