Abstract
To explore the impact of Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND) Foundation education, particularly from interviewees' narratives regarding recall of good and bad news messages and behaviour changes. In-depth, semi-structured interviews were conducted with a purposive sample (n=19) of people who had attended education sessions as part of a randomised controlled trial in two UK sites with ethnically diverse populations. Data collection and analysis were informed by the constant comparative approach and facilitated through charting. Findings were similar in people from different ethnic backgrounds. Exploration of levels of recall of the sessions suggested that this was variable and sometimes very limited, but that interviewees had all assimilated some relevant learning. Key themes emerged relating to the way in which interviewees recalled and had been influenced by positive (good news) and negative (bad news) messages within the education sessions, including biomedical explanations. Both types of message appeared to have an important role in terms of motivation to change behaviour, but a notable observation was that none of the interviewees recalled receiving bad news messages when diagnosed. Our findings have highlighted the importance of providing and combining both negative and positive messages within education designed to promote self-management behaviour change.
Highlights
Type 2 diabetes mellitus (T2DM) is a serious progressive chronic illness with potential associated complications including renal, heart and eye disease
We explore interviewees’ narratives about what they recalled learning from the DESMOND Foundation sessions generally and whether and how their behaviour had changed
[30] Preliminary analysis of a sample of interviews was used to devise a provisional coding frame, in which we focused on three emergent themes which were considered to be very relevant to our aims: recall of learning from DESMOND, knowledge and motivation based on good news and bad news; and reported behaviour change following the intervention
Summary
Type 2 diabetes mellitus (T2DM) is a serious progressive chronic illness with potential associated complications including renal, heart and eye disease. [2] Despite advances in pharmacological interventions, prevention of complications in T2DM remains a challenge because of the importance of patient engagement in their own care, for example, in relation to diet and lifestyle modification, adherence to prescribed medication and, for some people, self-monitoring of blood glucose. DESMOND (Diabetes Education and Self Management for Ongoing and Newly Diagnosed) is a programme of group-based structured patient education modules and related educator training that meets national standards and is a widely adopted programme in UK primary care. This is pertinent to the UK population, within which people of South Asian origin have a high prevalence of T2DM. [13,14] The DESMOND ‘Foundation’ programme is a version of the DESMOND Newly Diagnosed programme adapted to meet the needs of people with established T2DM (a duration of between 12 months and ten years)
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