People with diabetes need to be wary of different “heart diseases” at different times.
The impact of psychological status on diabetes self-management
In addition to patient behavior, there are many factors that affect the effectiveness of diabetes treatment, including drug regimens, disease duration, other health problems (such as comorbidities, combined medications), and socioeconomic status (such as economic conditions, medical resources, medical insurance coverage), etc. factor. Therefore, failure to achieve glycemic targets (hyperglycemia or hypoglycemia) cannot simply be attributed to poor patient self-management without a thorough evaluation.
When educating patients and their families about diabetes, doctors and nurses should not only emphasize that multiple factors affect blood sugar control, but also emphasize the importance of comprehensive management and the necessity of lifestyle intervention. When self-management is not effective, medical staff should encourage patients with diabetes during the communication process.
Diabetic patients with good compliance refer to those who strictly abide by the treatment plan in diabetes self-management, monitor and evaluate changes in the condition, and solve problems in disease management in a timely manner. Self-efficacy is a diabetic patient's perception of their ability to self-manage diabetes, and it is an important psychological factor that affects the effectiveness of diabetes self-management. Therefore, ongoing self-efficacy assessment of patients with diabetes should be done and incorporated into treatment plans.
Substandard self-management may be due to functional limitations (e.g., blindness, reduced dexterity, cognitive impairment), lack of appropriate diabetes education, daily life factors (e.g., family changes, unemployment), social factors (e.g., family and/or social support) Insufficient, incorrect information obtained about disease and treatment). Therefore, doctors need to assess the patient's needs and develop an individualized intervention plan for the problem. In most cases, self-assessment can be used. There are currently a variety of scales that can be used to assess mental status (this journal will introduce it in detail in future self-assessment columns - Note from this journal). Patients should report their self-assessment status Report to the doctor promptly.
The most difficult part of diabetes self-management is eating a balanced daily diet. In order to improve the compliance of dietary treatment, we can flexibly choose the dietary pattern according to the patient's condition. Self-monitoring of dietary intake may help people with diabetes understand their eating patterns, a process that can provide nutritionists with information that can help them develop meal plans and make targeted dietary recommendations for their patients. In addition, this monitoring is also important in the evaluation of eating disorders (eg, bulimia, anorexia).
The American Diabetes Association (ADA) recommends:
1. Upon diagnosis, regular follow-up visits, and when complications or condition changes occur, the diabetes care team should promptly evaluate the self-management behavior of diabetic patients and provide relevant education based on the evaluation results so that diabetic patients can master relevant operating techniques.
2. When formulating a treatment plan, it is necessary to consider treatment stress, the patient's self-efficacy/confidence in implementing management behaviors, and the level of social and family support.
Different stages have different “heart diseases”
To provide psychological care for patients with diabetes, it is necessary to combine diabetes treatment with diabetes-related psychological factors. Psychological care for patients with diabetes requires multidisciplinary collaboration. The nursing model should fully consider individual circumstances, such as original lifestyle, values, cultural background, economic conditions, available community resources, etc.
Psychological factors can affect self-care. For example, diabetes distress is the stress caused by diabetes itself and its treatment, such as worry about serious complications. Other influencing factors include lack of social and economic resources, as well as psychological problems or mental problems. Illnesses such as depression, anxiety, eating disorders, ability to recognize health information, cognitive impairment. To identify problems early and prevent worsening of their health, all people with diabetes should be evaluated at the time of initial diagnosis, even in the absence of obvious symptoms, and regularly during the management of the disease. Also, within six months of major illness and life changes, including complications, major changes in treatment (such as using an insulin pump for the first time or other forms of intensive therapy), life circumstances (such as living arrangements, work, important Any major changes in interpersonal relationships should undergo psychological evaluation.
