Consumer Preference in Diabetic Education P V Knight MB MRCP

Medical Registrar & lecturer in Geriatric Medicine University Department of Geriatric Medicine, Southern General Hospital, Glasgow C M Kesson MBMRCP

Consultant Physician Victoria Infirmary Glasgow

Correspondence: Dr P V Knight, ME3 MRCP, Lecturer in Geriatric Medicine, University Department of Geriatric Medicine, Southern General Hospital, 1345 Govan Road, Glasgow, G51 4TF

Abstract Three hundred and thirteen out-

patients attending the Victoria Infirmary Diabetic clinic completed a simple questionnaire detailing a number of different methods of diabetic education. The patients were asked to list their choice(s). A book, either alone or combined with some other method, proved the most popular.

Introduction Diabetes Mellitus is a chronic disorder

which is amenable to therapy. Improved metabolic control, with subsequently improved patient life-style and decreased complications (Ref I), can only be achieved with the co-operation of a patient who has a firm grasp of the basic patho-physiology of his or her condition. Unfortunately, poor knowledge of diabetes is extremely common in the average clinic population (Ref 2), and the elderly NIDD seems to be the most ignorant group (Ref 3). Therefore, in this context, education is treatment. At our clinic, like many others, the main process of education takes place through the clinic consultation, on an informal basis. Before embarking on a formal education programme, we felt that if the latter and ergo treatment was to be optimal, patient, ie consumer preference, should be ascertained.

Patients and Methods A randomly selected group of 313

outpatients (152 IDD and 161 NIDD) attending a routine clinic completed a simple questionnaire, which detailed a number of different education methods. They were asked to list their choice(s) by answering YEWNO to a number of options which are shown below in the results graphics.

As previously intimated, the main method of education at this clinic is the consultation. Books and pamphlets are given out to newly diagnosed insulin- dependent diabetics, who are also seen by our Diabetic Liaison Sister. This latter advance had only recently come into being when the survey was undertaken. Formal lectures, videos, films and group tutorials are not employed routinely.

Results The age distribution of the patients

surveyed is shown in the Table. The results are shown in graphic form in Figures 1-3 on page 42. The vertical axis represents the option provided and the horizontal axis the percentage of the group in favour of each choice.

Discussion There seems to be close correlation

between the choices of I D D and NIDD groups; the main idiosyncrasies develop with increasing age. It should be noted, however, that, whereas almost 90% of the total group desired some form of education, only 60% of the I D D group aged 65 were interested in instruction. This may reflect the fact that these people believe that they have nothing to learn.

A book, either alone or in combination with some other educational device, proved most popular (70% overall), probably indicating that people would like some form of text to refer to, even if they don’t read it from cover to cover.

This was followed by an equal preference for lectures from dietitians and doctors (45%). Videos or films were an attractive teaching method to the younger age groups (60%), but not to the elderly.

Group tutorials and individualised teaching from a specialist nurse

TABLE

30-64 > 65 19 74 TOTAL 152 161

Age distribution of patients

provoked a surprisingly unfavourable response of only 14%. We feel that the latter may be due to the fact that we had only recently appointed a specialist nurse when the survey was carried out. Group tutorials may be threatening to some patients and smack too much of the schoolroom. It should be re-emphasised that this study was prospective and none of the methods of education quoted are used routinely.

In conclusion, it would appear that education ofdiabetic patients need not be elaborate to be acceptable. Whether what is acceptable is efficient is another, thorny problem.

References (1) Pirart J.

Diabetes Mellitus and its degenerative complications; a prospective study of 4,400 patients observed between 1947 and 1973. Diabetes Care, 1978; 1: 168-88, 252-63

(2) Beggan M P, Cregan D, Drury M I. Assessment of the outcome of an educational programme of diabetes self-care. Diabetologia, 1982; 23: 246-51

(3) Knight P V, Cummins A G, Kesson C M. Elderly Diabetics: A case for education. J Clinical Experimental Gerontology, 1983; 5(4): 285-94

See Figs on page 42 41 Practical DIABETES September 1984 Vol. 1 No. 1

Figures for ‘Consumer Preference in Diabetic Education’

Cra h shows the preferences of the total group in insulin and non-insulin dependent dialetics for the educational methods listed on the vertical axis

Fig 2 %

L.ctunr from Dielitins

______-____

Boo* lncanlnnalii

o a m m u ) s o a o m 8 0 e o 1 0 0 ~ A n m r i n g a f f i

The preferences of each individual age group of IDD are displayed on the horizontal axis

Fig 3

nook k cmbmatmn ----

aftinnatin The preferences of the two groups of NIDD are displayed on the horizontal axis

42 Practical DIABETES September 1984 Vol. 1 No. 1 I