Care model
The model adopted in this project differs from the traditional
DM education programme, with a didactic approach which was
still widely used in general practice in Hong Kong during the
time of the study. Most of the diabetic patients without medical
insurance coverage attended the GOPC for care. The GOPC
would refer patients with poor control or complications to
hospital. The hospital would then refer stabilised cases back to
the GOPC. The model was jointly planned by Family Medicine
academic discipline and Community Rehabilitation Network
(CRN) of the Hong Kong Society of Rehabilitation (HKSR).
HKSR is a non-governmental organisation with subvention
from the Department of Social Services. Online Appendix 1
outlines the theoretical framework and how the selected
concepts are applied as interventions. This programme encouraged
the participants to build up healthy behaviours instead of
the traditional one-way knowledge based education. It stimulated
learning motives by promoting their own problem solving
skills related to their personal lifestyles, and tackling the
common problems by discussing the everyday caring difficulties
encountered and hence constructing a healthy behavioural
model. Activities included learning and practising how to use
a blood glucose metre; treating low and high values of blood
glucose; prevention of complications; taking drugs; and keeping
medical appointments properly. Self efficacy enhanced their
confidence and ability on self management so they did not get
feelings of helplessness with regard to complications. Participants
shared the effective strategies for diabetes management
during group sessions to relieve their stress on self management
during the process of sharing.
The Association of Diabetes Education (AADE) has identified
seven self care behaviours through a literature review which