Limitations of the Stages of Change model to Type 2 diabetes care at SMHC
The Stages of Change model was devised based on observations of people giving up smoking - an addictive behaviour requiring complete cessation [16]. Smoking can be considered to have one common set of behaviour patterns as it is a single behaviour. Managing type 2 diabetes by diet, exercise and medication use needs to consider the interaction of three different behaviours, each having differing sets of patterns, and each impacting on glycaemic control.
It is possible that patients engaging in exercise and dietary behaviours can be viewed as proceeding through a continuous directional flow through steps beginning with initiating the behaviour, followed by continuing it, while constantly adapting it during the diabetes-disease trajectory. Each of these steps, in turn, can be considered to have their unique set of SOC, including the possibility of new stages, and have their unique aims. The intervention model did not incorporate such a complex view of these behaviours and therefore it is possible that this could have contributed to the results observed.
As we noted above there is a need for economic considerations in whether the model succeeds or not.
Limitations of the Stages of Change model to Type 2 diabetes care at SMHC
The Stages of Change model was devised based on observations of people giving up smoking - an addictive behaviour requiring complete cessation [16]. Smoking can be considered to have one common set of behaviour patterns as it is a single behaviour. Managing type 2 diabetes by diet, exercise and medication use needs to consider the interaction of three different behaviours, each having differing sets of patterns, and each impacting on glycaemic control.
It is possible that patients engaging in exercise and dietary behaviours can be viewed as proceeding through a continuous directional flow through steps beginning with initiating the behaviour, followed by continuing it, while constantly adapting it during the diabetes-disease trajectory. Each of these steps, in turn, can be considered to have their unique set of SOC, including the possibility of new stages, and have their unique aims. The intervention model did not incorporate such a complex view of these behaviours and therefore it is possible that this could have contributed to the results observed.
As we noted above there is a need for economic considerations in whether the model succeeds or not.
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