D-PATH PROJECT
No: 2021-2-PL01-KA210-ADU-000050279
Good health and well-being are a fundamental pillar of prosperous societies. However, health policy across the EU tends to focus on disease treatment. A more ambitious and holistic approach to health and well-being that complements the biomedical model is thus required – shifting the focus towards health promotion and disease prevention. Such was our approach in the D-PATH project and are the results of the target groups assessment.
Our needs analysis is based upon scientific and experiential research of the Consortium. We took wide perspective of all the stakeholders into account, that is our target groups: diabetics, their families, medical staff and schools thanks to the D-PATH and D-CAMP projects on diabetes that were implemented. Both projects complemented each other. We also made analysis of wider, European community and Mexico.
Children and Adolescents with diabetes frequently have limited access to traditional camps because of the need for accessible medical staff. On the other note, adults with diabetes type I, have even less opportunities to attend such events, because they are mostly seen as those who have diabetes type II. In a collaborative effort between Partners from the D-PATH Erasmus+ project, a D-CAMP project, a local university in Poland, a local higher school of nursing in Poland and Romania, diabetes associations and other stakeholders from Europe, a diabetes camp was created to assist children, adolescents and adults in the management of their diabetes.
Diabetes Camp provides a secure and enjoyable setting for trying out novel selfcare techniques and learning new facts about managing diabetes. Children and teenagers can meet there and connect with people who share their experiences as well as those who have diabetes. Such was the reasoning behind D-CAMP project implementation.
On the other hand, we knew about lack of diabetes awareness in wider society, including immediate surroundings of people who have diabetes like nursing staff, family and school staff. Therefore we decided to invite our D-PATH project team and participants to take part in the D-CAMP (diabetes camp) in Poland in order for them to understand the challenges that persons with diabetes must face by being eyewitnesses of their everyday life for one week.
METHODS
This study assessed self-reports, interviews and sessions with the psychologist at the beginning, during and after attending diabetes camp. The issues tackled were: diabetes-specific emotional distress, diabetes-specific quality of life, and self-care behaviours by surveying campers: Adults (N = 13), Teenagers (N = 13), and Children (N = 10). D-PATH team consisted of 9 persons and D-CAMP of 10 paid staff and 25 Nursing Department volunteers.
Informed consent was obtained from 36 participants with T1D who participated in a summer camp and from their parents during an online meeting. The participants completed the questionnaires (adapted to their age) independently. The psychological evaluation was conducted throughout the camp. The interviews were conducted with the students of nursing department and nurses.
OBJECTIVE - Diabetes Camp for children, adolescents and adults with type 1 diabetes: Effects on well-being and quality of life.
Type 1 diabetes (T1D) is a chronic disease that affects more than just physical health. The impact of the diagnosis, due to changes imposed by treatment, can generate a high level of stress, alter emotions and decrease quality of life in the child and in the family. Accordingly, the relationship between the patient, the healthcare team and the family is critical to achieving good adaptation to the disease. The primary objective of contemporary diabetes care has shifted from being solely medical to aiming for optimum quality of life (QoL), normal psychosocial development, and optimal glycemic control. Our goal is to present empirical data demonstrating the benefits of disease-specific camps participants with long-term disease. Aside from its effects on health and physiology, several studies discuss the value of these camps on quality of life (QoL). Nonetheless, there aren't many studies in this subject that look at psychological factors, outcomes on emotional symptoms (such depression) are lacking from the literature. Our goal was to present an empirical assessment in a field that has not received much attention and to show the importance of the camps for people who have chronic diseases like diabetes type I.
The International Society for Paediatric and Adolescent Diabetes (ISPAD) in its 2018 statement reported that “adolescents with diabetes have a higher incidence of depression, anxiety, psychological distress and eating disorders compared to their peers without T1D. Depression and anxiety are related to fewer glucose controls and poor glycemic control. In addition, depression is also associated with poor treatment adherence and poor quality of life. Improved quality of life is associated with increased self-efficacy, less depression and better metabolic control. The entire family system suffers considerable stress, and some authors report that the psychological adaptation of children to the disease is governed by the reactions of their parents to this stress, which forces the family to modify their lifestyle and affects their quality of life. Thus, 48% of parents report poor quality of life and 81% feel overwhelmed by their child's diabetes, at times associating this feeling with anxiety and depression”.
Consequently, the aim of this assessment was to investigate both the outcome effectiveness of a diabetes summer camp program for children and adolescents with diabetes, and the expected changes in QoL in children, adolescents and adults who have diabetes type I.
Diabetes camps have become an integral part of diabetes care around the world. Although diabetes patients' knowledge and self-management may improve after camp, improvements in psychological variables have not been consistently demonstrated. Studies investigating the role of psychological variables in children and adolescents attending diabetes camps are lacking and may even be nonexistent for some of these variables not mentioning the studies concerning adults’ diabetes camps.
Instruments
Quality of Life (QoL): Psychological group interviews with parents, children, adolescents and adults which were partly based on KINDL® - Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents. The KINDL® Questionnaire for Children and Adolescents was developed and tested with a view to remedying the discrepancy between the urgency of the subject ‘Quality of Life in Children and Adolescents’ and the lack of appropriate measures. In our D-PATH project we used KINDL® more as a basis for our assessment than the full questionnaires.
For the adults the same type of assessment workshops focusing on slightly different questions were introduced.
Procedure
The summer camp lasted 7 days and the intervention team comprised 2 physicians, 1 dietician, 1 diabetes educator, Nursing academic staff 10 persons and students 15 persons. The non-medical personnel included the president of the NGO coordinating the camp, 1 psychologist, 2 sport and well-being trainers, 1 Life Plan Academy trainer, 2 trainers on LEGO (Greece), 2 trainers on Board Games (Sweden), 3 Art-trainers (Romania). Education consisted of workshops, sport activities and small group discussions with 10-13 participants per group. At each meal (breakfast, lunch, snack and dinner) insulin dose was calculated in collaboration with the physicians, analysing the insulin administered at the same meal the previous day. Among the special activities, there are some that should be highlighted: 1. motivational workshops based on Life Plan Academy by Marek Kamiński, a Polish explorer who is claimed to have reached both the North and the South Pole in one year without outside assistance; 2. Workshops on diabetes through LEGO and robotics; 3. Board Game workshops on diabetes or artistic workshops with the Director of Cultural Centre and a person working in the Theatre Maria Filotti in Braila, Romania. All these experiences enabled the participants to communicate in English and go beyond regular diabetes camps which are normally done in national languages.
Of the 36 participants, all were measured during the interviews with psychologist and through the questionnaires. Parents were interviewed during an online meeting with a psychologist.
Results Summary: (the full description of the assessment can be found as an Attachment no. 1 to this document).
From our perspective, the camp's greatest success was the implementation of a camp for adults and seniors, as well as the organization of an intergenerational camp. Firstly, in Poland there are no diabetes camps for adults, so they are left to deal with their own disease. Secondly, organizing an intergenerational camp seems the best way to convey the adults’ experience of disease management to kids and teenagers. On the other hand, it is the best laboratory for learning digital skills to adults with the support of children and adolescents.
The groups were homogeneous at baseline, with no statistically significant differences between the children, teenagers and adults in QoL. However, there were differences between previous two groups and most adults as the latter group did not have access to new technology e.g. sensors or insulin pumps due to lack 5 of reimbursement for these medical devices for adults in Poland at the time when the camp took place (sensors reimbursement was introduced only on the 1st January 2023). Self-esteem and emotional well-being were found to be significantly improved in 20 participants who participated in the camp.
Our needs analysis shows that there is a need for greater psychosocial support - whilst periods of denial, avoidance, anger, rebellion and sadness are all normal responses to having a life threatening health condition, if left unchecked for too long, these feelings can lead to depression, long-term neglect and irreversible health problems. These findings serve as a reminder of how important it is that kids, teenagers and adults are given the opportunity and encouragement to explore and understand their emotional response to having diabetes, and to get the help and support they need before they reach crisis point.
Secondly, the needs and preferences of young adults aged 15 to 35 are clearly quite different at different stages and events in their lives:
1. Compared to older age groups, 16-18 year olds are more likely to struggle with injecting insulin. Often, however, the biggest challenge at this age is dealing with the attitudes and prejudices of people who don’t have diabetes. Many teenagers with diabetes feel embarrassed by their condition, and are deeply concerned about what others think of them. At high school, they face the difficult and sometimes embarrassing task of explaining their situation to new teachers who don’t know them, or understand their needs. Several had stories of being berated by teachers in front of other students for eating in class, or being refused permission to leave the classroom to take their insulin.
2.Early adulthood (19-23 years old) appears to be a particularly challenging time for young adults with diabetes. This is a stage when many young adults are making the transition from the relative predictability and stability of the school environment, to university or work. Routines are disrupted, money is tight, and keeping control of their diabetes can seem like an insurmountable challenge. Another key issue for young adults at this stage in their lives is a lack of support for young adults as they make the transition from paediatric diabetes services to an adult system, which is seen to cater for older people who have type 2 diabetes. Challenges during this stage in their lives include staying positive and motivated, sticking to a routine, maintaining control and avoiding temptation.
3. For those mid-twenties-early thirties, the biggest challenges include time management, and learning how to ‘juggle’ diabetes with a hectic work and life schedule. Many careers do not follow a strict routine or allow staff the flexibility to eat when they need to, or take time off to see health professionals. The cost of 6 health care is also a key source of resentment; even with subsidies, medical expenses can become a significant burden. By now, many young adults are also starting to worry about their future, including complications and whether having diabetes will impact their chances of having a family.
While most diabetics see themselves as responsible for taking care of their own health, they also recognise the value of having a strong support network around them to provide on-going guidance, coaching and encouragement. The attitude and coping style of parents/partners was felt to have a significant influence on how young adults respond to having diabetes, particularly if they were diagnosed as a child or young teenager. Finding a good team of health professionals who have an extensive and up to date knowledge of diabetes and an understanding of what young adults go through can make the world of difference to a young adult with diabetes. The characteristics young adults seek most in their health care professionals include an extensive knowledge of diabetes and an up to date understanding of the latest developments and technology. However, it is also very important to them that health care practitioners are also willing and able to see their point of view. A common complaint amongst young adults with diabetes was that many health professionals are highly judgemental of people with diabetes, and are often ill-equipped to provide the type of emotional support and guidance that diabetics yearn for and need to keep them motivated. A further cause of frustration and grief for young adults who have diabetes is a lack of understanding around diabetes within the general community. Young adults with type1 diabetes complained that while there is a lot of media attention on diabetes, it is often negative, and nearly always focuses on type 2 diabetes.
During an online meeting with psychologist, parents reported experiencing high levels of emotional distress related to diabetes during their online consultation with the psychologist. The results indicated a positive increase of parents’ perceptions of their child’s resiliency and independence.
According to interviews with campers, they regarded the camp as a place where they could connect with people who truly got what it's like to have diabetes. Additionally, they say that camp exposes them to others coping with new technologies and gives them the opportunity to try out different self-care approaches.
Concerning QoL, after participants attended summer camp they had greater emotional well-being. This data is in line with the scientific literature.
Overall, this review provides empirical evidence of the benefits of attending diabetes camps for children, adolescents, and adults. Improvements in quality of life (mainly self-esteem and mental well-being) were noted. Therefore, we recommend summer camps as a very beneficial option for people with type 1 diabetes. This is also beneficial for the whole family. However, due to the small sample size (the main limitation of this assessment), these results cannot be generalized. Evaluation results showed that 77.14 % of camp participants (children and adolescents) felt they learned “a little” or “a lot” about important youth development outcomes (e.g. independence). One of the major challenges of living with diabetes is carrying out effective self-care. Lack of self-care can lead to emotional issues such as aggression, antisocial behaviour, anxiety, and depression. Poor diabetes management can lead to medical complications, including blindness, kidney failure, stroke, nonemergent amputation, and even death.
Resiliency
Resiliency is seen as the ability to make positive adaptions to life’s circumstances despite exposure to severe adversity and a multitude of risks. Resiliency characteristics that are fostered in children and youth are often carried into adulthood. Nevertheless, diabetes type I diagnosed in adulthood makes adults face a new normal that will invariably affect everything they do. Treatment is complex and demanding and necessitates regular blood glucose testing, determining appropriate insulin doses, and monitoring diet and exercise. Taking all these into consideration, we have implemented a Life Plan Academy training programme with the three groups of participants: children, adolescents and adults which were implemented by our trainer – Agnieszka Macyk.
To quote Agnieszka on children: “I was running the workshops for children, adolescents and adults that aimed at building resilience and openness to challenging ones’ limitations and obtaining life goals. The youngest group had classes "Sometimes you win, sometimes you learn" - about how not to be afraid of failures and not identify with them, as well as classes "Build a positive selfimage", i.e. about building self-esteem. The children were very engaged and responded eagerly, which proves that they want to be listened to, that they have fantastic thoughts and that they can show us a completely different perspective that we adults often ignore”.
Agnieszka on workshops with adolescents: “The youth took part in the full version of the Life Plan Academy programme and together we implemented the "My Pole" program. The classes required deeper self-reflection, which was very 8 difficult for some of them. Some teenagers disrupted classes, which indicates a great rebellion against the disease at this period of life. They are fighting the disease. The classes on self-esteem attracted a lot of attention because it was very difficult for many participants to list their own positive characteristics. There was even a sentence: "I am a nobody", "I am a failure". Such statements confirm how necessary such workshops and diabetes camps are at this stage of life.”
“What I noticed once again is that children and teenagers have a lot of trouble reflecting on themselves and going deeper into themselves. Some young people believed that they couldn't brag because it was "badly seen." That's why it's so important to help them discover what's beautiful in them."
Agnieszka on workshops with adults: “The group of adults approached their "Meeting with a Dream" very maturely and with great interest. This is evidenced by the fact that between classes we conducted coaching conversations with some people who said that they only now understood the importance of their dreams.”
Our observations during the workshops with a psychologist and trainer of Life Plan Academy are in compliance with what was observed by Borus and Laffel, “The spontaneity and sense of immortality and exceptionalism that are hallmarks of the teen years are counter to effective diabetes management”. Using resiliency as a framework for education that positions youth to address their own needs could be helpful. After such a disruption which diabetes type I diagnosis is, any workshops and training programmes bringing what is best in the patients will be highly valuable and could improve their self-esteem and resiliency.
Wolin and Wolin identified seven traits that make up resilient individuals’ strength: positive relationships, insight, independence, initiative, creativity, humour, and values orientation. With Life Plan Academy camp programming these seven traits were embedded in the workshops to demonstrate that each of us has impact on her/his life. Strengthening these traits associated with resiliency can be a powerful tool to overcome adversity throughout life.
Conclusions
Good health and well-being are a fundamental pillar of prosperous societies. However, health policy across the EU tends to focus on disease treatment. A more ambitious and holistic approach to health and well-being that complements the biomedical model is thus required – shifting the focus towards health promotion and disease prevention. Children and Adolescents with diabetes frequently have limited access to traditional camps because of the need for accessible medical 9 staff. On the other note, adults with diabetes type I, have even less opportunities to attend such events, because they are mostly seen as those who have diabetes type II. In a collaborative effort between Partners from the D-PATH Erasmus+ project, a D-CAMP project, a local university in Poland, a local higher school of nursing in Poland and Romania, diabetes associations and other stakeholders from Europe, we managed to implement a diabetes camp to assist children, adolescents and adults in the management of their diabetes.
Diabetes Camp provided a secure and enjoyable setting for trying out novel selfcare techniques and learning new facts about managing diabetes. Children, teenagers and adults could meet and connect with people who share their experiences of having diabetes type I.
On the other hand, we knew about lack of diabetes awareness in wider society, including immediate surroundings of people who have diabetes like nursing staff, family and school staff. Our decision to invite our D-PATH project team and participants to take part in the D-CAMP (diabetes camp) in Poland in order for them to understand the challenges that persons with diabetes must face, was one of the best decisions we could make. This further supports the importance of providing a diabetes camp experience, since children, adolescents and adults with type 1 diabetes are often prevented from contact with other people with type I diabetes. Our diabetes camp experience has shown that peer-to-peer learning might be of great emotional and practical importance.
Specialty medical camps not only need to incorporate more opportunities to foster resiliency, relationships, family support, and autonomy, but also collaborate with professionals who are certified, trained, and passionate about assisting children, youth and adults on their journey to a well-managed disease. Providing this type of opportunity can better assist patients as they address various aspects of diabetes self-management that develop as they age, which is essential to effective overall diabetes care and quality of life.
Practitioner Implications
Through partnerships formed and maintained between the local NGOs, university, the Polish Diabetes Association, and the other stakeholders, the implementation of the diabetes camp was possible in 2022. Each partner has played a vital role in keeping the camp free of charge, accessible, and entertaining for enrolled participants. University Nursing Department staff and students volunteered their time to gain additional professional experience as camp counsellors, night shift 10 guardians and trainers. The needs of those who have diabetes can easily be translated into skills and capabilities medical staff, teachers and family members should possess. While searching educational models existing on the markets, we found out there was no effective way of conveying knowledge about this disease.
The parents of children and adolescents and families of adults with type 1 diabetes need support as well. The camp offered one online parent session and one online spouse session during the weekend. The sessions taught parents how to assist in increasing their child’s resiliency and independence and gave them the opportunity to ask questions and interact with each other about their individual experiences.
Limitations and Future Directions
Our sample size was small which might be seen as a limitation to this assessment. However, medical specialty camps are often small due to the specialty staff needed. Based on the assessment outcomes, a longer camps would be recommended to assess better the impact on participants.
Attachment no. 1
Conclusions of Psychological Assessment made during Psychological workshops "Between control and freedom" for participants of the Diabetes Camp for the D-PATH project, Przemyśl, August 2022
I. CHILDREN GROUP
1. Children aged 7 to 11 participated in the workshops. Participants were motivated to tasks, willing to take action, creatively and constructively cooperated. The duration of the workshops and the proposed topics and exercises turned out to be adequate to their ability to perceive and maintain attention.
2. What do children associate diabetes with: needles, pain, measuring sugar, candy, something bad itself, supervision, knowledge, diet.
3. The children performed activities related to measuring or regulating sugar in a natural and trouble-free way.
4. For children's participants, diabetes is a burdensome, but relatively "obvious or normal" element of life.
5. A problematic phenomenon that accompanies some children is the overprotective attitude of parents/guardians.
6. The attitude of children towards the disease depends to a large extent on the attitude of their parents. What to do when working with children: Empower and teach: • responsibility for your health • self-care principles 12 • providing knowledge about illness and health in an age-appropriate manner • task-oriented and not emotional attitude • putting development goals in the center, with the disease as an aspect of life and not its meaning.
II. YOUTH GROUP
1. People aged 12 to 17 took part in the workshops. Participants showed an attitude of openness, curiosity, adhered to norms and rules, showed initiative, cooperated at a good level, were open in self-presentation, reflective, treated each other with respect.
2. The participants were engaged in discussing the medical, theoretical aspects of diabetes. An important topic for them. Understanding the physiological mechanisms is part of restoring control over their lives.
3. Participants, as negative effects of diabetes, indicated: responsibility (as a burden), night waking up, overprotective parents, stress, pinched fingers (pain).
4. The youth group is a very important group worth taking care of. The tumultuous period of adolescence, causing many tensions, is reinforced by the difficulty and suffering resulting from the disease. Adolescents are aware of their health and the risks of diabetes, and at the same time they are not fully mature in terms of defence mechanisms that allow them to cope better. The developing sense of value, control and agency is significantly weakened by the state of anxiety, threat and frustration. Therefore, supportive, educational and therapeutic activities should be addressed with particular care to teenagers. It is worth paying attention to the following issues: self-esteem, weakening of stigmatization, increasing the sense of control and agency, modelling adequate responsibility, increasing the sense of belonging and security. At the same time, other aspects of young people's lives and resources resulting from their development, which can be a source of value, satisfaction and happiness, should be strengthened.
III. A GROUP OF ADULTS
1. Adults have accepted their illness to varying degrees.
2. An important aspect of their participation in the project was the opportunity to feel part of a larger group (I am not alone, others understand me, I can talk openly about my illness, my fears, my suffering and limitations, I am normal).
3. Participants often talked about the feeling of loneliness, helplessness, relying only on themselves (a common motive in experiencing is not believing that other people can help us).
4. It was important for the participants to share their own experience and listen to others' accounts of coping with the disease.
5. A valuable element of the workshop was the opportunity for participants to express their emotions and the experience of direct contact with another person.
CONCLUSIONS
1. Organizing the D-CAMP is necessary and important, it meets many fundamental and important needs of the participants.
2. It is worth considering organizing classes for parents of children with diabetes.
3. The youth and children's group is susceptible to shaping a constructive attitude towards the disease - acceptance. This is the time when these children can be taught to deal with negative aspects, because the child's attitude is mainly modelled by the attitude of adults.
IV. AN ONLINE PARENTS’ GROUP
Diabetes. Psychological aspects.
• Illness - a non-normative crisis that appears suddenly, unexpectedly and is usually not accepted. • Illness means change and change evokes difficult emotions: fear, anger, shame, sense of exclusion. Phenomena appear: stigmatization, denial, excessive focus on the disease. • Illness is associated with mourning, mourning after the loss of: health, current lifestyle, plans, etc. • When one person is sick, the whole family is sick. Negative phenomena appear/increase: conflicts, parentification (role switching), "wrapping around illness", rejection, financial sacrifices, overprotectiveness. • Possible mental burdens accompanying diabetes: cognitive, biological, emotional disorders, relationships with others. And: depression, stress, selfdestruction, conflicts, negative self-image, eating disorders, sexual dysfunction, anxiety about the future. Which way to go: • give yourself time • do not blame yourself, because all reactions, even difficult ones, are adaptive • focus on the problem and support yourself with knowledge • move away from resentment towards challenge and acceptance • use constructive communication • anchor in the future • focus on the here and now • let yourself be helped • consciously and constructively participate in natural separation • share responsibility • handle psychological boundaries well • deal with stress 15 • avoid guilt, hurt and worry. I congratulate the team who cooperated in the D-CAMP. Great, smart and necessary work. Joanna Markin, Psychologist, who took on the role of the D-CAMP psychologist
Attachment no. 2
Activities Proposed for People with Diabetes and Local Schools – Teachers and Students, Parents and Seniors by Institute of Health of The State University of Applied Sciences in Przemyśl (SUAS):
Follow – Up Activities for People Who Have Diabetes and Others Subcarpathian Region Fundacja toTU toTAM + Institute of Health Państwowa Akademia Nauk Stosowanych w Przemyślu I. General information about the PANS collaborator 1. Name: Dyrektor Instytutu Ochrony Zdrowia dr n. o zdr. Bożena Majchrowicz e-mail: pielegniarstwo@pansp.pl Jolanta Karpińska-Ciuba – author of the activity plan 2. Academic Adscription Unit: Institute of Health Goals: • Providing recipients with information regarding: - the essence, mechanism, risk factors and causes of diabetes, - methods of diagnosing and treating diabetes, - causes, symptoms, treatment and complications of diabetes, • Equipping participants with skills in the field of: - recognizing acute complications of diabetes: hypoglycemia, hyperglycemia - assessment of glycemia level: measurement on a glucometer, interpretation of the results indicated by the sensor 17 - procedures in the event of hypoglycemia in a conscious person and with impaired consciousness - pen handling Forms of implementation: 1. "Diabetes - essence, causes, symptoms" - Lecture 2. "Complications of diabetes - diagnosis, management" – Workshops II. Long-term activities Recipients TEACHERS Goals: • Providing recipients with information regarding: - the essence, mechanism, risk factors and causes of diabetes, - methods of diagnosing and treating diabetes, - causes, symptoms, treatment and complications of diabetes, - school responsibilities in providing care for a child diagnosed with diabetes (legal basis, procedure, teacher's responsibilities, principal's responsibilities) - sources of information and examples of good practice • Shaping appropriate attitudes towards a child diagnosed with diabetes, i.e. tolerance, empathy, responsibility, readiness to provide help • Equipping participants with skills in the field of: - recognizing acute complications of diabetes: hypoglycemia, hyperglycemia - assessment of glycemia level: measurement on a glucometer, interpretation of the results indicated by the sensor - procedures in the event of hypoglycemia in a conscious person and with impaired consciousness - pen handling 18 - operating the glucagon pen Forms of implementation: 1. Diabetes - essence, causes, symptoms, school responsibilities in terms of care - Lecture 2. Hypo and hyperglycemia - causes, symptoms and treatment - Workshops PUPILS Goals: • Providing recipients with information regarding: - the essence, mechanism, risk factors and causes of diabetes, - methods of diagnosing and treating diabetes, - causes, symptoms, treatment and complications of diabetes, • Equipping participants with skills in the field of: - recognizing acute complications of diabetes: hypoglycemia, hyperglycemia - assessment of glycemia level: measurement on a glucometer, interpretation of the results indicated by the sensor - procedures in the event of hypoglycemia in a conscious person and with impaired consciousness • Shaping appropriate attitudes towards a child diagnosed with diabetes, i.e. tolerance, empathy, responsibility, readiness to provide help Forms of implementation: 1. "Diabetes - essence, causes, symptoms" - Lecture 2. "Complications of diabetes - diagnosis, management" - Workshops PARENTS Goals: 19 • Providing recipients with information regarding: - the essence, mechanism, risk factors and causes of diabetes, - methods of diagnosing and treating diabetes, - causes, symptoms, treatment and complications of diabetes, • Shaping appropriate attitudes towards a child diagnosed with diabetes, i.e. tolerance, empathy, responsibility, readiness to provide help 1. "Diabetes - essence, causes, symptoms, complications, treatment" - Lecture Action steps 1. Development of a strategy for educational activities a) Establishing cooperation with the Education Board in Przemyśl b) Establishing cooperation with school principals c) Development of a training implementation schedule 2. Establishing a team for the development of training materials and implementation of classes Proposed activities for seniors: 1. Depression - causes, symptoms, prevention, diagnostic and therapeutic procedures 2. Health and life-threatening conditions - symptoms, rules of conduct 3. Polypharmacy – essence, principles of prevention 4. Self-care deficit - ways of coping
Attachment no. 3
Action steps to improve the educational system of Nursing Studies – The proposal of our Mexican partner. México, Querétaro, Universidad Autónoma de Querétaro https://www.uaq.mx/ Datos generales de la colaboradora UAQ 1. Nombre: Juana Elizabeth Elton Puente 2. Unidad Académica de Adscripción: Ciencias Naurales 3. Campus: Aeropuerto 4. Máximo grado académico: Doctorado 5. Teléfono: +52 442-19-19-319 6. Correo electrónico: elizabeth.elton@uaq.mx I. Descripción del proyecto de investigación 1. Título del proyecto de investigación: Rediseño de los contenidos en la formación del personal de salud (nutrición, enfermería, medicina) para la atención de personas con Diabetes Mellitus 2. Tipo de investigación: Aplicada 3. Línea de investigación: Educación en salud 4. Área de conocimiento: Ciencias naturales y exactas 5. Objetivo general: Diseñar los contenidos temáticos relacionados con la formación del personal del área de la salud, para el mejor desempeño de su actividad profesional en la atención de personas con Diabetes Mellitus, mediante escenarios para las y los estudiantes de Enfermería que muestren las diversas situaciones que pueden ocurrir en la vida de una persona con Diabetes Mellitus. II. Planteamiento del problema La formación de profesionistas del área de la salud, implica una gran cantidad de contenidos y asignaturas con el fin de considerar la posibilidad de integrar todos los conocimientos necesarios para la atención de la enfermedades, 21 generalmente distribuidos en los diferentes aparatos y sistemas que conforman el cuerpo humano. Sin embargo, las enfermedades van cambiando en la medida que la población modifica sus estilos de vida, lo que conlleva a que los Planes y Programas de Estudio de las diferentes carreras del área de la salud, deban actualizar sus contenidos conforme la prevalencia e incidencia de las enfermedades. Tal es el caso de la Diabetes Mellitus, enfermedad que en los últimos años se ha convertido en un foco importante de atención a la salud, desde el nivel primario hasta el terciario, generando elevados costos en salud III.Antecedentes y justificación La Diabetes es una enfermedad que al no ser controlada adecuadamente, puede llevar a la persona a presentar complicaciones que van desde problemas de la visión, las extremidades, enfermedad renal crónica, entre otras. La Asociación Americana de Diabetes (ADA), publica año con año, los Estándares de cuidados para Diabetes, que guían la prevención, diagnóstico y tratamiento de la enfermedad, por otro lado, la Federación Internacional de Diabetes (IDF) propone siete conductas de autocuidado para las personas con diabetes, con base en ello, los contenidos de los programas académicos del Plan de Estudios de Enfermería, deberían considerar las recomendaciones de la ADA y la IDF. La Federación Internacional de Diabetes, estimó que en 2021 había 537 millones de personas con diabetes y que esta cifra puede aumentar a 643 millones para 2030 y a 783 millones en 2045, un 10% de la población mundial vive con diabetes, y de estos, el 90% presenta Diabetes tipo 2, y el 75% de las personas con diabetes, viven en países pobres o en vías de desarrollo. Afecta a un 18.3% de la población en México, y es la tercera causa de muerte anticipada y la enfermedad que ocasiona el mayor número de años de vida saludable perdidos, teniendo una tasa de mortalidad de 11.95 personas por cada 10,000 habitantes (IDF, 2021; ENSANUT, 2022) IV.Fundamentación teórica La perspectiva teórica desde donde se desarrollará el estudio. Los conceptos del tema que se consideran más significativos. V. Objetivos Objetivo general: Diseñar los contenidos temáticos relacionados con la formación del personal del área de la salud (nutrición, enfermería, medicina) para el mejor desempeño de su actividad profesional en la atención de personas con Diabetes Mellitus, mediante escenarios para las y los estudiantes, que 22 muestren las diversas situaciones que pueden ocurrir en la vida de una persona con Diabetes Mellitus. Objetivos específicos: a) Analizar las asignaturas contenidas en los Plan de Estudios de las carreras del área de la salud, relacionadas con la Diabetes Mellitus; b) Detallar los contenidos temáticos de las asignaturas de los Planes de Estudios de las carreras del área de la salud relacionados con la Diabetes Mellitus; c) Analizar las estrategias y técnicas didácticas empleadas en la formación del personal del área de la salud; d) Analizar los instrumentos y técnicas de evaluación del aprendizaje en la formación del personal del área de la salud, para el logro de las competencias para la atención de personas con Diabetes Mellitus; e) Rediseño de los nuevos contenidos de las asignaturas de los Planes de Estudios de las carreras del área de la salud, acordes con las recomendaciones de la IDF y ADA Summary Mexico: Introductory research has been done together with the Natural Sciences Department at the Autonomous University of Querétaro, México. As diabetes is becoming more commonplace worldwide, which is leading to higher rates of morbidity and death as well as higher healthcare expenses, it is difficult to provide patients with timely, high-quality care in low-resource settings. We concluded that it's important to put policies in place that enhance diabetes patient care in the neglected states like The State of Chiapas in Mexico, which has some of the lowest rates of diabetes detection and control in the nation. Shared medical appointments (SMAs) are one such tactic. Patients with similar medical conditions see the doctor in a group setting during shared medical appointments (SMAs), with each patient receiving care in turn. In addition to basic information pertinent to other patients with the same disease, the doctor also provides information tailored to each patient's unique needs. SMAs are a patient-centered approach that has demonstrated potential in fostering comprehensive care delivery and patient involvement among underserved communities. The SMA intervention which reorganizes patient-provider relationships, may be promising for low-resource settings. It can be used to counteract the oppressive power dynamics that are associated with traditional models of care, which disproportionately impact marginalized populations. SMAs encourage peer support and education, which makes patients feel more at ease and capable of managing their conditions. Last but not least, SMAs feel similar to the experience of diabetes camps where patients coexist in a full-day experience while SMAs could be more accessible to those who cannot afford (not only from the financial perspective but also a timely one) participation in a camp