DESMOND: Delivery of person centred care from the participant perspective
Introduction
DESMOND (Diabetes Self-Management for the Ongoing and Newly Diagnosed) is the National Diabetes Services Scheme (NDSS) endorsed one day structured self-management education program designed to support people with type 2 diabetes. The DESMOND program has been developed from extensive research and demonstrates positive outcomes.1
The positive outcomes for people with diabetes were shown to be influenced by the style of delivery by the Educators. DESMOND Educators undertake two days of training to learn core Educator behaviours which support participants learning in an interactive, non-didactic style.
Objective
The success of the DESMOND program lies not only in its content but crucially in how it is delivered by Educators. 2 A rigorous Quality Development process for Educators guarantees that delivery of the DESMOND program meets the required standard of Educator behaviours to ensure these positive outcomes. Participant perceptions of these Educator behaviours and style are also collected.
Methodology
Measurement of respondents’ perceptions of Educator behaviour occurs at post-session evaluation using questions from the Health Care Climate Questionnaire (HCCQ). A 5-point Likert scale is used with scores summed to provide an overall score the extent to which the Educators supported the respondents’ autonomy in making decisions about their diabetes management.
Results
HCCQ data was collected from 383 evaluation respondents from July 2016 to June 2017. The mean HCCQ score was 55.5 (out of possible maximum score of 60), suggesting respondents felt supported by the facilitators. Additional analyses revealed that HCCQ score was significantly positively correlated with diabetes empowerment at both post-session (r=.41) and three-month follow-up (r=.32), suggesting autonomy-supportive facilitator behaviour increased sense of empowerment both immediately an over time.
Conclusion
Results indicate that participants felt a sense of autonomy in learning about and making decisions relevant to self-management of their diabetes. Moreover, autonomy supportive facilitator behaviour may be an important component in improving people’s empowerment to manage their diabetes. Use of specific DESMOND Educator behaviours which facilitate development of this sense of autonomy is the cornerstone of the success of DESMOND programs in structured person centred education for people with type 2 diabetes.