DIABETES EDUCATION AND EMPOWERMENT
Introduction
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The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK, 2000) estimates that approximately 16 million Americans have diabetes which the institute defines simply as too much glucose in the blood. The Institute further notes that 50 percent (8 million people) of those who have diabetes are unaware that they have the condition and are receiving no medical treatment; the seriousness of this fact is heightened when one considers that diabetes is the seventh leading cause of death in America and constitutes a huge portion of yearly medical spending. Indeed, the NIDDK states that while diabetes affects 4.5 percent of the U.S. population, it accounts for 14.6 percent of all direct health care expenses. This translates into an annual average of $9,493 dollars for diabetics as compared to $2,604 for non-diabetics. Despite the alarming statistics, there is hope. Comprehensive diabetes education programs can operate to reduce these statistics, resulting in not only improved outcomes for diabetes patients but also in lowering hospital admissions and, therefore, costs (NIDDK, 2000). This paper examines the diabetes education literature, focusing on empowerment-based models and attendant evaluative issues. The reviewed literature is then used as the basis for proposing the formulation an evaluation instrument that can be used to assess the effectiveness of empowerment-based diabetes education; in other words,
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n is: What does empowerment look like? The next section of the paper examines for an answer to this question.
Review of the Literature
The failure of empowerment models to operationalize their goals and objectives in terms of discrete program outcomes has lead to many different notions of what empowerment looks like. For example, Funnell, Anderson and Oh (1994) hold that empowerment occurs if patients outcomes consist of an improvement of their attitudes toward having diabetes and their general knowledge of the disease.
On the other hand, Florian and Elad (1998) state that a given program is effective when outcomes include (but are not limited to) empowerment of caregivers assisting a diabetic spouse, parent, child, or other relative. Brown (1997) states that a key outcome of empowerment-based education must be an improvement in glycaemic control. McCaul (1987) states that patients will show a host of specific lifestyle changes such as improved nutrition, cessation of smoking, establishment of a daily exercise routine, and so forth.
Most of the foregoing authors have assessed those outcomes they consider to be essential to the effective operation of empowerment-based diabetes education. For example, in a empowerment-based
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Approximate Word count = 2476
Approximate Pages = 10 (250 words per page)
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