Attitudes in diabetes education

Educational programmes are widely used to teach the diabetic self-management, with the intention that the increase in knowledge will produce a corresponding improvement in metabolic control. However, research findings make it clear that the considerable expansion in the number and scope of such programmes in recent years has had little impact on levels of metabolic control. This might be explained by the inadequacies of many educational programmes in meeting the learning needs of the diabetic, and by the poor levels of knowledge of many of the staff involved in teaching - particularly nurses. It is suggested that diabetics' learning needs should be not just informational but should also concern their attitudes and beliefs about diabetes. Models of health beliefs and behaviour emphasise the importance of attitudinal and behavioural factors in effecting behavioural adjustment. The research makes it clear that such behavioural adjustment is critical to the success of any educational programme for diabetics. It appears that the diabetic's psychological adjustment and degree of attitudinal change influences metabolic control. By developing skills in moulding belief and attitude formation, educators could make substantial progress towards the goal of good metabolic control as well as providing a significantly better standard of psychological care and support.