Diabetes your Life your Journey: Development of a structured New Zealand focused group based diabetes self-management (DSME) programme for people, families and whanau with type 2 diabetes (T2DM)

Abstract

Rates of T2DM in New Zealand are reaching epidemic proportions and reducing the impact of this disease is a Ministry of Health, health strategy priority. Diet and lifestyle modifications remain the cornerstone of diabetes management, but before these diet and lifestyle changes can happen behaviour change needs to occur. Internationally there is a movement towards group education programmes for people with T2DM to help achieve behaviour change. This two part study developed a structured, New Zealand focused group-based diabetes self-management education (DSME) programme for people with T2DM called Diabetes: Your Life Your Journey. Part one, which formed this MSc thesis was the development, pilot and modification of the DSME programme. Part two was a longitudinal pre and post test intervention trial in 100 participants which was outside the scope of this MSc thesis project.

The literature review conducted reviewed national and international DSME programmes to determine if any one DSME programme could be adopted for this pilot. At this time there was no one national DSME programme that had been formally evaluated and had a written curriculum that could be adopted for this pilot. The international DSME programmes that have been formally reviewed and had written curriculums would require extensive modification to make them New Zealand specific. Therefore, aspects from all DSME programmes reviewed were combined to develop a New Zealand specific DSME programme that could be formally evaluated in New Zealand and have a written curriculum to the DSME programme to be conducted outside Wellington and to help uniform DSME education provided in New Zealand. To help develop the DSME programme a literature review of DSME programme guidelines was conducted to help shape the DSME programme developed. End user discussion groups were used to refine the DSME programme before piloting the DSME programme. Three pilot groups were run including a range of ethnic groups to ensure the DSME programme developed was culturally appropriate and helped those with the greatest diabetes burden become diabetes self-managers. Qualitative data was collected using an adapted version of the American Association of Diabetes Educators Qualitative assessment tool to assess lifestyle and psychosocial outcomes. Additionally clinical measurements were collected from the pilot groups and are reported in this thesis but this pilot did not detect change in these measures. Feedback from the research group, observing practice nurses, facilitators and participants was gained during the pilot phase and a modified version of the Diabetes: Your Life Your Journey was developed for use in part two of the study. This study achieved its primary goal of developing, piloting and modifying a DSME programme specific to the New Zealand population.