[Individualizing education for patients with diabetes attending an acute care unit].
BACKGROUND
An increasing number of diagnostic procedures and shortened length of stay impede education for patients with diabetes mellitus attending an acute care unit. Therefore, an individualized approach to patient education may be more suitable.


METHODS
The educational needs of inpatients with diabetes attending a department of general internal medicine were analyzed using a structured 5- to 10-minute interview. Within a period of 4 months, all patients with diabetes mellitus referred to the IVth Medical Department (speciality: geriatrics) were screened. Screening took place close to the day of admission. Following the screening interview, the interviewer initiated an individualized diabetes education according to the patient's needs and resources. The screening interview covered clinical data, functional limitations and disabilities, diabetes complications, patient's competence and motivation for further education.


RESULTS
205 patients with diabetes were seen (prevalence: 30.0%). 24 of them were newly diagnosed (prevalence: 3.5%). Overall, the screening revealed remarkable heterogeneity in patients with diabetes mellitus. 45 patients with previously known diabetes denied any diabetes education prior to hospital admission. Shorter diabetes duration, cognitive impairment, and treatment without insulin were significant and independent risk factors for missing diabetes education. Only 17.4% of patients on an insulin regimen prior to hospital admission performed no monitoring of blood glucose at home. Most patients holding their own blood glucose monitoring device performed daily measurements. Finally, 119 lessons of individual diabetes education were initialized in 73 patients (incidence: 17.4% of all admitted patients).


CONCLUSIONS
Lack of education is common. As heterogeneity of patients with diabetes is striking, diabetes education has to be tailored to the individual needs and resources of the patients attending an acute care unit. Therefore, an individualized approach has proven to be suitable. In this context, a short structured interview is a useful tool for data assessment and scheduling of education lessons.
Burkhardt
Heinrich
H
IV. Medizinische Klinik, Schwerpunkt Geriatrie, Universität Heidelberg, Klinikum Mannheim, Mannheim. heinrich.burkhardt@ med.ma.uni-heidelberg.de
Gehrlein
Max
M
Eisenhofer
Steffi
S
Elfert-Hartl
Brigitte
B
Gladisch
Rainer
R
D000368:Aged; D000369:Aged, 80 and over; D015190:Blood Glucose Self-Monitoring; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006761:Hospitals; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D015995:Prevalence; D013997:Time Factors
D007328:Insulin