The personal meaning of having diabetes: implications for patient behaviour and education or kicking the bucket theory.
Most diabetes educators (physicians, nurses, nutritionists) lack the time and expertise to become familiar with theories of human behaviour even though they may be relevant to the education of their patients. As a result, the current practice of diabetes patient education reflects, in many instances, an extension of the information transfer approach found in most schools. This approach is based on the idea that lack of knowledge and skills accounts for the major portion of the poor self-care behaviour observed in some diabetic patients. The emphasis on information transfer is probably partially attributable to the fact that it is easier to measure and evaluate. This approach is too narrow a view of behaviour or learning and fails to meet the needs of diabetes patient educators and their clients. The idea that the behaviour of patients with diabetes will be strongly influenced by their view of diabetes is explored. Diabetes educators need to become skilled designers of patient education programmes which facilitate changes in the personal meaning of diabetes. Researchers should test the utility of seeing disease-related behaviour and education as a process, at least in part, concerned with the personal meaning of diabetes.