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2.
J Am Dent Assoc ; 151(4): 303-304.e2, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32222178

RESUMEN

BACKGROUND: Human papillomavirus (HPV) is a sexually transmitted oncovirus associated with several malignancies, including oropharyngeal squamous cell carcinoma. The 9-valent HPV vaccine can help protect against the high-risk HPV strains most commonly associated with HPV-related cancers. METHODS: The authors used an electronic survey to assess the roles of dentists and their team members in discussing the HPV vaccine, as well as administering the vaccine in a dental setting. On December 6, 2019, the authors e-mailed a survey link to the American Dental Association Clinical Evaluators (ACE) Panel (n = 813), a sample of American Dental Association member dentists. After 1 e-mail reminder, the survey closed on December 19, 2019, and the authors conducted exploratory and descriptive data analyses using SAS Version 9.4 (SAS). RESULTS: A total of 329 dentists responded to the survey, and 83 (25%) of them reported that they or their team members discuss the implications of the HPV vaccine with age-eligible patients or their parents or guardians. Dentists lead two-thirds (n = 218) of the discussions, and the clinical examination is the most frequent moment during the patient visit in which HPV-related topics are discussed. Some of the top reasons respondents mentioned for not discussing the vaccine in their practice were the perception that these discussions are best left to other health care professionals and not knowing how to address the topic with patients. If the scope of dental practice is expanded to include administering the vaccine, 125 (38%) of respondents would feel uncomfortable administering the vaccine. The most common potential barriers to administering the vaccine in a dental setting include obtaining reimbursement and vaccine management and preservation. CONCLUSIONS: The survey results suggest that dentists' comfort levels and perceived roles in discussing and administering the HPV vaccine vary. PRACTICAL IMPLICATIONS: There is a need to further define the role of dentists and their team members in the promotion and administration of the HPV vaccine. Resources for dentists and dental team members may be helpful to support professional education and communication about the HPV vaccine.


Asunto(s)
Infecciones por Papillomavirus , Vacunas contra Papillomavirus , American Dental Association , Conocimientos, Actitudes y Práctica en Salud , Humanos , Encuestas y Cuestionarios , Estados Unidos
3.
J Am Dent Assoc ; 151(4): 245-254.e24, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31983391

RESUMEN

BACKGROUND: This objective of this umbrella review was to summarize the evidence on safety, efficacy, and effectiveness of human papillomavirus (HPV) vaccines in the general population. METHODS: The authors conducted a literature search and selected systematic reviews if they were published from January 2006 through November 2018, included randomized controlled trials or observational studies, related to the general population, and evaluated HPV vaccine-related clinical outcomes. The authors independently and in duplicate screened literature, extracted data, and appraised reviews using AMSTAR 2, a critical appraisal tool for systematic reviews. RESULTS: The authors selected 30 systematic reviews that included male and female participants aged 9 through 76 years from multiple countries. Reviews evaluated postvaccine seroconversion, HPV infection rates, precancerous or benign lesions, and adverse events; none of the researchers reported on oral or oropharyngeal lesions. Results from the reviews showed that, compared with those who received a placebo or non-HPV-type vaccine, HPV-vaccinated participants had statistically significantly higher rates of seroconversion and local adverse events, statistically significantly lower rates of HPV infection and condylomata lesions, and decreased rates of HPV-related precancerous lesions, which did not always attain statistical significance. CONCLUSIONS: Systematic reviews have found evidence that the available HPV vaccines are safe, effective, and efficacious against vaccine-type HPV infection and HPV-associated cellular changes, including precancerous and benign lesions. PRACTICAL IMPLICATIONS: Dentists may use this resource to better understand the literature on the potential harms and benefits of HPV vaccination.


Asunto(s)
Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Anciano , Odontólogos , Femenino , Humanos , Inmunización , Masculino , Vacunación
5.
J Am Dent Assoc ; 150(9): 739-747.e9, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31439203

RESUMEN

BACKGROUND: The purpose of this systematic review was to determine the potential effect of dental treatment before cardiac valve surgery (CVS) or left ventricular assist device (LVAD) implantation on morbidity and mortality. TYPES OF STUDIES REVIEWED: The authors included relevant studies from MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials, including randomized controlled trials and cohort studies, published from 1998 through 2019 and involving adults who received dental treatment before CVS or LVAD implantation. The authors assessed bias by using the Newcastle-Ottawa Quality Assessment Scale and evidence certainty by using the Grading of Recommendations Assessment, Development and Evaluation approach. The authors used a meta-analysis with a random-effects model to estimate dichotomous and continuous outcomes, expressed as relative risk (RR) and weighted mean difference. RESULTS: Six studies met the inclusion criteria for CVS but none for LVAD implantation. Very low certainty in the evidence suggested uncertainty as to whether health outcomes for patients undergoing dental treatment before CVS differed from those who did not. Postsurgical outcomes included all-cause mortality (RR, 1.00; 95% confidence interval [CI], 0.53 to 1.91), infective endocarditis (RR, 1.30; 95% CI, 0.51 to 3.35), postsurgical infection (RR, 1.01; 95% CI, 0.76 to 1.33), and length of stay in the hospital (weighted mean difference, 2.9; 95% CI, -2.3 to 8.1). CONCLUSIONS AND PRACTICAL IMPLICATIONS: From the available evidence, it is unclear whether postoperative outcomes differ in patients receiving dental treatment before CVS compared with outcomes in those who do not. Dentists and medical care professionals should collaborate on an appropriate course of action for each patient, weighing any potentially relevant care considerations.


Asunto(s)
Atención Odontológica , Complicaciones Posoperatorias , Adulto , Válvulas Cardíacas , Humanos
7.
Diabetes Educ ; 44(3): 260-268, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29589821

RESUMEN

Purpose The American Association of Diabetes Educators conducts the National Practice Survey (NPS) biennially to document current practice in diabetes education in the United States. The purpose of the study is to obtain insight about factors influencing the work of the diabetes educator. Method The 2017 NPS was comprised of 100 questions covering diabetes educator demographics, profile populations of people with diabetes, practice information, program accreditation, program curriculum, staffing, education delivery methods, data collection, and reporting. The basic survey consisted of 22 questions using branch logic, from which respondents were then directed to questions tailored to their particular practice setting, enabling them to answer only a relevant subset of the remaining questions. The web-based survey was sent to approximately 32 000 individuals who were either members of the American Association of Diabetes Educators (AADE) or Certified Diabetes Educators (CDE) with the National Certification Board for Diabetes Educators (NCBDE) but not AADE members. Weekly reminder e-mails were sent to recipients who had not yet responded. The outreach efforts resulted in the survey being completed by 4696 individuals, a 17% response rate yielding 95% confidence that these responses are within ±5% accuracy. Results Diabetes Self-Management Education and Support (DSMES) continues to be a field dominated by women (95%). Diabetes educators represent a diverse health care profession, with educators indicating most commonly that their primary discipline is nursing (48%), nutrition (38%), and pharmacy (7%). When asked about credentials, 82.6% indicated that they held a CDE, 3.8% held the Board Certified-Advanced Diabetes Management (BC-ADM) credential, and 16.5% held neither the CDE nor the BC-ADM. Nearly 75% characterized their role as a diabetes educator as providing direct patient care. DSMES continued to be provided in a varied array of settings to educationally, socioeconomically, and racially diverse patient populations. DSMES was delivered using a number of different educational strategies. Diabetes educators have direct influence in care and services that people with diabetes receive. Conclusions The results of the 2017 NPS demonstrate that diabetes educators are meeting the needs of varied populations in various practice settings. They are working with individuals with type 1 and type 2 diabetes, those at risk for diabetes, and women with gestational diabetes and are involved in recommending, implementing, and providing key referrals and recommendations for diabetes care, including insulin initiation, titration, medication adjustments, recommendations on devices, and technology. Identified areas for improvement include needs for increased racial and ethnic diversity in the workforce, recruiting young professionals, drawing practice approaches from related disciplines (eg, mental health and disability rehabilitation), and encouraging tracking of more areas of outcomes data. Diabetes educators are playing an increasingly central role within multidisciplinary care teams with people at risk for diabetes, those who have diabetes, and those with other chronic conditions.


Asunto(s)
Diabetes Mellitus , Educadores en Salud/estadística & datos numéricos , Educación del Paciente como Asunto/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Automanejo/educación , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Educación del Paciente como Asunto/métodos , Encuestas y Cuestionarios , Estados Unidos
8.
J Am Dent Assoc ; 149(4): 256-265.e3, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29599019

RESUMEN

BACKGROUND: Effective pain management is a priority in dental practice. Government and private agencies highlight the need to provide optimal pain relief, balancing potential benefits and harms of both opioid and nonopioid analgesic agents. The purpose of this study is to summarize the available evidence on the benefits and harms of analgesic agents, focusing on preexisting systematic reviews. TYPES OF STUDIES REVIEWED: An overview of systematic reviews was conducted to evaluate the efficacy or reported adverse events associated with orally administered medication or medication combinations for relief of acute pain. Reviews were inclusive of all age populations but were limited to those that evaluated medication and medication combinations marketed in the United States and had moderate or high methodological quality according to the A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 tool. RESULTS: Five reviews were found eligible for inclusion. The data identified combinations of ibuprofen and acetaminophen as having the highest association with treatment benefit in adult patients and the highest proportion of adult patients who experienced maximum pain relief. Diflunisal, acetaminophen, and oxycodone were found to have the longest duration of action in adult patients. Medication and medication combinations that included opioids were among those associated most frequently with acute adverse events in both child and adult-aged patient populations. PRACTICAL IMPLICATIONS: The best available data suggested that the use of nonsteroidal medications, with or without acetaminophen, offered the most favorable balance between benefits and harms, optimizing efficacy while minimizing acute adverse events.


Asunto(s)
Dolor Agudo , Analgésicos no Narcóticos , Revisiones Sistemáticas como Asunto , Acetaminofén , Dolor Agudo/tratamiento farmacológico , Adulto , Analgésicos , Analgésicos Opioides , Antiinflamatorios no Esteroideos , Niño , Odontología , Humanos , Dolor Postoperatorio
9.
J Am Dent Assoc ; 149(1): 38-50.e2, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29304910

RESUMEN

BACKGROUND: Patient safety is a priority in dentistry. Evaluating the benefits and harms associated with the addition of capnography to standard monitoring during moderate sedation for adult patients in the dental practice setting is needed. TYPES OF STUDIES REVIEWED: The authors used rapid review methodology to identify relevant systematic reviews, which they updated through a systematic search by using the same search strategy as the identified reviews. The authors searched PubMed and Google Scholar and through the references of the identified systematic reviews, which yielded 2,892 studies. Inclusion criteria were that the article was available in English, was original research in adult humans who had undergone moderate procedural sedation, and involved comparing standard monitoring with the addition of capnography. RESULTS: Sixteen studies were eligible, involving 3,866 adults undergoing procedural sedation. The authors used the Grading of Recommendations Assessment, Development and Evaluation approach to evaluate the evidence and rate it as being of moderate to low quality because of high risk of bias and heterogeneous effects for the outcomes of hypoxemia and adverse respiratory events. Capnography had higher sensitivity to detect adverse respiratory events than did standard monitoring alone (0.92; 95% confidence interval, 0.65 to 0.99) and may reduce the risk of developing hypoxemia by 31% (risk ratio, 0.69; 95% confidence interval, 0.57 to 0.82). Capnography did not affect the risk of developing serious adverse events, procedure time, sedation quality, or patient satisfaction. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Adding capnography to standard monitoring of adults during moderate sedation may reduce the risk of developing hypoxemia, increase detection of adverse respiratory events, and is not associated with additional harms. These findings suggest routine use of capnography during moderate sedation has the potential to reduce adverse anesthetic outcomes in dental practice.


Asunto(s)
Capnografía , Sedación Consciente , Adulto , Humanos , Hipoxia , Monitoreo Fisiológico , Seguridad del Paciente
10.
J Am Dent Assoc ; 148(3): 164-171, 2017 03.
Artículo en Inglés | MEDLINE | ID: mdl-28126227

RESUMEN

BACKGROUND: In this study, the authors compared the odds of exposure to Legionella pneumophila among currently active dental practitioners with that of nonpractitioners and evaluated demographic and clinical practice predictors of exposure. METHODS: The authors obtained demographic characteristics and dental practice behaviors from participants in the annual American Dental Association Health Screening Program survey administered from 2002 through 2012. The authors assayed serum samples obtained from participants for L pneumophila antibodies. The authors used an adjusted logit model to evaluate predictors of positive results. RESULTS: Among 5,431 participants, approximately 10% were positive for L pneumophila, with no significant differences between dental practitioners and nonpractitioners. Geographic location was the only significant predictor of seropositivity, with no increased risk of being exposed to L pneumophila associated with age, race, sex, years in practice, hours of practice per week, use of barrier protection, or infection control practices. CONCLUSIONS: Prevalence of L pneumophila antibodies was 10.4% among dental and nondental personnel. US Census division was the only significant predictor of seropositivity. The authors conclude that provision of dental care did not increase the risk of being exposed to Legionella. PRACTICAL IMPLICATIONS: Dentists should be aware of the prevalence of Legionella species in their practice areas to understand their personal risk of developing an infection.


Asunto(s)
Anticuerpos Antibacterianos/análisis , Personal de Odontología , Legionella pneumophila , Exposición Profesional/análisis , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , American Dental Association , Ensayo de Inmunoadsorción Enzimática , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Estudios Seroepidemiológicos , Estados Unidos
11.
Diabetes Educ ; 42(6): 678-685, 2016 12.
Artículo en Inglés | MEDLINE | ID: mdl-27621094

RESUMEN

PURPOSE: The purpose of this report is (1) to describe the use of the American Association of Diabetes Educators' (AADE's) model of implementation of the National Diabetes Prevention Program through nationally certified diabetes self-management education (DSME) programs and (2) to report the aggregated program outcomes as defined by the Diabetes Prevention and Recognition Program standards of the Centers for Disease Control and Prevention (CDC). METHODS: In 2012, the AADE worked with the CDC to select 30 certified DSME programs for National Diabetes Prevention Program delivery. For the following 3 years, the AADE continued to work with 25 of the 30 original programs. Results for all CDC recognition standards have been collected from these 25 programs and analyzed as aggregated data over the course of 36 months. RESULTS: At the end of the full-year program, average percentage body weight loss for participants across all 25 programs exceeded the CDC's minimum requirement of 5% weight loss. All programs on average met the CDC requirements for program attendance. CONCLUSION: Increasing access to the National Diabetes Prevention Program, through an array of networks, including certified DSME programs, will better ensure that people are able to engage in an effective approach to reducing their risk of diabetes.


Asunto(s)
Diabetes Mellitus Tipo 2/prevención & control , Educación del Paciente como Asunto/métodos , Evaluación de Programas y Proyectos de Salud , Automanejo/métodos , Programas de Reducción de Peso/estadística & datos numéricos , Adulto , Femenino , Implementación de Plan de Salud , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos , Pérdida de Peso
12.
Patient Educ Couns ; 99(6): 926-43, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-26658704

RESUMEN

OBJECTIVE: Assess effect of diabetes self-management education and support methods, providers, duration, and contact time on glycemic control in adults with type 2 diabetes. METHOD: We searched MEDLINE, CINAHL, EMBASE, ERIC, and PsycINFO to December 2013 for interventions which included elements to improve participants' knowledge, skills, and ability to perform self-management activities as well as informed decision-making around goal setting. RESULTS: This review included 118 unique interventions, with 61.9% reporting significant changes in A1C. Overall mean reduction in A1C was 0.74 and 0.17 for intervention and control groups; an average absolute reduction in A1C of 0.57. A combination of group and individual engagement results in the largest decreases in A1C (0.88). Contact hours ≥10 were associated with a greater proportion of interventions with significant reduction in A1C (70.3%). In patients with persistently elevated glycemic values (A1C>9), a greater proportion of studies reported statistically significant reduction in A1C (83.9%). CONCLUSIONS: This systematic review found robust data demonstrating that engagement in diabetes self-management education results in a statistically significant decrease in A1C levels. PRACTICE IMPLICATIONS: The data suggest mode of delivery, hours of engagement, and baseline A1C can affect the likelihood of achieving statistically significant and clinically meaningful improvement in A1C.


Asunto(s)
Glucemia/metabolismo , Diabetes Mellitus Tipo 2/sangre , Hemoglobina A Glucada/análisis , Educación del Paciente como Asunto/métodos , Autocuidado/métodos , Adulto , Automonitorización de la Glucosa Sanguínea , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Femenino , Humanos , Hipoglucemiantes/administración & dosificación , Hipoglucemiantes/uso terapéutico , Masculino , Persona de Mediana Edad
13.
Diabetes Educ ; 41(6): 665-76, 2015 12.
Artículo en Inglés | MEDLINE | ID: mdl-26424676

RESUMEN

PURPOSE: The purpose of the study was to examine the field of diabetes education along with identifying facilitators and barriers for future health care professionals entering the specialty field of diabetes education. METHOD: Faculty members who were currently teaching in a health-related discipline, the students of those faculty members, and nursing students who were members of the National Student Nursing Association were surveyed to gather descriptive data. RESULTS: While faculty members reported they are promoting diabetes education to their health professions students, many nursing students are not aware of this career path. Nursing students understand that diabetes is a significant problem and will be something they encounter in all areas of their careers, but many were not sure they wanted to specialize in it. CONCLUSIONS: There is a gap between what faculty members and students report as far as awareness of the diabetes education specialty. In addition, misinformation about diabetes and people living with diabetes may be a deterrent for potential future diabetes educators. American Association of Diabetes Educators, health professions faculty members, and practicing diabetes educators can do more to clear up misconceptions and promote diabetes education as a career path for students in the health professions.


Asunto(s)
Selección de Profesión , Diabetes Mellitus , Docentes Médicos/psicología , Educadores en Salud/psicología , Estudiantes de Enfermería/psicología , Adulto , Femenino , Educadores en Salud/educación , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Encuestas y Cuestionarios , Adulto Joven
14.
Diabetes Educ ; 41(5): 609-15, 2015 10.
Artículo en Inglés | MEDLINE | ID: mdl-26246596

RESUMEN

PURPOSE: The purpose of this comprehensive role delineation study of the Board Certification for Advanced Diabetes Management (BC-ADM) examination was to ensure its content validity. METHOD: The comprehensive role delineation study was conducted in 3 phases. In the first phase, a panel of 12 currently credentialed BC-ADM subject matter experts produced a list of practice domains, a unique set of content subdomains for each, and a series of knowledge statements for every subdomain. In the second phase, a validation study survey consisting of 3 sections was created. The first section was to rate each subdomain on three factors: criticality, frequency, and point in career at which knowledge is first used. The second section asked respondents to estimate the percentage of the examination to dedicate to the four domains. The third section captured demographic information of the respondents. A total of 667 BC-ADMs and 18 physicians were invited to take the survey. In the third phase, the subject matter expert panel analyzed the survey results and determined the weight that the domains and subdomains should have on the 150-item BC-ADM examination. RESULTS: Final domain weights and the corresponding number of items for the BC-ADM examination are provided in this report; these constitute the BC-ADM examination blueprint. CONCLUSIONS: The national role delineation study reported here for the BC-ADM examination ensures that it is reflective of the current practice and required knowledge of the advanced diabetes manager.


Asunto(s)
Certificación/normas , Diabetes Mellitus , Educación del Paciente como Asunto/normas , Competencia Profesional/normas , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios
15.
Diabetes Educ ; 41(5): 616-24, 2015 10.
Artículo en Inglés | MEDLINE | ID: mdl-26306525

RESUMEN

PURPOSE: The National Practice Study (NPS) is conducted biannually to assess current diabetes education practices in the United States with the goal of understanding current trends in the work in which diabetes educators engage. METHODS: The 2015 NPS contained 54 questions about the individuals providing diabetes education, people with diabetes participating in education, and programs providing the education. The survey was sent electronically to approximately 21 975 people who were members of the American Association of Diabetes Educators (AADE) or who were Certified Diabetes Educators with the National Certification Board for Diabetes Educators but were not currently AADE members. In addition, both the AADE and the National Certification Board for Diabetes Educators promoted participation in the NPS via social media. The combination of efforts resulted in completion of the survey by 4855 respondents. Testing was completed with a significance level of 0.05 or 95% confidence. RESULTS: Diabetes educators continue to represent a diverse group of health care professionals-nurses (50%), dietitians (35%), pharmacists (6%), and others (6%). By far, the most commonly held credential for the specialty continues to be the Certified Diabetes Educator (86%), with only 5% of survey respondents indicating that they held the Board Certified-Advanced Diabetes Management credential. Diabetes educators are working with individuals across the diabetes continuum, as well as with people who do not have diabetes but have other chronic conditions. The data demonstrate that much of the diabetes educator's work with people with diabetes is beyond the first year of diagnosis. Diabetes educators are increasingly seen to be providing a broader array of the integrated AADE7 Self-Care Behaviors™. CONCLUSIONS: The specialty of diabetes educator continues to be populated by a professionally diverse workforce, meeting the needs of people across a wide spectrum. Diabetes educators can be found providing services in primary prevention of diabetes, education and management for those diagnosed with diabetes, prevention of secondary complications, and more complex management of diabetes and its secondary complications. While diabetes educators were found to work with those newly diagnosed with diabetes, they continue to engage with people with diabetes at various times other than the year that they were diagnosed. There are still issues with participant readiness, as evidenced by program completion rates. Nonetheless, diabetes educators are increasingly seen to be providing the integrated engagement that is needed to better ensure that people with diabetes attain and maintain competency in self-management skills.


Asunto(s)
Certificación/tendencias , Prestación de Atención de Salud/tendencias , Diabetes Mellitus , Educación del Paciente como Asunto/tendencias , Autocuidado/tendencias , Adulto , Prestación de Atención de Salud/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Educación del Paciente como Asunto/métodos , Competencia Profesional , Encuestas y Cuestionarios , Estados Unidos
16.
Diabetes Educ ; 41(4): 466-71, 2015 08.
Artículo en Inglés | MEDLINE | ID: mdl-25985786

RESUMEN

PURPOSE: The purpose of this study is to gain insight about patient experience of diabetes self-management education in a patient-centered medical home. METHODS: Six focus groups consisting of 37 people with diabetes, diverse in race and ethnicity, were conducted at 3 sites. Participants described their experience in the program and their challenges in diabetes self-management; they also suggested services to meet their diabetes care needs. RESULTS: The most common theme was ongoing concerns about care and support. There was much discussion about the value of the support provided by health navigators integrated in the diabetes health care team. Frequent concerns expressed by participants centered on personal challenges in engaging in healthy lifestyle behaviors. Ongoing programmatic support of self-management goals was widely valued. CONCLUSIONS: Individuals who received health care in a patient-centered medical home and could participate in diabetes self-management education with integrated support valued both activities. The qualitative results from this study suggest need for more formalized exploration of effective means to meet the ongoing support needs of people with diabetes.


Asunto(s)
Prestación Integrada de Atención de Salud/métodos , Diabetes Mellitus/psicología , Educación del Paciente como Asunto/métodos , Autocuidado/psicología , Adulto , California , Diabetes Mellitus/terapia , Manejo de la Enfermedad , Femenino , Grupos Focales , Conductas Relacionadas con la Salud , Humanos , Masculino , Ohio , Atención Dirigida al Paciente , Autocuidado/métodos , Tennessee
17.
Diabetes Metab Syndr Obes ; 7: 45-53, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24550679

RESUMEN

Diabetes is a chronic, progressive disease that affects millions worldwide. The paradigm of diabetes management has shifted to focus on empowering the person with diabetes to manage the disease successfully and to improve their quality of life. Diabetes self-management education is a collaborative process through which people with diabetes gain the knowledge and skills needed to modify their behavior and to self-manage successfully the disease and its related conditions. Diabetes educators are health care professionals who apply in-depth knowledge and skills in the biological and social sciences, communication, counseling, and pedagogy to enable patients to manage daily and future challenges. Diabetes educators are integral in providing individualized education and promoting behavior change, using a framework of seven self-care behaviors known as the AADE7 Self-Care Behaviors™, developed by the American Association of Diabetes Educators. The iterative process of promoting behavior change includes assessment, goal setting, planning, implementation, evaluation, and documentation. Diabetes educators work as part of the patient's health care team to engage with the patient in informed, shared decision making. The increasing prevalence of diabetes and the growing focus on its prevention require strategies for providing people with knowledge, skills, and strategies they need and can use. The diabetes educator is the logical facilitator of change. Access to diabetes education is critically important; incorporating diabetes educators into more and varied practice settings will serve to improve clinical and quality of life outcomes for persons with diabetes.

19.
Diabetes Educ ; 39(5): 614-22, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23928837

RESUMEN

PURPOSE: The National Member Practice Survey (NPS) of the American Association of Diabetes Educators (AADE) is conducted biannually to describe the current diabetes education practice in the United States and identify trends, opportunities, and areas for improvement. METHODS: The 2012 NPS contained 49 questions about diabetes education providers, patients, and programs. The survey, sent electronically to approximately 13,000 AADE members, was completed by 3644 members. Testing was completed using a significance level of .05 or 95% confidence. RESULTS: While nurses and dietitians continued to comprise the majority of diabetes educators in 2012, a significant increase from 2010 occurred in the respondents identified as pharmacists (5% vs. 4%). Individuals holding the certified diabetes educator (CDE) credential decreased slightly in 2012 from 2010. Practice settings for diabetes education increased significantly in 2012 versus 2010 for hospital outpatient/clinic (44% vs. 37%) and hospital inpatient (20% vs. 15%) settings. Prediabetes education was provided by 78% of respondents. Nearly 53% of educators indicated they devoted more than 4 hours per week to data entry, significantly higher than any other amount of time. Collection of clinical and behavioral outcomes increased significantly in 2012 from 2010. CONCLUSIONS: Results of the 2012 NPS provide evidence that the practice of diabetes education is continuing to adapt to evolving models of health care in the United States by expanding the mix of practitioners providing education, engaging in necessary system support activities, and broadening the range of patients seen to include individuals at risk of developing diabetes.


Asunto(s)
Diabetes Mellitus/prevención & control , Educación en Salud/tendencias , Educación del Paciente como Asunto , Autocuidado , Sociedades Médicas/tendencias , Chicago/epidemiología , Prestación de Atención de Salud , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/enfermería , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Nutricionistas/tendencias , Educación del Paciente como Asunto/tendencias , Farmacéuticos/tendencias , Evaluación de Programas y Proyectos de Salud , Autocuidado/tendencias , Especialidades de Enfermería/tendencias , Estados Unidos/epidemiología
20.
Diabetes Educ ; 39(4): 436-46, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23649727

RESUMEN

PURPOSE: The purpose of the article is to explore challenges and opportunities associated with the state of practice for diabetes education and diabetes educators. METHODS: Observations, assumptions, predictions, and recommendations based on a literature review and the 2011 workforce study and workforce summit held by the American Association of Diabetes Educators (AADE) are presented. RESULTS: Demand for diabetes educators is projected to increase. The employer base will broaden beyond traditional outpatient venues and extend into industry, retail pharmacy clinics, and community-based organizations. Increasing roles in management, quality assurance, and technology interface design are possible for diabetes educators. Challenges limiting diabetes education such as poor understanding of what diabetes educators do and underutilization of diabetes education continue to need redress. CONCLUSIONS: Increasing utilization of diabetes education and insight about health care trends can allow diabetes educators to thrive in the workplace of the future. Diabetes educators are urged to promote the evidence concerning the benefits of diabetes education, to work to increase physician referrals, and to acquire needed competencies for the workplace of the future.


Asunto(s)
Diabetes Mellitus , Práctica Clínica Basada en la Evidencia/organización & administración , Educación en Salud/organización & administración , Educación del Paciente como Asunto/organización & administración , Garantía de la Calidad de Atención de Salud , Autocuidado , Análisis Costo-Beneficio , Industria Farmacéutica , Práctica Clínica Basada en la Evidencia/estadística & datos numéricos , Práctica Clínica Basada en la Evidencia/tendencias , Educación en Salud/estadística & datos numéricos , Educación en Salud/tendencias , Necesidades y Demandas de Servicios de Salud , Humanos , Educación del Paciente como Asunto/estadística & datos numéricos , Educación del Paciente como Asunto/tendencias , Satisfacción del Paciente , Farmacias , Guías de Práctica Clínica como Asunto , Sociedades Científicas , Lugar de Trabajo
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