Search

In 2022, the American Diabetes Association and the European Association for the Study of Diabetes emphasized that type 2 diabetes care is a person-centered holistic care concept. This article summarizes the concepts of holistic care for individuals with type 2 diabetes and proposes a complete model of the six-layer whole-person care circle for individuals with type 2 diabetes. This model treats individuals with type 2 diabetes as the core of care and adopts their specific needs, preferences, and values to design individualized care plans. The overall goal of care is to maintain quality of life and to avoid or delay complications. Management methods must be holistic. Based on people and comprehensive considerations, six circles of care are listed. The first layer is caregivers, taking into account the influence of the family and the community on the individual. The second layer is multiprofessional and multi-disciplinary team care, which provides support to individuals with diabetes. The third layer emphasizes the need for the following thirteen principles in diabetes care: monitoring and screening for complications, behavior modification for healthy habits, monitoring and continuous assessment, reducing the risk of hypoglycemia, effective implementation and care organization, considering underlying physiological conditions, avoiding therapeutic inertia, considering social determinants of health, psychological factors, structured diabetes education, language proficiency, shared decision-making, and considering regional healthcare institutions and related resources. The fourth layer is the decision cycle of care, which applies the principles of care and conducts continuous and dynamic case management based on the decision cycle. The fifth layer is the healthcare network through which health providers provide hospital, long-term care, and primary clinics/ primary network care referrals based on the needs of individual with diabetes. The sixth layer leverages the chronic care model to construct a supportive healthcare system comprising organizational support, clinical information systems, delivery system design, decision support, self-management support, and community resources. This proposed model may provide a reference for constructing healthcare systems to care for patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

In 2022, the American Diabetes Association and the European Association for the Study of Diabetes emphasized that type 2 diabetes care is a person-centered holistic care concept. This article summarizes the concepts of holistic care for individuals with type 2 diabetes and proposes a complete model of the six-layer whole-person care circle for individuals with type 2 diabetes. This model treats individuals with type 2 diabetes as the core of care and adopts their specific needs, preferences, and values to design individualized care plans. The overall goal of care is to maintain quality of life and to avoid or delay complications. Management methods must be holistic. Based on people and comprehensive considerations, six circles of care are listed. The first layer is caregivers, taking into account the influence of the family and the community on the individual. The second layer is multi-professional and multi-disciplinary team care, which provides support to individuals with diabetes. The third layer emphasizes the need for the following thirteen principles in diabetes care: monitoring and screening for complications, behavior modification for healthy habits, monitoring and continuous assessment, reducing the risk of hypoglycemia, effective implementation and care organization, considering underlying physiological conditions, avoiding therapeutic inertia, considering social determinants of health, psychological factors, structured diabetes education, language proficiency, shared decision-making, and considering regional healthcare institutions and related resources. The fourth layer is the decision cycle of care, which applies the principles of care and conducts continuous and dynamic case management based on the decision cycle. The fifth layer is the healthcare network through which health providers provide hospital, long-term care, and primary clinics/ primary network care referrals based on the needs of individual with diabetes. The sixth layer leverages the chronic care model to construct a supportive healthcare system comprising organizational support, clinical information systems, delivery system design, decision support, self-management support, and community resources. This proposed model may provide a reference for constructing healthcare systems to care for patients with type 2 diabetes.

Copyright of Macau Journal of Nursing is the property of Macau Journal of Nursing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The study aimed to explore preceptors' and student nurses' learning experiences on the concept of patient-centered nursing by using the holistic care model developed by Hiroko Usui. Data were collected from student nurses' homework, including whole-person image and three-dimensional image. The researchers, as preceptors, scrutinized the extent of student nurses' progress on biopsychosocial perspective and the preceptors' instruction by comparing each student nurse's homework from the first to the last drafts. Among 18 sets of homework, four were chosen and presented. The findings showed that the student nurses, in the process of completing the whole-person image and three-dimensional image, could quickly figure out patient's need of care by virtue of bio-psycho-social viewpoint, and complete related nursing care. In addition, the images served as useful communication platforms among preceptors, student nurses, and other team members. The findings were significantly different from those appraised through NANDA or Gordon 11 functional assessment. The zone of proximal development (ZPD) of scaffolding conceived by Vygotsky was used to highlight the interaction between the preceptors and the student nurses. The Hiroko Usui holistic care model can help student nurses learn patient-centered care. The study provides a useful case for coaching a nurse or student nurse to acquire the concept of "patient-centered". [ABSTRACT FROM AUTHOR]