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Tuesday, 22 May 2012 09:37

Diabetes Self-Care isn't working. Maybe it's time to try a different approach.

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In the movie Dead Poets Society, the teacher makes students stand on desks in order to change their perspectives.  I've used this tactic myself when a group seems 'stuck', and I have to say it works beautifully: It's amazing how doing something a little differently can lead to a positive change.

dead poets society standing on desks to make change

Maybe we need to do more of this with some of the societal problems whose solutions seem to elude us. Take Diabetes Self-Care, for example.

Diabetes is one of the biggest healthcare challenges facing the US at the moment, with more than 8% of Americans diagnosed with  Type 1 or Type 2 diabetes.  In the 65+ age group, that number rises to 27%.  Worldwide, the WHO predicts diabetes to afflict as much as 10% of the population by 2025.  The result is enormous pressure on healthcare resources - and budgets.  In the UK, diabetes-related care already accounts for 10% of the total NHS budget.

Overall health - and quality of life - for people living with diabetes can be improved dramatically with efficient self-care, but as many as 75% of people with diabetes don't stick to the self-care plan provided by their doctors.  They don't exercise enough; they don't adhere to a low-glycemic diet; they don't take insulin when they should.

Hundreds of studies have been done in an effort to understand this non-compliance.  Some conclude that individuals' 'health beliefs' or lack of 'societal supports' are the problem.  Others suggest that it's a lack of numeracy or literacy that's getting in the way.  Still others find that the problem is that healthcare providers simply don't have the time to sufficiently educate patients.  No doubt these researchers are on to something. But in the meantime, maybe we need to stand on a few desks.

Maybe we need to stop spending so much time studying psychosocial behaviors and societal beliefs and external barriers to compliant self-care.  Maybe we need to look at a person's instincts and how that affects the way they approach their life in general, and their diabetes in particular.

Leveraging striving instincts to generate more effective results

At a recent conference, Kathy Kolbe - who has been studying conation (striving instincts) for more than 30 years - revealed that when a person strives in harmony with their instincts, their brain clearly shows minimal engagement with maximum results.  And the opposite is also true: When working against instincts, the brain is highly engaged but produces minimal results. Kolbe calls these striving instincts Action Modes®.  She considers these Action Modes to be 'talents'.

The Four Kolbe Action Modes are:

Fact Finder - how we gather and share information

Follow Thru - how we arrange and design

Quick Start - how we deal with risk and uncertainty

Implementor - how we handle space and tangible solutions

Each Action Mode has three operating zones: Prevent, Respond or Initiate.  We may initiate in Quick Start, respond in Follow Thru and Implementor and prevent in Fact Finder.  According to Kolbe, any possible combination creates a unique way in which we initiate actions, respond to opportunities or prevent problems.  The combination of the modes and zones makes up a person's MO (modus operandi).

How can we apply this to Diabetes Self-Care?

Imagine you've just been diagnosed with Type 2 diabetes and your doctor/healthcare team provides you with an approach which has been customized for your striving instincts.  Suddenly your self-care plan will require less energy while yielding better results.

Now we're standing on a desk!   Instead of the doctor wondering how to get you to comply with the required protocol, they approach you ready to engage your unique talents to effectively manage your own Diabetes Self-Care.

Using the Kolbe approach, your doctor knows your MO because, in addition to your blood tests, s/he also had you complete the Kolbe A instrument during your first office visit.  Now the whole staff - the doctor, the nurse practitioner or PA, the nutritionist, maybe the social worker - all know your talents and how you approach the world, and can tailor your self-care education process accordingly.  And now, managing your life with diabetes doesn't seem as difficult - because they're engaging you at your striving instinct level.

This is just my theory.  But maybe, instead of studying the same things over and over again hoping that we'll suddenly find the answer all the previous researchers have missed, we need to study this:  How can we make better use of our knowledge of how people interact with their world, via the Kolbe instrument, to make a huge difference in Diabetes Self-Care - and thereby prolong and save lives?



Read 6866 times Last modified on Thursday, 24 May 2012 03:41

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