The Chronic Disease Prevention Alliance of Canada (CDPAC) identifies that the cost of chronic disease in Canada arises from 4 key risk factors: excess weight, physical inactivity, smoking and alcohol use.
Your patient has type 2 diabetes and would like to work on their physical activity level and their excess weight.
1. Please describe 2 strategies that you would use to identify their priorities for their health.
2. How would you support their participation in a program(s) to address these risk factors?
3. How would you promote a patient’s self-management of their chronic disease?
1. Strategy 1: I would ask the patient to describe to me how their condition makes them feel physically and what they think they should do to improve their health. Based on what they answer, I could then prioritize with the patient what they should address first.
Strategy 2: Knowing that the patient would like to work on their physical activity level and their excess weight, I would ask them what they are ready to do to address these, rather than what they think they should do (what they think they should do and what they are ready to do may differ).
2. I would support a patient's participation in a program to address these risk factors by providing the patient information on the program in question beforehand, and ensure they feel it's something they think they can do. I would then follow-up with the patient within a day or two of the first session or appointment to show support to the patient and to see if they enjoyed it and if they thought it was of value to them.
3. I would promote a patient's self-management of their chronic disease by giving them information on their condition and how to manage it. I believe some patients may feel empowered with more knowledge about their condition. I also believe patients should keep track of their journey by using a log/journal/blog, where they can write down the small victories and also the obstacles faced. I think it's important to keep track of progress.
1. (Strategy 1) Identify what are the patient’s current conditions – what they are, whether or not they are being treated/kept under control, whether or not there are next steps to take towards them.
(Strategy 2) Make a list of priorities in terms of the health-related conditions that require action and list out ways that these could be addressed (relating to things/activities the patient might actually enjoy).
2. Support for the patient’s participation in given programs could be done through having follow-up/check-in meeting to ensure that the patient is enjoying and benefiting from them, as well as potentially offering that the patient keep a log/journal of his/her experience to make the most of it and keep track of his/her learnings and progress. This way, the patient could have the “challenges” (i.e. risk factors) listed out, which would keep him/her aware of them but also motivated to overcome these. Should the need be, a change of plan (i.e. Plan B) would be more easily feasible at any time to keep the process going.
3. Similar to the support in participation, I would recommend that the patient keep track, in whatever creative way they might see fit (i.e. blog, making videos/chats, journaling, etc.) in order for them to keep track of their progress and also be able to manage and monitor their condition.