Group Care. Programma per persone con diabete tipo 2. Laboratorio di Pedagogia Clinica. Dipartimento di Scienze Mediche. Università di Torino.

These teaching modules for group treatment are the result of investigations which date-back to January 1996 when we started to investigate whether it was possible to substitute the traditional one-to-one doctor-patient approach with group sessions for non-insulin dependent and non-insulin treated diabetic patients in order to improve metabolic control and favour the acquisition of new health behaviours. The randomised clinical trial involved 112 patients subdivided between cases and controls. The first group was divided into 6 groups of 9/10 persons whereas the second group continued with traditional one-to-one consultations. Group sessions took place every three months. At each session, all patients were tested for metabolic control (weight, blood glucose, glycated haemoglobin, glycosuria) and once a year underwent screening for complications. Procedures, methodology and on-going group education treatment are described below. In the section “General Overview of Procedures”, the structure which characterizes each session is outlined together with its various phases and methodological teaching considerations. It is hoped that this will allow for flexibility, clarity and, above all, simplicity. This section describes: formation of groups and room set-up, observers’ role, rules and norms assumed by the group, facilitator’s role and duties, patients’ role and duties, time-frame and methods – presentation, time-frame and methods - helping to make changes, patient participation. A description of each session and subjects covered will be found in the second section, “Session Programme”. The “referencing behaviours” or “health conducts” which are the objective of each session are explained at the start of each session. There is both on-going checking for the acquisition of new health conducts and a final patient questionnaire on “referencing behaviours” Methodology and procedures are more detailed in this section: individual session subject, presentation for explanation of different goals, materials used, methods for communications with patients, materials for the patients. The programme, methods, procedures and materials have been developed, evaluated and modified over the course of several years of group sessions comparing the results with patients’ glyco-metabolic data and feedback through questionnaires which test understanding, health conducts (“Condotte di Riferimento”) and quality of life. Some observations, opinions and comments by the patients themselves form the final part of this manual. It’s only fair that they get a chance to have their say after the experience of these past few years.