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2013-ISDEM and 2nd APCDE >> 专家访谈 >> 新型的糖尿病管理技术与方法

新型的糖尿病管理技术与方法

时间:2013-10-12| 来源:糖化教育网| 作者:Prof. Odenburg| 浏览量:3096

    A1CEDU:Psychological analysis and support plays an important role in diabetes care; however, in real life practice this can be difficult to apply. As a renowned psychologist can you please outline what are some of the more popular methods of psychological support and what are your experiences of their role, in diabetes care, education and management?
    Prof Odenburg:In recent years we have done a lot to help people with psychological problems. Indeed, we have developed a range of psychological intervention and treatment approaches, and these can be successfully implemented with people. Commonly, these approaches can be called cognitive behavioral therapies; this involves understanding how people think about a particular problem or issue, which are making them depressed and anxious. From this we can suggest ways to modify their thinking and behavior to address these issues; however, for those people where this kind of brief therapy does not work, then they will need some sort of drug medication as well.
    糖化教育网:心理支持在糖尿病管理中扮演了重要角色,作为心理学家,能否请您谈谈,如何将心理学理念和方法用于糖尿病教育和管理中?能否请您介绍一下当今糖尿病教育管理中在心理支持方面还有哪些尝试?
    Prof Odenburg:近年来,我们针对患者的心理问题做了大量的工作,发展出一系列成功的心理干预、治疗的方法,即认知-行为疗法。这涉及到如何理解患者为何会对某个特定问题产生沮丧、抑郁和焦虑的情绪;据此我们建议患者调整他们的想法和行为来处理这些问题。当然,有时候认知-行为疗法不足以解决问题,这时还是需要药物治疗。
    A1CEDU:Currently, we are all searching for innovative technological approaches for the management and treatment of diabetes; indeed,one of these is the so-called “TLC Program” can you please introduce its roles and functions in these respects?
    Prof Odenburg: The TLC Diabetes Program, stands for“Telephone Linked Care”. Essentially the program aims to provide assistance and support for people with diabetes over the telephone. What is unusual about this program is that the patient or caller will be talking to a very smart computer with pre-recorded conversations and recommendations directed at different areas of diabetes management and care. For example, if somebody rings up the program, the computer will ask them: how are they coping with their diabetes at the moment and whether or not they have any difficulties. If for example, the patient says they have problems raising the levels of physical activity, in order to gain a clearer understanding of the patient profile the program will then ask how much physical activity the patient is already doing in a typical day. From this the patient will talk to the program about all the different kinds of physical activity they do, be it walking, brisk walking or any other forms of exercise. After this conversation, the program can then devise ways as to how the patient can increase the levels of physical activity and also set goals for how much of this they should do over a set period of 1-4 weeks. When that patient calls the program again after the set period, the program will recognize the voice and will ask about the progress set from the last conversation. If the patient was unable to meet the set target, the program will then try to understand why this was the case by asking the relevant questions and devise further strategies for the patient to follow, so that these targets can be meet in the next set period.
    糖化教育网:如您所说,学界一直在寻求新的糖尿病管理技术,TLC项目即是其中之一。您为为我们介绍TLC系统的功能吗?
   
Prof Odenburg:TLC系统的全称是“电话连接护理”(Telephone Linked Care),目的是通过电话为糖尿病患者提供帮助和支持。TLC系统的特别之处在于,通过呼叫,患者能够直接与一台预先存储了大量糖尿病管理知识、推荐与解决方案的智能电脑对话。例如,当患者提出“如何提高身体活动”的问题,系统会询问患者“目前每天的身体活动强度”等信息以更好地了解患者的基本情况;然后患者可以询问不同种类的运动方式等,最终系统会给出1~4周内的运动建议和目标。每一次方案设定后,当患者再次呼叫系统时,系统能通过语音辨别,询问方案的进展情况;如果患者不能很好的执行方案或者达不到预定目标,系统会通过询问相关问题调整方案,以保证在下一次通话时患者能达到目标。     
    A1CEDU:In your experience, on average how often do patients use this TLC Program?
    Prof Odenburg: The trials that we have been undertaking regarding this program in Australia; typically patients call once a week over a 6 month period. Each time they call their discussions can range from 10-12 minutes in duration regarding some aspects of diabetes care or management.
    糖化教育网:根据您的经验,患者平均多长时间会呼叫一次TLC系统? 
    Prof Odenburg:根据在澳大利亚做过TLC系统的应用调查,通常患者持续6个月内每周呼叫一次TLC系统,每次会与系统对话10-12分钟,讨论糖尿病管理中的问题。
    A1CEDU: Telephone support and feedback appears to be a rather recent cost effective development in diabetes care and management. Can you offer your comments on the past and more recent developmentsin this area?
    Prof Odenburg: I think this question raises the issue that we are really struggling to cope with the sheer number of people suffering with diabetes and there are just not enough healthcare professionals available to see all of these patients face to face.  Consequently, I believe with more new innovative approaches such as TLC, it is possible to provide some of the care, assistance and support over the telephone either by real time with a real person or with a pre-recorded computer program.
    糖化教育网:电话支持真正作为管理手段还是近些年的事情,包括用于解决问题、设定目标、激励患者、对饮食和活动的指导帮助等,因为被认为是具有经济性效益的干预手段。您如何看待电话支持在糖尿病教育管理中的现状与未来?
    Prof Odenburg:我认为这个问题引出了另一个我们真正需要面对的问题:我们真的难以应付海量的受糖尿病之苦的患者,缺少足够的医疗人员来面对面地教育和管理糖尿病患者。不过,我相信在未来,随着更多新型的技术和方法出现,如TLC系统,能够通过预先设置的智能电话协助和支持糖尿病的管理。

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