Beliefs of Australian Diabetes Educators in the Care of People with Diabetes and Intellectual Disability Beliefs of Australian Diabetes Educators in the Care of People with Diabetes and Intellectual Disability J.Lehmann 1. V.Stevenson 2. R.Lehmann EdHealth Australia, Highgate, South Australia, Australia. 2. Austin Health, Diabetes Education Services, Heidelberg, Victoria, Australia. 3. Department of Genetics, University of Adelaide, South Australia, Australia. Introduction Discussion Results Method This study captured a snapshot of self reported confidence and beliefs of Australian DEs in the care and education of PWDID. In the preceding 2 years, 85% of DEs had provided services to PWDID, however their statistically significant drop in confidence in educating PWDID, in contrast to people without ID was concerning. Of note, 77% of DEs experienced dilemmas or issues in providing this care. The majority of DEs (66%) had a poor-fair understanding of the disability care system which is likely to have contributed to their lack of confidence in educating PWDID. However, the beliefs held by DEs regarding their understanding of working with PWDID was not as consistent (Figure 3) with 38% strongly disagreed – disagreed with the statement and requires further investigation. It is likely that the knowledge and skills developed by DEs can be further enhanced to improve confidence levels in educating PWDID. The majority of DEs (72%) felt insulin commencement was delayed in PWDID and the issues with paid carers in administering insulin was a contributor. (57%) It is likely their response was reflective of the replacement of nurses with less qualified paid support workers in the Australian disability care workforce over the past 10 years. The majority of DEs believed paid carers can safely administer insulin(81%), glucagon (86%) and manage hypoglycaemia(92%) with the development of processes to do these safely (Figure 9). A number of questions recorded a high number of ‘unsure’ responses (Figures 4,5,8). It is likely this is reflective of the lack of knowledge and experience of the DEs in the care and education of PWDID in Australia. This was also reflected in their lower confidence levels. Further research is required to understand how DEs can be better supported in their diabetes care and education of PWDID and their paid carers. Given their poorer health outcomes attention is also required to the development of low literacy education and support strategies and support material. References: 1.Australian Institute of Health and Welfare 2010 Health of Australians with Disability: Health Status and Risk Factors Bulletin no. 83. Het N Conclusion DEs reported statistically poorer confidence levels in the care and education of PWDID. This, together with their poor understanding of the disability care system, identified possible contributors to the poorer health outcomes experienced by PWDID. DEs believed a process to safely administer insulin and manage hypoglycaemia can be designed to prevent insulin delay in PWDID. The development of an education and skills evaluation process is required for DEs and paid carers to support improved health outcomes in PWDID. These study results are likely to be similar in other countries. People with an intellectual disability (ID) comprise 2-3% of the general population. An Australian Institute of Health and Welfare report (2010) identified people with severe or profound disability were more likely to have diabetes or an elevated glucose level before the age of 25 compared to the general population (23% vs. 7%) 1. People with diabetes and intellectual disability (PWDID) experience poorer health outcomes than those without disability. 1 The contributing factors to these poorer outcomes need to be identified to create evidence based approaches to improve health of PWDID. A questionnaire consisting of yes/no, tick-a-box, Likert scales and free writing options were administered to DEs at a national diabetes and disability workshop in Quantitative and qualitative data was collected on the experience of DE participants with PWDID and their beliefs about the role of paid carers in insulin therapy. 66% identified they had a poor to fair understanding of the disability care system in their state (Figure 2) However, only 38% strongly disagreed to disagreed with the statement: “I have little understanding of working with PWDID which makes it difficult for me to help PWDID”. (Figure 3) Aim To explore self reported confidence and beliefs of Australian diabetes educators (DEs) in the care of PWDID. 53 respondents (100% response rate) DEs represented all Australian states 32 (60%) Credentialled DEs. Mean experience yrs (range 0-32yrs) DE professional background: Nurse – 92%, Dietitian - 2% Pharmacist - 2% Unknown professional background - 4% 85% DEs provided services to PWDID in past 2 years 77% faced dilemmas or issues providing this care. Insulin Therapy in PWDID 72% of DEs believed insulin therapy is delayed in PWDID (Figure 4) 57% believed issues related to using paid carer’s to administer insulin contributed to this delay but an additional 37% were unsure (Figures 5). Figure 4. Do you believe insulin therapy is delayed in PWDID? (n = 50) Figure 5. Do you believe insulin therapy is delayed in PWDID due to the issues related to using paid carers to administer insulin? (n = 51) Figure 1. I feel very confident to address the diabetes care and education needs of people... Likert scale: 1=strongly disagree, 2=disagree, 3=unsure, 4=agree, 5=strongly agree. Results are expressed as the mean ± SEM for each group (n = 47-50). **** = p< in Student’s t-test Figure 3. I have little understanding of working with PWDID which makes it difficult for me to help PWDID. (n = 50) Figure 2: Participants’ current understanding of the disability care system. (n = 50) Diabetes Care and Education of PWDID by DEs Role of Paid Carers in Diabetes Care of PWDID Figure 6. Do you believe paid carers should be able to assist PWDID to administer their insulin? (n = 50) Figure 8. Do you believe paid carers should be able to administer insulin to PWDID? (n = 51) Figure 7. Do you believe paid carers should be able to administer glucagon to PWDID? (n = 50) The level of DE confidence in the education of PWDID was significantly lower than that of people without intellectual disability (Figure 1). Demographics Figure 9. Do you believe a process can be designed for paid carers to... (n = 51) **** 86% of DEs believed paid carers should be able to assist people to administer insulin (Figure 6) and administer glucagon (Figure 7). 61% believed paid carers should be able to administer insulin, with 24% unsure.