In Control: Living a Healthy Life With Diabetes [book on CD-ROM], by Cynthia Degazon. New York: Hunter-Bellevue School of Nursing; (nd). Price not provided. DVD is not copyrighted.
The 20-minute-DVD program presents vignettes about typical daily challenges of people with diabetes through interviews with individuals diagnosed with diabetes and their selected family members. On the cover of the DVD, the purpose statement given is, "It is hoped that information shared on this DVD will motivate persons diagnosed with diabetes and caregivers to engage in healthier lifestyle choices." The program could be shown to people with diabetes, to their family members and friends, as well as to healthcare professionals who are learning to help patients with diabetes. The program was developed by Cynthia Degazon, a nurse researcher from the Hunter-Bellevue School of Nursing in New York, in conjunction with the Health Professions Education Center of Hunter.
Program content is well organized and includes a brief introduction along with 8 segments focusing on the following topics: (1) initial diagnosis, (2) adjusting to your diet, (3) exercise, (4) social temptations, (5) cheating, (6) long-term effects, (7) caregivers' concerns, and (8) staying the course. Segments range in duration from 1:02 minutes to 3.17 minutes. The setup of the DVD allows one to select specific topics from the outline or to view all video segments in sequence. The topics are briefly introduced on the screen by a label for each segment, and in some cases, introductory comments are added by Dr Degazon. The program is technically well done, with excellent video quality, music, and written labels that are clear and not distracting. The emphasis of the background information and the interviews is on members of minority communities with high rates of diabetes (ie, African American, Latino, and American Indian populations), thus vignettes feature African American and Latino families. Additional sources for information about diabetes are provided in the credits at the end of the program.
The vignettes of the individuals with diabetes and their family members are interesting and authentic and thus compelling. The topics reflect the realities of trying to live with diabetes on a daily basis and typical struggles to make good decisions to manage the disease while balancing ones' quality of life. The short length of the program (20 minutes) means that topics are only touched upon briefly and incompletely-however, this brevity also means that short vignettes on each topic can be used to enhance discussion because "not everything has been said."
The introductory statement at the beginning of the program says that the vignettes are part of a research project by the developers. Although this statement may be necessary from an "academic honesty" perspective, it is somewhat confusing and distracting to potential patients and families who might wonder, "Why are you showing me something about research?" It would be better to put this "disclaimer" at the end with the credits so as to keep the focus on helping people with diabetes.
The purpose that the authors give of "motivating persons diagnosed with diabetes to engage in healthier lifestyle choices" seems ambitious for this brief program, however laudable. A more realistic purpose might be to help people with diabetes to explore the challenges and begin to problem solve with the help of healthcare professionals. A particular area of weakness is the tendency to present each problem area with relatively little emphasis on solutions, although the overall tone is positive. One example of the latter is the introduction to the segment on "Long-Term Effects," in which the narrator makes a statement that diabetes increases ones' risks for cardiovascular disease, kidney disease, amputations (etc), but the narrator does not add the crucial point that keeping one's blood sugar level under control will decrease these risks and promote a longer, healthier life. This point is made briefly in a later segment but needs to be emphasized throughout to increase the understanding that daily choices matter in big ways. A major strength of the program is its display of a great deal of valuable information in a brief, well-designed video segment-one example being a segment of a man with diabetes who likes to cook and who demonstrates cooking a meal while also talking about how he now uses olive oil sparingly instead of large quantities of butter he used previously. The emotional elements of living with diabetes are well displayed in segments that focus on topics such as social temptations and caregivers' concerns.
The topics and presentation of this program about living with diabetes are timely and relevant to patients and care providers. The program presented in the DVD format provides useful materials for healthcare professionals, who are interested in learning from patients about the challenges of living with diabetes. Educators could use this program to stimulate discussion with healthcare professionals and students. Similarly, the vignettes lend themselves to stimulating discussion and problem solving among patients and family members in either group or individual patient sessions. The developers are generous in offering the program on a DVD without copyright to encourage widespread use.
-Sharon Williams Utz, PhD, RN
Associate Professor, University of Virginia, School of Nursing, Charlottesville, VA