The Balancing Person: an innovative approach to person-centred education in chronic illness

Abstract

Rationale, aims and objective: Most patient education is based on a professional understanding of patients’ needs for learning, rather than a patient perspective. This generates a risk of neglecting issues that are important to patients, but unrecognised by educators. The aim of this study was to develop a health educational model for group-based patient education in chronic illness based on patient-perceived challenges.Methods: Design Thinking was used as a method of inquiry. Four interactive workshops with 25 Danish patients with Type 2 diabetes, heart disease and chronic obstructive pulmonary disease provided data on patient-perceived challenges. Workshops with 28 educators informed the development of the model. A constant comparative method was used for analyses.Results: Patients with chronic illness experience a constant need to balance their lives, which imposes new challenges in their everyday life. We identified 4 main challenges: Bodily Infirmities, Lowered Expectations, Challenging Relations and Changeable Moods. In response to these challenges, researchers and educators developed The Balancing Person, a health educational model with 4 interconnected meta-needs for the education process: Wholeness, Clarity, Timeliness and Connectedness.

Patients’ perception of disease and experience with type 2 diabetes patient education in Denmark

“…Study participants remarked that they felt like they were back in school after many years, which was not always positive. This model of instruction is most often ineffective at encouraging, enabling and supporting patients to take responsibility for control and management of their condition . Nevertheless, some participants did learn to take responsibility and improve their self‐management skills.…”

A dialogue-based approach to patient education

“…The exercises in the toolkit are based on two theoretical health education models, “The Balancing Person” and “The Health Education Juggler.”[ 5 6 ] The Balancing Person describes how patients experience life with a chronic condition. The development of the model was guided by interviews and workshops with patients about the experience and challenges of living with a chronic disease.…”

“…Four main challenges were identified for patients with chronic illness: Bodily infirmities related to physical changes, lowered bar related to practical limitations imposed by living with chronic illness, challenging relations related to social changes arising from the limitations of chronic illness, and changeable moods related to emotional changes. [ 4 5 ] These challenges were then translated into four related meta-needs that are important to address in the education process: Wholeness, clarity, timeliness, and connectedness. [ 5 ] The first meta-need, wholeness, describes the need for patient education to ensure a link to the patient's whole life, e.g.…”

“…[ 4 5 ] These challenges were then translated into four related meta-needs that are important to address in the education process: Wholeness, clarity, timeliness, and connectedness. [ 5 ] The first meta-need, wholeness, describes the need for patient education to ensure a link to the patient's whole life, e.g. the patient is seen as a whole person and not just a person with a disease.…”

Patient Perspectives of Sharing Experiences in Group-Based Diabetes Education: A Second-Order Analysis

“…Aging populations and changes in lifestyle have led to an increasing prevalence of diabetes. Patient education has been identified as an important method for improving health in people with diabetes through enhancement of disease self-management skills (Hansen et al, 2014). There is ongoing academic discussion about effective methods for diabetes education.…”