Supporting positive self-care between clinic visits using Inspirational Postcards

Summary

It was felt that writing a ‘note to self’ on a postcard could help motivate the young adult diabetes clinic population (15-23-year-olds) to look after their own diabetes. The postcards used initially were replaced by more appropriate and cheaper cards designed by the Diabetes Specialist Nurse. The postcards were assessed for suitability in different settings. A questionnaire for service users and healthcare professionals found the postcards were well-liked by young people with diabetes: 83% would ‘recommend’ or ‘highly recommend’ using them and 87% felt more engaged with their diabetes team between clinic visits; 74% felt more motivated to manage their own diabetes.

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Method

Initially, the DSN bought a box of 100 ‘off the shelf’ Ladybird book cover postcards to test with the young people. However, they thought the postcard selection was dated and more for a generation who remembered the original books. Next, she designed some Inspirational Postcards using free pictures from the internet. She also contacted a local design and print company for ideas. In total, 20 designs were shown to service users. The 10 most popular were selected and 100 of each design were printed. Permission was given to use an audit design tool from another department in the Trust, which was changed to suit this project. It was agreed not to focus on the clinical measures of HbA1c and blood glucose control, as the scheme was trying to help young people to help themselves between clinic visits. They chose what to write on their postcards, so sometimes the things written had no direct link with their diabetes. The audit questionnaire was reviewed by service users and work colleagues in Poole only. In the pilot audit, questionnaires were posted to individuals with a self-addressed envelope to post them back, each with a brief note explaining why they were being asked to assess the Ladybird postcards. A total of 10 audit tools were sent out and three were returned. The audit tool was not changed for the inspirational postcards. The tool needed to be quick to complete and to fit on an A5-size piece of paper. A total of five questions would be used, as service users felt any more would be too long. Following this review, two audit tools were created, based on the same design, but with slightly different questions. One was for people with diabetes and the other was for healthcare professionals (HCPs) to complete. Instructions were posted or emailed so the HCP knew the timeline for the audit and how the postcards had been used in Poole. The idea was for those people with diabetes, who wanted to join in with the idea, to choose a postcard, write something positive about themselves, then a ‘note to self’, and then finish off with another positive comment. Following this, everyone was asked to choose a smiley face sticker and place it on their card instead of a stamp. The young person and the HCP both signed the card. It was kept by the diabetes team for two weeks and then posted to them via hospital postal services, in an envelope to maintain confidentiality. Posting this way maximised space for the young person to write their note and ensured that they were accepted through hospital posting procedures. An audit form was sent with the postcards and a quick reminder note to please complete the audit tool and post it back in the stamped, self-addressed envelope to their diabetes nurse. The audit forms were assessed from three different centres.

Results

The inspirational postcards were used by 120 people with diabetes and 62 returned their survey form. Of these 62, 52 (83%) said they would recommend or highly recommend using the postcards; 54 (87%) felt more engaged with their diabetes team and 53 (87%) were satisfied or very satisfied to receive their postcard; 46 (74%) felt more motivated to engage with their own diabetes. A total of 43 people (69%) reported that they were satisfied or very satisfied with the postcard selection. The HCP audit generated nine replies from three sites. All nine (100%) said they would recommend or highly recommend the idea of Inspirational Postcards for use with their patients with diabetes; eight (89%) said they agreed or strongly agreed that the postcard scheme allowed them to feel more engaged with their patients after they left clinic; eight (89%) felt positive or very positive about using the postcard support scheme in the future; seven (78%) felt sure or very sure the Inspirational Postcards could remind a person with diabetes to stay motivated with their diabetes and eight (89%) would recommend or highly recommend the postcard scheme to other HCPs.

Sustainability and Spread

The original idea and postcards were offered to other Tomorrow’s Leader participants and Wessex Change Lab to see if they worked in their own areas. These were programmes that the Poole YPDS team was working with at the same time. They were also shared with adult and paediatric colleagues in other organisations in Dorset that were working together on a county-wide Diabetes Transition project. The DSN gave postcards to local specialist nurses in the Trust to use with their own patient cohorts. She also met with the Innovation Team to see if the original postcards could be used locally and funded by either the Poole Hospital Charity or a local business by engaging with the local Chambers of Commerce. This work was hampered by COVID-19, but discussions are ongoing. The project has stretched beyond Dorset; the medical director of a major insulin production company agreed to use the idea for diabetes teams across the UK as the audit results were so positive and the idea is simple and effective. Discussions are also underway regarding adding the Inspirational Postcard designs to the DigiBete website and a local paediatric epilepsy nurse wants to share the idea with the Roald Dahl Charity. The YPDS DSN has also been invited to speak at the virtual Abracadabra Nursing Conference in 2020.

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QiC Diabetes Finalist 2020
Type 1 Specialist Service
Supporting Positive Self-care Between Clinic Visits Using Inspirational Postcards
by Poole Diabetes Centre, Poole Hospital NHS Foundation Trust


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  • 2021 KEY DATES
  • Open for entry:
    Tuesday 20 April 2021
  • Extended Entry Deadline:
    Monday 12 July 2021
  • Judging day:
    Tuesday 7 September 2021
  • Awards ceremony:
    Thursday 14 October 2021