**3. Provision of diabetes healthcare services to outpatients**

Diabetes outpatients receive treatment at Primary Health Care (PHC) facilities, which is nurse driven. The South African Department of Health, in an attempt to manage chronic diseases including DM introduced Chronic Disease Outreach Program (CDOP) to follow-up on patients, particularly those with NCDs [11]. In line with CDOP, health professionals such as general practitioners, dietitians, physiotherapists and psychologists regularly visit PHC facilities to see patients requiring their services. Diabetes patients are required to consult these healthcare professionals 2–3 a years. The introduction of the outpatient's services in SA helped in reducing management costs which are imposed by mere presence of diabetes, and more costly in the presence of complications. The outpatient services also helped in improving family involvement in the care of loved ones.

### **4. Assembling diabetes team for the care of outpatients**

The diabetes team for the treatment and care of outpatients at PHC facilities with recognition of the outreach programs by other healthcare professionals who may not be full time at the PHC facilities, and are as follows:

#### **5. Family-centered diabetes care**

The FCC is defined as "provision of healthcare in partnership or in recognition that the family has a role to play in the treatment of persons living with chronic

**261**

mation [18].

recipients [17].

*Family-Centered Diabetes Care for Better Glycemic Outcomes of Outpatients in Rural Areas*

diseases and specifically diabetes" [12]. The FCC is an approach of responding to the needs, values and cultural needs of the patient and FMs [13]. The FCC begins from consultation at the healthcare facility involving healthcare professional, patients and family members, being involved in decision making and shared leadership [14]. Family Members are often asked to share responsibility in support of person living with diabetes, and such activities includes driving patients to appointments, and social and emotional support among others. The FCC in diabetes care has so far produced better outcomes in younger children who are usually cared for by their parents or families, since younger children are unable to perform certain tasks related to self-care [7]. However, the FCC have so far failed to utilize same family support for better care of older people who are mostly affected

The aim of the FCC is to maintain and strengthen family bond and roles so as to provide healthy family functioning, and at the same time improving the Quality of Life (QoL) of patients, as well as minimizing new cases involving family members who are already at risk due to family history. Despite the benefits of adequate diabetes knowledge, it is worrisome that international knowledge and awareness of diabetes stays low [15]. In SA, diabetes knowledge among T2DM patients in most affected areas is reportedly inadequate [16]. It is essential for healthcare providers to assess knowledge of patients and family members so as to design appropriate diabetes intervention and educate properly. Therefore, the FCC seeks to close the knowledge gap through family-patient consulting healthcare provider together.

The FCC principles are frequently aligned with a vision of effective health care

practitioners, patients and family members all must share information for better care of patients. See **Table 1** on responsibilities of diabetes team. The process of sharing information should be open, objective and without bias [17]. Patients and family members timely are empowered with complete and

• **Respect and Dignity:** Healthcare professionals need to understand that patients are vulnerable and do their best to maintain patients' dignity [19]. After healthcare professionals have discussed medical options with patients and family, they should respect that patients have final decision [17].

• **Participation:** This principle acknowledges that patients and family members have role to play in the care, after being empowered with diabetes care infor-

• **Collaboration:** This principle acknowledges that healthcare professionals must primarily involve and engaging patients as the main consumer on the involvement or adoption of family-centered care for its successful implementation. Furthermore, once patients have been engaged and approved adoption of FCC, in the provision of ongoing diabetes self-care education and support, patients, families and healthcare professionals jointly make diabetes interventions programs together that considers the needs, strengths, values, and abilities of

delivery as described by Johnson and Abraham [17], and are as follows:

accurate information for the care and decision-making [18].

• **Information Sharing**: This principle acknowledges that healthcare

*DOI: http://dx.doi.org/10.5772/intechopen.96223*

**6. Principles of family-centred care**

by diabetes [1].

### *Family-Centered Diabetes Care for Better Glycemic Outcomes of Outpatients in Rural Areas DOI: http://dx.doi.org/10.5772/intechopen.96223*

diseases and specifically diabetes" [12]. The FCC is an approach of responding to the needs, values and cultural needs of the patient and FMs [13]. The FCC begins from consultation at the healthcare facility involving healthcare professional, patients and family members, being involved in decision making and shared leadership [14]. Family Members are often asked to share responsibility in support of person living with diabetes, and such activities includes driving patients to appointments, and social and emotional support among others. The FCC in diabetes care has so far produced better outcomes in younger children who are usually cared for by their parents or families, since younger children are unable to perform certain tasks related to self-care [7]. However, the FCC have so far failed to utilize same family support for better care of older people who are mostly affected by diabetes [1].

The aim of the FCC is to maintain and strengthen family bond and roles so as to provide healthy family functioning, and at the same time improving the Quality of Life (QoL) of patients, as well as minimizing new cases involving family members who are already at risk due to family history. Despite the benefits of adequate diabetes knowledge, it is worrisome that international knowledge and awareness of diabetes stays low [15]. In SA, diabetes knowledge among T2DM patients in most affected areas is reportedly inadequate [16]. It is essential for healthcare providers to assess knowledge of patients and family members so as to design appropriate diabetes intervention and educate properly. Therefore, the FCC seeks to close the knowledge gap through family-patient consulting healthcare provider together.
