Background. Individuals with cognitive impairment arising from acquired brain injury (ABI) are often supported to engage in diabetes self-management through verbal guidance provided by carers. Guide, developed by O’Neill and Gillespie (2008), is an automated verbal prompting system which aims to replicate the verbal guidance often provided to individuals with cognitive impairment by carers. Aims. The aim of this study is to investigate whether Guide can improve the ability of individuals with cognitive impairment to self-manage their diabetes. Methods. Participants were two individuals recruited from a specialist brain injury rehabilitation unit who had a diagnosis of diabetes and ABI. The study employed an ABA design using multiple baseline across participants Single Case Experimental Design (SCED) methodology. Results. Results indicated that the use of Guide significantly reduced the level of staff prompting needed for task completion when compared to baseline for both participants. For participant 1, use of Guide reduced the number of errors made during task performance and for participant 2 it increased the proportion of the task that was sequenced correctly. Applications. It is possible that Guide could be used more widely to support individuals with cognitive impairment (e.g. dementia, learning disability) and to support other complex behavioural sequences.
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Supporting diabetes self-management in persons with cognitive impairment after acquired brain injury