Chronic Diseases: Diabetes
Chronic illnesses predispose the victims to comorbidity. The use of tobacco, obesity, poor dietary choices, high blood plasma glucose levels, and high blood pressure are some of the risk factors for chronic illnesses such as diabetes. According to the case study, Mr. Storey smokes occasionally, does not engage in physical exercise or active activities, and struggles with weight issues, which are all behavioral risk factors. Mr. Storey’s medical history shows that he is predisposed to hypertension and cardiovascular diseases (Personal Information, n.d). The patients consult a general practitioner, which limits his account to specialized healthcare hence the suboptimal blood sugar level and sugar control, limited information on diabetes, and poor dietary choices. Mr. Storey’s family medical history, lack of specialized healthcare, and limited information are biomedical risk factors Mr. James Storey was diagnosed with diabetes, which predisposes him to other diseases. Age is a risk factor for comorbidity. According to research, a person who is above sixty-five years of age is most likely to have more than two chronic diseases (Australian Health Ministers’ Advisory Council, 2017). The most likely common comorbidities of chronic illnesses that Mr. Storey could suffer from are cardiovascular diseases, arthritis, and back pain. Research shows that despite eliminating all risk factors, some chronic diseases are not preventable. Regular physical activity and adhering to good nutrition would reduce the risk of contracting non-preventable chronic diseases.
Nurse’s assessment aim at providing accurate and updated information about the patient’s condition, hence, allowing them to receive the appropriate healthcare interventions. The nurses have to assess Mr. Storey’s medical history. The assessment should include his lifestyle, the suggested diet and his adherence to the prescribed diet, the patient’s blood sugar level, and impacts of the disease on the patient’s functionality (Queensland Health, 2017). Mr. Storey needs the medical history assessment to clear his doubts about his diagnosis, and to give him knowledge on the symptoms of diabetes. Mr. Storey could be subjected to a physical condition assessment. The physical condition assessment would be used to determine the patient’s orthostatic changes, body mass index, and his visual ability. Mr. Storey’s feet, mouth, and skin should also be examined. Despite the patient experiencing good pain, he has neither received a foot examination nor foot care instructions. Laboratory examinations could be used to diagnose the patient conclusively. Some of the tests that could be carried out in the assessment include the urinalysis test, ECG, lipid profile, and albuminuria (NSW Agency for Clinical Innovation, 2013). The results from laboratory examinations would guide the diabetes specialists on the best care to give Mr. Storey.
Self-management practices can be used in promoting health and reducing the complications caused by chronic diseases. Prevention methodologies could be put in place to curb the behavioral risk factors of diabetes (Lecture Notes, 2019). For instance, Mr. Storey, his family, and the healthcare professionals should come up with a plan to quit smoking, take up a healthy diet, and engage in physical activity. Poor nutrition and smoking are the most common risk factors for chronic illness; hence the risk factors should be prioritized for self-management. Biomedical risk factors can be incorporated into the self-management plan. Biomedical risk factors for chronic illnesses patients include high blood pressure, stress, mental instability, communicable diseases, obesity, and trauma (Deravin & Anderson, 2016). Mr. Storey needs a self-management plan on how to handle stress, impaired sugar tolerance, and overweight. The biomedical factors should be prioritized because, if present, they intensify the other risk factors. The modifiable social and economic factors should be prioritized in self-management since they influence peoples’ lifestyles. Mr. Storey’s education can be improved by teaching him about diabetes and other chronic diseases. Non-modifiable risk factors such as age, genetics, and environmental factors should not be prioritized in self-management as they cannot be influenced in any way.
Mr. Storey will set a goal of losing twelve kilograms within three months by losing four kilograms every month, by reducing the portions of fruits to two portions per day, reducing alcohol consumption to one bottle per day, replacing pasta and other starchy foods with vegetables and walking for thirty minutes daily. The goals were selected because it has the greatest probability of managing Mr. Storey’s blood sugar level and weight. Controlling the risk factors for diabetes would alleviate foot pain and stabilize Mr. Storey’s sugar level hence eliminating chances comorbidity (Chang & Johnson, 2018). The goal is specific as it clarifies the vision of the patient: being healthier. Mr. Storey’s goal is measurable since it gives a measure that can be used to monitor progress. The goals are achievable since it is within reach of the patient. The behavioral health is realistic as it gives a realistic time frame and aims at gradually improving Mr. Storey’s behavioral choices as opposed to quitting immediately. Additionally, the patients have alternatives for starchy foods, which increase the chances of success for the goals. The goal is time-bound; hence it enhances accountability and acts as a source of motivation for Mr. Storey.
Goal setting is impacted positively by patients who are actively engaged in their healthcare. Active engagement of patients in their healthcare considers the decisions and expectations of the patients. People diagnosed with chronic diseases should be actively involved in their healthcare. Healthcare professionals should work hand in hand with the patients, their families, and concerned members of society. Active engagement of patients in their health care ensures that different aspects of their lives, such as psychological needs, economic factors, and social needs are taken care of (Davy et al., 2017). Decisions on engaging in physical activity, losing weight, and quitting smoking require the commitment of patients. Despite knowing the importance of practicing a healthy lifestyle, Mr. Storey experiences obstacles in dropping his negative behavior. Goal setting would help Mr. Storey to navigate the physical, emotional, psychological, and environmental barriers that inhibit him from changing his lifestyle. Setting goals enables the patient to make small adjustments in his lifestyle, which would reduce the risk factors to comorbidities and aid in the treatment of diabetes. Goal setting can only be successful if it is a collaborative effort between the healthcare providers, the patient, and their family. For instance, Mr. Storey may experience difficulty in quitting smoking within the first week. Therefore, the patient could be committed to walking for forty minutes every day, which is an achievable goal. The healthcare provider ought to periodically monitor the results and celebrate success. The set goals should be revised to keep improving the patient’s lifestyle.
References
Australian Health Ministers’ Advisory Council. (2017). National Strategic Framework for Chronic Conditions. Australian Government. Canberra.
Chang, E., & Johnson, A. (2018). Living with chronic illness and disability principles for nursing practice Elsevier.
Davy, C. et al. (2017). Towards the development of a wellbeing model for aboriginal and Torres Strait Islander peoples living with chronic disease. BMC Health Services Research 17: 659.
Deravin, L., & Anderson, J. (2016). Chronic Care Nursing: A Framework for Practice. Cambridge University Press.
Lecture Notes. (2019). Introduction to Chronic Care across the lifespan. The University of Southern Queensland.
NSW Agency for Clinical Innovation. (2013). Understanding the process to develop a Model of Care: An ACI Framework. Retrieved on 18th June 2020 from www.aci.health.nsw.gov.au
Queensland Health. (2017). The burden of disease and injury in Queensland’s Aboriginal and Torres Strait Islander people 2017. Retrieved on 18th June 2020 from https://www.health.qld.gov.au/atsihealth/burden_of_disease