Impact of a Priority Health Issue on a Population Group and Implication for the Nurse - Assignment Example

Impact of a Priority Health Issue on a Population Group and Implication for the Nurse Student Name: Institution: City: Date Due: Introduction This paper will discuss the impact of diabetes on overseas born Australians and its implication on nursing. Australia is a multicultural nation with approximately 27 percent of its population comprised of people born overseas. Recent research shows that, particular health conditions, such as diabetes, are more prevalent among Australians from overseas. An AIHW report released in 2003 showed that approximately 35% of self-reporting diabetics in 2001 being overseas-born. The current paper will report on the impact of diabetes on the individual, family, and the population in parts A, B and C respectively. In part D, the report will look at the implications discussed in parts A, B, and C, on the role of the nurse. PART A: Impact on the Individual Diabetes is a progressive long-term condition, which has no cure and that is accompanied by a significant self-management burden on the individual. People with diabetes, are confronted by a huge challenge in developing an understanding of the condition as well as adapting to it. Living with diabetes often entails a variety of physical problems that impact both private and working life of the individual and may necessitate additional support from family or friends (Dudzińska, et al., 2008). However, the burden of the managing diabetes is largely the sole responsibility of the individual living with diabetes. Primarily, the management of diabetes comprises regularly trying to maintain safe levels of blood glucose, through regular medication, and/or controlling the amount and timing of food consumed. In addition to the immediate outcomes of abnormal blood glucose levels, diabetics have to be aware of the long-term consequences/complications of ineffectively controlled diabetes such as kidney, eye, nerve and circulatory diseases. As such, self-management or self-care activities are vital for attaining and maintaining optimal levels of blood glucose as well as averting any complications associated with the disease. However, according to Speight et al. (2012) self-management of diabetes is a complex social and behavioral process that requires a comprehensive understanding of the condition as well as high levels of self-efficacy, perceived control and empowerment (Speight, et al., 2012). Consequently, the day-to-day self-management of diabetes can be a source of stress for the individual leading to anxiety, distress, denial, fear, anger, and/or, depression, particularly for young people (Aikens, et al., 2008). Further, research shows that diabetes dramatically declines life expectancy and the quality of life especially with the onset of complications such as neuropathy and retinopathy. In addition, to the physical and psychological impacts, diabetes may impact the individual economically, through reduced work output because of disability and changes in the quality of life, as well as medical care expenditures. Diabetes also has an impact on the social life of the individual whereby according to Dudzinka et al (2008) patients reported feelings of isolation and inability to maintain social relations due to declined functionality, unemployment and loss of income associated with diabetes related complications (Dudzińska, et al., 2008). PART B: Impact on the Family Every family serves many purposes, such as the caring-hygienic one, the material-consumerist one, the social-controlling one, the emotional one, and the role associated with culture and an individual’s social life. Diabetes has a huge impact on these roles of the family particularly on psychological, emotional, economical, sociocultural and physical levels. First, Dudzinka et al. (2008) note that having a diabetic in the family impacts on the family dynamics especially when the diabetic requires constant attention and where major changes are required to accommodate the care of the diabetic (Dudzińska, et al., 2008). Specifically, where the care of the diabetic demands a reverse in family roles, such as where the children have to take care of a diabetic parent, then the family dynamics are greatly compromised. Additionally, jealousy and other feelings of neglect may arise among siblings where parents devote their attention to taking care of a diabetic child. Further, diabetes can be a source of strife for the family where the diabetic is a teenager or youth since the condition tends to magnify the normal forms of conflict experienced among this age group (Mustapha, et al., 2012). Emotionally, the day to day management of a diabetic can be a source of stress for the entire family especially where the patient relies in his/her family members for both psychological and physical support. Moreover, the highs and lows associated with the condition’s relapses or complications as well as the terminal nature of the complications may cause significant emotional distress. Economically, having a diabetic in the family can drain the family’s finances through huge expenditures on diabetes medication and nutritional management of the condition. The economic burden increases greatly where the diabetic was the family’s sole source of income and is forced to quit providing for the family due to diabetes related complications. Moreover, due to the stress accompanying the care of a diabetic, family members may experience declined performance in their work or others are forced to resign, leading to declined financial status and loss of income. Socially, diabetes impacts greatly on the social and interpersonal relationships of the family members especially those providing full time care to the diabetic (Mustapha, et al., 2012) PART C: Impact on the Community Diabetes is a critical and highly pervasive health concern that has significant impacts on the society and the overall Australian population. Notably according to AIHW as cited in Abouzeid et al (2013), the prevalence rates and vulnerability to diabetes is higher (at 4%) among overseas born or migrant communities in Australia (Abouzeid, et al., 2013). The impact of diabetes on the society is large-scale and its impacts on daily life, social relationships and work life embody a significant impairment of the societal quality of life. This may cause feelings of disconnectedness among individuals and the impact is more overwhelming among migrants who already feel isolated from the mainstream society. Indeed, diabetes related complications, fear of losing their jobs and declined interest in making friends may add to lost opportunities for social interaction or compromise their quality and frequency among these migrant communities (Mustapha, et al., 2012). Further, increased mortality rates from diabetes related complications translates to declined socio-economic status of these communities hence increasing the gap between migrant communities and the mainstream society. Increased prevalence rates also means that the community has to spend more in terms of medical interventions, prevention, and management and community awareness programs at the expense of other social amenities (Reddy, et al., 2011) PART D: Implications for the Role of the Nurse The main goal of diabetes treatment is to alleviate its symptoms; maintain and improve the patient’s quality of life as well as slow the development of both diabetes-specific and non-diabetes-specific complications. As mentioned earlier, effective self-management of diabetes requires patients to be actively involved in managing and monitoring their condition. This entails self-monitoring of blood glucose levels, setting goals and adherence to a daily management plan, record keeping, responding to complications and managing medication. Notably, research has shown that positive engagement with health professionals is a central enabling factor to self-management of diabetes (Jowsey, et al., 2010). The lived realities of immigration or relocation to another country are often complex, particularly for individuals with chronic illnesses such as diabetes. This complexity is formed by language barriers, social circumstances and cultural nuances, within the background of an unfamiliar health systems or policies. Collectively, they exercise a powerful influence over the individual’s capacity and opportunity to self-manage the condition. In their study, Kokanovic & Manderson (2009) demonstrated that migrant Australians from CALD backgrounds experience a significant difficulty in adapting to a diagnosis of diabetes and as well as its management, and that both the experience of immigration and culture influence the individual’s experience within the Australian health system (Kokanovic & Manderson, 2009). Specifically, overseas born Australians encounter challenges with Australian health policies such as translation and interpretation alongside dignity and cultural appropriateness in the access and provision of support (Rowland, 2007). Further, according to Kokanovic & Manderson (2009) diabetic overseas born Australians experienced significant stress caused by the socio-cultural barriers arising from the symptoms of the condition and the subsequent lack of control over their lives. Additionally, in a comparative study, Furler et al (2008) found deep cultural variations in attitudes to the disease and the body had a significant impact on self-management of diabetes. Distinctively, Furler et al noted that Australian immigrants from English speaking countries considered diabetes as ‘….an unjust and unwarranted imposition in their lives. They saw health professionals and self-management strategies as a means to regain control… especially where healthy nutrition was involved….’ (Furler, et al., 2008). In contrast, migrants from non-English speaking backgrounds expressed confusion in accessing healthcare support and a general lack of awareness regarding self-management strategies. The Role of the Nurse The implication of the diabetic migrant community in Australia for the nursing role is that nurses have a critical role to play in assisting these patients to improve their health knowledge and subsequently, effectively manage diabetes. It is critical that nurses are able to provide diabetes related information in a manner that is comprehensible by individuals and family members from non-English CALD backgrounds. Moreover, migrants require extensive support on how to apply this knowledge in manner that will elicit and guarantee positive health outcomes and reinforce the patient’s quality of life. Nurses have a duty to also take time to explain the nature of the disease; its causes, effects, risk factors for complications and the best treatment options; within their understanding of the particular social and dietary customs of the migrant background. Consultation and communication with the patient and their family is also vital in the establishment of healthier meal plans and self or caregiver management strategies that do not serve to culturally alienate members from a specific CALD group. In addition, nurses must realize that majority of the changes they expect their patients to make are made more complex by the fact that, in many communities, the culture often revolves around the very issues that demand altering. While excellent cultural competency is vital, nurses must be aware that ‘there something more fundamental and more important than cultural competency in comprehending the patient’s life; and this is understanding the moral meaning of suffering- what the patient stands to lose or gain; and at a deep level, what is at stake for them’ (Kleinman & Benson, 2006). In areas where nurse of similar CALD background are not available, it is critical that a medical translator is made available so that patients do not experience feelings of isolation, separateness and confusion. In addition, nurses should establish support groups designed to assist caregivers deal with the stress and challenges that accompany living with a diabetic in the family. Moreover, nurses must provide care giver oriented information concerning the disease to patients’ families, and friends. This will advance the family’s understanding and therefore enrich their support of the needs of the individual with diabetes. In essence, the role of the nurse in dealing with the impact of diabetes at the individual and family level is to empower thorough knowledge and support. Empowerment is critical in building partnerships and collaborations between the patient, their families and nurses. Indeed, nurses, patients and their families must work together to create appropriate treatment plans and manage the condition around the patient’s lifestyle rather than attempting to shape the patient’s life around treatment of the disease. This ultimately, reduces symptoms of depression, anxiety and stress in both the patient and their families. At the community level, for overseas born populations to attain more positive experiences in managing and living with diabetes, health services that are specifically oriented to these communities must be made available. Nurses must actively champion, at the community level, initiatives, such as changes in diet and physical activity that have been proven to decline the prevalence of diabetes (Carr, 2012). Nurses must endeavor to persuade at-risk migrant communities to conform to the Australian guideline of maintaining ‘healthy body weight by balancing food intake and regular physical activity’ (Mustapha, et al., 2012). To achieve this nurses must employ culturally and linguistically sensitive tools of communication and collaboration. Specifically, nurses must engage community leaders, opinion leaders and health professionals to disseminate information and increase community awareness of diabetes and its management. Community education or interaction programs where members can actively engage nurses regarding the disease and the challenges they encounter will also serve to increase awareness and decline prevalence rates while at the same time enriching the quality of life for patients (Reddy, et al., 2011). Conclusion This paper has examined the impact of diabetes among overseas born individuals in Australia and the implication of this impact on the role of nurses. Indeed, diabetes is a serious pandemic with higher prevalence rates among this population group and significant impacts at the individual, family and community level. Specifically, diabetes has been associated with declines in the quality of life of the individual, family and community, stress, anxiety and depression among patients and sociocultural declines in the society. The role of the nurse is to support and empower patients, their families and overall community through making available information regarding the disease and its management. Bibliography Abouzeid, M. et al., 2013. Type 2 diabetes prevalence varies by socio-economic status within and between migrant groups: analysis and implications for Australia. BMC Public Health, Volume 13, p. 252. Aikens, J., Perkins, D., Piette, J. & Lipton , B., 2008. Association between depression and concurrent Type 2 diabetes outcomes varies by diabetes regimen. Diabet Med, Volume 25, p. 1324–1329. Carr, V., 2012. Minority ethnic groups with type 2 diabetes: The importance of effective dietary advice. J Diabetes Nurs , Volume 16, pp. 1-6. Dudzińska, M. et al., 2008. Social problems of diabetics. The influence of diabetes on patients’ daily, family and personal lives. Diabet Dośw I Klin, 8(4), pp. 150-156. Furler, J., Walker, C., Blackberry, I. & et al, 2008. The emotional context of self-management in chronic illness: a qualitative study of the role of health professional support in the self-management oftype 2 diabetes. Health Serv Res, Volume 8, p. 214–23. Jowsey, T., Gillespie, J. & Aspin, C., 2010. Effective communication is crucial to self-management: the experiences of immigrants to Australia living with diabetes. Chronic Illness, Volume 0, pp. 1-14. Kleinman, A. & Benson, P., 2006. Anthropology in the Clinic: The Cultural Competency Problem and How to Fix It. PLoS Med, Volume 3, p. e294. Kokanovic, R. & Manderson, L., 2009. "Worried all the time’’: distress and the circumstances of everyday life among immigrant Australians with type 2 Diabetes. Chronic Illn , Volume 5, p. 21–32. Mustapha, W., Hossain, S. & O’Loughlin , K., 2012. Detection, management and impact of diabetes among the Lebanese Community of Sydney: A qualitative study. J Community Med Health Educ, Volume 2, p. 160. Reddy, P., Rankins, D., Timoshanko, A. & Dunbar, J., 2011. Life! in Australia: translating prevention research into a large-scale intervention. Br J Diabetes Vasc Dis, 11(4), pp. 193-197. Rowland, D., 2007. Ethnicity and ageing. In: A. Borowski , S. Encel & E. Ozanne , eds. Longevity and social change in Australia. Sydney: University of New South Wales Press, pp. 117-41. Speight, J. et al., 2012. Diabetes MILES--Australia (management and impact for long-term empowerment and success): methods and sample characteristics of a national survey of the psychological aspects of living with type 1 or type 2 diabetes in Australian adults. BMC Public Health , Volume 12, p. 120. Read More