Occupational Therapy in Diabetic Care - Assignment Example

Question 1 This is the case of Ruben (not his real name), 50 years old, diagnosed with Type II diabetes mellitus. He suffered a knife injury which caused a 2-inch cut on his left arm. The wound has taken a long while to heal and has become infected. He also complains of blurred vision and extreme thirst, as well as a frequent need to urinate. His functions are impaired because he is suffering from inflammation and pain on his left arm where his injury is. This sometimes causes him to limit his normal activities which include carpentry and woodwork. Due to his blurred vision, he also often has trouble carrying out his daily activities like grooming, getting to and from the comfort room, reading, writing, watching television, surfing the internet, working, and driving. His frequent feelings of thirst also require him to have access to drinking water at all times, which in his work as a carpenter is not always possible. Moreover, his frequent need to urinate also interferes with his daily activities causing him to frequently take bathroom breaks and to be near a toilet at all times. His recent injury has also caused him to limit his social activities and his participation in the community and other work activities because the inflammation on his arm is very much apparent and he feels embarrassed by it. Question 2 An intervention I can apply to this patient to improve and promote his level of functioning is to teach the patient to manage his diabetic retinopathy which is causing his visual impairment. The recommended management would be to reduce the blood glucose levels in order to prevent the progression of the retinopathy (Rodrigues, 2012). Reduction of blood sugar levels can include diet and lifestyle changes. These changes have to be discussed with the client, mainly focusing on the diet changes he can make, what his regular meals can include, what he can eat in between meals, and the portions he can take for each type of food (Martinez-Gonzales, et.al., 2008). Regular exercise can also help. However, exercise has to be monitored by a health professional in order to prevent any injuries. In order to promote functioning for this patient, I would recommend magnifying lenses in order to allow regular reading and writing activities to be carried out by the client (Hume, et.al., 2012). Eye glasses with special lenses which serve to enlarge the letters and allow reading and writing can also be fitted to the patient. Magnifying lenses can also assist in the management of the disease allowing the patient to self-administer his insulin and to take appropriate doses for his medications (Hume, et.al., 2012). Coding objects can also assist in improving the functionality of patients. Coding can guide the client in remembering which medicines to take and the amounts for each medication. Coding can also help in facilitating normal activities like getting dressed – which clothes go together and similar specific details (Sloan, et.al., 2008). Syringes with magnifiers are also recommended for the client; or in some instances, pre-filled syringes are preferred especially when insulin injections are needed. These interventions would help in the self-management of the disease and also ensure relatively normal functioning despite the visual impairment. The risk involved in the coding strategy is on wrong medications or wrong coding of medications. In order to prevent any mistakes in the type, frequency, or dose of medications, the coding has to be checked regularly by health professionals (Schmier, et.al., 2009). In fact, it is recommended that the coding be carried out by the nurse on a weekly basis, ensuring that each medicine taken is correct. Question 3 Another health professional working with this patient is the occupational therapist. The function of this therapist is to assist and guide the patient in his regular functions (Hwang, et.al., 2009). Since the patient is suffering from visual impairment, the occupational therapist can teach the patient how to move about in his house without tripping or without falling. He is also teaching the patient how to fix his clothes in his closet in order to make it easier for him to choose the appropriate clothes to wear on a daily basis (Hwang, et.al., 2009). The therapist also teaches him how to read and sign important documents. Safety precautions in the patient’s home would also be recommended by the occupational therapist. This therapist can also teach the patient how to stay socially connected with friends despite his functional limitations (Hwang, et.al., 2009). This therapist is targeting the patient’s functionality in relation to his daily activities. By addressing the ability of the patient to perform regular activities, the patient’s independence and autonomy can be ensured. This would also improve his self-esteem and reduce incidents of depression. It would decrease fall risks as well as his risks for other injuries (Hwang, et.al., 2009). Question 4 There are various characteristics of professionalism; three of these would be described herein: Approachability, trustworthiness, respectfulness. I would demonstrate approachability by making myself available to the patient (Wong, et.al., 2011). I would approach the patient, introduce myself to him, give him my full attention, listen to him, and allow him to express all his physical as well as psychological concerns, needs, and problems (Wong, et.al., 2011). I would also take the time to explain to the patient about his diabetic retinopathy and to explain the various interventions which would be carried out in order to ensure his cooperation and compliance with the interventions. I would demonstrate trustworthiness by first establishing a good rapport with the client, maintaining his confidentiality, and asking for his permission each time a procedure and intervention is to be carried out (Polit and Beck, 2009). I would also give him privacy during the implementation of interventions. In teaching him how to manage his retinopathy, I would ensure that we would be talking in closed quarters and that he is afforded sufficient privacy at all times. I would close the doors or draw the drapes during each examination and during each assessment (Polit and Beck, 2009). Finally, I would demonstrate respectfulness by listening and being fully attentive to the patient (Ulrich, 2009). I would also listen and not talk at the same time the patient is talking. I would also consider the patient’s opinions and feelings regarding his care. I would also give value to what the patient is saying and what he prefers (Ulrich, 2009). I would first greet the patient as I enter his room, introducing myself each time in order to prevent any surprises and anxiety on the patient’s part (Ulrich, 2009). Question 5 In order to ensure patient-centred care, I would include a more engaged relationship between the healthcare professionals and the patient. This would include a personal assessment of the patient needs, not just the physiological, but also the psychological and functional needs (Stenner, et.al., 2011). This relationship would ensure that the care administered to the patient is based on his individual needs as well as his individual qualities. What may in fact work for another diabetic patient, may not always work for this same patient even though their circumstances may be similar. The communication with the patient would therefore be frequent and the preferences of the patient would be prioritized (Stenner, et.al., 2011). This would apply well in the diet where certain foods may be preferred by the patient and work better for him. The dietician may recommend red meat for the patient’s protein source, but the patient may prefer beans as his source of protein. For as long as the preferred choices would be for the patient’s well-being, these preferences must be prioritized (Stenner, et.al., 2011). This would make the patient compliance higher and prevent any complications in the long-term treatment of the disease. Question 6 In order to maintain my professional development, I would gather as much information as I can about the management of diseases, especially on the particular cases I am handling at any particular time. Although I have already learned these data in school, I believe that checking on the latest data about the diseases of the patient I am handling would help ensure that I am updated about the patient’s case and that the latest interventions are being considered for the patient (Webster-Wright, 2009). I would also maintain my professional development by attending trainings and seminars on various diseases and aspects of nursing practice. Attending these seminars and trainings would help update my skills and knowledge about the latest interventions and developments in the healthcare profession (Forsetlund, et.al., 2009). These trainings can also offer technological advancements which would require some changes in the practice. With each passing year, research advancements feature constant changes and new medicines and interventions for diseases (Forsetlund, et.al., 2009). In attending these trainings and seminars, I can learn about these new interventions and how to apply these in practice. I can also update my knowledge on evidence-based practice which is the current focus of healthcare (Forsetlund, et.al., 2009). These seminars can help enhance my professionalism in the nursing practice and in the management of the patient’s diabetes. References Forsetlund, L., Bjorndal, A., Rashidian, A., Jamtvedt, G., et.al. (2009). Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane Collaboration. Retrieved 20 May 2012 from http://apps.who.int/rhl/reviews/CD003030.pdf Hwang, J., Truax, C., Claire, M., and Caytap, A. (2009). Occupational therapy in diabetic care— areas of need perceived by older adults with diabetes. Occupational Therapy in Health Care, vol. 23, no. 3: pp. 173-188. Hume, D., Lovblom, L., Ahmed, A., Yeung, E., et.al. (2012). Higher magnification lenses versus conventional lenses for evaluation of diabetic neuropathy by corneal in vivo confocal microscopy. Diabetes Res Clin Pract. Martinez-Gonzales, M., de la Fuente-Arrillaga, C., Nunez-Cordoba, J., Basterra-Gortari, F., et.al. (2008). Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study. BMJ, vol. 336, no. 7657: pp. 1348–1351. Polit, D. and Beck, C. (2009). Essentials of nursing research: appraising evidence for nursing practice. London: Lippincott Williams & Wilkins. Rodrigues, F., Antonio dos Santos, M., Regina, C., de Souza Teixeira, C., et.al. (2012). Relationship between knowledge, attitude, education and duration of disease in individuals with diabetes mellitus. Acta Paul Enferm, vol. 25, no. 2: pp. 284-90. Schmier, J., Covert, D., Matthews, P., and Zakov, N. (2009). Impact of visual impairment on service and device use by individuals with diabetic retinopathy. Occupational Therapy in Health Care, vol. 31, no. 8: pp. 659-665. Sloan, F., Bethel, A., Ruiz, D., Shea, A., et.al. (2008). The growing burden of diabetes mellitus in the US elderly population. Arch Intern Med., vol. 168, no. 2: pp. 192-199. Stenner, K., Courtenay, M., and Carey, N. (2009). Consultations between nurse prescribers and patients with diabetes in primary care: a qualitative study of patient views. University of Surrey. Retrieved 20 May 2012 http://epubs.surrey.ac.uk/7381/20/Consultants_between_nurse_prescribers_and_patients_with_diabetes.pdf Ulrich, B., Breugger, R., and Lefton, C. (2009). Respect: Beginning to Define the Concept in Nursing. Nurses First, vol. 2, no. 3: pp. 6-9 Webster-Wright, A. (2009). Reframing professional development through understanding authentic professional learning. Review of Educational Research, vol. 79, no. 2: pp. 702-739 Wong, E., Woo, J., Hui, E., Chan, C., et.al. (2011). Primary care for diabetes mellitus: perspective from older patients. Patient Prefer Adherence, vol. 5: pp. 491–498. Read More