Applicability of Hildegard Peplaus Nursing Theory to the Teaching Interventions - Research Paper Example

? Teaching Plan Teaching Plan Introduction The specialized role of nursing in educating diabetic patients began approximately thirtyyears ago (Boswell, 2007). Exposure of patients to relevant education about their health enables them to make accurate decisions regarding their health behaviors. Nurse educators aim at encouraging patients to seek informed medication for their illnesses while encouraging them to comply with treatment regimes that promote healthy lifestyles. The emergence and growth of advanced nursing practices have led to the expansion of direct care component to incorporate the aspect's medical care while maintaining patient education (Goldman, Shah, Greenberg & Cogen, 2012). The nurse practitioner model creates enhanced patient-nurse relationships, which provide both self-care education and cancelling within the context of disease state management. The nurse teacher for a diabetic person needs to assess the patient’s needs, predict the expected outcomes from the teaching, and develop intervention plans based on a suitable nursing theory. Patient Assessment Albert Boyle is a 69-year-old man with five-year history of type 2 diabetes (Spollett, 2003). The doctors diagnosed Joseph’s condition in the year 1997. Two years prior to diabetes type 2 diagnoses, Albert Boyle had symptoms indicating hyperglycemia. Albert’s fasting blood glucose ranged between 118-127 mg/dl (Spollett, 2003). The doctors advised Albert to lose at least 10 lb of his weight, but he did not take any action. The family physician referred Albert Boyle the diabetes specialty clinic where he reported recent weight gain, foot pain, and suboptimal diabetes control. Albert’s attempts to lose weight through increased exercises were not successful. Albert takes 10 mg of atorvastatin daily for hypercholesterolemia (Spollett, 2003). He took gymnema sylvestre, pancrease elixir and chromium picolinate with an attempt to improve his diabetic condition; however, he stopped these supplements because he did not see any improvements (Spollett, 2003). Albert Boyle does not test the levels of his blood glucose at home because he does not belief that this condition would help him improve his diabetes control. Albert questions the benefits of knowing the numbers since after all the doctor is already aware that the sugar level is high. Albert Boyle does not have knowledge of diabetes self-care management, and expresses that he is worried about what causes his diabetic condition since he does not eat sugar. Albert has been physically active by playing golf once in a week and gardening; however, he has reduced more than 3 lb of weight (Spollett, 2003). Albert has neither consulted a dietician nor been instructed in self-monitoring of blood glucose. Defining Characteristics Albert Boyle has a misconception about the approaches to improve his health status. He does not believe that knowing his health status can help him manage his diabetes control. Albert argues that there is no need of him of knowing his blood-sugar level; he claims that the doctors already know that the level of sugar in his body is high. Another characteristic of Albert Boyle is that he does not demonstrate self-care skills concerning his diabetic controls. Albert is not aware of the critical skills that are required to control his blood sugar. Albert does not believe that he is diabetic. This is evidenced by the fact that he questions the source of the condition, and he does not eat sugar. Albert is ignorant that direct intake of sugar does not cause diabetes. Diabetes results from two factors: when the pancreas fails to produce insulin, and when the cells fail to respond to the insulin that is produced (Boswell, 2007). This leads to accumulation of blood sugar in the body. Related Factors Patients with diabetic conditions have extremely comprehensive learning needs. The diabetic patients’ needs focus on informing them proper measures of managing their sugar levels and preventing their diabetic conditions. Learning needs of these patients include menu planning, skin care, medications, knowledge of the disease process, monitoring sugar levels and management of hyperglycemic episodes (Goldman, Shah, Greenberg & Cogen, 2012). Accessing knowledge about the management of these needs is one of the greatest challenges that patients encounter. The factors that make the process of learning difficult include limited intellectuality, inability to initiate and implement copying strategies, lack of motivation to learn and inattention. Most diabetic patients experience intellectual limitations in the medical field. Patients do not understand the measures and treatment strategies available for managing their conditions. Albert Boyle is a retired man ageing sixty-seven years old, but he is not informed about control of his condition. Albert Boyle cannot initiate strategies to manage his diabetic conditions. Albert sounds as if he has given up in dealing with his condition. His expression that there is no need of knowing the values of his blood-sugar level shows that he is disinterested in managing his diabetes control (Spollett, 2003). This is an indication that Albert is unable to cope with his current state of diabetes and implement strategies to limit its adversities. Albert could be one of those patients who are not motivated to learn new self-care skills. Albert’s wife regularly does research in the Internet to find out if there are new medications for diabetes. The information about measures of controlling and managing diabetes is aired daily in radios, televisions and the Internet. Several agencies also publish periodical newsletters focusing on enlightening diabetic patients. Albert, however, might not be motivated to learn since he has no hope for living. Inattention is another factor related to Albert’s current state of awareness deficit. People who want to learn do pay attention to the information that medical professionals spread through both electronic and print media. Most people like watching, listening or reading specific topics. When information about health care is aired or printed, these people lose attention. This factor leads to ignorance among the people and cultivates further fallacies about self-care. Expected Outcomes The teacher expects Albert to be able to describe the medications suitable for his diabetic condition. Albert will be informed that his core target is to improve glucose control without causing further weight gain. Thiazolidinediones and pioglitizone are effective in addressing insulin resistance, but may lead to weight gain (Germino, 2011). Improving glycemic control will need prescription of 500 mg of metformin everyday (Tahrani Bailey, Prato & Barnett, 2011). Albert will develop interest in self-monitoring of his blood-sugar level using a blood-glucose meter as demonstrated by the nurse teacher. The teacher will train Albert how to use a glucose meter. Albert will begin using it twice a day: during breakfast and dinner when the metformin dose is being titrated (Germino, 2011). This will enable Albert to understand the need for glucose readings as they guide the choice of medication and evaluate the effects of dietary changes. The teacher will explain the benefits of regular exercises to Albert’s health and diabetic condition. The teaching plan will focus on how regular exercises can help improve Albert’s blood sugar control. Regular exercises help to control the level of blood sugar and prevent the risk of cardiovascular diseases (Germino, 2011). The methods of exercising that the teacher will recommend to include rowing, water aerobics, bicycle riding and fast paced walking. Albert will acquire and demonstrate proper measures of foot and skin care. The teaching plan is devoted to explaining to the patient the procedures of taking care of his skin and feet. The nurse teacher will demonstrate to Albert the cause of his inability to sense the touch of the monofilament. The loss of protective sensation from peripheral neuropathy implies that Albert will be more vigilant in regular checking of his feet Tahrani Bailey, Prato & Barnett, 2011). This will enable him to identify skin lesions caused by poorly fitting footwear worn during the exercises. Strategies The teacher will use both discussion and lecture techniques to teach Albert the measures of managing and controlling his diabetic condition. The teacher will ask Albert to explain his understanding of self-care and measures to reduce the pains associated with diabetes. This will enable the nurse teacher to identify any prior knowledge that Albert could be having concerning his present condition. The nurse teacher and Albert Boyle will engage in a series of conversations meant for mutual benefit. The teacher will use the lecture method to explain to Albert the real meaning self-care for diabetic people. The teacher will focus on proper strategies that can help Albert to prevent the adversities associated with diabetes type 2 and the necessity of seeking advice from the dietitian. Interventions The teacher will provide accurate and relevant information related to diabetes type 2 and its possible treatments. The teacher will inform Albert Boyle that diagnosis of diabetes can be unexpected and potentially devastating, just like other chronic illnesses. The teacher will enlighten Albert that diabetes is a lifelong disease requiring lifelong attention, commitment, and lifestyle adjustments Tahrani Bailey, Prato & Barnett, 2011). The teacher will also empower Albert through enabling him to identify the resources critical for his health and knowing how to use them. Albert will also be taught that managing the disease will involve eliminating and minimizing other cardiovascular risk factors such as controlling blood pressure and lipids intake (Germino, 2011). The teacher plans to explore Albert’s interpretation of the self-care and its meaning in life. This will be possible through the technique of discussion, which will be made possible through exchange of ideas between Albert and the nurse teacher. Interpretation of the prior knowledge will enable the teacher to identify the causes of Albert’s intellectual limitations and concentrate on these weaknesses to make the learning process possible. Demonstration and encouraging Albert to apply the new skills will be another critical responsibility of the teacher. The teacher will encourage Albert to continue with his regular exercises and comply to the doctors’ prescriptions. The nurse teacher will instruct Albert to continue taking his insulin and supplements when ill and when unable to eat. Omitting insulin is the primary cause of ketosis and can cause diabetic ketoacidosis (Germino, 2011). The teacher will recommend Albert to the dietitian to help Albert make a list of foods that contain fast acting carbohydrates. Albert will be required to eat these foods when the signs and symptoms of hypoglycemia are experienced. Albert may need further assistance from specialized professionals later in life. The teacher will provide a list of contacts of other medical doctors and practitioners such as dietitians, physiotherapists, and counselors. Albert, therefore, will be able to contact these health professionals when he needs specialized assistance. Applicability of Hildegard Peplau's Nursing Theory to the Teaching Interventions Hildegard Peplau's Nursing Theory proposes that the primary purpose of nursing is to help patients identify their health difficulties (Merritt & Procter, 2010). Nurses, therefore, need to apply the principles of human relations to problems that arise at all levels of experience. Hildegard Peplau's theory views nursing as an art because it is therapeutic; it assists people who are sick or need health care education (Merritt & Procter, 2010). The theory describes the phases of the interpersonal process, the roles of nursing function and methods of studying nursing as a human relations process. Hildegard Peplau's theory stresses on the significance of the nurse and the patient working together for mutual benefit in both knowledge and maturity (Merritt & Procter, 2010). The intervention strategies for this teaching plan are based on teaching the patient through discussions and lecture methods. The teaching plan concentrates on the necessity of creating a mutual relationship between Albert and the nurse teacher. The discussions between the nurse teacher and Albert promises to build a personal relation that is critical in the process of patient education. Intervention plans also reveal the role of the nursing function in the healing of the patient. Albert and the nurse teacher will work together, and both will become mature and knowledgeable in the process. Conclusion The teaching plan aims at informing Albert Boyle about the necessity of taking care of his own health. The learning needs of the plan focuses in managing Albert’s level of glucose and prevent further complications of diabetes. Albert will identify the accurate and relevant information related to diabetes and possible treatment strategies. Albert is expected to apply the new strategies learnt into his daily life in order to reduce the problems of diabetes. The teacher intends to teach Albert how to manage his diabetes condition when ill and when the warning signs of hyperglycemic are experienced. The intervention techniques of the teaching plan apply Hildegard Peplau's Nursing Theory since it focuses on creating personal relationships for mutual benefit. References Boswell, C. (2007). The nurse's guide to teaching diabetes self-management. The Journal of Continuing Education in Nursing, 38(5), 239. Germino, F. W. (2011). Noninsulin treatment of type 2 diabetes mellitus in geriatric patients: A review. Clinical Therapeutics, 33(12), 1868-1882. Goldman, E., Shah, K., Greenberg, L., & Cogen, F. R. (2012). A pediatric resident diabetes curriculum targeting different learning styles. Diabetes Spectrum, 25(1), 45-48. Merritt, M. K., & Procter, N. (2010). Conceptualising the functional role of mental health consultation-liaison nurse in multi-morbidity, using peplau's nursing theory. Contemporary Nurse : A Journal for the Australian Nursing Profession, 34(2), 158-166. Spollett, G. (2003). Case study: A patient with uncontrolled type 2 diabetes and complex comorbidities whose diabetes care is managed by an advanced practice nurse. Diabetes Spectrum, 16(1), 32. Tahrani, A. A., Bailey, C. J., Del Prato, S., & Barnett, A. H. (2011). Management of type 2 diabetes: New and future developments in treatment. The Lancet, 378(9786), 182-197. Read More