Diabetic Patient Awareness of Self-Management in Saudi Arabia - Research Paper Example

Background Diabetes is a global health issue with 347 million people estimated to be suffering from the chronic illness (WHO, . In addition to that, it was estimated that approximately 3.4 million people globally succumbed to diabetes as a result of high blood sugar (WHO, 2012). These figures have been increasing over the past years. In 2013, the number of individuals worldwide diagnosed with diabetes rose to 382 million. In addition to that, the International Diabetes Federation (IDF) projected that by 2035, the prevalence of diabetes would be at 592 million people globally. The prevalence of diabetes mellitus (DM) in the Kingdom of Saudi Arabia was revealed to be approximately 23.7% of the population (Al-Nozha et al., 2004). Moreover, in a recent study that was conducted on the prevalence of diabetes mellitus (DM) in the Kingdom of Saudi Arabia, it was established that 29% of the entire population had been diagnosed with DM (Alqurashi et al., 2010). Therefore, it can be evidenced that the prevalence of diabetes (type 1 and type 2) has been on the rise over the past few years. It is also further projected by the World Health Organisation (WHO) that in the coming years, diabetes prevalence and deaths shall even be higher if no education, treatment and management strategies are implemented by nurses and other health professionals, as well as diabetic patients. Diabetes self-management is an essential element in patient care as it helps the patient to learn, understand and manage their illness so as to improve patient outcomes. Moreover, it is designed to ensure quality in interventions as well as assisting diabetes educators to secure evidence-based education (Tschannen, et al., 2012). Due to the complicated quality of health care and diabetes-related studies, standards are assessed and revised regularly by national organizations as well as federal agencies in the diabetes education setting. Nurses have a major role to play in diabetes self-management so as to improve patient outcomes and the quality of life. These include: offering diabetes self-management education (DSME) to the patient (Funnell et al., 2012); assisting the patient to perform self-care with little or no intervention; elaborating to the patient the importance of self-care activities and why compliance is essential (Shrivastava et al., 2013). In a study that was conducted to reveal the effectiveness of self-management in Saudi Arabia and Oman respectively, it was established that patients who received and performed self-management training had a better chance of managing diabetes as compared to those who had no form of self-management training (Al-Shahrani et al., 2012; Elliott et al., 2013). Population Information The prevalence of diabetes over the past few years has been on a rapid increase for many nations. Figures reveal that there has been a 42% increase from 2003 to 2005. Diabetes in the Gulf regions has also been noted to be on a steady increase with rates reported to be 25.7% in Bahrain and 16.1% in Oman (Alqurashi et al., 2010). In a community-based national epidemiological health survey that was conducted in the Kingdom of Saudi Arabia, the prevalence of diabetes mellitus in adults was projected to be 23.7% (Al-Nozha et al., 2004). These figures projected that the prevalence of diabetes in gulf nations was also increasing. It was also noted that type 2 diabetes was the most common type of diabetes worldwide with 80% of the people diagnosed being from low and middle income nations. Moreover, it highly affected individuals who were 40 years and above as compared to those who were younger (NHS, 2011). Based on that, majority of patients who are older are not in a position to offer diabetes self-care management. A number of studies on diabetes self-care management in older patients revealed that when nursing intervention was initiated, the patient health outcomes were improved. However, when the diabetes self-care management was terminated in a period of 1 to 3 months, the patient’s health outcomes (GHb levels) were decreased (Norris et al., 2002). In a study based on Saudi Arabia diabetic patients, it was also revealed that patient outcomes were massively improved with intensive five (5) day nursing interventions and decreased with the lack of nursing interventions (Al-Shahrani et al., 2012). Moreover, individualized diabetic self-care management strategies were highly preferred as compared to the use of primary health care centres in Riyadh (Azab, 2001). The following are the impacts (effects) of nursing interventions on diabetes self-management care: Diabetes knowledge empowerment: Diabetes self-management education (DSME) is important because it helps promote patient outcomes. As such, the National standards are responsible for setting the correct diabetes self-management education. In turn, this helps diabetes educators to offer evidence based education to patients. Medical technology keeps changing almost every day. Based on that, the standards for offering diabetes education are also reviewed every five (5) years so as to ensure that the information being disbursed to diabetes patients is relevant, and that it would improve health outcomes and the quality of patients’ life (Funnell et al., 2012). While offering Diabetes Self-Management Education and Training (DSME/T), it is important to establish the outcomes (results) of the processes being undertaken in order to know whether change needs to be done or not. Diabetes self-management outcomes: There are a number of outcomes that are used to measure the success of diabetes self-management. These include: learning, behaviour and health care (AADE, 2003). Learning outcomes refer to the knowledge and skills that the patient has acquired and whether they could implement it for personal gain. Moreover, it also involves the ability of the patient to offer self-care as well as handle any challenges that could be associated with self-care. Behaviour outcomes refer to the capability of the patient to set goals (for example healthy eating or physical exercise) and work towards achieving the goals as well as developing self-esteem in their social life. Health care outcomes refer to the capability of the patient to improve their quality of life as well as gain economic benefits with regard to diabetes care and management (Mulcahy et al., 2003). The diagnosis and/ or recognition of the nurse’s impact on diabetes self -management can be realized through literacy of the patient on diabetes, patient outcomes as well as improved quality of care. Studies conducted to establish the effectiveness (impact) of nurse led interventions revealed that nurse-led interventions promoted health outcomes (Renders, 2000; Hunt, 2013). Lack of nursing interventions led to: poor diabetes self-care management behaviour; little or no use of medications; higher levels of psychiatric problems such as anxiety and depression since the patient does not receive motivation and/ or support; poor glycaemic control (Al-Hayek et al., 2012). Moreover, the nurse’s deficit in diabetic knowledge led to decreased patient outcomes and the quality of health care (Clement, 1995). The prognosis is that nursing interventions on diabetes self-care management have a positive impact on patient outcomes, health status and quality of life as compared to the lack of self-care management for the patient with diabetes (Funnell et al., 2012; Renders, 2000; Hunt, 2013). The costs associated with diabetes self-care management in the US in 2012 were $245 billion. This was an increase from $174 billion in 2007 (ADA, 2013). Moreover, in Saudi Arabia, the costs were projected to be higher than $0.87 billion excluding indirect diabetes costs such as absenteeism, unemployment due to disability, productivity loss due to mortality and disease-related absenteeism (Alhowaish, 2013). Therefore, it can be established that the costs related to diabetes shall keep on scaling higher in the coming years in a majority of nations. Search Strategy What is the impact of nursing intervention related to diabetes self-management for diabetic patients? Population: patients with diabetes Intervention: Nurse led education on diabetes self-management comparator: regular care Outcome: Better control of blood glucose levels (HbA1c) The search strategies that have been used to describe the scenario include: the use of databases, search engines and library sources that contain peer reviewed literature reviews. The search terms that were used were: diabetic nursing interventions, impact of nursing interventions, diabetes self-management care, age group affected by diabetes type 2, diabetes complications, diabetes type 1, diabetes type 2, physical activity in patients with diabetes, healthy eating in patients with diabetes, blood sugar monitoring and improved quality of life. The inclusion criteria were based on articles that were free and readily available for access while the exclusion criteria were articles that were not visible for free access. Search strategy summary Search strategies come in a number of forms. For example, a search can be conducted through the use of a form where the key search terms are keyed in and the results are portrayed; subject titles and categories and through links to related material and/ or content. The search strategies that were used in this research paper were all the above. This was due to the fact that a research paper focuses of gaining literature reviews from a number of reliable sources. In addition, this information has to be analysed, evaluated and even compared so as to come up with an effective conclusion. As such, a number of search mechanisms have to be employed so as to get the most reliable and accurate information for the specific study. It is also worthy to note that there are a number of online access tools which can be used to perform searches and retrieve reliable information. These include: library catalogues; search engines such as Google, Yahoo and Bing; scientific databases such as Google Scholar, pLos and MedicineNet. When it comes to library searches, the best strategy that was employed was the use of search terms. These made the searching very easy since the name of the article and/ or keywords were readily available. While searching in databases, the best search strategy that was used was also related to the search terms stated above. Lastly, conducting searches through search engines required one to determine the best search engine that produced more results with less time. Next, the search was performed using the key words mentioned above. Works cited Al-Hayek, A. A., Robert, A. A., Alzaid, A. A., Nusair, H. M., Zbaidi, N. S., Al-Eithan, M. H., & Sam, A. E. (2012). Association between diabetes self-care, medication adherence, anxiety, depression, and glycemic control in type 2 diabetes. Saudi medical journal, Volume 33(6), pp. 681-683. Alhowaish, A. K. (2013). Economic costs of diabetes in Saudi Arabia. Journal of family & community medicine, Volume 20(1), p. 1. Azab, A. S. (2001). Glycemic control among diabetic patients. Saudi medical journal, Volume 22 (5), pp. 407-409. Alqurashi, K. A., Aljabri, K. S., & Bokhari, S. A. (2010). Prevalence of diabetes mellitus in a Saudi community. Annals of Saudi medicine, Volume 31(1), pp. 19-23. Al-Shahrani, A. M., Hassan, A., Al-Rubeaan, K. A., Al Sharqawi, A. H., & Ahmad, N. A. (2012). Effects of diabetes education program on metabolic control among Saudi type 2 diabetic patients. Pak J Med Sci, Volume 28 (5), pp. 925 – 930. Al-Nozha, M. M. et al. (2004). Diabetes mellitus in Saudi Arabia. Saudi medical journal, Volume 25(11), pp. 1603-1610. American Association of Diabetes Educators (AADE). (2003).Technical Review: Diabetes Self-Management Education and Training (DSME/T) Outcomes Measures. Web. Retrieved from: http://www.diabeteseducator.org/export/sites/aade/_resources/pdf/publications/Outcomes_Technical_Review_Aug.pdf American Diabetes Association (ADA). (October, 2013). The Cost of Diabetes. Web. Retrieved from: http://www.diabetes.org/advocacy/news-events/cost-of-diabetes.html Clement, S. (1995). Diabetes self-management education. Diabetes care, Volume 18(8), pp. 1204-1214. Elliott, J. A. et al. (February 2013). Diabetes Self-Management and Education of People Living with Diabetes: A Survey in Primary Health Care in Muscat Oman. PloS one, Volume 8(2), pp. e57400. Funnell, M. M. et al. (2012). National Standards for Diabetes Self-Management Education. Diabetes care, Volume 35 (Supplement 1), pp. S101-S108. International Diabetes Federation (IDF). (2014). Diabetes Atlas.Web. Retrieved from: http://www.idf.org/diabetesatlas Hunt, C. W. (2013). Self-care management strategies among individuals living with type 2 diabetes mellitus: nursing interventions. Nursing: Research & Reviews, 3. NHS. (2011). Diabetes. Web. Retrieved from: http://www.nhs.uk/Conditions/ Norris, S. L., Engelgau, M. M., & Narayan, K. V. (2001). Effectiveness of Self-Management Training in Type 2 Diabetes A systematic review of randomized controlled trials. Diabetes care, Volume 24(3), pp. 561-587. Norris, S. L., Lau, J., Smith, S. J., Schmid, C. H., &Engelgau, M. M. (2002). Self-Management Education for Adults With Type 2 Diabetes A meta-analysis of the effect on glycemic control. Diabetes care, Volume 25(7), pp. 1159-1171. Renders, C. M., Valk, G. D., Griffin, S., Wagner, E. H., Van Eijk, J. T., &Assendelft, W. J. J. (2000). Interventions to improve the management of diabetes mellitus in primary care, outpatient and community settings. Cochrane Database of Systematic Reviews, 4. Shrivastava, S. R., Shrivastava, P. S., &Ramasamy, J. (2013). Role of Self-Care in Management of Diabetes Mellitus. J Diabetes MetabDisord, Volume 12(1), p. 14. Tschannen, D., Aebersold, M., Sauter, C., &Funnell, M. M. (2013). Improving nurses perceptions of competency in diabetes self-management education through the use of simulation and problem-based learning. Journal of continuing education in nursing, Volume 44(6), pp. 257-263. World Health Organisation (WHO). (2012). Diabetes.Web. Retrieved from: http://www.who.int/mediacentre/factsheets/fs312/en/ Read More