Diabetes Self-Management In Urban, Underserved Population

In the following case study, the author will discuss the issues surrounding a seventy-year-old female with a chronic neuropathic ulcer on the sole of her right foot and the rationale and implications of

Diabetes affects nearly 10% of the total population and national cost of more than $200 billion each year in the United States (Center for Diseases Control and Prevention, 2017). Before the patient protection and affordable care act (PPACA), many low-income diabetes patients had no or very limited access of health insurance coverage due to financial disadvantage. PPACA Title II-Role of public programs expanded Medicaid coverage to individuals under 133% of the federal poverty level (Obamacarefacts.com, 2013). Nurses directly interact with low-income diabetes patients to guide, advocate, educate and navigate the complex healthcare system to deliver the best evidenced care (Marquis &

The Faith, Importance and influence, Community, and Address in Care (FICA) Spiritual History Tool provides a way for “the clinician to efficiently integrate open-ended questions into a standard medical history and can be used by any health care professional” (Borneman, Ferrell, & Puchalski, 2010). The FICA tool explores the presence of faith, the importance of spirituality, the influence a person’s spirituality has on their health care decisions, the involvement in a spiritual community, and the interventions to address spiritual needs (Borneman et al., 2010).

It is estimated that 387 million people, globally live with diabetes (Phillips & Mehl, 2015). According to Medical News Today [MNT], diabetes is a metabolic disorder; which causes patients to be extremely thirsty and produce a lot of urine. Diabetes arises due to high blood pressure, due to the body not being able to produce enough insulin or because the body does not respond well to high insulin levels (MNT, 2016). There are four types of diabetes; there is the pre-diabetic stage, type 1 diabetes, type 2 diabetes and gestational diabetes. In 2014, 29 million people died due to diabetes. This equates to 1 diabetic patient dying every seven seconds due to preventable complications (including complications affecting lower limbs) caused by diabetes. It is said that 20-40% of health care costs are spent on the treatment of lower limb complications due to diabetes. The risk of a diabetic patient developing a foot ulcer is 25% and foot ulcers account approximately 85% of lower limb amputations. Diabetic complications that affect lower limbs are caused by both type 1 and type 2 diabetes (Phillips & Mehl, 2015). It is said that the World Health Organization described diabetic foot syndrome as including all possible complications in relation to the feet of a diabetic patient. Diabetic foot syndrome is defined as the ulceration of the foot, from the ankle downwards. Causes of foot ulceration include peripheral sensory neuropathy, vascular disease (ischaemia) and infection

venous leg ulcers and diabetic foot ulcers. Canadian Association of Wound Care (CAWC) has published

We reflecting the author’s own culture, she like many people in the United States are a blend of many different cultures and ethnicity. By not having one single ethnic culture her family views health traditions based on their religion of Christian Scientist. Being raised in this religion molded views of health promotion, prevention and treatment that influence her health behaviors today. There is a difference of opinion between Christian Science and traditional medical views. “Christian Scientist interpret disease from a spiritual view where medicine interprets disease from a material point of view” (Stoddard, 2010). As a child our family was raised with the belief that good nutrition, physical activity, and the role of positive thinking and mind over matter, would provide health and help us remain strong and healthy. Not having over the counter medications or turning to traditional medicine for simple medical issues was chosen as our families way of viewing illness. Growing up with the view of health and illness as spiritual using techniques such as meditation, prayer and positive thinking, has stayed as a health tradition among our families beliefs and practices to this day. Today modern medicine is looking at the mind as a valuable tool to prepare persons and bodys for wellness and rehabilitation. An example of this would be biofeedback. This is a technique where people are

Diabetes is a chronic disease that requires constant self-care management practices among diabetic patients. The patients have to make decisions to stick to a strict diet and exercise plan, they also have to be involved in complex activities aimed towards their care and health. Diabetes self-management education provides patients with essential information and has been shown to have a positive impact on the health of patients. Self-management enhances patients with skills and knowledge and information for self-care. The problem focus for this project is lack of culturally diabetes self-management education for the diabetic Hispanic adult population who receive care at a free clinic in Indio, California. Patients who have diabetes need information about their behavior and diet plans to help in the management and maintenance

The goal to treat an ulcer in a diabetic patient is to heal the wound faster to prevent infection, pressure has to be take off the area by “offloading” the foot, remove dead tissue by the process of debridement, apply to dress per doctors order, and focus on managing the patient’s blood sugar effectively to promote healing. In addition, to prevent infection, the patient must keep the dressing clean, cleanse the wound daily and change the bandage and dressing, the patient must also avoid walking on barefoot.

For health care providers to deliver the best holistic care that patients deserve, a thorough spiritual assessment must be included during their care. With more research showing a relationship between supporting a patient’s spirituality with their health and ability to cope with illness, it is now a requirement of organizations to include a spiritual assessment to maintain accreditation with The Joint Commission. The minimum required of a spiritual assessment by The Joint Commission is to determine the patient’s religion and

According to Pozgar (2016), “Spirituality implies that there are purpose and meaning to life; spirituality generally refers to faith in a higher being” (p. 52). In the health care settings, patients and providers need to face unique situations in where sometimes their spirituality is their only hope to cope with the results. In the present days, with an emphasis on a holistic approach, it is very important to consider the spiritual and religious preferences of patients. However, not only spirituality and religion can be a support for patients, also, patient’s beliefs can affect their treatments and health care providers need to learn how to approach this type of situations with ethics. As

Commonly used techniques in clinical practice for healing and preventing foot ulcers are offloading and footwear. The goal of this article was to assess the medical, scientific literature to have a

According to Healthy People 2012 there are more then 800,000 new cases of diabetes each year, with the numbers on the rise. With this in mind, Healthy People 2012 has identified diabetes as their number five focus area. In order to reach their goal of improving the quality of life for people with diabetes they have identified diabetes teaching as their number one objective. Furthermore, in order to reduce the number of complications of diabetes, Healthy People 2012 has identified foot ulcers as their ninth objective. Through patient education Healthy People 2012 hopes to reduce the number of foot ulcers in people with diabetes, as diabetes is the number one cause of nontraumatic amputations in the United States. In order to

There is a high incidence of diabetes within this community. According to the American Diabetes Association, Depression can affects 20-25% of patients who have diabetes, but due to the stigma, finances, and other barriers many patients may go undiagnosed or untreated. A patient’s mental health can have an influence on their glycemic control and overall quality of life. The driving force behind this project was a need to raise awareness of mental health, enhance collaboration, and to improve patient outcomes.

Self-efficacy and the value of health had lead the patients to better outcomes and less complications (Nugent, Carson, Zammitt, Smith, & Wallston, 2015). It was also observed by Gomersall, Madill and Summers that spirituality and self-management of T2DM had both positive and negative correlations (Gomersall et al., 2011). African American patients with T2DM who were Christians had two distinctively different views on their chronic illness; some saw the God as a supporter and others as a healer (Gomersall et al., 2011). Patients who viewed the God as a supporter were more motivated and able to produce positive results when others who viewed the God as a healer became passive and had negative outcomes (Gomersall et al., 2011). Observed individual’s spirituality was perceived similarly to the former. Being an active and sincere Buddhist for more than 20 years, she accepted her fate and her illness as a part of her journey. The observed individual believed that the illness also has been guiding her to live a purified life and have a clean body by exercising and eating healthy that contributed to positive outcomes of

Abstract- Diabetic foot ulcers speak to a critical medical problem. Right now, clinicians and medical caretakers primarily construct their injury evaluation in light of visual examination of wound size and mending status, while the patients themselves rarely have a chance to play a dynamic part. Henceforth, love quantitative and practical examination technique that empowers the patients and their parental figures to take a more dynamic part in every day wound care