Student’s
Name
Instructor
Course
Institution
Date
Theoretical Framework
The theoretical framework helps to explain the
reason for a specific theory and a concept that is being used in a research,
related to a practice problem. The
researcher will use the theoretical framework to connect the research to an
existing nursing theory (Grove, Burns, & Gray, 2013). A theory can be tested with the research to
prove or a new theory can be developed
by conducting a research (Lunney, 2008).
Identified Article and Theoretical Framework
The article that I chose to use for this week’s
discussion is about the health literacy and self-care activities,
self-efficacy, and health-related outcome of patients with type 2 Diabetes. The
poor health literacy among the population will increase the complications,
decrease the patient outcomes, and escalates the health care costs. There are many factors that may lead to poor
health literacy (Weld, Padden,
Ramsey, & Garmon Bibb, 2008). I
work in a community hospital and our patient population has a higher number of
homeless population and Hispanic patients.
In this population, there is an identifiable knowledge deficit about
health is seen due to low economic status to access health care and minimal
knowledge due to language barriers.
Social cognitive theory was used in this research about self-care, self-efficacy,
and quality of life in patients with type 2 Diabetes. The study revealed that the health care
literacy is directly linked with patient’s self-efficacy. Self-efficacy can be
improved by health literacy about diet, self-monitoring blood glucose levels,
compliance with medications and treatment, and lifestyle modification with
exercise (Lee, Lee, & Moon, 2016).
Framework and the Research
Health belief model (HBM) and social cognitive
theory (SCT) was used in the research.
The concept of HBM is when there is an increased patient awareness of a
disease condition; it will decrease the negative health outcomes (Weld.et.al,
2008). Albert Bandura developed the
SCT. Self-efficacy is one of the
constructs of this theory. SCT is being
used in many community-based researches that involve public health problems and
health literacy (Weld.et.al, 2008). The
selected research study was conducted to assess the health literacy level of
the participants in 12 items related to diabetes management and compared with
HbA1c results of the participants. The
study revealed that the self-efficacy and self-care activities were linked with
improved health care outcomes (Lee, Lee, & Moon, 2016). The selected framework was appropriate for
the research as it revealed the association of health literacy in improving the
patient outcomes.
My Insights and Application to a practice problem
Theories guide nursing practice (McEwen & Wills, 2014). I learned about how health belief model and
social cognitive theory can be applied to a practical problem that relates to
health literacy. In my workplace, many
patients are readmitted with chronic obstructive pulmonary disease (COPD). I can correlate the health literacy to
minimize the readmissions due to acute exacerbation of COPD. The readmissions can be minimized by
improving the health literacy of the population by incorporating HBM and SCT in
the clinical practice.
Treatment
of diabetes is known to be a lifelong commitment to medication, monitoring of
blood sugar and lifestyle modification. It involves a physical and emotional
commitment that may decrease the life expectancy of a diabetic patient. Due to their instability, diabetic patients
must maintain their blood sugar within a certain range to avoid hypo or
hyperglycemia. Non-adherence to
treatment leads to retinopathy (blindness), diabetic nephropathy (kidney
disease), neuropathy (amputation) strokes and heart diseases. Diabetes
shouldn't be a death sentence if there's a proper collaboration between a
patient's primary doctor, psychiatrist, and psychology.
Depression
treatment, self- efficacy, peer support, lifestyle intervention, literacy, self
-management and involvement of social worker when put into consideration can
determine longevity in a patient with diabetes. Compliance with treatment in the care of a patient
with Type 2 Diabetes can be affected by implementing cognitive behavioral
therapy, mental contrasting, community resource involvement, and peer support.
Addition of supportive therapy increases compliance to therapy and longevity in
the adult with Type 2 diabetes. The responsibility of compliance with diabetic
care lies within the patient; patient must accept and be receptive to the
treatment of this chronic disease in other to have a positive and optimum
outcome.
In
addition to aforementioned determinants, the role of social worker as part of
determinants of longevity in patients with diabetes was emphasized. Information from the (Avalon et al., 2008)
acknowledged diabetes as a biopsychosocial disease; that brings the role of
social worker in as an aid to assist the patients with diabetes to achieve
longevity. Management of diabetes involves a change in lifestyle that includes
keeping a low sugar diet, maintaining an exercise regime, monitoring daily
blood sugar and taking oral or insulin supplement". These changes are
overwhelming that the patients who did not have a support or an assist in
getting medical needs will not be able to perform. The social worker has a
unique impact in helping patients with diabetes to maintain a healthy lifestyle
(Avalon et al., 2008).
According to (Yin et al, 2015), one method of reducing
hierarchical relationships, as related to diabetic care, and increasing
compliance in care of the adult with Type 2 diabetes has been accomplished in
“train the trainer” programs. These
programs enlist individuals with diabetes ready to be trained as a
trainer. “Train the trainer” programs
provide basic knowledge and emotional support to individuals with Type 2
diabetes. The training focuses on peer
to peer communication, diabetic diet reviews, weight management, and physical
activity. This “train the trainer”
method of diabetic teaching helped to increase compliance through per support,
thereby helping to increase longevity in the adult diagnosed with Type 2
diabetes.
As per (Chuenijid et al., 2014), Parental advice and
psycho-socio-economic support like self -value and esteem, group psychotherapy,
along with the use of antidepressant helped children in overcoming the impediment
of adherence. As patient move along his or her lifespan, he or she must be
willing to move more independently toward self- care to increase longevity. These findings affirmed that a collaboration
of care through multidisciplinary treatment, such as cognitive therapy, the
patient’s own acceptance of his diagnosis, and his willingness to participate
in treatment will improve treatment outcomes. Acceptance is demonstrated
through various self-care activities such as blood sugar monitoring, adherence
to medications and insulin when necessary.
The trainer will be taught how to be an empathetic
listener to be able to appropriately answer questions that the patient might
have. The training includes the use a licensed dietician to educate diabetic
patients on the misconception of diabetes diet, cooking tips and suggested ways
on weight management. Qualified nurse educator can deliver a training on
physical activity, precaution to take during exercise and how to acquired
motivation for daily exercise. (Yin et al, 2015). Furthermore, individual’s confidence in the
ability to perform routine glucose monitoring, diet compliance and weight
reduction exercises and treatment will influence involvement in the overall
treatment. A patient with diabetes has to have self-efficacy, meaning believing
in one’s ability to succeed in a particular situation. If interventions are
made towards self-efficacy, then patients will display improvement in
self-management of chronic disease and positive health outcome.
According to a study by (McCleary-Jones, 2011), Diabetes
was an irreversible autoimmune disorder, the disease of the endocrine system
that developed when there is an impaired fasting glucose or impaired glucose
tolerance. Due to these, the research was based on how the healthcare
professional can effectively improve the quality of life and increase the
longevity of diabetes patients. In the study, it was found out that to
determine the longevity of diabetes patients there must be collaboration in
treatment. The treatment needs to involve psychiatrist, psychology, social
worker and level of literacy of patient with type 2 diabetes. The study
emphasizes on Depression, Quality of life, Peer support, Literacy,
Self-efficacy, Lifestyle Intervention and Cognitive Behavioral treatment as the
intervention for the determinant of longevity for a patient with diabetes.
Conclusion
Diabetes is known to be an irreversible autoimmune disorder
that attacks pancreatic bête cell and there are many compensatory hormonal and
inflammatory changes that may exacerbate depression in an adult with type 2
diabetes. If the healthcare provider can collaborate with each other on the
treatment of diabetes with the review of suggested determinants of longevity as
discussed above, a patient with diabetes will have a good quality of life and
have long longevity. When self-efficacy
is enhanced, stress management, goal setting, and decision- making will improve
metabolic control in people with diabetes.
References
Grove, S. K., Burns, N., & Gray, J.
R. (2013). The practice of nursing research: Appraisal, synthesis, and generation of
evidence (7 ed.). St. Louis, MO:
Elsevier Saunders.
Ayalon, Liat. Gross, Revital. Tabenkin,
Hava. (2008, August). Determinants of Quality of Life in Primary Care Patients
with Diabetes: Implications for Social workers. Health and Social Work, 33(3),
229-236. Retrieved from http://web.b.ebscohost.com.pgcmls.idm.oclc.org/ehost/delivery.
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