NURS2038 Illness Prevention and Management Study Guide 2024 S2 (PDF)

+-----------------------+-----------------------+-----------------------+ | | **Key Content** | | +=======================+=======================+=======================+ | | Chronic Illness - | | |...

+-----------------------+-----------------------+-----------------------+ | | **Key Content** | | +=======================+=======================+=======================+ | | Chronic Illness - | | | | | | | | "A chronic | | | | illness/disease is a | | | | health condition that | | | | is persistent or | | | | otherwise | | | | long-lasting in its | | | | effects or a | | | | | | | | disease that | | | | progresses with time. | | | | The social and | | | | economic consequences | | | | of chronic disease | | | | can impact on | | | | peoples' quality of | | | | life. The term | | | | chronic is generally | | | | applied when the | | | | course of the disease | | | | lasts for more than | | | | three months." | | | | | | | | While some chronic | | | | conditions can be | | | | cured, generally the | | | | focus of care is on | | | | preventative | | | | management and care. | | | | | | | | The Australian | | | | Institute of Health | | | | and Welfare commonly | | | | reports on 10 major | | | | chronic conditions | | | | | | | | - - - - - - | | | | - - - | | | | | | | | \*focus on these | | | | ones, not the ones | | | | from the ABS provided | | | | in week 3 lecture. | | | | | | | | **Disease** = | | | | pathophysiology of a | | | | condition | | | | | | | | **Illness** = "the | | | | human experience of a | | | | disease (how it is | | | | perceived, lived with | | | | responded to by | | | | individuals, their | | | | families, and | | | | healthcare | | | | professionals)" | | +-----------------------+-----------------------+-----------------------+ | | 47% (1 in 2) of | | | | Australians report | | | | having at least 1 | | | | chronic condition | | | | from the 'top 10 most | | | | prevalent conditions' | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | | Chronic illness | | | | accounts for **1 in | | | | every 2 | | | | hospitalisations** | | | | | | | | Chronic illness/ | | | | disability can affect | | | | all dimensions of a | | | | person's life - | | | | **physical, | | | | psychological/ | | | | social, spiritual and | | | | environmental** | | | | | | | | Care provision must | | | | be holistic C | | | | culturally sensitive | | | | | | | | Care must be relevant | | | | to the person (person | | | | centred) who has the | | | | chronic illness and | | | | their family | | | | | | | | Care providers must | | | | take a 'whole of | | | | life' approach, with | | | | understanding of risk | | | | factors that | | | | contribute to chronic | | | | illness | | | | | | | | Principles of Chronic | | | | Care: | | | | | | | | - - - | | | | | | | | | | | | | | | | - - | | | | | | | | | | | | | | | | - - | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | | - | | +=======================+=======================+=======================+ | | The nurse's role in | | | | chronic illness | | | | management | | | | | | | | Leveraging the | | | | principles of chronic | | | | illness management, | | | | the nurse's role is | | | | to | | | | | | | | - - - - | | +-----------------------+-----------------------+-----------------------+ | | Is cost-effective, | | | | efficient, care | | | | approach to | | | | preventing and/or | | | | managing health | | | | risks, enhance | | | | quality of life and | | | | affect enduring | | | | change. Primary | | | | health care uses | | | | person-centred care | | | | to address physical, | | | | mental and social | | | | well-being. | | | | | | | | Rather than being | | | | reactive and dealing | | | | with a problem when | | | | it arises, focus on | | | | regular maintenance | | | | and quality education | | | | to prevent issues | | | | arising. | | | | | | | | **Principles of | | | | Primary Health | | | | care:** | | | | | | | | **Access:** The | | | | ability of | | | | individuals to obtain | | | | and utilize | | | | healthcare services | | | | when needed. This | | | | includes factors such | | | | as availability, | | | | affordability, and | | | | geographic proximity | | | | of services to ensure | | | | everyone can receive | | | | the care they | | | | require. | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | | **Equity**: The | | | | principle of fairness | | | | in healthcare, | | | | ensuring that | | | | individuals have | | | | access to the care | | | | they need based on | | | | their specific | | | | circumstances, rather | | | | than everyone | | | | receiving the same | | | | level of care. It | | | | focuses on reducing | | | | health disparities | | | | across different | | | | populations. | | | | | | | | **Empowerment**: (see | | | | below) A process | | | | designed to | | | | facilitate | | | | self-directed | | | | behaviour change by | | | | encouraging a focus | | | | on strengths and | | | | abilities. | | | | Empowerment allows | | | | patients to build | | | | capacities to gain | | | | access, networks | | | | and/or a voice, to | | | | gain control over | | | | their health | | | | decisions. | | | | | | | | **Health Literacy:** | | | | (see below) Health | | | | literacy is the | | | | skills, knowledge, | | | | motivation and | | | | capacity of a person | | | | to access, | | | | understand, appraise | | | | and apply information | | | | to make effective | | | | informed decisions | | | | about their health. | | | | | | | | **Community | | | | Participation:** The | | | | involvement of | | | | individuals and | | | | communities in | | | | decision-making | | | | processes, planning, | | | | and implementation of | | | | health interventions | | | | or programs that | | | | affect their | | | | well-being. It | | | | promotes a sense of | | | | ownership and | | | | relevance to local | | | | health needs (note | | | | this does not refer | | | | to the socialisation | | | | of the socially | | | | isolated. The focus | | | | is on planning and | | | | development of health | | | | programs). | | | | | | | | **Cultural | | | | Sensitivity:** | | | | Awareness and respect | | | | for the cultural | | | | differences, beliefs, | | | | values, and practices | | | | of | | | | | | | | individuals and | | | | communities when | | | | delivering healthcare | | | | services. It involves | | | | adapting care to meet | | | | the unique cultural | | | | needs of patients. | | | | | | | | **Cultural Safety:** | | | | Providing an | | | | environment in | | | | healthcare where | | | | individuals feel | | | | respected, valued, | | | | and safe, free from | | | | discrimination or | | | | harm due to their | | | | cultural identity. It | | | | requires healthcare | | | | providers to | | | | challenge power | | | | imbalances and ensure | | | | care is responsive to | | | | cultural diversity. | | | | | | | | **Intersectoral | | | | Collaboration**: | | | | Cooperation and | | | | coordination between | | | | various sectors | | | | (e.g., health, | | | | education, housing, | | | | social services, and | | | | government) to | | | | address the broader | | | | determinants of | | | | health and improve | | | | public health | | | | outcomes. It | | | | emphasises integrated | | | | approaches across | | | | multiple fields to | | | | solve complex health | | | | | | | | problems. | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | | **Health Promotion**: | | | | The process of | | | | enabling individuals | | | | and communities to | | | | increase control over | | | | and improve their | | | | health by addressing | | | | broader social, | | | | environmental, and | | | | behavioural | | | | determinants. Health | | | | promotion includes | | | | initiatives such as | | | | education campaigns, | | | | public policies, and | | | | community-based | | | | interventions. | | | | | | | | **Appropriate | | | | Technology**: The use | | | | of technology that is | | | | well-suited to the | | | | specific social, | | | | economic, and | | | | cultural contexts of | | | | the population it is | | | | intended to serve. In | | | | healthcare, this | | | | means using tools and | | | | solutions that are | | | | affordable, | | | | accessible, and | | | | sustainable for a | | | | particular community, | | | | such as telehealth in | | | | rural areas. | | +=======================+=======================+=======================+ | | **Health Literacy** - | | | | Health literacy is | | | | the skills, | | | | knowledge, motivation | | | | and capacity of a | | | | person to access, | | | | understand, appraise | | | | and apply information | | | | to make effective | | | | informed decisions | | | | about their health. | | | | | | | | Outcomes associated | | | | with high health | | | | literacy: | | | | | | | | - - - - - - | | | | - - - - | | | | | | | | **Health education is | | | | "***any combination | | | | of learning | | | | experiences designed | | | | to help individuals | | | | and communities | | | | improve their health, | | | | by increasing their | | | | knowledge or | | | | inffuencing their | | | | attitudes*" | | | | | | | | Health education can | | | | be delivered in two | | | | different ways: | | | | | | | | **Planned** -- | | | | structured, organised | | | | and prescheduled, | | | | often focused on an | | | | identified need. | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | | **Opportunistic** -- | | | | spontaneous, informal | | | | and often provided | | | | throughout routine | | | | provision of care as | | | | it relates to an | | | | episode of care. | | | | | | | | **8 factors that | | | | affect learning**: | | | | | | | | - - - - - - | | | | - - | | | | | | | | Prior to planning and | | | | implementing health | | | | education it is | | | | important to first | | | | assess a person's | | | | health literacy | | +=======================+=======================+=======================+ | | **Self-**Management | | | | is the ability of | | | | individuals and their | | | | support networks to | | | | promote and maintain | | | | health, and | | | | | | | | prevent disease, or | | | | cope with illness or | | | | disability. | | +-----------------------+-----------------------+-----------------------+ | | **Empowerment** is a | | | | process designed to | | | | facilitate | | | | self-directed | | | | behaviour change by | | | | encouraging a focus | | | | on strengths and | | | | abilities. | | | | Empowerment allows | | | | patients to build | | | | capacities to gain | | | | access, networks | | | | and/or a voice, to | | | | gain control over | | | | their health | | | | decisions. | | | | | | | | The role of the nurse | | | | in fostering | | | | empowerment is: | | | | | | | | - - - - - | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | | Disempowering | | | | behaviour includes: | | | | | | | | - | | | | | | | | Disempowerment may | | | | cause ongoing patient | | | | dependence or | | | | withdrawal from | | | | healthcare | | +=======================+=======================+=======================+ | | The **Readiness to | | | | Change Model**, also | | | | known as the | | | | Transtheoretical | | | | Model (TTM), consists | | | | of five stages of | | | | change. These stages | | | | reflect an | | | | individual\'s | | | | readiness to modify | | | | behaviour, often used | | | | in contexts like | | | | health behaviour | | | | changes (e.g., | | | | quitting smoking, | | | | weight loss, or | | | | managing chronic | | | | conditions). The | | | | stages are: | | | | | | | | 1. 2. 3. 4. 5. | | | | | | | | A sixth stage is | | | | anticipated: | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | | 6\. Lapse and | | | | relapse: **Lapse** | | | | is a one-off return | | | | to behaviour that | | | | doesn't lead to old | | | | patterns of use | | | | | | | | A lapse can present | | | | an opportunity for | | | | self-discovery and | | | | learning that will | | | | promote meaningful | | | | change | | | | | | | | **Relapse** involves | | | | a return to previous | | | | patterns of behaviour | | | | | | | | People can cycle | | | | through these stages' | | | | multiple times, and | | | | they may not always | | | | be linear. | | +=======================+=======================+=======================+ | | The **5As model of | | | | behaviour change** is | | | | a structured | | | | framework used in | | | | healthcare to help | | | | individuals adopt | | | | healthier behaviours. | | | | It is particularly | | | | useful in managing | | | | chronic conditions, | | | | promoting lifestyle | | | | changes, and | | | | preventive | | | | healthcare. The 5As | | | | stand for: | | | | | | | | 1. 2. | | | | | | | | | | | | | | | | 3. 4. 5. | | | | | | | | The 5As model | | | | provides a systematic | | | | approach to guiding | | | | patients through the | | | | process of behaviour | | | | change, supporting | | | | them at every stage. | | | | This also requires | | | | the nurse to: | | | | Establish a rapport | | | | so clients have | | | | opportunities to | | | | express concerns | | | | freely | | | | | | | | - - | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | | - | | +=======================+=======================+=======================+ | | **Co-morbidity** - | | | | The presence of two | | | | or more chronic | | | | conditions in a | | | | person at the same | | | | time. Comorbidity | | | | means that one | | | | \'index\' condition | | | | is the focus of | | | | attention, and others | | | | are viewed in | | | | relation to this. | | | | | | | | **Multimorbidity** - | | | | The presence of two | | | | or more (unrelated) | | | | chronic conditions in | | | | a person without any | | | | of | | | | | | | | conditions holding | | | | priority over the | | | | others (definition | | | | provided in lecture, | | | | though conditions may | | | | be related and still | | | | considered | | | | multimorbid, eg. CVD | | | | and CRD). | | +-----------------------+-----------------------+-----------------------+ | | **Burden of disease** | | | | measures the impact | | | | of living with | | | | illness and injury | | | | and dying | | | | prematurely. | | | | | | | | Burden of disease is | | | | measured using | | | | disability-adjusted | | | | life years | | | | **(DALYs)** | | | | | | | | One **DALY** is 1 | | | | year of 'healthy | | | | life' lost due to | | | | illness and/or | | | | death---the more | | | | DALYs associated with | | | | a disease or injury, | | | | the greater the | | | | burden | | +-----------------------+-----------------------+-----------------------+ | | **Modifiable risk | | | | factors** are | | | | behaviours or | | | | characteristics that | | | | individuals can | | | | change or control to | | | | reduce their risk of | | | | developing chronic | | | | illnesses. These | | | | factors are directly | | | | influenced by | | | | lifestyle choices, | | | | behaviours, or | | | | environmental | | | | exposures. Addressing | | | | modifiable risk | | | | factors can help | | | | prevent or manage | | | | chronic conditions. | | | | Common (but not all) | | | | modifiable risk | | | | factors include | | | | Smoking, Nutrition, | | | | Alcohol, Physical | | | | inactivity | | | | | | | | **Non-modifiable risk | | | | factors** are aspects | | | | of an individual\'s | | | | health or | | | | circumstances that | | | | cannot be changed or | | | | controlled. These | | | | factors may increase | | | | the likelihood of | | | | developing chronic | | | | diseases but are | | | | beyond a person\'s | | | | ability to alter. | | | | Understanding | | | | non-modifiable risk | | | | factors helps | | | | healthcare providers | | | | assess an | | | | individual\'s risk | | | | for certain | | | | conditions and guide | | | | preventive measures. | | | | These may include | | | | genetics/family | | | | history, age, cis- | | | | | | | | gender or ethnicity. | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | | **Social determinants | | | | of health** are the | | | | non-medical factors | | | | that influence health | | | | outcomes. These | | | | include the | | | | conditions in which | | | | people are born, | | | | grow, work, live, and | | | | age, and the wider | | | | set of forces and | | | | systems shaping the | | | | conditions of daily | | | | life. | | | | | | | | Some common SDH are: | | | | | | | | 1. 2. 3. 4. 5. 6 | | | |. 7. 8. 9. 10. | | +=======================+=======================+=======================+ | | **Motivational | | | | Interviewing** is a | | | | strategy to encourage | | | | behavioural change, | | | | with the health | | | | professional working | | | | in partnership with | | | | individuals and | | | | families to offer | | | | non-judgmental | | | | information and | | | | strategies to | | | | facilitate | | | | | | | | positive change. | | | | | | | | This is a technique | | | | used to facilitate | | | | empowerment, but it | | | | is not the same as | | | | empowerment. Make | | | | sure you know the | | | | subtle difference | | | | between the two. | | | | | | | | It uses the following | | | | stages: | | | | | | | | 1\. **Engaging**: | | | | Establishing a | | | | trusting, | | | | collaborative | | | | relationship with | | | | the patient by | | | | actively listening | | | | and showing | | | | empathy. | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | | 2. 3. 4. | | | | | | | | A common | | | | communication | | | | technique used in | | | | motivation | | | | interviewing is the | | | | OARS model: | | | | **Open-ended** | | | | questions to engage | | | | person in | | | | conversation | | | | (increases | | | | participation) | | | | **Affirm** a person's | | | | strengths and | | | | progress | | | | | | | | **Reflect** on | | | | person's situation -- | | | | helps person see a | | | | way forward/ missing | | | | 'piece of the puzzle' | | | | | | | | **Summarise** to | | | | confirm understanding | | +=======================+=======================+=======================+ | | A **health strategy** | | | | is a plan that guides | | | | the actions and goals | | | | of a healthcare | | | | organisation or | | | | system. It can help | | | | improve the quality, | | | | efficiency, and | | | | effectiveness of | | | | healthcare services, | | | | as well as address | | | | the challenges and | | | | opportunities in the | | | | changing healthcare | | | | environment. These | | | | are usually developed | | | | at a federal or state | | | | level and identify | | | | key areas of | | | | priority, funding and | | | | resources available | | | | and outcome measures. | | | | They do not provide | | | | specific | | | | interventions or | | | | programs, as these | | | | need to be developed | | | | by local health | | | | networks and | | | | communities to meet | | | | the specific needs of | | | | the community. | | | | | | | | To support those | | | | living with chronic | | | | illness the | | | | Australian government | | | | has a range of | | | | illness management | | | | programs. These | | | | include: | | | | | | | | Medicare Benefits | | | | Schedule | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | | - - - | | +=======================+=======================+=======================+ | | **Person-centred | | | | care** - The practice | | | | in which patients | | | | actively participate | | | | in their own medical | | | | treatment in | | | | | | | | close cooperation | | | | with their health | | | | professionals. | | | | Person-centred care | | | | considers the | | | | patient's (and their | | | | family's) goals, | | | | values and | | | | preferences when | | | | developing a health | | | | care plan | | +-----------------------+-----------------------+-----------------------+ | | People living in | | | | rural and remote | | | | areas have higher | | | | rates of | | | | hospitalisations, | | | | deaths, injury | | | | | | | | People living in | | | | rural and remote | | | | areas have poorer | | | | access to and are | | | | less likely to | | | | utilise primary | | | | health care services, | | | | than people living in | | | | urban areas. | | | | | | | | Generally, people | | | | living in rural and | | | | remote areas have: | | | | | | | | - - - - - - | | | | - - - - | | +-----------------------+-----------------------+-----------------------+ | | **eHealth** refers to | | | | "cost-effective and | | | | secure use of | | | | information and | | | | communications | | | | technologies in | | | | support | | | | | | | | of health and | | | | health-related | | | | fields, including | | | | health-care services, | | | | health surveillance, | | | | health literature, | | | | and health education, | | | | knowledge and | | | | research" (WHO, n.d.) | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | | **Telehealth** refers | | | | to "the use of | | | | electronic | | | | information and | | | | telecommunications | | | | technologies to | | | | support long- | | | | distance clinical | | | | health care, patient | | | | and professional | | | | health-related | | | | education, public | | | | health and health | | | | | | | | administration" | | | | (HRSA, n.d.) | | +=======================+=======================+=======================+ | | '**Health | | | | inequities** are | | | | differences in health | | | | status or in the | | | | distribution of | | | | health resources | | | | between different | | | | population groups, | | | | arising from the | | | | social conditions in | | | | which people are | | | | born, grow, live, | | | | work and age.' These | | | | inequities have | | | | significant social | | | | and economic costs | | | | both to individuals | | | | and societies. | | | | | | | | '**Vulnerability** is | | | | the degree to which | | | | an individual, | | | | population\...is | | | | unable to anticipate, | | | | cope with, resist, | | | | and recover from the | | | | impact of disease and | | | | disasters'. | | | | | | | | Vulnerable | | | | populations are | | | | groups of people who | | | | experience a | | | | disproportionate | | | | burden of disease, | | | | due to barriers to | | | | accessing adequate | | | | health care, that can | | | | lead to differences | | | | in health outcomes | | | | and life | | | | | | | | expectancy. These | | | | populations have a | | | | higher risk of | | | | developing chronic | | | | conditions. Some | | | | vulnerable | | | | populations in | | | | Australia include: | | | | | | | | - - - - - - | | | | - - - - - | | | | - | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | | **Stigma** refers to | | | | a negative set of | | | | beliefs, perceptions, | | | | or attitudes that | | | | society or | | | | individuals hold | | | | toward a person or | | | | group, often based on | | | | characteristics such | | | | as illness, | | | | disability, race, | | | | gender, or behaviour. | | | | Stigma leads to | | | | discrimination, | | | | marginalisation, and | | | | social exclusion, | | | | which can affect the | | | | mental, emotional, | | | | and physical | | | | well-being of those | | | | who are stigmatised. | | | | In healthcare, stigma | | | | can prevent | | | | individuals from | | | | seeking treatment or | | | | support due to fear | | | | of judgment or | | | | rejection. | | +=======================+=======================+=======================+ | | **Illness behaviour** | | | | is any activity, | | | | undertaken by a | | | | person who feels ill, | | | | to define the state | | | | of his health and to | | | | discover a suitable | | | | remedy. It is | | | | ddefined by the | | | | shifting of | | | | priorities and | | | | unfolds over time as | | | | people struggle to | | | | achieve some | | | | accommodation or | | | | management over their | | | | chronic illness | | | | | | | | Stages of illness | | | | behaviour: | | | | | | | | These 5 stages of | | | | illness behaviour are | | | | | | | | - - - - - | | | | | | | | **Illness behaviour | | | | can be influenced | | | | by**: | | | | | | | | - - - - - - | | | | | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | | **Adaption to | | | | Health** refers to | | | | the phenomenon that | | | | individuals, over | | | | time, adjust to a | | | | deterioration in | | | | their health and may | | | | lead to an increase | | | | in reported levels of | | | | quality of life, even | | | | if the health status | | | | has not improved | | +-----------------------+-----------------------+-----------------------+ | | **Advocacy** - | | | | Promoting patient | | | | safety and quality | | | | care. | | | | | | | | This includes; | | | | protecting patients, | | | | provision of quality | | | | care and | | | | interpersonal | | | | relationship as well | | | | as educating | | | | patients. | | | | Additionally, | | | | advocacy gives | | | | patients a voice in | | | | situations or | | | | settings where they | | | | could possibly be | | | | ignored or | | | | disregarded | | +-----------------------+-----------------------+-----------------------+ | | **Illness | | | | trajectory** | | | | describes the course | | | | or progression of | | | | chronic illness as | | | | experienced over time | | | |. | | | | | | | | The four defining | | | | \*\*illness | | | | trajectories\*\* | | | | describe patterns of | | | | decline experienced | | | | by individuals with | | | | chronic illness or | | | | terminal conditions. | | | | These trajectories | | | | help predict the | | | | course of a disease | | | | and guide appropriate | | | | care and management. | | | | Here are the four | | | | illness trajectories, | | | | along with examples: | | | | | | | | 1. - - | | | | | | | | | | | | | | | | 2. - - | | | | | | | | experiences periodic | | | | flare-ups requiring | | | | hospitalisation, | | | | followed by partial | | | | recovery. | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | | 3. - - | | | | | | | | | | | | | | | | 4. - - | | | | | | | | There is another | | | | illness trajectory | | | | not included in the | | | | lecture (so don't | | | | memorise this one): | | | | Terminal Illness | | | | | | | | - | | | | | | | | distinguishing it | | | | from prolonged | | | | decline trajectory), | | | | with a clear terminal | | | | phase. This | | | | trajectory is common | | | | in illnesses where | | | | death is expected | | | | after a defined | | | | period of illness. | | | | | | | | - | | | | | | | | Understanding these | | | | trajectories allows | | | | healthcare providers | | | | to tailor | | | | interventions, offer | | | | appropriate timely | | | | interventions, plan | | | | and organise | | | | interventions in | | | | anticipation of needs | | | | preventing delays in | | | | care, and better | | | | | | | | communicate with | | | | patients and their | | | | families about | | | | prognosis and | | | | planning. | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | | Betty Batfish is a | | | | 58-year-old lady who | | | | lives with her | | | | husband in Mt Lawley. | | | | Betty is overweight | | | | and drinks 'a couple | | | | of wines on the | | | | weekend'. Betty is | | | | employed as a chef at | | | | a popular restaurant. | | | | Betty has a busy | | | | social life and | | | | enjoys 'fancy dinners | | | | with my friends'. | | | | Betty has recently | | | | been diagnosed with | | | | T2DM. Though she was | | | | prescribed Metformin, | | | | Betty doesn't like | | | | taking any medication | | | | because 'taking | | | | tablets makes me feel | | | | old'. | | | | | | | | Discuss the different | | | | dimensions of Betty's | | | | life as they have | | | | been affected by her | | | | diagnosis. | | | | | | | | Points for | | | | consideration: | | | | | | | | 1. | | | | | | | | Betty's diagnosis of | | | | T2DM directly affects | | | | her metabolic health. | | | | Being overweight is a | | | | significant risk | | | | factor for the | | | | progression of | | | | diabetes and its | | | | complications, such | | | | as cardiovascular | | | | disease, neuropathy, | | | | and vision problems. | | | | Her reluctance to | | | | take medication could | | | | potentially worsen | | | | her blood sugar | | | | control and increase | | | | her risk of long-term | | | | complications. It is | | | | also important to | | | | consider her weight | | | | and diagnosis of T2DM | | | | may not be exclusive | | | | to diet and exercise. | | | | There could be | | | | stressors in her life | | | | leading to cortisol | | | | release that will | | | | increase chronic | | | | blood sugars, she may | | | | have genetic risk | | | | factors, she may have | | | | been previously | | | | required to take high | | | | | | | | doses of | | | | corticosteroids for | | | | another condition -- | | | | there are a range of | | | | other biophysical | | | | elements and it is | | | | | | | | important not to make | | | | assumptions about | | | | causes of her | | | | diabetes. Stress will | | | | disrupt sleep which | | | | can further increase | | | | risk of diabetes, and | | | | weight or metabolic | | | | problems. Part of our | | | | holistic approach | | | | needs to consider | | | | assessment of all | | | | these factors. | | | | | | | | Betty enjoys | | | | socialising, | | | | including frequent | | | | fancy dinners and | | | | alcohol consumption. | | | | These lifestyle | | | | factors, particularly | | | | diet and alcohol | | | | intake, can affect | | | | her ability to manage | | | | T2DM, as these | | | | activities likely | | | | include high-calorie, | | | | high-carbohydrate | | | | meals and alcohol | | | | that can spike blood | | | | glucose levels as it | | | | is a carbohydrate. | | | | Alcohol can also | | | | inhibit insulin | | | | function. These are | | | | areas where Betty | | | | gets enjoyment and | | | | quality of life, so | | | | we need to consider | | | | the importance of | | | | these lifestyle | | | | features in our | | | | health plan with | | | | Betty. | | | | | | | | 2. | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | | Betty's resistance to | | | | taking medication | | | | because it makes her | | | | "feel old" reflects a | | | | psychological | | | | struggle with her | | | | diagnosis, especially | | | | as it relates to her | | | | identity and | | | | perceptions of | | | | ageing. Feeling | | | | \"old\" might make | | | | her reluctant to | | | | fully engage in her | | | | treatment, affecting | | | | her long-term health | | | | outcomes. | | | | | | | | Betty's busy social | | | | life, which revolves | | | | around food and | | | | alcohol, may feel | | | | threatened by her | | | | diagnosis. Managing | | | | her diabetes may | | | | require changes in | | | | her social | | | | interactions, | | | | potentially affecting | | | | her relationships or | | | | sense of enjoyment | | | | when dining out with | | | | friends. | | | | | | | | Receiving a diagnosis | | | | of T2DM can be | | | | emotionally | | | | challenging. Betty | | | | may be experiencing | | | | denial, frustration, | | | | or fear, especially | | | | if she sees the need | | | | for lifestyle changes | | | | as an unwanted | | | | disruption to her | | | | life. | | | | | | | | Betty's husband and | | | | social circle will | | | | play a crucial role | | | | in supporting her | | | | management of T2DM. | | | | If they are not aware | | | | or supportive of the | | | | changes Betty needs | | | | to make (like | | | | moderating alcohol | | | | consumption and | | | | making healthier food | | | | choices), it may be | | | | difficult for her to | | | | implement effective | | | | changes. | | | | | | | | Betty's identity as | | | | someone who enjoys | | | | "fancy dinners with | | | | friends" is deeply | | | | intertwined with her | | | | social life. Adapting | | | | to a new way of | | | | managing her diabetes | | | | might mean rethinking | | | | how she engages with | | | | her friends socially, | | | | which could lead to | | | | feelings of isolation | | | | or loss if not | | | | handled sensitively. | | | | | | | | 3. | | | | | | | | As a chef, Betty's | | | | occupation is | | | | directly tied to food | | | | and cooking. Managing | | | | T2DM might pose a | | | | challenge in her work | | | | environment, where | | | | she is constantly | | | | surrounded by food | | | | and may have to make | | | | changes to her diet. | | | | Her job may make it | | | | harder for her to | | | | maintain a healthy | | | | eating routine or | | | | avoid tempting foods. | | | | | | | | The restaurant | | | | industry is known for | | | | its high levels of | | | | stress, irregular | | | | hours, and physically | | | | demanding work. | | | | Stress can impact | | | | blood sugar levels, | | | | and irregular work | | | | hours might make it | | | | harder for Betty to | | | | maintain regular meal | | | | times and glucose | | | | monitoring. | | | | | | | | 4. | | | | | | | | Betty may not fully | | | | understand the | | | | importance of | | | | Metformin in managing | | | | her condition or how | | | | T2DM affects her body | | | | long-term. Addressing | | | | health literacy will | | | | be key to helping her | | | | feel empowered in | | | | making informed |