Case Study: Jean

The case study is about the 55-year-old women Jean recently she is facing exacerbation of the type 2 diabetes and she was diagnosed with the type 2 diabetes previously. The increasing difficulty of Jean requires attention as it is increasing discomfort of the patient. The family background of Jean indicates that she is a smoker and smokes ten cigarettes per day. She is unable to quit because her husband also smokes. The education and behavioural intervention can be used to help Jean to quit smoking as it is not good for health and increasing the health complication. The behavioural strategies that can help to reduce the discomfort of the patient include the development of self-monitoring, coping skill in the individual. The motivational strategy is also another aspect that can help the individual to quit smoking which includes a technique to clarify the desire for change and reduce ambivalence toward change. The educational intervention helps to increase understanding of the individual regarding the risk factor associated with smoking (Reddy et al., 2015). The aim of this paper is to discuss the aspect of person-centred care considering Jean’s case study.

The carelessness toward medication is also increasing complication for Jean as she forgot to have medicine when she is feeling good. The medication plays an important role in maintaining the blood glucose level and irregularity in medication can lead to increased complication. The nurse educational intervention plays a vital role in managing the schedule for the medication that will help to reduce the complication. The nurses can help the patient to increase understanding toward the benefit of medicine and associated negative effect that can occur due to skipping the medicine. The educational intervention includes providing the patient with wall medicine chart that helps to remember the dose of the medicine. The second aspect of the intervention includes providing them medicine alert system that helps to the aware patient regarding the medicine (Zandiyeh et al., 2015).

The last aspect that is increasing concern is the weight gain as it can lead to obesity which can increase the complication of the individual. Her diet plan indicates she is not careful regarding the healthy diet as she drinks six soft drink a day that can lead to increased weight. The dietary intervention will help the patient to maintain the nutritional intake and improve the metabolism that directly reduces the burden over the body. The dietary intervention includes providing the patient with the diet plan that is tailored according to the patient preference which needs to follow daily to improve dietary intake. The diet of the patient should be included with vegetable, fruits, dairy product, use of olive oil and wholegrain that will directly help to maintain the weight and reduce complication associated with diabetes (Forouhi et al., 2018).

The patient satisfaction and health care experience directly depend upon the behaviour of the health care professional, mainly including the nurses, as they are in continuous contact with the patient (Karaca & Durna, 2019). The health care professionals are expected to empower the patient to reduce the health care disparities that can lead to negative consequences. Patient-empowerment is an important aspect here. The nurses are expected to encourage the patient to participate in the care process that directly provides the power to decide and prefer the care process. The autonomy of the patient should be respected that directly increase their self-confidence and help them to understand the care process. The nursed should respect the different cultural background and belief of the individual that is to be considered during the conversation to increase the comfort of the patient which directly helps to develop customer satisfaction. The clinical need of the patient should be preferred by collaborating with individual preference that helps to provide the person-centred care to the patient (Chen et al., 2015).

The increased complication of the Jean due to type 2 diabetes increases the need for the individual to understand the different aspect of the disorder. The self-management technique is considered to be one of the best methods to improve the independence of the individual in managing the health-related issue (Chester et al., 2018). The self-management technique provided with the nurse help the patient to understand different aspect that includes routinely blood glucose monitoring, nutritional education and physical activity training. The blood glucose management techniques help the patient to understand the correct procedure to measure the blood glucose level and maintain a record. The second aspect includes nutritional education that includes portion control counting, balanced meal and identifying carbohydrate. The last aspect of the intervention includes physical activity that weight loss exercise and improving metabolism. This intervention will help to decrease the burden created by type 2diabetes by improving the lifestyle (Chester et al., 2018).

There are many potential challenges and barrier that can lead to poor management of diabetes which can increase the complication of the individual. The barriers can be divided into two groups: individual and system barriers that decrease the management of diabetes. The individual barrier includes the different cultural belief that set back the patient to avail health care services as they face irrelevant behaviour of the health care associates. The second aspect includes lack of resources which include glucometer strips, food supplements and medication. The third aspect includes lifestyle modification challenges and lack of family support is also another aspect. The system barriers that directly decrease management of diabetes include decrease clinical resources, staff poor skill and patient engagement barrier. These are some factor that set back the individual health by decreasing the management process of diabetes (Whittemore et al., 2019).

The first recommendation that can be provided to Jean is the consultation with the diabetes care centre if he encounters any health issue which requires immediate doctor assistance. The different diabetes care centres which can help to reduce the issue associate with health include The Bankstown Diabetes centre, Fairfield Hospital Diabetes Service, Macarthur Diabetes Service and Liverpool Diabetes Endocrine Service (South Western Sydney, 2020). Westmead hospital diabetes clinics also provide special care associated with individual facing difficulty managing diabetes (Health Western Sydney Local Health District, 2020). Another recommendation that can be provided to Jean is about the local diet as she has gained weight and her unhealthy diet should be planned to reduce complication associated with diabetes. The Dieticians Association of Australia provides the individual to find the local dietician near them and this will help the patient to manage their diet plan according to the professional (Dieticians Association of Australia, 2020). These facilities can help to reduce the complication faced by the diabetes patient by understanding the issue that helps to provide accurate treatment.

The practice that can be utilized to deal with the chronic condition is the cultural competency that directly helps to increase the understanding of the healthcare associate regarding the issue faced patient that can be addressed by the accurate treatment. Cultural competency helps to increase the comfort level of the client that is required to improve the communication which can lead to positive health outcomes. The patient-nurse bond is required to improve the care process and cultural competency help to develop a rapport which helps the client to freely express their view that can help in the care process. Cultural competency is considered to be the essential component as it helps the health care professional to respect the diversity of the individual and help to mould the conversation in a culturally appropriate way. Different aspects can help to improve the cultural competency that includes workforce training, increasing diversity in the workforce and reflection over action (Jongen et al., 2018).

The next practice will be the patient-centred approach which aims to prefer the patient choice during the care process that directly improves the health status of the individual. The patient-centred approach help to equal participation in the care process and decision making that make it more personalized which increase the chances of the patient cooperation in the care process. The changing health care increase the need for the care process to tailor according to the individual and considered every patient to be unique so require different care process. The patient-centred care covers all the patient aspect which include social, physical and psychological which can lead to better health status. The patient-centred approach prioritizes the individual need and tailors the care process accordingly (Fix et al., 2017).

Therapeutic communication is one of the aspects that will be included in future research to improve the communication between by increasing understanding of the patient regarding the care process. Therapeutic communication method helps the health care professional to utilize the verbal and nonverbal communication skill to develop a trust which can help to increase understanding of the individual regarding the disorder. The holistic and quality care requires the collaborative efforts of the patient with health care associate that is developed by therapeutic communication. The therapeutic communication of the individual utilizes the interpersonal skill of the health care professional during the conversation which helps to show empathy and improve the patient experience (Abdolrahimi et al., 2017).

References

Abdolrahimi, M., Ghiyasvandian, S., Zakerimoghadam, M. & Ebadi, A. (2017). Therapeutic communication in nursing students: A Walker & Avant concept analysis. Electron Physician, 9(8), 4968–4977. https://doi.org/10.19082/4968

Chen, J., Mullins, C. D., Novak, P., & Thomas, S. B. (2015). Personalized strategies to activate and empower patients in health care and reduce health disparities. Health Education & Behavior, 43(1), 25–34. https://doi.org10.1177/1090198115579415

Chester, B., Stanely, W. G., & Geetha, T. (2018). Quick guide to type 2 diabetes self-management education: creating an interdisciplinary diabetes management team. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 11, 641–645. https://doi.org/10.2147/dmso.s178556

Dietician Association of Australia. (2020). Find an Accredited Practicing Dietitian. https://daa.asn.au/find-an-apd/

Fix, G. M., VanDeusen Lukas, C., Bolton, R. E., Hill, J. N., Mueller, N., LaVela, S. L., & Bokhour, B. G. (2017). Patient-centred care is a way of doing things: How healthcare employees conceptualize patient-centred care. Health Expectations, 21(1), 300–307. https://doi.org/10.1111/hex.12615

Forouhi, N. G., Misra, A., Mohan, V., Taylor, R., & Yancy, W. (2018). Dietary and nutritional approaches for prevention and management of type 2 diabetes. BMJ, k2234, 1-8. https://doi.org/10.1136/bmj.k2234

Health Western Sydney Local Health District. (2020). Diabetes Clinics. https://www.wslhd.health.nsw.gov.au/Department-of-Diabetes-and-Endocrinology--Westmead-Hospital-/Outpatient-Services/Diabetes-Clinics

Jongen, C., McCalman, J., & Bainbridge, R. (2018). Health workforce cultural competency interventions: a systematic scoping review. BMC Health Services Research, 18(1). https://doi.org/10.1186/s12913-018-3001-5

Karaca, A., & Durna, Z. (2019). Patient satisfaction with the quality of nursing care. Nursing Open, 6(2), 535-545. https://dx.doi.org/10.1002%2Fnop2.237

Reddy, U. K., Siyo, R. K. N., Haque, M. A. U., Basavaraja, H., Acharya, B. L. G, & Divakar, D. D. (2015). Effectiveness of health education and behavioral intervention for tobacco de-addiction among degree students: A clinical trial. Journal of

International Society of Prevention and Community Dentistry, 5(Suppl 2), 93–100. https://doi.org/10.4103/2231-0762.172949

South Western Sydney. (2020). Diabetes Services. https://www.swsphn.com.au/diabetesservices

Whittemore, R., Vilar-Compte, M., De La Cerda, S. (2019). Challenges to diabetes self-management for adults with type 2 diabetes in low-resource settings in Mexico City: a qualitative descriptive study. International Journal Equity Health 18, 133, 1-10. https://doi.org/10.1186/s12939-019-1035-x

Zandiyeh, Z., Hedayati, B., & Zare, E. (2015). Effect of public health nurses' educational intervention on self-care of the patients with type 2 diabetes. Journal of Education and Health Promotion, 4, 88. https://doi.org/10.4103/2277-9531.171802

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