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  • Subject Name : Nursing

Case Study: Mr James Storey

Risk Factors

Mr James Storey is 66 years old which forms part of the age group that are easily prone to chronic illness. At this age, the immunity is low and hence with poor self-management strategies, the old man could easily contract any of the chronic diseases that mostly affect the aged (Lawn & Skinner, 2014). He also has a medical history of type 2 diabetes which usually when handled wrongly, it poses a risk to his life. Knowing that he has a past history of type 2 diabetes, James lives a lifestyle that also poses a risk to his life.

He wonders how his sugar level is high and yet he rarely takes sugar but yet the types of food that he ignorantly takes, increases the level of sugar in his body and hence the diabetes could get worse. He also has neglected a lot some professional medical advices, for example he ignores testing for his glucose level as recommended. He also lacks motivation to do exercises as advised by his doctor and hence this introduces a risk factor of increased weight which does not go well with diabetes patients. His medical records couple the type 2 diabetes together with hypertension and hence he is exposed to high risk to heart attack if not well maintained.


James urgently needs to seek the attention of a dietitian who would help him manage his diet and develop a balanced diet based habits that would assist in managing the type 2 diabetes. He lacks knowledge on how he is exposed to diabetes when he doesn’t consume sugar and this necessitates the attention of the dietitian to explain to him the causes of diabetes and the types of food he should take. James should also go for a blood sugar level testing since he has not been doing the tests. He needs this test in order to determine which type of medication or professional advice on his diet he should receive. He also requires more counsel on the importance of regularly performing these tests while he is alone at home. James needs to get assessed on his body weight, diabetes condition and his foot condition. This would give his local General Practitioner a way forward in matters pertaining his exercise and hence help him develop strategies to lose weight, reduce foot pain and regulate his diabetic condition (Coyne & Correnti, 2014).

Self-management Priorities

Most habits that James has developed with time require attention in order to develop self-management strategies towards controlling the chronic illness he is diagnosed of. He usually drinks beer on a daily basis and this poses a risk in increasing his weight which eventually makes the disease worse. A plan therefore should be put in place in order for him to regulate his consumption or quit drinking beer. He also lacks motivation in exercising which leads to him adding weight. He should be encouraged to keep exercising daily by making a routine that should guide his exercise. On realizing that he has a past historical and medical record of chronic illness, he should take heed of the advices by his doctors which wold prevent him from falling into the trap of contracting other chronic diseases (Valadare & Leite, 2015). Since his age also contributes to him being prone to contracting chronic illness, he should incorporate the prescribed habits and lifestyle which would maintain his health condition.

Goal Details

Exercise contributes greatly towards the physical fitness of a person. The health conditions could be regulated through having a planned exercise schedule that when followed, it contributes to not only physical health but also mental health. James is ailing a chronic disease that is directly affected by weight gain and hence exercise would be a perfect goal towards helping him manage the disease. First, he should identify the specific type of exercise that would suit his need in burning of calories. Maybe he could consider for example a daily run, a routine that should be followed without fail. He should set a target which is to lose weight which should be determined by his local General Practitioner. After identifying how many kilograms he should lose, he is supposed to set a plan that he is able to follow depending on his schedule and ability to perform. He also should set a timeline by which he should have achieved the goal of the weight loss and with this plan he could lead a healthy life and manage his chronic illness.

Impact of Goal Setting

Goal setting helps in the focusing of both the social relations and health conditions of the patients. Their routine in trying to accomplish their goal should therefore be incorporated in their careers and families. The people they associate with should be made aware of the goals for persons with chronic conditions and hence help them towards achieving their goals (Dwarswaard, & Boeije, 2016). James quit his business simply because it was stressing him and therefore the environment that surrounded him was not suitable in nurturing his condition. His wife also never encouraged him much in providing better pieces of advice and encouragement towards nurturing his health condition. Persons with chronic illness should not be allowed to fight their conditions alone but rather we should help them fight it by setting goals and incorporating them in our social settings of interactions (Magnan & Smith, 2015).


Lawn, S. & Skinner, T. (2014). Control in chronic condition self‐care management: how it occurs in the health worker–client relationship and implications for client empowerment. Journal of advanced nursing, 70(2), 383-394.

Dwarswaard, J. & Boeije, H. R. (2016). Self‐management support from the perspective of patients with a chronic condition: a thematic synthesis of qualitative studies. Health Expectations, 19(2), 194-208.

Magnan, E.& Smith, M. A. (2015). Establishing chronic condition concordance and discordance with diabetes: a Delphi study. BMC family practice, 16(1), 42.

Valadare, G. & Leite, J. L. (2015). Nursing care management for children hospitalized with chronic conditions. Revista brasileira de enfermagem, 68(4).

Coyne, N., & Correnti, D. (2014). Effectiveness of motivational interviewing to improve chronic condition self-management: what does the research show us?. Home Healthcare Now, 32(1), 56-63.

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