Mprove Many different risk factors are associated with deteriorated health of the James that include a family history of diabetes, hypertension, age, non-adherence to medication, sedentary lifestyle, decrease management understanding, poor dietary pattern and consumption of beer with smoking. These factors in combination have increased complication for James. The studies presented by Asiimwe et al. (2019) discusses abut many risk factors that are associated with an increasing prevalence of diabetes and one of the determinant is increased age that directly increases the risk for diabetes. Heredity and sedentary lifestyle are another risk factor that can directly lead to overweight and diabetes. Smoking and alcoholism are also considered to ion crease risk for diabetes due to increase burden over the metabolic system and harmful substances in smoking. Hypertension is also a risk factor associated with diabetic patient and non-adherence to medicine can also increase the risk for complication. Australian Government Department of Health, (2019a) proposed a National Strategic Framework for Chronic Conditions that proposed that there are many determinants of health that should be considered during the chronic condition. The different determinant of health includes social, physical, economical and individual factors. The individual factor also includes behavioural and biomedical factors.
The first nursing assessments that can be utilized by the nurse to understand the James condition include ABCDE assessment. The ABCDE assessment is utilized as James has a history of hypertension and cardiovascular disease that need to analyse the patient current condition. The ABCDE assessment includes airways assessment, breathing assessment, circulation assessment, disability assessment and exposure assessment. The ABCDE assessment help to utilize the holistic approach to analyse different issues associated with individual health status that needs urgent attention (Fernández-Méndez et al., 2019). The Pain assessment is the second method that can be utilized to understand the complication of James as he complains about the bilateral foot pain. The pain assessment follows the set pattern that can be utilized to understand the intensity of the pain. The self-reported pain scale is preferred to understand the patient perception in regards to the intensity of the pain. There are many self-reporting pain scale that can be utilized by nurses like visual analog scale, Verbal descriptor scale and Numeric rating scale (Booker & Herr, 2016). Blood glucose assessment is another factor that is required to assess the blood glucose level of James. A glucometer can be utilized to monitor the blood glucose level which can help to plan intervention accordingly. Patient with hyperglycaemia should be continuously monitored to track the blood glucose level which will help to evaluate the patient health status (Choukem et al., 2019).
Australian Government Department of Health, (2019b) proposed a National Strategic Framework for Chronic Conditions state the Objective 1 Focus on prevention for a healthier Australia. Strategy 1 states that the patient should receive an accurate evidence-based intervention. The self-management method for diabetes that can be utilized for managing the complication associated with diabetes. The first aspects that will be included in the intervention include food and diet management that helps to balance the nutrition intake of the individual. The patient can be educated regarding the accurate dietary intake by providing the diet plan following the patient preference. The patient can also be educated about the self-glucose monitoring by the help of glucometer that helps the patient to keep a track of the blood glucose level. Medication management is another aspect that should be considered while patient education to increase medicine adherence by utilizing a reminder system. Physical activity is also one of the important factors that should be included in the self-management to decrease sedentary lifestyle of the individual and better metabolism. These methods can be utilized to enhance the self-management practice of the individual which lead to quality of life (Weller et al., 2017).
The goal that is set following the health status of James will aim to enhance the health status as the intervention is to increase the self-management skill of the patient that enhance the health status. I will try to assist the patient during the intervention to enhance his self-management skill in one month which helps to enhance the health status. The specificity in the goal is to enhance the quality of life of the patient and by supporting the health status. The health status of the patient can be evaluated for measurement. The goal is achievable as the patient will be educated regarding the self-management technique that helps to enhance the quality of life of the individual. The realistic approach is used during the goal-setting as the first patient is required to learn self-management techniques and then he should accurately follow the guidelines. One month is a good time frame that is required to enhance the self-management skills that help to enhance the quality of life. The goal is achieved by the collaboration of the health care associates with the patient to increase the patient understanding and accurate utilization of different self-management skill in daily routine.
The first perspective of the patient and family regarding the goal is to be the long-term effect that includes life goal on the other hand nurses focus on short term goal to enhance the current health status of the patient. Thus it increases the need for the collaboration between the health care associates and patient to increase accuracy of the goal and different method that can be used to achieve the goal (Ashford et al., 2015). The goal framing directly associated with the increased motivation of the patient concerning the intervention and it increased the participation of the patient. The supported staff is required to assist the patient in the intervention that helps to achieve the goal (Ogawa et al., 2016). Australian Government Department of Health, (2019c) proposed objective 2 that state that active engagement during patient care is one of the important steps. The active engagement approach utilizes the person-centred phenomena during care to enhance the quality of care. Health care professionals are expected to provide accurate and all information regarding the chronic condition and management method. The personalized goal setting should be preferred during care. The partnership between the health care professional and patient is required to provide integrated care to the patient.
Ashford, S., Turner-Stokes, L. & Rose, H. & Singer, B. (2015). Patient engagement and satisfaction with goal planning: Impact on the outcome from rehabilitation. International Journal of Therapy and Rehabilitation, 22, 210-216. 10.12968/ijtr.2015.22.5.210.
Asiimwe, D., Mauti, G. O. & Kiconco, R. (2019). Prevalence and risk factors associated with type 2 diabetes in elderly patients aged 45-80 years at Kanungu District. Journal of Diabetes Research, 2020, 1-5.
Australian Government Department of Health. (2019a). National Strategic Framework for Chronic Conditions. Retrieved from: https://www.health.gov.au/resources/publications/national-strategic-framework-for-chronic-conditions
Australian Government Department of Health. (2019b). National Strategic Framework for Chronic Conditions. Retrieved from: https://www.health.gov.au/resources/publications/national-strategic-framework-for-chronic-conditions
Australian Government Department of Health. (2019c). National Strategic Framework for Chronic Conditions. Retrieved from: https://www.health.gov.au/resources/publications/national-strategic-framework-for-chronic-conditions
Booker, S. Q. & Herr, K. A. (2016). Assessment and measurement of pain in adults in later life. Clinics in geriatric medicine, 32(4), 677–692. https://doi.org/10.1016/j.cger.2016.06.012
Choukem, S. P., Sih, C., Nebongo, D., Tientcheu, P. & Kengne, A. P. (2019). Accuracy and precision of four main glucometers used in a Sub-Saharan African Country: a cross-sectional study. The Pan African medical journal, 32(118), 1-10. https://doi.org/10.11604/pamj.2019.32.118.15553
Fernández-Méndez, F., Otero-Agra, M., Abelairas-Gómez, C., Sáez-Gallego, N. M., Rodríguez-Núñez, A. & Barcala-Furelos, R. (2019). ABCDE approach to victims by lifeguards: How do they manage a critical patient? A cross sectional simulation study. PloS one, 14(4), 1-12. https://doi.org/10.1371/journal.pone.0212080
Ogawa, T., Omon, K., Yuda, T., Ishigaki, T., Imai, R., Ohmatsu, S. & Morioka, S. (2016). Short-term effects of goal-setting focusing on the life goal concept on subjective well-being and treatment engagement in subacute inpatients: a quasi-randomized controlled trial. Clinical Rehabilitation, 30(9), 909–920. https://doi.org/10.1177/0269215515622671
Weller, S. C., Baer, R., Nash, A. & Perez, N. (2017). Discovering successful strategies for diabetic self-management: a qualitative comparative study. BMJ open diabetes research & care, 5(1), 1-8. https://doi.org/10.1136/bmjdrc-2016-000349
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