Disadvantaged community is the area where people live and are socially discriminate from society because of various factors. They have strong trust in their beliefs, culture, traditions, and work, which however different from the other society of region. This difference made them socially discriminate and determinant. This leads them to face inferior opportunities in health care, education support, wellbeing, and other facilities. Diabetes Mellitus is the most common form of disease among the people of disadvantaged community. This may be due to the improper treatment, healthcare services unavailability, and inferior lifestyle. Thus, there is a need to develop the proper health care management strategies which could provide the health benefit to discriminate society.
The essay will address the issues faced by the people of disadvantaged community. The essay will also highlight the solutions to problems, challenges, and address the loopholes which are faced by the disadvantage. The people living in the disadvantaged community have worse health care facilities due to many reasons, which need to be addresses. The registered nurse along with the help of community will extrapolate the requirement needed for the providing health care to the individuals. The essay will addresses all the possible strategies along with mutual support and collaboration which can be adopted to attain the health care goal.
Diabetes Mellitus is a metabolic disorder; occur due to the increase in blood glucose level in body. The higher level of blood glucose is because of inadequate pancreatic insulin secretion or may be due to weaker insulin mediated mobilisation of glucose by the target cells. It is a one of the major public health problem across globe, estimate that the number of cases could reach to 642 million by the end of 2040 (Al-lawati, 2017). An article published by Piero, Nzaro, &Njagi (2015) , state that according to WHO, the rising incidence of diabetes mellitus is due to social dynamics, social culture, physical inactivity, elderly population, and unhealthy lifestyle. The pathophysiology of the diabetes mellitus includes decrease glucose uptake, inferior insulin secretion, increase lipolysis, increase glucose reabsorption, hepatic glucose hike, and increased glucagon secretion (Thrasher, 2017).
Diabetes is one of the chronic endocrinology metabolic disorder which affect Queenslanders. Due to lower availability of healthcare facility, poor and undiagnosed diabetes condition increases the risk of other health problems such as renal, limb amputation, eye disease, urological or cardiovascular disease. This can further lead to the development of lifelong health complication as well. In an article published by the Chief Health Officer Queensland, mentioned that in 2011, diabetes is recognised as 12th largest burden of disease in Queensland. The leading reasons responsible for the burden in community is preventable hospitalisation, inferior long-term health opportunity, and degraded quality life.
Disadvantage community were observed as different people with different beliefs, culture, and traditions. This creates sense of social discrimination among them. Disparity in health status, education, facilities, and other living conditions create a higher risk and exposure of ill health outcome. From the article (Hill, Ward, Grace, & Gleadle, 2017), it was opined that the indigenous people in Australia have worst health, lower life expectancy, and higher child mortality. The underlying cause of these factors is associated with higher susceptibility and incidence of diabetes mellitus among population residing in disadvantage community.
The higher level of diabetes mellitus encountered among the people residing in disadvantage community is due to various risk factors that are associated with the development and incidence of diabetes mellitus in region. Some of the issues faced by the people which are responsible for the commencement of diabetes mellitus symptoms are as follow:
The people of community were at greater risk of developing health problems such a obesity, high blood pressure, abnormal cholesterol level, higher fatty acids, higher bad cholesterol level, and rising oxidants in body. The reason for the development of these health issues are malnutrition, improper physical activity, and inferior quality of food intake.
Social and cultural implications also affect the health of the people. The disadvantage community experiences the drawback in various fields due to their social, cultural;, traditional, and beliefs. The found to be treated as social determinant in terms of education, unemployment, lower wages, poor housing facility, racism, and poor access to services. These create situation of grief in their personality which further lead to the development of ill health condition.
The indigenous people of Australia suffers multiple types of socioeconomic disadvantage such as low income, inferior education, inferior health care system opportunity, chronic ill health and poor housing settlement. The paper (Wei, McDonal, Coumarelos, 2015) opined that the disadvantage is due to vulnerability, and detriment towards the legal problems. The people suffer increased prevalence of government, human rights, and standard health problems (Wei, McDonal, Coumarelos, 2015). Due to improper activities, it becomes difficult for disadvantage people to overcome these barriers. Moreover, cultural identity is another potential barrier which interferes with the treatment of indigenous people (Li, 2015). Cultural identity refers to the feelings of people belong to disadvantaged community. Physical, biological differences prevent the indigenous people to actively participate in the treatment process.
With the easy accessibility of equal justice towards social exclusion, cross cultural factor, and proper literacy, the indigenous people can overcome their potential barrier. Strengthening the cultural competencies of the healthcare provider and the and the healthcare system can be an effective and efficient solution for diminishing the racial, ethnic, and cultural disparities in healthcare (Li, 2015).
The registered nurse provides a primary care, with culturally adapted strategies and activities. These provide to support and help disease management in the community disease control and prevention. The good support and good professional identity help to reduce the health disparities in high-risk, poor resource, and underserved communities. The registered nurse provides adapt the following role to implement the health management strategies and provide health care treatment.
Education – educating patient about the diabetes, its implication, and medication treatment will help in increasing patient knowledge. The knowledge will provide long term benefit as it help the patient in terms of stress management, physical activity, medicine adherence tips, problem solving, cognitive development, and meal preparation.
Advocacy – Advocacy is one of the best roles played by the community healthcare nurse in disadvantaged community. The role comprises advocating the patient and their family about the medication to be used and accesses them how to take health resource availability from the health facility (Egbujle, Delobelle , Levitt, Puoane, Sanders, & Wyk, 2019).
Analyse and evaluate the person understanding in health promotion activities. This will implement and assess the community based client care (Registered nursing, 2020).
To overcome and reduce the implications of diabetes mellitus, there is a need of adopting many healthcare strategies within the professional system and management. As a registered nurse the following are some of the strategies which need to follow to lower the incidence of diabetes mellitus:
Disease process treatment option – as the people are located in remote area whre the health facility is inferior or negligible, thus government policies should be updated to implant the region with the wide spectrum of diabetes mellitus treatment options.
Medical nutrition therapy – proper nutrition diet need to be incorporate in individual. People of disadvantaged community were given medical nutrition therapy and were made aware of the importance of nutrias foods. The diet of an individual must contain the 50-55% of carbohydrates, 30% fat fiber of which 15-20% should be protein and 10% should be saturated fatty acids (Deepthi, Sowjanya, Lidiya, Bhargavi, &Babu, 2017).
Diabetes awareness and education – the diabetic person must be informed about the incidence, prevalence, symptoms attainment, and other disease related key points. The top professional must provide an insight to the people of disadvantage community regarding the disease overview and health maintenance (Bzowyckyj, 2017). The awareness program should be in proper terminology and language that is acceptable by the disadvantage community people. The education program will help them to know more about the disease and its outcome.
Early diagnosis and timely treatment of diabetes mellitus will save the long term complications in individual. Thus, the health provider should provide timely treatment.
Australian government is actively involved in curing diabetes in its nation by implementing various strategies and policies. Some of the strategies and activities done by Australian government are as follow:
Australian Health Survey – This is one of the most recent and advanced national survey that clinically assesses and analyse the diabetes prevalence by fasting plasma glucose test (FPG). The survey also uses HbA1C test.
AusDiab Study – this is one of the oldest surveys done in Queensland community. It is a longitudinal cohort study which monitors diabetes, obesity, and risk factors for chronic disease.
National diabetes register – this is a register which determines the list of person suffering from diabetes. The register is based on information from national Diabetes Service Scheme and Australian Pediatric Endocrine Group database. The register identifies the cases which require the financial, health, or medical support for testing (The Chief Health Officer Queensland).
Increasing Hospitals and medical center – in 2016-2017, the number of hospitals specially for the treatment of diabetes were increased. The number of hospitalisation of individual increase to one million (AIHW, 2019).
National Diabetes Service Scheme (NDSS) – the government provide funding support to various NDSS programs. The various program included under this provide education support, awareness support, and disease management program. The various program come under this includes KeepSight, Foot Forward, Mydemond, BabySteps, Type 2 and me, and AUSDRISK tool.
Mutual support and partnership between nurse and community improve the health of community people. The paper written by Conway; Tsourtos; & Lawn (2017), mentioned the evidence on the chronic condition management through partnership. In this paper, the author describe the value of Flinders Closing the Gap Program (FCTGP) tool, to implement the critical care programing through self-managing chronic condition. It is opined that critical care management promote collaboration, multi-disciplinary communication, and engagement of patient in providing primary patient care.
In the paper (Conway; Tsourtos; & Lawn, 2017), the case study confined that supportive collaboration help in providing effective cultural based communication with the indigenous group and the health care provider. By harnessing the shared knowledge, family involvement, cultural education, and government policies, provide the positive feedback towards health of individuals.
Moreover, another paper published by (McCalman, et al; 2019), confined that indigenous associated workforce and indigenous people collaboration promote the adoption of strategies that influence human resource management effort and thus help to achieve improved healthcare performance. The wellness based approach adopted by them includes strategic human resource management, detail awareness program, integrated and well developed workforce model, and timely management and diagnosis of diabetes mellitus. These strategies provide the beneficial insight to the individual’s health and wellbeing.
The disadvantaged community suffers a lot in getting basic health standard needs. Thus, there is need to adopt certain changes in management, hospital, government policies, and behaviour of health care provider. The strength based approach within the community health standards need to be adopted. Some of the positives strategies and approaches are as follow:
Health equity is one of the basic human right which is required by everyone. However, some of people of disadvantage community witness inferior quality of life due to their social status. Through overcoming cultural barriers, cultural security, inferior lifestyle, and proper communication, they can attain good lifestyle. From the above essay it can be concluded that the registered nurse or the community health care provider plays a vital role in this situation. They are the mediator between the community patient and the government or big organisation, which provide a support in the well-being of individual.
From the above essay it can also be concluded that the implementation of policies into the practices or actions can only be accompanied through the adoption of right strategy. In this entire scenario, the role of nurse is out most important in improving the health of indigenous people and also responsible to provide advocacy in diminishing the diabetes mellitus, and its implications.
Aboriginal people in Queensland: a brief human rights history.
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Deepthi, B., Sowjanya, K., Lidiya, B., Bhargavi, R. S., & Babu, P. S. (2017). A modern review of diabetes mellitus: An annihilatory metabolic disorder. Journal of Insilico & in Vitro Pharamacology, 3, 1-5.
Department of Health. Burden of disease and injury: summary results for Queensland. Queensland Government: Brisbane; 2017.
Hill, K., Ward, P., Grace, B., Gleadle, J. (2017). Social disparities in the prevalence of diabetes in Australia and in the development of end stage renal disease due to diabetes for Aborginal and Torres Strait islanders in Australia and Maori and Pacific Islanders in New Zealand. BMC Public Health, 17, 1-8.
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Royal College of Nursing (2020). Education, prevention and the role of the nursing team.
Thrasher, J. (2017). Pharmacologic management of type 2 diabetes mellitus: available therapies. The American Journal of Cardiology, 120, 5-15.
Wei, Z., McDonal. H. M., and Coumarelos, C. (2015). Indegeneius people, multiple disadvantage and response to legal problems. The Law and Justice Foundation of North South Wales, 48, 1-13.
Li, J. (2015). Cultural barriers lead to inequitable healthcare access for aboriginal Australian and Torres Strait Islanders. Chinese Nursing Research, 7, 207-210.
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