Behaviour For Chronic Disease

Introduction

Beatriz et al., (2011) aimed at studying the food security issues as experienced by individuals with low income and suffering from type 2 diabetes. The research was set the backdrop of increasing prevalence of diabetes across the world, including Australia, where 800,000 individuals live with this chronic condition. The study was a qualitative examination that explored the influence of socio-economic disadvantages on diabetes. Data collection was done through focus groups and semi-structured interviews. 38 patients took part in the research that included both indigenous and nonindigenous groups. Recruitment was done from areas in Perth that had high indices of socio-economic disadvantage. Deductive data analysis was done from a conceptual framework for indicating the relationship between diabetes health outcomes and socioeconomic position. An inductive approach was taken fro identification of new themes. The results indicated that participants had an up-to-the mark understanding of their respective dietary requirements. Nevertheless, access to food that is healthy was not realised under all circumstances. In addition, participants indicated high levels of dependency on others for their diet and meal preparation. Further, they could not accommodate the price for the healthy food due to a constraint of the budget. The primary inference drawn was that low-income earners faced food security issues.

The present paper aims to undertake a critical review of the chosen article as it contributes greatly to the best nursing practice of assisting low-income earning patients suffering from type 2 diabetes for addressing food security issues.

Research methods and design

The research adopted a qualitative methodology for addressing the research objective of understanding the challenges faced by low-income earners suffering from diabetes pertaining to their food intake. Focus groups were conducted with 38 patients as the data collection method. Thematic analysis was done subsequently. Silverman (2016) point out that qualitative analysis is beneficial in recording the feelings and behaviours of study participamts. It is a good way of stimulating individual experiences of people. A detailed picture can be built up about why people behave in a certain manner and what exactly are the changes faced by them. According to Nieswiadomy and Bailey (2016), though qualitative research has its strnghths, the limitations cannot be overlooked. Since a small group of people are studied in such cases, it is not suitable to generalise the findings of the study. It is also difficult to make the systematic comparisons in an appropriate manner. Subjectivity leads to procedural problems in qualitative research and replicability is difficult. Researcher bias is also an issue. The small size of the study sample is also a concern since small sample size influences the result’s reliability. Large sample size also leads to lesser standard deviation and more accurate results.

As focus groups were conducted in this case, skills of the researcher to extract information from the participants might have been a concern. This is crucial since the research topic was experiences of the patients pertaining to their socio-economic background. As the same is a sensitive issue, the participants had to be motivated and encouraged to come up with their feelings and experiences (Glesne, 2015). The thematic analysis also has some limitations. Comprehensive and in-depth narrative analysis limits the scope of the study.

Impact of psychosocial factors

The present paper adds to the existing knowledge of the psychosocial issue of socioeconomic constraints pertaining to diabetes diet to the extent that it highlights the facts of food security issues. The study has been prominent in bringing into focus the need for healthcare workers, including nurses to address the socio-economic circumstances in which the populations coming from vulnerable background live while caring for their diabetes rated issues. Nurses play a crucial role in self-management of patients with diabetes, and since diet is a key element of self-management, nurses need to come up with strategies to resolve challenges (Black, 2016). Patients living with diabetes depend largely on the care provided by nurses within and outside the clinical setting. Since diabetes is a chronic illness leading to numerous long term and short term complications, patients are in need of specialist care so that they are better able to carry out self-management (Dunning, 2013). The present article contributes to the understanding that nurses need to give special focus on to dietary needs of patients and the manner in which the patients can be counselled for addressing their challenge of proper diet intake in spite of constraints.

Contribution of article to the interdisciplinary approach

The present article brings in deeper insight into the knowledge of the involvement of interdisciplinary team for diabetes care. Best management practices rest upon interdisciplinary team approaches, and the article focuses on the involvement of such a team for meeting dietary needs of diabetic patients. Apart from a registered nurse delivery overall care to the patient, a diabetes specialist nurse must take a central position in supporting patients over the course of disease with special attention to diet. The nurse can fulfil responsibilities for costing, planning and developing strategies that can enable the patients to intake food as per their convenience and accessibility (Sullivan et al., 2016).

The role of the dietician is to be highlighted in this context. Fulfilment of the dietary needs of the patients as per their economic capability can only be possible with the input from a dietician.  The role of the dietician would be integral since the patients would be from a low socioeconomic group (Whittle et al., 2017). A dietician would become a lifestyle coach and meet the patients to educate them about the implications of a healthy diet. In addition to outlining a diet chart, the role would also encompass education on adjustments in diet and physical exercise and self-monitoring. Strategies are to be taught to the patients so that they can actively solve their problems and compensate for their low quality dietary intake through other measures.

Application of article to clinical practice

The review of the article holds much importance for its findings to be applied to my practice as a student RN. I have gained the knowledge that nurses are to come to a step forward for addressing the needs of diabetic patients for those who face food security issues. It is my responsibility to communicate appropriately with the members of the interdisciplinary team so that care is of high quality. I would change my current approach in that barriers to seek information faced by patients would be reduced considerably and patient communication would be made better. The aim would be to foster optimal quality nursing practice.

Study strength and limitations

The strength of the study lies in the fact that valuable insights have been added to the topic of nursing practice for diabetic patients. The limitations of the study are to be mentioned. Feasibility and time constraints restricted the study to one area in Perth. Due to financial constraints, no participant was recruited from the Vietnamese community which is the largest linguistically and culturally diverse group in the area. Lastly, it is to be highlighted that participants might have agreed to take part in the research due to monetary incentives offered. The validity of the research data is under question since the data was self-reported. Recall bias is also there in the study (Beatriz et al., 2011).

Conclusion

The present critical review of the article gave valuable insight into the fact that socioeconomic disadvantage has a profound impact on diabetes management. From the analysis, the fact that emerges is that nurses are to address the socioeconomic circumstances in which the vulnerable populations live. Nurses must engage in further research to highlight novice and advanced strategies by which patients can be given better care in spite of their low economic background without compromising on their quality.

References

Beatriz, C. B., Sherry, S., & Alexandra, M. (2011). ‘You get the quickest and the cheapest stuff you can’: food security issues among low-income earners living with diabetes. The Australasian medical journal, 4(12), 683. DOI: 10.4066/AMJ.20111104

Black, B. (2016). Professional Nursing-E-Book: Concepts & Challenges. Elsevier Health Sciences.

Dunning, T. (2013). Care of people with diabetes: a manual of nursing practice. John Wiley & Sons.

Glesne, C. (2015). Becoming qualitative researchers: An introduction. Pearson.

Nieswiadomy, R. M., & Bailey, C. (2017). Foundations of nursing research. Pearson.

Silverman, D. (Ed.). (2016). Qualitative research. Sage.

Sullivan, N., Dunbar, P., & Murphy, G. (2016). Moving On… with Diabetes: Transition Education Program for Parents/Caregivers of Youth/Young Adults with Diabetes. Canadian Journal of Diabetes, 40(5), S29. DOI: https://dx.doi.org/10.1016/j.jcjd.2016.08.082

Whittle, S., Barrett, A., Humayun, M., Williams, E., & Brooks, A. M. S. (2017, March). Multidisciplinary team secondary diabetes clinics (MDTSDC): a new role for the diabetes dietitian?. Diabetic medicine.,32.125-126.