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1. Which social determinants of health and cultural factors are impacting on Matai’s chronic heart failure? ?


Points to consider: What are social determinants of health??What social determinants influence Matai’s condition and why? How do I ?know (i.e. where did I get this information from?)? What are the cultural beliefs and attitudes of the Samoan community? ?


2. State which of Matai’s assessment data mentioned in the scenario were indicative of this chronic condition? 


Points to consider: How do you know this assessment data is not within normal parameters? What’s normal parameters? Link the assessment data back to the chronic condition. 

Impact of social determinants of health on Samoan migrants in Queensland

Social determinants of health can affect the health of different individuals and therefore need to be identified by professionals so that they can develop care plans and advise patients with effective lifestyle management. This assignment will mainly help in pointing two important arenas through the case study of a Samoan patient who had been diagnosed with heart disorders and have diabetes and other disorders as well. This will show how identifying the social determinants of health and conducting of proper health assessment help individuals to understand the pathophysiology that is resulting in poor quality life of the patient.

Social determinants of health can be described as the conditions of the environment where people takes birth, live, play, work, worship as well as age which affects the health and disrupts the normal functioning of life. It has tremendous impacts on the quality of outcomes in the daily life of the individuals and exposes them to different types of physical, mental and financial risks. Statistical data have shown that Samoan born migrants in the nation of Queensland are found to be present in the disproportionate manner in the middle to low income brackets (Torres et al., 2015). Levels of education as well as employment of such people in the nation of Australia are seen to be much lower in comparison to that of the general population. Only 25% of the Samoan born people are seen to fall in the category of higher education in comparison to that of the 56% of the total population (Corin, 2017).

Poor health literacy is also one of the social determinants of health that is mainly evidenced by lack of knowledge as well as awareness of available health services. Moreover, low many of the researchers are also of the opinion that cultural beliefs and attitudes of the Samoans also affect the health literacy (Torres et al., 2015). This can be explained with the help of an example where sickness is considered not only as the physiological condition affecting the health but also as the social or familial circumstance. Therefore, individual tend to procrastinate with their health until the disorder becomes worse. Many of the researchers have found out a peculiar thinking where the Samoans believe reveal an individual with large body size with power, wealth and prosperity in the Samoan culture (Pega & Veale, 2015).

In case of Matai Williamo, it was found that he had no health literacy about his disorders and was only following the previous doctor’s advice blindly n taking 30 minutes walk every day. He had no idea about the importance of diabetes management and therefore he was not careful about taking the correct medications and checking the blood glucose level every day. As their culture believes in the concept of developing bid body size, therefore the diet which they undertake may result in negative effects on the health (Gray, 2017). Diabetes and heart disorders are the immediate issues that are also observed in the patient named Matai Williamo in the case study. This cultural traditions support taking of diet that are huge in amount and are mainly rich in the saturated fat as well as energy dense, nutrients poor foods that result in developing situations like obesity or make them overweight.

Poor health literacy and cultural beliefs affecting Samoan health

Researchers are of the opinion that food related risk factors are mainly seen to include uncontrolled diabetes, high blood pressure, obesity as well as high amount of saturated fat (Fadini et al., 2015). All such issues were found to be present in the patient of the case study and this resulted in the risk if the heart disorder that mainly showed the signs of congestive heart failure signs for the future.

The nursing professionals mainly conduct two types of assessment. One of them is the objective assessment. One of the abnormal rate which was found is the respiratory rate where the patient had 24 breaths per minute when normal respiratory rate in adults should be 12 to 20 breaths per minute. The blood pressure was also found to be quite high about 145/90 when the normal blood pressure level should be 120/80. The normal blood glucose level in every human being should be between 4.0 to 5.4 mmol/L when that of the patient was found to be 6.5 that shows the patient had uncontrolled diabetic management of the blood glucose levels. Ankle odema as well as high respiration rate easily proved that the patient was suffering from symptoms of heart disorder (Subica et al., 2017).  Heart failure can be described as the illness where the pumping motion of the heart is weakened and as a result, blood does not move efficiently through the circulatory systems and thereby starts to back up. These forces increase in the blood pressure and fluid is forced to enter from the blood vessels in the body tissues.

When the heart is seen to fail, it results in collection of fluid in the lungs causing edema. The extra fluid accumulated in the lung thereby makes it difficult for the airways to undergo expansion when the individuals inhale air. Therefore, breathing becomes very difficult for the patient and as a result, the person feels shortness of breath especially when the persons are conducting exercises. Therefore, the patient of the case study also faced similar symptoms when he was undertaking exercise regimes. Researchers are also of the opinion that when right side of the ventricle fails, fluid also starts accumulating in the feet as well as the lower legs of the individuals (Thorpe et al., 2015). Puffy leg swelling is indeed one of the signs hat states of the chances of heart failure especially in cases when the nursing professionals recognize them as the pitting edema.

Case study: Matai Williamo - a Samoan patient with heart disorders and diabetes

Moreover, poorly controlled diabetes is also stated to be one the factor that results in heart failures. High blood glucose level resulting from heart damage can hear the blood vessels as well as the nerves that are responsible for controlling the heart and blood vessels. As the patient named Matai had poorly controlled diabetes due to improper following of medications. He is found to be careless about his diabetes management and his high blood glucose level is the proof of the claim. Moreover, he also has high blood pressure which is also a risk for heart disorder. Researchers have found positive relationships between hypertension and insulin resistance. Therefore, when patients have hypertension and diabetes, the risk of heart failure increases and this is the case for Matai Williamo. Moreover, patients with diabetes also have unhealthy cholesterol levels that might include high LDL cholesterol, low HDL and high triglycerides. Such lipid disorders also remain associated with insulin resistance that is also called atherogenic dyslipidemia (Bando & Murohara, 2014). All of them act as contributors to heart disorders and proper assessment of the signs and symptoms, vital signs and past medical history can help in understanding the pathophysiology of the disorder.

References:

Bando, Y. K., & Murohara, T. (2014). Diabetes-related heart failure. Circulation Journal, 78(3), 576-583. https://doi.org/10.1253/circj.CJ-13-1564

Corin, E. (2017). The social and cultural matrix of health and disease. In Why are some people healthy and others not? (pp. 93-132). Routledge. Retrieved: https://www.taylorfrancis.com/books/e/9781351471640/chapters/10.4324%2F9781315135755-6

Fadini, G. P., Avogaro, A., Degli Esposti, L., Russo, P., Saragoni, S., Buda, S., ... & Martinetti, S. (2015). Risk of hospitalization for heart failure in patients with type 2 diabetes newly treated with DPP-4 inhibitors or other oral glucose-lowering medications: a retrospective registry study on 127,555 patients from the Nationwide OsMed Health-DB Database. European heart journal, 36(36), 2454-2462. https://doi.org/10.1093/eurheartj/ehv301

Gray, L. (2017). Social Determinants of Health, Disaster Vulnerability, Severe and Morbid Obesity in Adults: Triple Jeopardy?. International journal of environmental research and public health, 14(12), 1452. https://doi.org/10.3390/ijerph14121452

Pega, F., & Veale, J. F. (2015). The case for the World Health Organization’s Commission on Social Determinants of Health to address gender identity. American journal of public health, 105(3), e58-e62. DOI: 10.2105/AJPH.2014.302373

Subica, A. M., Agarwal, N., Sullivan, J. G., & Link, B. G. (2017). Obesity and Associated Health Disparities Among Understudied Multiracial, Pacific Islander, and American Indian Adults. Obesity, 25(12), 2128-2136. https://doi.org/10.1002/oby.21954

Thorpe Jr, R. J., Duru, O. K., & Hill, C. V. (2015). Advancing racial/ethnic minority men’s health using a life course approach. Ethnicity & disease, 25(3), 241. doi:  10.18865/ed.25.3.241

Torres, A., Blasi, F., Dartois, N., & Akova, M. (2015). Which individuals are at increased risk of pneumococcal disease and why? Impact of COPD, asthma, smoking, diabetes, and/or chronic heart disease on community-acquired pneumonia and invasive pneumococcal disease. Thorax, thoraxjnl-2015. https://dx.doi.org/10.1136/thoraxjnl-2015-206780

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