Managing Diabetes Mellitus Using The Health Promotion Model Essay.

The Case of Kath Smith

Kath Smith (pseudonym) is a 40 years old White woman staying in Australia with her husband and three children. She is a teacher by profession and her husband works as a construction worker. She works the whole day and depends on takeaway meals for lunch. In the evening she prefers wine with her dinner and smokes 4 packets of cigarettes every day. She is very busy with her school and three children and hardly does any workout. She loves doing social service and visits orphanages every Sunday. She is obese with a Body Mass Index of 33kg/m2. Her past medical history includes hyperlipidaemia, hypertension, and urine microalbumin. Over the past month, she had complained about acute weakness, disorientation, and tiredness on numerous occasions. She suffered drowsiness and widespread weariness in a previous bout three weeks prior. When questioned, she stated that she had an insatiable thirst and that she needed to urinate frequently. Due to this she has not been able to sleep properly. She is also having blurry vision (diabetic retinopathy). She has been diagnosed with Type 2 diabetes and her blood pressure has been recorded as 170/90. For Kath the two nursing priorities will be managing her retinopathy and high blood pressure. Type 2 diabetes mellitus is a long-term illness that prevents the cells of the body to utilize insulin the way they should. It is also known as insulin-resistant diabetes. Diabetes fatigue is more than just a tired feeling; it can lead to increased depression (Galicia-Garcia, et al., 2020). The health model that will be suitable for managing the condition of Kath is the health promotion model as Diabetes mellitus patients require adequate health awareness, health promotion, and referral to expert care (Kurnia, Amatayakul & Karuncharernpanit, 2017).

Nola J. Pender developed The Health Promotion Model as an alternative to the health protection models." Health in this model is defined as a positive active state as compared to the absence of disease. The goal of health promotion is to increase the entire well-being of a patient. The health promotion model explains the multidimensional structure of people as they engage with their surroundings in order to achieve health. The desired behavioural objective and conclusion in the Health Promotion Model is the behaviour that promotes good health (Gonzalo, 2021). Health-promoting habits must lead to improved health, increased functional capacity, and a higher standard of living at all stages of development. It evolves to encompass health-improving practices and is applicable throughout the life cycle. The goal of this model is to provide assistance to the nursing staff s so that they can learn about and comprehending the primary determinants of health behaviours so that they may use behavioural counselling to encourage well-being and healthy lifestyle choices. The model emphasizes three aspects: individual features and encounters, thoughts and feelings and feelings related to behaviour, and behavioural outcomes (Aqtam & Darawwad, 2018).

The first priority is retinopathy or blurred vision that Kath is having. She has been diagnosed with type 2 diabetes mellitus and has been complaining about blurred vision. Diabetes retinopathy is an eye condition caused by diabetes. Impairment to the vascular system of the tissues which are sensitive to light at the rear of the eye causes it (Wang & Lo, 2018). In order to provide a holistic therapy method, the RLT framework has been thoroughly developed to account for a patient's psychological, biological, and social needs. It underlines the need of employing a comprehensive strategy when evaluating patients, as well as the need for nurses to collect data not only from the patient but also relevant data about the patient in order to construct a more extensive and thorough evaluation. The RLT model is made up of twelve daily activities: maintaining a secure environment to stay, having effective communication skills, breathing, eating and drinking, excretion, bathing and dressing, controlling temperature, mobility, working and playing, expressing sexuality, sleeping, and death and dying (Williams, 2017). Kath has been working as a teacher. She maintains a safe environment for her kids and husband. She works at an orphanage. She has issues with sleeping because of frequent urinating. She is consuming takeaway food for lunch and drinks wine daily with dinner. She is not doing any workout and smokes 4 packets of cigarettes per day.

Health Promotion Model: A Brief Overview

If this condition is not treated, it can lead to the formation of aberrant blood vessels in the retina. Consequences can result in severe eyesight impairment such as vitreous hemorrhage a condition in which fresh blood vessels leak into the transparent, spongy fluid that occupies the centre of the eye. If the quantity of blood is minor, Kath may only notice small dark dots known as floaters. Blood can enter the vitreous cavity and entirely obstruct her eyesight in more extreme circumstances. Detachment of the retina during which Diabetic retinopathy is characterised by aberrant blood vessels that accelerate the creation of damaged tissue, that can force the retina outward from the back of the eye. This can result in floating dots, sensitivity to light, or serious loss of sight. It can also lead to glaucoma and complete blindness (Dansinger, 2021).

Kath must be informed of and practise self-care in order to reduce risk factors for Diabetic Retinopathy, such as increased levels of sugar and cholesterol in the blood. The nurse must recognize how diabetes can affect the health of the eye and encourage Kath to have her eyesight checked on a regular basis. The nurse should double-check Kath's understanding of the material by urging her to recite what she learned. The nurse should ask Kath questions about her eye health during her every visit to the clinic (Beaser, Turell & Howson, 2018). The nurse should teach Kath the ABCs so that she can take action to prevent the situation she is experiencing. She must believe that if she does not control her disease, it will lead to major consequences. A blood test stand for A1C. A1C is a blood test that will indicate Kath's average blood sugar level over the last few months. B stands for blood pressure. Kath must believe that controlling her blood pressure is just as important as controlling her glucose levels because she has diabetes. Her high blood pressure puts her at risk of myocardial infarction, a stroke, and kidney damage. The letter C stands for cholesterol (Delahanty, 2018). For optimal health, the nurse must encourage Kath to maintain her sugar levels, blood pressure, and lipid profile within normal parameters. The nurse should eat a nutritious diet that includes plenty of fruits and vegetables, whole grains, and low-fat dairy products. She should minimize her diet of meat and fried, high-fat foods. She should be physically active and exercise for at least 30 minutes three times a week. The nurse should ask Kath to join diabetes self-management education and support (DSMES) services (CDC, 2022).

The second priority for Kath is managing her high blood pressure. After monitoring her blood pressure, the nurse recorded it 170/90. Diabetes damages arteries, making them susceptible to hardening, a condition known as atherosclerosis. This can lead to high blood pressure, which, if not addressed, can lead to consequences such as blood vessel damage, heart attack, retinopathy, and renal failure (Bergmark, 2018). Kath is obese with a Body Mass Index of 33kg/m2. Her past medical history includes hypertension. She is consuming takeaway food for lunch and drinks wine daily with dinner. She is not doing any workout and smokes 4 packets of cigarettes per day.

Managing Diabetic Retinopathy: A Holistic Therapy Approach

High blood pressure exerts undue strain on the artery walls, which can injure both the blood vessels and the organs. The more the damage, the higher the blood pressure and the longer it goes uncontrolled. High blood pressure can cause artery stiffness and thickness, a condition known as atherosclerosis, which can lead to a heart attack, stroke, or other complications. Aneurysms form when the blood vessels deteriorate and widen as a result of excessive blood pressure. An aneurysm that ruptures can be fatal. It can result in cardiac failure. It can also weaken and constrict the veins and arteries in the kidneys (Fuchs & Whelton, 2020).

The nurse should include an instructive information sheet on high blood pressure that defines the situation, states possible ramifications if not treated properly, clinical manifestations that should notify the practitioner, and evidence-based suggestions for patients to decrease blood pressure, such as adherence to medication and lifestyle changes. Hypertension can be managed with dietary changes and, in certain situations, medication. Kath should believe that she needs to devise a plan to put her blood pressure back into normal range (Spies, et al., 2018). She should eat a diet high in fibre and potassium. Her eating habits should be low in sodium, fat, and added sugar. Her sodium intake should be less than 2.4 gm per day. As Kath is obese the nurse should promote weight loss. She should be encouraged to keep a healthy body weight. She should be made aware to eat a wide range of fresh fruits and vegetables. Whole grains, such as whole-wheat pasta, brown rice, and whole-grain bread, should be consumed. She must consume low-fat dairy products. She must avoid fatty meat portions, cooked or preserved meats, skinned poultry, and pre-made or prepared meals.  She should be physically active and exercise for at least 30 minutes three times a week. She should include muscle-strengthening workouts in her routine. She should avoid using any products that include nicotine or tobacco. She must keep her long-term health issues, such as diabetes, under control. She should avoid smoking cigarettes and also cut her alcohol consumption. She should control her stress by engaging in hobbies such as yoga and meditation (Ozoemena, et al., 2019).

In conclusion, it can be said that chronic conditions such as diabetes and hypertension that Kath is dealing with can lead to many serious diseases such as cardiovascular diseases which can be very dangerous for the health and can be life-threatening. The health promotion model can be very beneficial in Kath’s case as it will help her in managing her condition and lead a life that is healthy.

References

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Beaser, R. S., Turell, W. A., & Howson, A. (2018). Strategies to improve prevention and management in diabetic retinopathy: qualitative insights from a mixed-methods study. Diabetes Spectrum, 31(1), 65-74.

Bergmark, B. A., Scirica, B. M., Steg, P. G., Fanola, C. L., Gurmu, Y., Mosenzon, O., ... & SAVOR-TIMI 53 Investigators. (2018). Blood pressure and cardiovascular outcomes in patients with diabetes and high cardiovascular risk. European heart journal, 39(24), 2255-2262.

(2022). How to Promote Eye Health for People With Diabetes. https://www.cdc.gov/diabetes/professional-info/health-care-pro/diabetes-eye-health.html

Dansinger, M. (2021). What Is Diabetic Retinopathy? https://www.webmd.com/diabetes/diabetic-retinopathy

Delahanty, L. M. (2021). Patient education: Type 1 diabetes and diet (Beyond the Basics). UpToDate. Retrieved February, 18, 2022.

Fuchs, F. D., & Whelton, P. K. (2020). High blood pressure and cardiovascular disease. Hypertension, 75(2), 285-292.

Galicia-Garcia, U., Benito-Vicente, A., Jebari, S., Larrea-Sebal, A., Siddiqi, H., Uribe, K. B., ... & Martín, C. (2020). Pathophysiology of type 2 diabetes mellitus. International journal of molecular sciences, 21(17), 6275.

Gonzalo, A. (2021). Nola Pender: Health Promotion Model. https://nurseslabs.com/nola-pender-health-promotion-model/#what_is_health_promotion_model

Kurnia, A. D., Amatayakul, A., & Karuncharernpanit, S. (2017). Predictors of diabetes self-management among type 2 diabetics in Indonesia: Application theory of the health promotion model. International journal of nursing sciences, 4(3), 260-265.

Ozoemena, E. L., Iweama, C. N., Agbaje, O. S., Umoke, P. C., Ene, O. C., Ofili, P. C., ... & Anthony, E. (2019). Effects of a health education intervention on hypertension-related knowledge, prevention and self-care practices in Nigerian retirees: a quasi-experimental study. Archives of Public Health, 77(1), 1-16.

Spies, L. A., Bader, S. G., Opollo, J. G., & Gray, J. (2018). Nurse?Led interventions for hypertension: A scoping review with implications for Evidence?Based practice. Worldviews on Evidence?Based Nursing, 15(4), 247-256.

Wang, W., & Lo, A. C. (2018). Diabetic retinopathy: pathophysiology and treatments. International journal of molecular sciences, 19(6), 1816.

Williams, B. C. (2017). The Roper-Logan-Tierney model of nursing. Nursing2020 Critical Care, 12(1), 17-20.