Teaching in Nursing Research Paper

The prevalence of Diabetes mellitus (DM) has increased disturbingly globally. This chronic, non-communicable, progressive metabolic disorder is associated with hyperglycemia, primarily due to the deficiency of insulin hormone in the blood system. DM virtually has an impact on all body systems, mostly due to metabolic changes. Approximately 422 million adults were diagnosed with diabetes mellitus by 2014. This number represents about 8.5% of the total world’s population.  The figure has increased from 108 (4.7) million adults diagnosed with the disease in 1980. Therefore, the global prevalence of Diabetes Mellitus in adults has doubled from 4.7 to 8.5% in 1994 and 2014, respectively (World Health Organization, 2017). Consequently, about 1.5 million deaths worldwide annually are attributed to Diabetes Mellitus. Additionally, hyperglycemia accounts for around 2.2 million deaths annually by raising the risk for chronic illnesses, especially Cardiovascular Disease (CVD) (WHO, 2017). Furthermore, health complications associated with DM have adverse socioeconomic effects on patients with DM and their families. Teaching in Nursing Research Paper. In addition to individuals, diabetes imposes a high economic burden on the public healthcare system due to the direct and indirect medical costs incurred in the management of diabetes mellitus (DM). The high prevalence of DM is attributed to multiple determinants, including feeding habits, sedentary habits, and stress management, among other factors (Standl et al., 2019). The alarming landscape requires an intervention to reduce the effect of this disease on the public. Diabetes education is one of the significant components of diabetes management. Education will enable people with diabetes to participate actively in the management and treatment of their conditions. This health education program will focus on a middle-aged male patient who works as a taxi driver. He was diagnosed with Diabetes Mellitus (DM) around five years ago. Teaching in Nursing Research Paper.  However, he has been non-compliance with his treatment, thus increasing the risk of developing a foot ulcer. The first part of the paper will include a session that will be conducted highlighting vital health information required by the patient. Additionally, it will evaluate the patient learning process. Secondly, the paper will entail a critical discussion on the significance of therapeutic education in preventing complications and enhancing treatment compliance among patients with DM to improve life quality.

Therapeutic Education Session: The Significance of the required Health Information and the Evaluation of Patients Learning

Therapeutic education involves various educational activities, which are significant for managing chronic conditions, including diabetes and hypertension. The education is conducted by competent and qualified health professionals who have been trained in the field of education. Their primary aim is to help individual patients or groups of patients diagnosed with chronic disease manage their conditions, thus preventing further complications. The education program’s ultimate goal is to empower patients and their families, thus enabling them to take an active role in the treatment and management of their conditions to prevent avoidable complications and improve the overall quality of life. According to Contreras et al. (2017), education is among the primary components of the treatment of DM2.  Therefore, patients with diabetes mellitus, close acquaintances, caregivers, and family members should be educated continually about this condition. A considerable percentage of chronic complications associated with diabetes can be prevented through the health education program.

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Therapeutic education involves various stages of clinical care. Educational objectives are set from each of these stages. These goals should be assessed systematically and continuously to improve metabolic control, thereby enhancing the patient’s quality of life. Therefore, health education provides individuals with learning opportunities, thus improving their health literacy and the public’s knowledge regarding health. This knowledge improves individuals’ self-esteem, personal skills, and productivity. The short-term educational interventions, which are conducted in less than six months, have effectively improved the control of DM2 (Contreras et al., 2017). Consequently, a multidisciplinary team conducts an education program to enable patients with DM to improve their metabolic control by implementing various measures. Therefore, this therapeutic education program focuses on educating the client to enhance his glycemic control by adhering to the prescribed treatment and lifestyle modification in diet and physical activity changes.

The Significant Health Information required by the Patient

The patient requires some vital information, which is transferred to self-care activities to enhance his compliance with the treatment to improve glycemic control, thereby reducing the risk of developing a foot ulcer. This information includes nutritional patterns appropriate for patients with diabetes and physical exercises, Self-Monitoring of Blood Glucose (SMBG), foot care, and risks associated with treatment non-compliance.

Nutritional Patterns Appropriate for Diabetes Patients

People diagnosed with diabetes should receive “nutritional medical treatment” depending on individual patients’ health needs. Therefore, the information about appropriate nutrition will be significant to the middle-aged male patient. In particular, the client will be educated about Carbohydrate Counting (CHO). A proper diet will enhance the efficacy of the prescribed treatment. First, the education program will create awareness about the significance of controlling his weight to balance his energy level. Total energy consumption is a crucial component that individuals with diabetes should consider to achieve optimal glycemic control (Forouhi et al., 218). Taking low carbohydrates (130 g/day) diets will reduce his total energy, thus preventing him from becoming obese. The client should ensure that his primary carbohydrates are vegetables, whole grains, fruits, grains, and low-fat dairy products.

Secondly, the client will be educated about the significance of taking foods of lower loads or index to substitute those with high glycemic load or index. Taking food with a lower index improves glycemic control among individuals diagnosed with diabetes (Gray & Threlkeld, 2015). He should ensure that his total CHO consumption ranges between 55 and 60% of the total consumption requirement.

Additionally, the client will be educated about the dangers of protein intake. Plasma insulin values increase due to the intake of proteins. However, no significant change was caused to glycemic levels. The client is advised to ensure that his total amount of protein intake is similar to that of the general population ranging from 15 to 20% of the total consumption requirement. Nonetheless, the client should not consider “hyper-protein” diets as a technique for long-term weight loss. Teaching in Nursing Research Paper.

Another significant health information for this patient involves the amount of fats that he should take. He should concentrate on the quality of the fat rather than the quantity. In particular, he should take polyunsaturated fats due to their health benefits, such as enhancing the intake of omega-3s and reducing cardiovascular disease risk.

The client will also be educated about the appropriate number of bluefish that he should consume. He should take this fish at least two times weekly. Additionally, he will be advised to take saturated fatty acids (FA) in proportions below 7% of the TCR. However, he should lower the amount of FA Trans consumed to below 1% (Contreras et al., 2017).

Finally, the client will be educated about the importance of taking at least 25g of whole grains and fiber daily. This is the quantity recommended for the public. The consumption of a large number of starches and soluble fiber and starches enhances blood glucose control. His appropriate amount of sodium is equal to the general population’s quantity (less than 2,300 mg/day). According to Contreras et al. (2017), people with diabetes should take sodium equal to that of the general population.

Physical Activities

In addition to nutritional diet details, the patient requires information about the relationship between physical exercises and diabetes. Physical activities enhance glycemic control among diabetic patients to reduce the risk of cardiovascular problems. For this reason, the patient will be educated about the significance of engaging in aerobic exercises regularly. In particular, the benefits of engaging in strength, resistance, and elasticity exercises will be emphasized. These exercises will enable the patient to improve and maintain cardiorespiratory and muscular mobility muscular. Nonetheless, the patient will be advised to consider some factors before starting the exercises. First, he should seek a critical medical evaluation to ensure he is fit before beginning the exercises. Secondly, the patient and his family members or caregivers should understand the signs and symptoms of hypoglycemia and the most appropriate action to take in such an incident. Moreover, the patient should always have a sugary product, a notebook with personal details, and a mobile phone with emergency contacts. Lastly, the patient should maintain proper foot hygiene.

The patient will be advised to strive at losing a minimum of 1000 calories weekly through physical exercises. He should give a particular exercise enough warm-up and cooling protocol that ranges from 5 to 10 minutes to prevent cardiac arrhythmias and give the body adequate time to adapt to the exercise. He should exercise for about 10 to 15 min duration at the beginning. He will increase the duration of his exercise sessions progressively to a duration between 30 and 60 minutes per day. It is recommendable to subdivide this exercise duration into multiple shorter sessions to give his body some time to relax. Maintaining adherence to physical activity will improve glycemic control, thus reducing the risk of developing a foot ulcer.

Self-Monitoring of Blood Glucose (SMBG)

Details about using self-monitoring of blood glucose (SMBG) will also be necessary to the client. Effective use of SMBG facilitates blood glucose monitoring among individuals diagnosed with patients (Young et al., 2017). The systematic glucose monitoring technique will reveal essential patterns of glycemia, which occur throughout the day. Therefore, educating the patient about the SMBM will provide the patient with a highly valuable strategy for enhancing his condition’s daily management. Additionally, SMBG will improve patient’s glycemic control, in the long run, to prevent chronic complications of diabetes, in particular cardiovascular diseases. Finally, SMBG will enhance the patient’s understanding of hypoglycemia, thus improving the self-regulatory prevention of hypoglycemic episodes.

Foot Care

            Another important piece of health information required by this client is about foot care. Diabetes is associated with nerve damage and low blood flow. This diabetes complication puts individuals diagnosed with this condition at the risk of developing a foot ulcer that might either in the form of a wound or a sore. The healing of the foot ulcer might delay in case it gets infected. Additionally, failure of the infection to improve with treatment puts the affected part, such as a toe or foot, at risk of being amputated, in which the body part is removed by surgery primarily to prevent the infection from spreading to some delicate body parts such as the heart and the kidney. For this reason, the patient will be educated on how to keep his feet healthy to reduce the risk of developing a foot ulcer. First, he will be advised to inspect his feet daily. In particular, he should check for cuts, redness, blisters, swelling, or nail problems. He should seek medical attention in case of any situation. Secondly, the patient was educated about the benefits of using lukewarm water to bathe his feet. Additionally, he should be gentle when cleaning his feet. Maintaining feet hygiene by washing them daily kills any pathogens, thus preventing infections. Lastly, the patient will be advised to moisturize his feet regularly to prevent cracking or itching. However, he should not moisturize between the toes to prevent fungal infections (CDC, 2019).Teaching in Nursing Research Paper.

Risks associated with Treatment Non- Compliance

The last significant health information required by this client is about treatment compliance. The client will be educated about the dangers of treatment non-compliance in diabetes patients. According to Ahmed et al. (2020), treatment non-compliance occurs when patients with diabetes fail to take medications prescribed by the care provider. This behavior is associated with various dangers, including developing long-term diabetes-related complications that might lead to death. Additionally, hyperglycemia is attributed to poor adherence to antidiabetes medications (Rathish et al., 2019). For this reason, the need to take medicines as prescribed by the clinician in terms of dosage and frequency will be emphasized to the patient.

Evaluation of Patient’s Learning

Evaluation can be described as the last stage of the teaching process. It entails assessing the patient’s learning progress continuously during and after teaching. It enables the trainer to find out if the patient has understood what was taught. Therefore, evaluation enables the teacher to assess whether the primary goal of a particular education program has been achieved. Several techniques can be used to evaluate the learning process of this client. First, the evaluation will be conducted by assessing the patient’s ability to demonstrate some psychomotor skills for managing diabetes. Also, the evaluation will involve asking the patient to use his own words to explain provided guidelines for the management of diabetes. More so, asking the patient questions from what was taught will be used to evaluate the learning process’s success. The learning process if the patient will provide the correct answer. On the contrary, failure to give the correct response indicates that the learning process was unsuccessful and the program’s primary goals were not achieved.

The Significance of this Therapeutic Education as a Strategy for Prevention of Complications and Treatment Compliance in DM to Preserve the Quality of Life

Therapeutic education is a substantial approach in the management of diabetes mellitus. The patient was provided with significant health education during the program that can be incorporated into self-care management. First, the education would address an appropriate nutritional diet, which is recommendable for diabetes patients. He was particularly educated about the correct amount of all food components, including carbohydrates, proteins, fats, and fiber. Taking the recommendable quantities will improve glycemic control, thus preventing diabetes complications such as cardiovascular diseases. Secondly, the patient would be educated about the recommendable aerobic exercises, durations that an exercise program should last, and precautions to take before exercising. Exercising regularly will burn excess energy in the body, thus enhancing blood glucose control to prevent severe illnesses associated with diabetes.

Furthermore, the patient was education would include SMBG, which will improve the patient’s glycemic control in the long-run. Controlled glycemic will prevent the development of chronic complications of diabetes, in particular cardiovascular diseases. Additionally, SMBG would enhance the patient’s understanding of hypoglycemia, thus improving the self-regulatory to prevent hypoglycemic episodes. Another significant aspect of therapeutic education in foot care.Teaching in Nursing Research Paper. This section includes tips for taking care of one’s feet to prevent foot ulcers. Finally, therapeutic education involves treatment compliance, which involves taking medicines as prescribed by the care provider. Treatment compliance results in improved glycemic control among diabetes patients, thus preventing further complications associated with this condition that might lead to death. According to Guerci et al. (2019), treatment non-compliance is among the primary factors that hinder glycemic control in individuals diagnosed with diabetes mellitus. Additionally, treatment compliance prevents hyperglycemia in diabetes patients. Prevention of further complications and treatment compliance will improve patient’s clinical outcomes and quality of life.

Conclusion

Therapeutic education is one of the significant components of diabetes management. Education enables people diagnosed with diabetes to participate actively in the management and treatment of their conditions. This therapeutic education program focuses on a middle-aged male patient who works as a taxi driver. In particular, the education program has captured significant education required by this patient, including nutritional patterns appropriate for patients with diabetes and physical exercises, Self-Monitoring of Blood Glucose (SMBG), foot care, and risks associated with treatment non-compliance. The learning process’s effectiveness can be evaluated through various techniques, including asking the patient questions related to what was taught and asking him to restate what was learned in his own words. Therapeutic education is a significant strategy for preventing complications and enhancing treatment compliance in patients with diabetes to preserve life quality. This clinical outcome will be achieved through the implementation of the acquired knowledge into self-care management.

References

Contreras F, Sanchez M, Martinez MS, Castillo MC, Mindiola A, et al. (2017) Management and Education in Patients with Diabetes Mellitus. Med Clin Rev. 3:7. DOI: 10.21767/2471-299X.1000049.

Forouhi, N. G., Misra, A., Mohan, V., Taylor, R., & Yancy, W. (2018). Dietary and nutritional approaches for prevention and management of type 2 diabetes. BMJ, 361. Teaching in Nursing Research Paper.

Gray, A., & Threlkeld, R. J. (2015). Nutritional recommendations for individuals with diabetes. Europe PMC. https://europepmc.org/article/nbk/nbk279012

Young, L. A., Buse, J. B., Weaver, M. A., Vu, M. B., Mitchell, C. M., Blakeney, T., … & Donahue, K. E. (2017). Glucose self-monitoring in non–insulin-treated patients with type 2 diabetes in primary care settings: a randomized trial. JAMA internal medicine, 177(7), 920-929.

Centers for Disease Control and Prevention. (2019). Diabetes and Your Feet. U.S. Department of Health & Human Services. https://www.cdc.gov/diabetes/library/features/healthy-feet.html#:~:text=Check%20your%20feet%20every%20day%20for%20cuts%2C%20redness%2C%20swelling%2C,Don’t%20soak%20your%20feet.

Ahmed, S. M., Sami, W. M., Alkanhal, H. F., Alenzi, A. N., Alotaibi, W. S., Alotaibi, K. A., & Almshafi, A. A. (2020). Study of the Prevalence and Risk Factors of Treatment Non-compliance among Elderly Diabetic Patients in Majmaah, KSA. Annals of Medical and Health Sciences Research.

Guerci, B., Chanan, N., Kaur, S., Jasso-Mosqueda, J. G., & Lew, E. (2019). Lack of treatment persistence and treatment nonadherence as barriers to glycaemic control in patients with type 2 diabetes. Diabetes Therapy, 10(2), 437-449.

Standl, E., Khunti, K., Hansen, T. B., & Schnell, O. (2019). The global epidemics of diabetes in the 21st century: Current situation and perspectives. European journal of preventive cardiology, 26(2_suppl), 7-14.

World Health Organization. (2017). Global diffusion of eHealth: making universal health coverage achievable: report of the third global survey on eHealth. World Health Organization.

Rathish, D., Hemachandra, R., Premadasa, T., Ramanayake, S., Rasangika, C., Roshiban, R., & Jayasumana, C. (2019). Comparison of medication adherence between type 2 diabetes mellitus patients who pay for their medications and those who receive it free: a rural Asian experience. Journal of Health, Population, and Nutrition, 38(1), 1-8.

ASSIGNMENT QUESTION

OBJECTIVE:

This assignment is to evaluate learners’ capability and analytical skills in carrying outpatient education and recognizing the strategies for prevention of complications and treatment compliance in Diabetes Mellitus.

SYNOPSIS:

Patient health education is a significant part of a nurse’s job. Nurses are responsible for teaching patients about preventing and managing medical conditions. Education empowers patients to improve their health status. Patients with Diabetes Mellitus (DM), for instance, can actively participate in the management of this disease.  The therapeutic education playing an essential role in the optimization of knowledge, resources, and skills required to achieve targets of metabolic control, reduce the onset of acute and chronic complications, and preserve the quality of life.

QUESTION:

You are assigned to give health education to a middle-aged male patient, a taxi-driver, who is diagnosed with Diabetes Mellitus (DM), about 5 years ago.  He is known for being non-compliance with the treatment and at the risk of developing a foot ulcer.

1. Describe the session that you are going to conduct by highlighting the significant health information required by the patient, and evaluating of patient learning.
2. Critically discuss the significance of this therapeutic education as a strategy for prevention of complications and treatment compliance in DM to preserve the quality of life. 

[Total:  40 Marks]

SOALAN TUGASAN

OBJEKTIF:

Tujuan tugasan ini adalah untuk menilai keupayaan dan kemahiran pemikiran analitikal pelajar dalam melaksanakan pendidikan pesakit, dan mengenali strategi untuk mencegah komplikasi dan kepatuhan rawatan Diabetes Mellitus.

SINOPSIS:

Pendidikan kesihatan pesakit adalah satu bahagian penting dalam pekerjaan jururawat. Jururawat bertanggungjawab untuk mengajar pesakit mengenai pencegahan dan pengurusan masalah perubatan. Pendidikan memperkasakan pesakit untuk meningkatkan taraf kesihatan mereka. Pesakit dengan Diabetes Mellitus (DM), misalnya, dapat mengambil bahagian secara aktif dalam pengurusan penyakit ini.  Pendidikan terapi memainkan peranan penting dalam pengoptimuman pengetahuan, sumber dan kemahiran yang diperlukan untuk mencapai sasaran kawalan metabolik, mengurangkan permulaan akut dan komplikasi kronik, dan mengekalkan kualiti hidup. 

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SOALAN:

Anda ditugaskan untuk memberi pendidikan kesihatan  kepada seorang pesakit lelaki pertengahan umur, pemandu teksi, yang telah didiagnos menghidap Diabetes Mellitus (DM), kira-kira 5 tahun yang lalu. Dia diketahui tidak mematuhi rawatan dan berisiko mendapat ulser kaki.

1. Huraikan sesi yang anda akan jalankan dengan menetengahkan maklumat kesihatan penting yang diperlukan oleh pesakit, dan penilaian pembelajaran pesakit.
2. Bincangkan secara kritis kepentingan pendidikan terapeutik ini sebagai strategi pencegahan komplikasi dan kepatuhan rawatan DM untuk mengekalkan kualiti hidup.

[Jumlah: 40 Markah] 

ATTACHMENT

ASSIGNMENT RUBRICS

NBBS1304 TEACHING IN NURSING/JANUARY 2021

 Teaching in Nursing Research Paper