Diabetes Assignment

Diabetes is a common, chronic and costly health problem. In Australia, diabetes is the fifth national health priority and the sixth leading cause of death. In the last few years, the standardised death rate for diabetes has risen to 16.5 per 100 000 population. The patient interview is just one of the many middle aged men affected by this notorious disease. The patient is a 54 y.o male from Sri Lankan decent, a father of two. He leads a stressful lifestyle, working a physically demanding job in the day and then doing the paper rounds at night. Due to this lifestyle his eating and sleeping pattern are not considered to be normal, (something he himself has mentioned upon questioning). It is to be noted that to secure the identity and confidentiality of the person interviewed from here on in will be referred to as "the patient". (Holman H, 2004)

After examining contemporary trends in the patients diabetes care; it was observed that Emotional, psychological and social factors are not just impacting the quality of life, but it is also often responsible for the role in chronic illness outcomes. Diabetes care, in particular, is significantly predisposed by psychosocial factors when they deter a person's capability to not only control the disease but also to obtain metabolic control. Healthy coping, can be defined as retorting to a physical and psychological challenge by employing any obtainable resources to enhance the chance of favourable outcomes in the future, Healthy coping is fundamental to and effective self-management by people with diabetes. (Holman H, 2004)

During our Conversation I enquired about meeting the need of the individual with diabetes. Furthermore, the a variety of obstacles associated to diabetes add to the load of illness and can be the cause of further psychological distress. Recognizing that people with diabetes are in many ways healthier when they effectively deal with the issues (predominantly psychosocial) in their lives, the AADE (American Association of Diabetes Educators) and other renowned Diabetes association's has recognized "healthy coping" as one of its behavioural self care essential for successful diabetes self-management. There are numerous potential hurdles to healthy coping . Among those acknowledged by some organisations and the patients were: financial stress or constraint, low social support, , low problem-solving ability, external locus of control , low educational level, low health numeracy/literacy, stressful life events, external focus (taking care of others), lack of access to providers and diabetes educators, poor prioritization skills, perceived stigma attached to admitting an inability to cope and compounding health problem ( cognitive or physical limitations). There was also a mentioned note of the emotional paralysing consequence of what many clinicians regard to as ''diabetes over whelm us.'' The intricacy of the disease can frustrate the individual's sense of ability to cope and self-efficacy. (Newman S, 2004) Bleakness which leads to feeling of depression, can ensue. In contrast, some patients fail to understand or admit the importance or the seriousness of diabetes; this deficiency of knowledge may be the consequence of trivializing annotations from providers, such as the comment that the patient has ''a touch of sugar.'' The individual's surroundings also may be a barricade to healthy coping. An example of this is , inner city neighbourhoods often offer a number of convenience stores but few supermarkets or grocery stores, thus discouraging healthy eating. (Newman S, 2004)

The effect diabetes had on the individual and their family was also discussed. Diabetic patients have an increased likelihood to have depression in comparison to individuals who do not have diabetes. However diabetic patients may oblige depression treatment at early stages of their diagnosis, as depression is going to have a negative affect them which may be the cause of disability in later life. (Norris SL, 2001) Adults who have diabetes also presenting with co-morbid depression, also have the likelihood of deprived metabolic control , increased health care use and costs, more complications, reduced quality of life, lost productivity, higher mortality rates and greater disability. Studies in the past have acknowledged the relationship between diabetes and depression outcomes, showing the interrelated effects of depression on glycemic control in patients with diabetes. Issues that can interfere with a patients confidence and ability to manage

their diabetes is often related to psychological. There are evidence suggesting that depression can be related to deprived glycemic control which further envisages a subordinate course of depression in adults. (Norris SL, 2001) Depression can rise impediments, not only due to poor self-care, but possibly also through the nervous system and brain chemistry idiosyncrasies that accompany depression. Research has also indicated with increasing evidence that upon treating depression it is possible to also assist in improve the outcome of handling the co-occurring illness. Depression has destructive effects on outcomes of diabetes, diabetes obscures depression, and these problems are both growing and worse, hence the efforts to identify and treat depression in diabetic patients should be encouraged. A reported effective method of Improving metabolic control, is family therapy, which incorporates developmentally appropriate negotiated responsibility. (Johnson JF, 2003)

From the perception of the patient, reducing the burden forced upon by diabetes entails an process that assures services are affordable, integrated and accessible. (Johnson JF, 2003) They must also be patient centred, with a convincing distinction on sustaining patients' confidence and having the potential to successfully control their illness. Patient reported outcomes such as assessments of quality of care and quality of life are becoming more extensively used as indicators of health care systems. They are now regularly believed to be crucial to the assessment of the receptiveness of health systems in meeting the necessities of their users .Self management of diabetes is a social and complex behavioural process, which requires not only a broad understanding of the condition but also increased levels of empowerment, self-efficacy, and perceived control. Predictably, having diabetes can pessimistically influence the quality of life of people who live with the disease. A substantial number of investigations have found reasonably elevated levels of distress, and, in a significant minority subset, considerable depressive symptomatology. (Odegard PS, 2002)

Healthy coping techniques differ among various populations.