Global Health Issue and Significance to Nursing

Diabetes is frequently connected with high blood sugar or glucose levels. Diabetes type 2 is caused by the body cells' inability or unwillingness to produce or utilise insulin. Insulin is a hormone generated by body cells that aids in the conversion of glucose to energy in the circulation. When there is no insulin in the body, the blood contains a high concentration of glucose. High amounts of glucose in the blood may eventually lead to major health problems affecting the nerves, kidneys, eyes, and heart, as well as the teeth and gums. Burgeoning research has ascertained that people who do not do physical exercise, the old, obese, and those with a family history of diabetes stand high chances of developing type 2 diabetes. Moreover, studies have revealed that those who have prediabetes are also at high risk of developing diabetes type 2 (McGuire & Anderson, n.d). Prediabetes in this context means that an individual has a blood sugar level, which is higher than the average level but is not enough to be classified as diabetes. The symptoms of type 2 diabetes might not be easily detected early since they are gradual. In fact, some diabetic patients do not notice the symptoms at all until a diagnostic test is run.

Part A- Global Health Issue and Significance to Nursing

Type 2 diabetes is a significant health challenge both to the national and international communities. The health issue has been identified as a policy area for management and prevention of strategies and policies. Other than being one of the leading causes of morbidity among the young and the old, type 2 diabetes has also been identified as one of the key players in the global mortality. Many people, particularly the old have died because of this type of diabetes. As mentioned earlier, diabetic patients hardly recognize the symptoms of the disease in advance, making early interventions difficult. Consequently, the misdiagnosis makes it difficult to ascertain the prevalence of the health issue within the populace. In-depth research has obtained that there is a high prevalence of type 2 diabetes among women aged 45 and above (McGuire & Anderson, n.d). Similar research revealed that diabetes type 2 was the primary cause of deaths among the old women aged 65 and above. Diabetes, being one of the underlying causes of high mortality, has a strong association with the causes of mortality such as stroke and heart failure, kidney disease, and not limited to coronary heart disease.

Health interventions have established that a high percentage, (roughly 80%) of diabetes type 2 can be prevented by positive health behaviors such as regular physical exercise and healthy feeding (Girardi et al., 2015). There is a possibility that the interventions targeting the modifiable risk factors can curtail the relative risk of developing the disease among the high-risk population such as the old and those with the family history of diabetes. Another evidence has shown that the type 2 diabetes risk factor reduction lessens the short and long-term complications of the disease as well as improving the diabetic control. Hence, when diagnosing the type 2 diabetes, both education and essential components of diabetes care ought to include assessment of modifiable and non-modifiable risk factors particularly nutrition, smoking, physical activity, and alcohol intake. Over the world, it has been estimated that diabetes affects more than 200 million people (Girardi et al., 2015). Some of the chronic disorders linked with diabetes such as vascular, renal, and ocular diseases are the most common causes of absenteeism at work and hospitalization.

The complications of type two diabetes are not only felt in the people’s health but also the global economy. Apart from the reduced productivity at work, the severity of the disease’s complications and means of controlling the health issue makes it an expensive disease to the global healthcare system. Even so, its implications such as anxiety, pain, and inconvenience for the quality of life in the lives of families and patients are hard to quantify. On top of directly compromising the lifestyle and quality of life of patients, the type 2 diabetes can also reduce the life expectancy of a given population dramatically by affecting the metabolic control, which can increase the disease complications. As a global health issue, it is also worth adding that the prevalence and occurrence of diabetes type 2 used to be diagnosed among the old but currently affects a significant number in the population ranging from the young to the old.

Part B- Appraisal Synopses

Study # 1: Australian Research Study

Citation:

McGuire, A. M., & Anderson, D. J. (n.d.). Lifestyle risk factor modification in midlife women with type 2 diabetes: theoretical modeling of perceived barriers. AUSTRALIAN JOURNAL OF ADVANCED NURSING, 30, 49-57.

Synopsis:

What was the purpose of the study (research questions, purposes, and hypothesis)?

The purpose of the research was to ascertain whether the idea of lifestyle risk factor modification’s perceived barriers could be integrated into the current frameworks for the type 2 diabetes education to improve the knowledge regarding the lifestyle risk factors in diabetes type 2. The study also aimed to highlight the significance of the perceived barriers’ concept for risk factor reduction in health promotion and to explain the risk factor modification and perceived barriers model. (McGuire & Anderson, n.d)

How was the sample obtained?

The study participants in the research were obtained through convenience method, where a sample of older women with approximately 66 years and 46 midlife women attending community health clinics were enrolled in the study.

What inclusion or exclusion criteria were used?

The nurses used random sampling of the midlife women who visited the community health clinics in Australia to get 46 middle-aged women for the survey. All the elderly women who attended the clinics, and were 66 years and above, were enrolled for the study. The populations excluded in the study were elderly women who did not visit the clinics and the young women who visited the health centers where the research was conducted.

Who from the sample participated or contributed data (demographic or clinical profile,

and dropout rate)?

The female patients who met the criteria for inclusion were involved in data collection. Among the total sampled population were the old women and the 46 middle-aged women who contributed the data for the research.

What were the methods used to collect data (e.g., sequence, timing, types of data, and measures)?

The researchers used both quantitative and qualitative approaches to obtain the data from the sampled population. The quantitative method included survey data whereas the qualitative approach involved group interviews in finding out the attitudes and perception based on the health belief models. (McGuire & Anderson, n.d) The research also employed a cross-sectional study design.

Was an intervention tested?

The intervention was not tested in this study.

What were the findings?

According to the research, women face several challenges that deter them from participating in lifestyle activities. Moreover, diabetes is not just a cause of death, but it is also associated with other death-causing conditions including kidney diseases, stroke, coronary diseases and heart failure. A literature review of the study on the quality of life of people living with diabetes type 2 conducted in the state revealed perceived barriers as crucial determinants governing health behavior. It revealed a negative correlation between body exercise and community sense with the physical environmental barriers. In Australia, the perceived barriers for women with diabetes type 2 included depression, improper oral health, lack of social inclusion and low moral support from the family. (McGuire & Anderson, n.d) The research showed that diabetes type 2 is primarily preventable through regular exercise and positive behavioral changes such as healthy feeding habits.

Study # 2: Brazilian Research Study

Citation

Girardi, C. E., Heck, R., Bobek, M. L., & Benetti, E. R., et al. (2015). QUALITY OF LIFE OF PEOPLE IN LIVING GROUPS WITH DIABETES MELLITUS TYPE 2. Journal of Nursing, (1981-8963), 7239-7246. doi:10.5205/reuol.7275-62744-1-SM.0904201508

Synopsis

What was the purpose of the study (research questions, purposes, and hypothesis)?

The main intention of this research was to evaluate the quality of life of diabetic patients. The research narrowed down to assess the life expectancy of the population that was at risk of diabetes, specifically examining the quality of life (QOL) of individuals with diabetes mellitus type 2.

How was the sample obtained?

The sample in this study was obtained through convenience sampling which was then scheduled for interviews.

What inclusion or exclusion criteria were used?

All the individuals (18 years and above) with a history of diabetes and the diabetic patients fell under the inclusion criteria. The community group members who were linked to the Cerro Largo Family Health Strategy were also allowed to participate in the study. Moreover, the members of the municipality of Rio Grande do Sul, and the Northwest Region took part in the study. (Girardi et al., 2015) On the other hand, people who reported no history of diabetes were excluded from the research.

Who from the sample participated or contributed data (demographic or clinical profile,

and dropout rate)?

The study respondents gave the primary data. Even so, the researchers also obtained secondary data from the Form-36 Health Survey (SF-36) designed to evaluate QOL.

What were the methods used to collect data (e.g., sequence, timing, types of data, and measures)?

The study was conducted quantitatively with the use of simple structured questionnaire tools. Descriptive statistics were used to analyze the raw data electronically. The data was then presented in the form of tables and charts for easy interpretation.

Was an intervention tested?

The researchers did not test interventions in this research

What were the findings?

The study realized that the patients who had a history of diabetes mellitus type 2 had a depreciated health. In other words, the quality of life of the diabetic patients was compromised as compared to the non-diabetic patients. However, in the self-rated health, the diabetic patients recorded their life as good. (Girardi et al., 2015). The assertion confirmed that diabetic patients hardly realize that they are sick since they hardly notice the symptoms of the disease.

Study # 3: A Synthesis of the United States’ Literature

Citation:

Roux, G., Solari-Twadell, A., & Ackers, S. (2014). Community Interventions and Survivors and Their Families. CLINICAL JOURNAL OF ONCOLOGY NURSING, 19, 63-69

Synopsis

What was the purpose of the study (research questions, purposes, and hypothesis)?

The purpose of the study was to educate the researchers and nurses regarding the contemporary evidence-based community intervention outcomes for survivors and their families. The study also aimed at making recommendations for support systems among the cancer survivors.

How was the sample obtained?

The study did not use a population sample but instead conducted a systematic literature synthesis. The materials included in the study included a comprehensive search of literature from CINHAL database, which involved more than 200 results. (Solari-Twendell, Roux, & Ackers, 2014)

What inclusion or exclusion criteria were used?

The literature search only covered the articles that were published between 2004 and 2013. Moreover, only scholarly articles touching on community-based interventions for families and survivors were selected for analysis.

Who from the sample participated or contributed data (demographic or clinical profile,

and dropout rate)?

Articles from JSTOR, PubMed, CINAHL, and not limited to the other credible sources provided a synthesized review that met the research objectives. Information obtained from the abstracts reviewed provided the desirable data for systematic review.

What were the methods used to collect data (e.g., sequence, timing, types of data, and measures)?

The community intervention’s literature search was carried out with a survivor component. The researchers selected fifteen scholarly materials, which were analyzed in two phases of community intervention study. (Solari-Twendell, Roux, & Ackers, 2014). The two categories were people with all types of cancer and the women with breast cancer.

Was an intervention tested?

The validity and the reliability of the scholarly materials were tested by checking for the presence of the keywords required in the synthesis.

What were the findings?

The outcome of the literature synthesis showed that the interventions based at the community level are significant in improving the quality of life as well as lessening the symptoms of the disease among the survivors. Besides, support, exercise, and family interventions for spouses and children showed positive results. The findings of the literature synthesis also revealed varied implications for community nursing practice where health professionals and oncology nurses can start concentrating intervention efforts. (Solari-Twendell, Roux, & Ackers, 2014).

Study # 4

Citation:

Stevens, C., & Sidlinger, L. (2015). Integration of Primary Care into a Mental Health Center: Lessons Learned From Year One Implementation. Kansas State Nurses Association, 12- 15.

What was the purpose of the study (research questions, purposes, and hypothesis)?

The research sought to find out if there is the need to enhance the primary care services for people suffering from severe mental illnesses. It further aimed at substantiating whether there is need to integrate the traditional primary care systems to the care at the modern mental health care centers.

How was the sample obtained?

The sample was obtained through convenience sampling, where the researchers visited the mental health clinics within the community.

What inclusion or exclusion criteria were used?

The consumers of mental health services were put under the study. Another inclusion criteria involved individuals with 18 years and above. (Stevens, & Sidlinger, 2015)

What were the methods used to collect data (e.g., sequence, timing, types of data, and measures)?

The observation was made throughout an interactive session between the participants and the health care providers. The session involved both group and individual therapy, drug and alcohol treatment, and supportive/ residential living services.

Was an intervention tested?

No intervention was tested.

What were the findings?

The research revealed that the health consumers have a specific comfort level in environments that de-stigmatize mental health. It also showed that patients, more so the mentally challenged often show a high level of satisfaction of care with empathetic health practitioners. (Stevens, & Sidlinger, 2015). Besides, the authors found out that patient-specific challenges include poor access to healthy supportive environments and low health literacy.

References

Girardi, C. E., Heck, R., Bobek, M. L., & Benetti, E. R., et al. (2015). QUALITY OF LIFE OF PEOPLE IN LIVING GROUPS WITH DIABETES MELLITUS TYPE 2. Journal of Nursing, (1981-8963), 7239-7246. doi:10.5205/reuol.7275-62744-1-SM.0904201508

McGuire, A. M., & Anderson, D. J. (n.d.). Lifestyle risk factor modification in midlife women with type 2 diabetes: theoretical modelling of perceived barriers. AUSTRALIAN JOURNAL OF ADVANCED NURSING, 30, 49-57.

Roux, G., Solari-Twadell, A., & Ackers, S. (2014). Community Interventions and Survivors and Their Families. CLINICAL JOURNAL OF ONCOLOGY NURSING, 19, 63-69.

Stevens, C., & Sidlinger, L. (2015). Integration of Primary Care into a Mental Health Center: Lessons Learned From Year One Implementation. Kansas State Nurses Association, 12- 15.