Discuss about the General Practice Nurse The National Survey Report.
Western Sydney is regarded as a hotspot of diabetes having higher rates than the average of New South Wales (NSW). It is of significance for the issue to be addressed as fast as possible because failure to which will result in societal and unsustainable economic burden on the healthcare system of the state. The region is facing many daunting issues especially the health social determinants that promote active living, healthy eating and social inclusion. The health social determinants are not working favorably to reduce the prevalence of diabetes in Western Sydney. The ever-increasing diabetes threat in the health of the community and individual has prompted for the formation of the Western Sydney Diabetes (WSD) initiative to respond to the health issue. The core function of the initiative is to encourage all government levels, the non-government partners and private sectors to collaboratively work together in minimizing the growth of diabetes (Wan et al. 2016, p. 67).
Diabetes has become one of the mounting problems for most of the individuals in the New South Wales. It is evident that in 2014, almost 9.4 percent of the population of the state had high blood glucose or diabetes. Due to the growth of diabetes in Western Sydney, the government has released the Australian National Diabetes Strategy 2016- 2020 (Harris et al 2012, p.45). The mandate of the strategy is to ensure barriers that prevent the control of diabetes are done with to enhance the prevention of diabetes and care which need the response from various sectors lead by the government and implemented at the community level.
The Western Sydney Local Health District, as well as Went West which is known as the Western Sydney Primary Health Network (WSPHN), have facilitated a full district methodology through the Western Sydney Diabetes (WSD) initiative. The WSD initiatives recognize diabetes as a business for every person and therefore it is encouraging partnerships between the health services of the community, hospitals, general practice and allied health to improve the health need of diabetes people or at diabetes risk to have access to better and detailed services of diabetes (Daiski et al. 2012, p.37).
The social determinant of health is the conditions in which people are born, grow, live, work, and age. The health social determinants have been increasingly noted for their relationship with the prevalence of diabetes in Western Sydney and the opportunity they present for individuals to counter the conditions. Notably, the social determinant of health that has necessitated the increase of diabetes in Western Sydney includes low educational attainment, low income, insecurity of employment and the poor living condition.
According to Blas, Sommerfeld, and Kurup (2014, p.19) people who have attained the low educational level and those with a low income are 2 to 4 times likely to develop diabetes than the privileged people. The social determinant role should be adequately addressed in the management of chronic condition since they pose to be the main barrier to the population health improvement. Poverty is another health social determinant that may result to increase in the development of diabetes. Poor individuals are likely to develop high chronic stress levels affecting both the biological and psychological responses (Hill, Nielsen, and Fox 2013, p. 99). The chronic stress eventually leads to anxiety and depression, low self-esteem and reduced motivation and energy which may result in self-destructive choices and behaviors. Chronic stresses eventually lead to increased blood pressure, high blood glucose levels and inability to respond to future stressors (Corcoran and Adams 2013, p. 51). With time, these physiologic reactions, behavioral practices as well as psychological responses contribute to diabetes.
Moreover, diabetes can cause many problems to poor patients for various reasons. The increased care costs pose personal financial burden which increases poverty effects since it consumes a large portion of the income (Dinca-Panaitescu et al 2014, p.48). Secondly, a poor person cannot fully access the necessary resources to manage the condition which includes nutritious diet, adequate housing, and services of healthcare. Diabetes also reduces a person productivity in the workplace and consequently limit educational attainment especially when the condition is not managed to lead to further problems related to employment (Raphael et al. 2014, p.27). The diabetes conditions increase the inequality cycle because they lead to increased poverty as well as social exclusion if the poor people are left to care for themselves.
For proper control of diabetes, nurse-led interventions need to be taken to manage the condition symptoms and modifying of behavior, which incorporates improvement of diet, increasing physical activities, and close monitoring of medication. According to Medicare local alliance (2012, p. 24), there has been a nursing considerable growth in the general practice in the last decade that has many consumers to access services of nursing. The nursing interventions needed for reducing the growth of diabetes include; nurses educating the patients on how to check their blood sugar and interpretation of the results (Mikkonen and Raphael 2013, p.14). For proper control of diabetes, the nurse is also required to educate the patients on how to perform an insulin injection by themselves by using the sliding scale.
Furthermore, the nurses need to intervene and educate patients when to check the blood sugar, diet regime for diabetics, encourage patients to develop a daily menu that meets the requirement of his or her diabetic conditions. It is of importance for nurses to educate diabetic patients on the proper insulin lancelets and syringes disposal (Dennis et al. 2016, p. 78). The nurses are needed to capitalize on the gaps in the management and prevention of diabetes by gathering information on factors that are nonmedical and utilize them in improving health policies and interventions used currently (Harris et al 2012, p.77).
The interventions used by nurses in the management of diabetes have resulted to be a solution to meet the growing demand for diabetes care in Western Sydney. The nurse-led interventions have encouraged patients to acquire self-management skills in the management of diabetes. Patients have started to take the active role in the diabetes care as well as health professionals actively changing the behavior of patients toward the care of diabetes. The nurse-led interventions have also improved the process and the clinical outcome of diabetes.
Nurse-led interventions in diabetes management besides having various strength in the control of diabetes, there are weaknesses that are identified. Firstly, the nurse interventions lack adequate resources needed to educate and supervise their patients. This prompts for the insufficient dissemination of information to the diabetes patient. Another weakness of the nurse-led interventions in the management of diabetes is the lack of personal resources on the side of patients which contribute to impaired interactions with the nurses. The emotional response, changing identity and lifestyle, and failure to accept self-management of diabetes for patients are among the weaknesses. Lack of funding for the disadvantaged is also a weakness that discourages nurse interventions in the management of diabetes since after being educated on the self-management of diabetes cannot perform due to lack of resources.
The nurse-led interventions for diabetes have numerous opportunities for the management of diabetes. Evidently, the nurse is needed to bridge the gap between the health services delivered to the disadvantaged and the advantaged by funding for those who lack access to health facilities. The response time for the diabetes patients needs to be improved as well as improve the links between the health professionals. For effective management of diabetes, various disciplines should be incorporated for proper patient consultation. More so, the interventions are required to encourage patient to observe a proper diet and involve physical activities in their day to day work.
The changing trends in consumption of food and lifestyle activities are the threats that are hindering the nurse-led intervention in the management of diabetes. As much as nurses are trying their level best to reduce the prevalence of diabetes in Western Sydney, the increased changing trend in food consumption is a challenge. Currently, individuals have shifted to the consumption of fast foods instead of observing healthy foods that can reduce the growth of diabetes. Besides, most people use cars on a daily routine which have led to the decline of physical activities that involve walking and cycling. Therefore, the changes in the consumption of food, lifestyle and inadequate are among the threat for the management of diabetes.
Conclusively, diabetes is posing many problems to the society and therefore there is need to develop appropriate interventions that incorporate many sectors for effective management. Patients as well as health professionals should take the initiative to manage diabetes prevalence. Patients should be educated on the aspect of self-management by the health professionals.
References
Alliance, A.M.L., 2012. General practice nurse national survey report. AML Allience, Canberra.
Blas, E., Sommerfeld, J. and Kurup, A.S., 2014. Social determinants approaches to public health: from concept to practice. Ginebra: Organización Mundial de la Salud.
Corcoran, M. and Adams, T., 2013. Race, sex, and the intergenerational transmission of poverty. Consequences of growing up poor, pp.461-517.
Daiski I., Raphael, D., Pilkington, B., Bryant, T., Dinca-Panaitescu, M. and Dinca-Panaitescu, S., 2012. A toxic combination of poor social policies and programmes, unfair economic arrangements and bad politics: the experiences of poor Canadians with Type 2 diabetes. Critical Public Health, 22(2), pp.127-145.
Dennis, S.M., Zwar, N., Griffiths, R., Roland, M., Hasan, I., Davies, G.P. and Harris, M., 2016. Chronic disease management in primary care: from evidence to policy. Medical Journal of Australia, 188(8), p.S53.
Dinca-Panaitescu, S., Dinca-Panaitescu, M., Bryant, T., Daiski, I., Pilkington, B. and Raphael, D., 2014. Diabetes prevalence and income: results of the Canadian Community Health Survey. Health policy, 99(2), pp.116-123.
Harris, M.F., Infante, F.A., O’Toole, B.I., Priddin, D. and Ruscoe, W., 2012. Quality of care provided by general practitioners using or not using division-based diabetes registers. The Medical Journal of Australia, 177(5), pp.250-252.
Hill, J., Nielsen, M. and Fox, M.H., 2013. Understanding the social factors that contribute to diabetes: a means to informing health care and social policies for the chronically ill. The Permanente Journal, 17(2), p.67.
Mikkonen, J. and Raphael, D., 2013. Social determinants of health: The Canadian facts. York University, School of Health Policy and Management.
Mitchell, P., Smith, W., Chey, T. and Healey, P.R., 2015. Open-angle glaucoma and diabetes: the Blue Mountains eye study, Australia. Ophthalmology, 104(4), pp.712-718.
Raphael, D., Anstice, S., Raine, K., McGannon, K., Rizvi, S. and Yu, V., 2014. Type 2 Diabetes: Poverty, Priorities and Policy The Social Determinants of the Incidence and Management of Type 2 Diabetes. Social Science & Medicine, 47(9), pp.1189-1195.
Wan, Q., Harris, M.F., Jayasinghe, U.W., Flack, J., Georgiou, A., Penn, D.L. and Burns, J.R., 2016. Quality of diabetes care and coronary heart disease absolute risk in patients with type 2 diabetes mellitus in Australian general practice. BMJ Quality & Safety, 15(2), pp.131-135.
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