HSC Multicultural Issue In Healthcare: Effects Of Diabetes On Kidney Failure

Method

Write an essay on HSC Multicultural issue in healthcare.

Diabetes mellitus is one of the prevalent diseases that have encircled the maximum amount of the human pool in its trap globally. In the US, this disease affects twenty-four million of individuals (Reidy et al., 2014). The patient with this illness cannot secrete enough insulin or cannot use the natural amount of insulin secreted properly. Insulin hormone regulates the blood sugar level in organisms. If the body has higher blood sugar level, it might be detrimental to the various parts of the body (Inzucchi et al., 2014). A patient with Diabetes might experience kidney failure. Diabetes injures the blood vessels in the kidney, leading to retention of more amounts of salt, water and waste materials (Sellares et al., 2012). This leads to various critical problems in the body. To manage this disease patients must adhere to specific treatments which include physical activity, dietary restrictions, self-monitoring of the level of glucose, etc. (Levey & Coresh, 2012)

The aim of this context is to review various studies based on the effects of Diabetes in our family with a particular focus on kidney failure. Further, the outcome of this disease and the plan of action that could be developed to take precaution and stay safe in life, work places, and the educational institute will be discussed.

For this study, the author undertakes qualitative analysis including the literature research for supporting the argument and critically analyze on the chosen subject. PubMed, NCBI and Google Scholar are searched with keywords “Kidney failure”, “Diabetes”, “Diabetes care”, “Diabetes care and control”, “psychological impacts of kidney failure”, “Renal failure and depression”, “Diabetes management” etc.

Empirical studies reflect the fact that there is a significant and positive relationship between treatment adherence amongst diabetes patient and the social support (Vanmassenhove et al., 2013). Regarding the Diabetes patients, non-adherence is linked with reduced “glycemic control,” long-term complications including, “neuropathy,”“retinopathy” and “renal disease” (Jha et al., 2013).

 Diabetes mellitus show the close association with several renal infections which include “emphysematous pyelonephritis and cystitis,”“candidiasis” and “perinephric” (Inzucchi et al., 2015). Individual studies revealed that Diabetes patients are five times more chances and frequency of “acute pyelonephritis at autopsy” in comparison to the non-diabetics (Tonelli et al., 2014). Around seventy two percent of twenty patients in 1980 were observed to have chronic “emphysematous cystitis” (Jha et al., 2013). Acute urinary infections frequent in diabetic women since they have short urethra which is readily accessible to micro organisms (Vanmassenhove et al., 2013). The presence of this disease predisposes to certain severe infections in patients with less diabetic control, acute ketoacidosis, neuropathy, etc.  (Fox et al., 2012).

Literature Review

A literature review shows that if the cause of the renal failure is due to Diabetes, with “urinary tract obstruction,” then sepsis can produce a favorable outcome (Reidy et al., 2014). Moreover, NSAIDs drugs should be avoided in case of patients with Diabetes nephropathy (Inzucchi et al., 2015). One study reveals that the outcome of the renal failure was active, almost around forty-seven patients recovered from renal failure with appropriate treatment using renal transplantation (Fox et al., 2012).

Studies reveal that if there exist a family history revolving kidney disease, then it can elevate the chances of a risk of diabetic nephropathy (Levey & Coresh, 2012). But some procedures can be changed to lower the risk of diabetic nephropathy. These changes or prevention measures include controlling the increase in the blood sugar levels, controlling the weight, monitoring the disease related nerve or vision complications (Sellares et al., 2012).

Kidney failure requires artificial means of excretion for survival as the result of which such patients undergo a “number of lifestyles, dietary, and fluid restrictions to accommodate their illness.” According to (Buckingham, et al., 2013) such lifestyle changes and constraints disrupt the social functioning with patients struggling hard to maintain “vitamin, iron, and protein levels.”  (Finnegan-John & Thomas, 2012) said that “such restrictions impact on patients’ illness beliefs, sense of personal control leading to anxiety and depression, inhibiting coping, and adjustment.”

According to (Poppe et al., 2013) End-stage renal failure has the significant influence on family members, therefore, irrespective of age every patient needs family’s support who are also affected by the lifestyle changes.  There are several diabetic patients who want to manage the disease on their own, but family members also learn how to handle such disease living with and witnessing their affected loved ones (Finnegan-John & Thomas, 2012). Several patients prefer to take “self-care,” for example, preparing their machines or “needling” their fistula’s for hemodialysis treatment. Patients reported a sense of independence and autonomy which was critical in coping with the routine of therapy. An experienced patient can provide peer support and education. Social support and mental support from the family members provides practical help to the patients who can buffer the stresses to live with the illness (Hippisley-Cox & Coupland, 2016).

Studies conducted by Novo Nordisk named as “Diabetes Attitudes, Wishes and Needs 2” or (DAWN2) (Rosland et al., 2012). It intended to realize the unmet needs of diabetic patients and their families. The results of this study would enhance “self-management and psychological support in diabetes care”. According to this study, 60% of the relatives of diabetics undergo tremendous emotional stress worrying about the proposed complications likely to affect the person they are living with (Rosland et al., 2012). Non-adherence to medication in many cases has been reported to cause depression and other psychosocial effects in patients consequently impacting their family (Cole & Reiss, 2013). ESRD also transforms personal relationships. A study by (Buckingham et al., 2013) shows that ” Fatigue, infertility, low energy, and mood, physical changes to the body, for example, catheter, weight gain, and scarring, all played a role in undermining confidence and self-esteem. Sexual activity and intimacy were also reported as significantly compromised requiring adjustment for both patients and their partners. Changes in perceptions of roles within the relationship were also evident.”

A similar study was published by Joslin in “Diabetic Medicine, called the Impact of continuous glucose monitoring on diabetes management and marital relationships of adults with Type 1 diabetes and their spouses: a qualitative study” (Cole & Reiss, 2013).  The majority of the “spouses” stay uneducated about such diseases and requirement of continuous glucose monitoring. It is the contributing factor in problems associated with management of diabetes (Levey & Coresh 2012). According to (Chiang et al., 2014) family members should be included in the diabetes management else a due lack of knowledge and information they can never assist their loved ones in tackling the disorder. In this study, it was indicated that majority of the spouses are concerned about the “hypoglycemia, or low blood sugar”. Therefore, to reduce the anxiety and stress among spouses, it is mandatory for them to use CMG and understand its operation (Poppe et al., 2013). A study by Joslin indicated that “collaborative diabetes management and relationships with patients” are positively influenced by CMG as it helps in decreasing the anxiety in spouses due to higher awareness.

Clinical studies by (Cole & Reiss, 2013) identified that the cases in which family member regularly visited with the patient to clinics, management sessions and showed greater involvement were capable of creating an “open home environment” that suits easy management of diabetes. They were able to provide open discussing or dialogue and friendly support system to make patients more comfortable and stress-free (Rosland et al., 2012). Patients need a home environment that has “more diabetes-friendly lifestyle” (Inzucchi et al., 2015). People with diabetes crave for the atmosphere where the surrounding people are cognitive about their condition which in fact makes them they have collaborators and feel less alone (Jha et al., 2013).

From the above literature review, it is apparent that psychological support is essential to assist patients in tackling lifestyle restrictions. It will, therefore, enhance “personal control through self-management strategies” which is critical, as outlined in the “National Service Frameworks” (Department of Health, 2005). According to NICE need assessment is important in creating an evidence base for “developing a comprehensive health psychology service to run concurrently with a renal counseling support service as a means of responding to the recommendations made by the National Services Frameworks”.

The literature review has given an in-depth knowledge of the consequences of Diabetes and kidney failure and the role of family members in its management. The findings reveal that patients with renal impairment have the considerable impact on the quality of their life and give an insight into complexities, psychological and medical consequences of such chronic illness. Within the renal setting, patients with psychological distress should be supported and assisted by practitioners and psychologists to help enhance their coping style. It can be achieved by providing “services or multidisciplinary care approaches which incorporate a holistic framework”. In the next section, I am going to describe my personal experience with family.

One of my maternal uncles John expired during my childhood and I went through a period of anxiety, depression, and chaos in my house. He died due to kidney failure, and I remember the experiences right from his final stage till his death, his family and friends struggling hard to save his life till his last breath but in vain, their pain, guilt, and agony faces still flashes in my mind. I learned a lesson with this incidence and was greatly influenced being close to him. Last year my other maternal uncle was diagnosed with diabetes. This time, everybody is more involved in his disease management including me. 

I accompany him when he goes to measure his A1C level, and I ensure that he takes his insulin injections and gets blood glucose monitoring on the timely basis. I always request him to not to miss on his urine test required for predicting Kidney disease. I always assist him in meal planning, performing physical activity and made sure he adhere to his medication. Mostly I cook for him only protein low diet.

 The family history of “diabetes and kidney failure” is a major risk factor for kidney disease and it is well known to run in families. Therefore, I insist my mother, father, and sister for the regular check-up to detect any signs kidney disease and be preventive. I do not want to undergo similar experiences once again in my life. I keep reading a lot shuffling through the journals, articles, magazines, and blogs finding out any modern therapy or curative medicines recently launched in the market with success rate. I keep informing friends and my family about the recent researches going on in this field to keep them updated, and I learn new recipes related to low protein diet which I prepare for my parents thrice a week. In order gain more knowledge on this subject, I consult my teachers, counselors, and professors to learn to be as much preventive as I could to enhance active and healthy lifestyle. Every morning since last year my parents and I are attending meditation classes. There are several positive changes in our lives; it has increased self-efficacy and self-esteem. I am sure we all will be able to manage adverse health issues by continuing such practices.

Conclusion

Living with “chronic illness such as kidney failure” can significantly compromise the “belief system” and undermines every phase of life. Several interventions have been developed to empower patients with ESRD, including educational programs and training sessions. Both parents and carers are acquiring good approaches and contacts to services required to empower them in managing their lifestyle and health (Rosland et al., 2012). It is essential that health care providers “teach these patients that they are the leaders for their disease”, how to control and that “self-management care is not an easy task if they are not motivated”. However, by assisting and following those on the regular basis will help these patients and their family to live a healthy lifestyle while becoming “their doctors in self-managing their condition.” 

References:

American Diabetes Association. (2013). Economic costs of diabetes in the US in 2012. Diabetes care, 36(4), 1033-1046.

Buckingham, J. L., Donatelle, E. P., Thomas Jr, A., & Scherger, J. E. (2013). Family medicine: principles and practice. R. Taylor (Ed.). Springer Science & Business Media.

Chiang, J. L., Kirkman, M. S., Laffel, L. M., & Peters, A. L. (2014). Type 1 diabetes through the life span: A position statement of the American Diabetes Association. Diabetes Care, 37(7), 2034-2054.

Cole, R. E., & Reiss, D. (Eds.). (2013). How do families cope with chronic illness?. Routledge.

Finnegan-John, J., & Thomas, V. J. (2012). The psychosocial experience of patients with end-stage renal disease and its impact on quality of life: findings from a needs assessment to shape a service. ISRN Nephrology,2013.

Fox, C. S., Matsushita, K., Woodward, M., Bilo, H. J., Chalmers, J., Heerspink, H. J. L., … & Tonelli, M. (2012). Associations of kidney disease measure with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis. The Lancet, 380(9854), 1662-1673.

Hippisley-Cox, J., & Coupland, C. (2016). Diabetes treatments and risk of amputation, blindness, severe kidney failure, hyperglycemia, and hypoglycemia: the open cohort study in primary care. BMJ, 352, i1450.

Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., … & Matthews, D. R. (2015). Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes care, 38(1), 140-149.

Inzucchi, S. E., Lipska, K. J., Mayo, H., Bailey, C. J., & McGuire, D. K. (2014). Metformin in patients with type 2 diabetes and kidney disease: a systematic review. Jama, 312(24), 2668-2675.

Jha, V., Garcia-Garcia, G., Iseki, K., Li, Z., Naicker, S., Plattner, B., … & Yang, C. W. (2013). Chronic kidney disease: global dimension and perspectives. The Lancet, 382(9888), 260-272.

Levey, A. S., & Coresh, J. (2012). Chronic kidney disease. The Lancet,379(9811), 165-180.

Poppe, C., Crombez, G., Hanoulle, I., Vogelaers, D., & Petrovic, M. (2013). Improving quality of life in patients with chronic kidney disease: influence of acceptance and personality. Nephrology Dialysis Transplantation, 28(1), 116-121.

Reidy, K., Kang, H. M., Hostetter, T., & Susztak, K. (2014). Molecular mechanisms of diabetic kidney disease. The Journal of clinical investigation,124(6), 2333-2340.

Rosland, A. M., Heisler, M., & Piette, J. D. (2012). The impact of family behaviors and communication patterns on chronic illness outcomes: a systematic review. Journal of behavioral medicine, 35(2), 221-239.

Sellares, J., De Freitas, D. G., Mengel, M., Reeve, J., Einecke, G., Sis, B., … & Halloran, P. F. (2012). Understanding the Causes of Kidney Transplant Failure: The Dominant Role of Antibodyâ€ÂMediated Rejection and Nonadherence. American Journal of Transplantation, 12(2), 388-399.

Vanmassenhove, J., Vanholder, R., Nagler, E., & Van Biesen, W. (2013). Urinary and serum biomarkers for the diagnosis of acute kidney injury: an in-depth review of the literature. Nephrology Dialysis Transplantation, 28(2), 254-273.