Hanadi Massalkhi, BSN-MSN
Outpatient Department Coordinator, AUBMC
Clinical Instructor, Psychiatry & Mental Health, AUB
The prevalence of Diabetes is alarmingly increasing worldwide. Collaboration between healthcare providers and patient/family partnership are key elements in Diabetes management.
The role of nurses is critical to maintain the physical and psychological wellbeing of patients with Diabetes. Nurses should give a message of hope from the initial encounter with the patient with Diabetes. Where change is needed, it must be inspired and directed by the individual if it is to be truly effective. The most difficult aspect of learning is the aspect of unlearning; and changing a habit takes at least 3-12 months.
Education is the cornerstone of Diabetes management. Education promotes compliance. The goal in Diabetes Education is a better quality of life. Education is not a plan that fits all. Thus, nurses should remember that people have different learning styles. It has to be tailored to the individual learning needs of every person; involving both rational and emotional aspects. Here comes the importance of maintaining the same healthcare team to promote continuity of care.
The aim of education is to improve patients' knowledge, skills and confidence, enabling them to take increasing control of their own condition and integrate effective self-management into their daily lives. High-quality structured education can have a profound effect on health outcomes and can significantly improve quality of life.
Diabetes self-management and control of blood glucose, blood pressure, lipid profile, and other preventive care habits, prevent, reduce, or delay potential diabetes complications.
There are multiple components involved in the management of Diabetes, such as nutrition, exercise, monitoring, medications, problem solving, healthy coping, and reducing risks. In many cases, Diabetes can be controlled through better nutrition, maintaining a healthy weight and physical activity. Prevention of complications is also important through proper foot care, eye exam, regular follow up, and periodic blood tests.
Diabetes patients have a non-adherence rate of around 50% when it comes to complying with a treatment plan.
To improve adherence to the treatment plan, nurses may consider the following strategies:
• Altering patients’ perceptions about illness, treatment, and insulin therapy
• Training in advanced skills development: self monitoring, empowering the patient, identifying and overcoming barriers
• Flexibility in treatment
• Behavior change strategy
• Medication education: all about drugs, actions, reactions, side effects, …
• Frequent follow-up
• Smoking reduction programs
Physical illness has been shown to greatly impact psychological well-being of people. Patients living with chronic physical conditions are twice as much prone to depression and anxiety than the general population. The rate for depression occurring with Diabetes is more than 25%.
Nurses should promote the adaptive coping skills of patients by emphasizing positive aspects, qualities, and abilities inherent in an individual. Nurses should encourage patients to:
• Learn how to live with the physical effects of the illness
• Learn how to deal with the treatments
• Communicate clearly with the healthcare professionals
• Control negative feelings/thoughts
• Maintain confidence and a positive self-image
• Get help as soon as symptoms of anxiety or depression appear
• Understand the illness
• Develop realistic goals
• Express feelings and disappointments
High quality holistic nursing care that meets the physiological, psychological, and sociological needs of patients can have a positive impact on the course of Diabetes illness. It increases compliance with the treatment, helps prevent complications and repeated hospitalizations, and minimize the development of psychosocial problems secondary to the illness.