Effectiveness of Pragmatic Lifestyle Interventions for the Prevention of Type 2 Diabetes
Support Needs of a Participant The interview with a patient points to several supporting needs important to improve and maintain her quality of life. In particular, the descending order of the patient’s needs is as follows: lifestyle modification, patient education, and technology use. It seems critical to consider each of the mentioned elements in detail, thus making an attempt to align these needs and Healthy People 2020 objectives to assist the present patient.
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The first need of this patient is lifestyle modification that involves a change in nutrition and physical activity. Currently, she tries to eat more vegetables and avoid carbonated drinks, yet it is insufficient to reduce her weight and eliminate obesity as a risk factor. In addition, the patient does not exercise or play active games, which also creates an additional risk for developing concomitant diseases. In this regard, the very lifestyle of the patient should be adjusted through consultation with a nutritionist and adequate physical activity (Dunkley et al., 2014). Most importantly, taking into account the age, behavioral patterns, and preferences of the patient is critical. Second, the given patient needs support with increasing her awareness of her disease. In other words, she needs patient education that can be provided by means of group sessions or one-to-one consultations with a nurse. The patient needs to learn how to recognize the symptoms that signalize the deterioration of her condition (Dunkley et al., 2014). This will allow for visiting the corresponding specialist in a timely manner and preventing more severe consequences. Third, since the patient expressed her interest in using innovative technologies, one may assume that she needs help in learning how to use them. While she uses an application to control her blood glucose level, it seems to be beneficial to her to consider some more applications. For example, she needs a reminder to eat healthy food and drink enough water or to examine her state and detect any alarming symptoms. According to the comprehensive diabetes management algorithm, 2013 prepared by the American Association of Clinical Endocrinologists (AACE), patients with diabetes should be aware of self-care fundamentals to ensure a high quality of their lives (Garber et al., 2013). Thus, the implementation of technology in diabetes management for this patient will be useful to follow the mentioned recommendations. Implementing Objectives of Healthy People 2020 With the aim of increasing the wellness of the identified patient, it seems important to consider Healthy People 2020 objectives related to diabetes management. One of the objectives set by the mentioned initiative is to reduce the rate of mortality caused by diabetes, which is pertinent to the given patient (“Diabetes,” 2018). The studies show that even small changes in lifestyle and physical activity may significantly facilitate the condition of a patient with diabetes (Milani & Lavie, 2015). To accomplish the above objectives, a nurse may apply such an approach as pragmatic lifestyle intervention, focusing on an empathy-building approach and self-regulatory techniques. Milani and Lavie (2015) state that the systematic review of the use of pragmatic interventions shows that it was found as effective by 24 scholarly studies. Namely, the positive outcomes were noted in weight loss as well as in increased energy and motivation to self-care. One more objective set by Healthy People 2020 that should be implemented regarding this patient is to “reduce the rate of lower extremity amputations in persons with diagnosed diabetes” (“Diabetes,” 2018, para. 6). The patient reports that she has no problems with her feet, and it seems that she will visit a doctor only if she feels discomfort. However, it is important to prevent amputations, which reflects the significance of annual examinations. The role of a nurse, in this case, is to explain to the patient that the effectiveness of the therapy should be reviewed regularly by “monitoring of co-morbidities, relevant laboratory data, and diabetic complications” (Garber et al., 2013, p. 336). Therefore, patient education should be applied as the specific intervention to meet the identified objective with a focus on the patient’s current level of knowledge and care expectations. At the same time, the described intervention will implement the objective of increasing the percentage of persons diagnosed with diabetes who are engaged in formal education. Furthermore, there are three significant objectives that should be followed with regard to this patient: lipid, blood pressure, and glycemic control. A nurse may use the mobile diabetes intervention to make sure that the patient follows these objectives. Mobile management of diabetes modifies and intensifies the traditional approach and pays attention to behavioral interventions (Milani & Lavie, 2015). Since mobile phones became a part of a person’s routine, it will be helpful to use them, which is also corresponds to the patient’s support needs. Utilizing the specified method, a nurse will have the opportunity to review the patient’s records about self-care, provide timely recommendations, and act as a coach to monitor and improve her overall well-being. Thus, a set of interventions is required to implement the objectives stated by Healthy People 2020 for diabetes management.
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References Diabetes. (2018). Web. Dunkley, A. J., Bodicoat, D. H., Greaves, C. J., Russell, C., Yates, T., Davies, M. J., & Khunti, K. (2014). Diabetes prevention in the real world: Effectiveness of pragmatic lifestyle interventions for the prevention of type 2 diabetes and of the impact of adherence to guideline recommendations: A systematic review and meta-analysis. Diabetes Care, 37(4), 922-933. Garber, A., Abrahamson, M., Barzilay, J., Blonde, L., Bloomgarden, Z., Bush, M.,… Grunberger, G. (2013). AACE comprehensive diabetes management algorithm 2013. Endocrine Practice, 19(2), 327-336. Milani, R. V., & Lavie, C. J. (2015). Health care 2020: Reengineering health care delivery to combat chronic disease. The American Journal of Medicine, 128(4), 337-343.