Health Promotion Among Individuals With Diabetes Nephropathy, Essay Example

Abstract

This paper is a concept analysis of health promotion among individuals with diabetes nephropathy. This paper presents the analysis using Walker & Avant’s steps of concept analysis.

Introduction

This concept analysis paper is a clarification of health promotion for individuals with diabetes nephropathy or kidney failure as a result of diabetes. If there is one disease whose progression and all complications can be managed that would be diabetes. One of the many developments in the treatment of diabetes and kidney disease is the fact that people are starting to realize that it only takes proper management and the impact of the disease to the body can be mitigated. It is true that there is no cure for diabetes. It is a lifetime condition. However, it does not mean that it has to destroy the quality of life of someone who has it. This development in the management and treatment of the disease is imperative in the lives of not just a few diabetic individuals but as well as over 29.1 million people in the United States of America in 2012 alone in which about 8.1 million are undiagnosed. It is also found out that about 86 million of the population are on a prediabetes state. To make matter worse, diabetes (with the inclusion of all its complications and related diseases) is named the 7^th leading cause of deaths among the Americans. Yet, despite the development of knowledge in combating the disease, a lot of people remain uneducated. This may be rooted from the lack of assuming responsibility for self-care among patients with diabetic nephropathy.

The concept of health promotion for individuals with diabetic nephropathy can also be linked to the self-care and management that involves compliance to the health and treatment plan as well as the adherence to it. This is critical due to the fact that people with diabetes and exhibiting complications and other related diseases, more often than not, do not follow through the treatment plan and health management.

The purpose of this concept analysis is to understand how health promotion can help the patients with diabetes nephropathy to achieve and maintain optimum health and quality of life. This is important due to the fact that most of the patients with the aforementioned disease do not have a full grasp of their disease and do not understand that it can be managed with proper treatment plan (Simmons, 1989). Undeniably, health practitioners have a perception about the disease that is different from the patients. Although patients are informed that they can managed their disease, the main problem lies on the fact that they do not believe it to be true. Most of diabetic patients think that when they acquire the disease, it will only result to either amputation or death. Health is important and the fully understand it is imperative in reaching a positive health promotion among the patients. This is even in the midst of lack of consideration of how important the maintenance of health is until one becomes very sick. The foundation of proper treatment and maintenance of the disease is the knowledge that health promotion that combines empowerment and education are crucial in the nursing profession and in the comprehension of health concepts. Therefore, there is a need to understand the concept of health promotion in relation to the individuals with diabetic nephropathy.

Review of Literature

The concept of health promotion has gone a long for over the years. It has developed into a new approach to defining health and wellness. The emergence of the concept of health promotion has brought about new methodologies in improving and tackling the health and wellness of people and their communities (Wilson, 1969). Health promotion, as defined, is the process in which every individual is being given the chance to take control over their health in the aspects of improvement and management.

The main goal of health promotion is the enhancement of the health of the society in terms of enactment of various public policies that pertain to health. In addition, it also points to the creation of a healthy environment and the promotion of personal resiliency. In other words, in the context of health and sciences, health promotion is the manner in which individuals are being enabled to take charge of their own health. Moreover, health promotion is also founded on the desire to strengthen health education to ensure that every patient with certain diseases (not just diabetes and kidney failure) will be sufficient and effective in the aspect of health management (Bennet, et.al, 2009). However, it is imperative to note that the concept of health promotion goes beyond the management of health and the disease. As a matter of fact, it extends to the prevention of the diseases.

Back in the 1940s, health promotion is not just about teaching people to take care of themselves and improve their health. The concept of health promotion in the early medicine is used in the context of good labor environment, physical ethos, approved standard of living and quality of education (Bury, 2005). In this regard, the promotion of health was not just given to the health practitioners and other health care workers but also called for the involvement of statesmen, educators, labor, and physicians. Therefore, the process of health promotion is about the collaborative efforts of patients, health workers, physicians and the community in general. This is due to the fact that there are various factors that can influence the health of a person such as that environment, family, and climate among many others. It is a holistic perspective that nurses and other medical practitioners need to understand in order to aid people in improving their health and their families.

Elucidating further, health promotion is also related to the concept of advocacy and empowerment. Health movements that are lobbying to increase and open the access to health care, homes that are safe to live in, care planning and changes and improvement of health care policies. In lieu of this, health promotion can also be described as a form of life coaching where people, more particularly the patients, are being assisted to identify ways and means that can help them achieve optimum health, wellness and quality of life.

Defining Attributes

The defining attributes of health promotion among individuals with diabetic nephropathy can be summed up in the following: 1) individual process; 2) empowerment and education; 3) self-care and; 4) prevention and management.

The attribute of process in the context of promotion of health among individuals with diabetic nephropathy involves the proper diagnosis and creation of treatment plans that are unique and attentive to the health condition of the recipient. It has to be remembered that every person is different and so as each medical condition. Even though all the recipients can be diagnosed with diabetic nephropathy, they still have varying symptoms, level of care needed, and level of progression. Hence, individual process must be respected and treated based on the merits on individual case. The individualized process involves the interventions of health care workers and physicians to foster a patient-centered plan that aims to improve the health of the patients.

Empowerment and education, on the other hand, must be centered on the disease process, needs of the patients as well as their values. As previously mentioned, most of the diabetic patients will give up on their condition and will accept the notion of whatever will be will be. This can be prevented if health promotion is utilized. People struggle with the disease because of the lack of knowledge on how to properly monitor, manage and treat the disease. Education is the key to a successful management of diabetic nephropathy.

In the past, the model for health care is geared towards the treatment of diseases, whether acute or advanced. In this kind of model, health professionals will make a proper diagnosis of the disease, provide treatment and see that the health of the patients is improving. Imperative to understand as well is that health promotions used to be prescriptive. The health care workers will tell a patient what to do and the patients, in return, will have to do as told. Even in the presence of therapeutic objectives and processes from the health care workers, the prevalence of diabetic nephropathy is apparent in the society. But the truth of the matter is that it did not work. The model that is based on doctor knows best did not work. It only made patients and the society to think that they were merely obligated to follow the recommendations that were set forth by the doctors and other health care workers. However, the model of health promotion has changed and shifted from doctors know best to a collaborative efforts between patients and health care workers (Fawcett, 2005). Education, as an aspect of health promotion, is now being used to include strategies that are motivational and behavioral in nature. This is to ensure observance and compliance to the plan as well as to impact the quality of life of the patients. Yet, even in the prevalence of education and empowerment of the patients, there is a clear indication that the statistics on the noncompliance among the patients is high.

Hence, in order increase compliance among the diabetic patients, self-care has become the new approach for diabetes care. In this aspect of health promotion, physicians are no longer making recommendations based on what they think will work. Rather, the recommendations for treatment and management are being based on the goals of the patients. The strategies for diabetes care are also geared towards the creation and establishment of a plan that fits the lifestyle and the priorities of the patients. This is tantamount to the needs of the patients and to ensure that change is implemented and patients will be encouraged to follow through the plan of action.

Moreover, the prevention and management attribute of the concept of health promotion speaks of the encouragement to adopt a permanent lifestyle and a change in behavior among the patients. It is a known fact that diabetes is a lifetime disease. Once a person has it, there is no turning back. The management of the disease is not something that can be done through a one day surgery. It will take a lifetime to manage the disease as there is no cure for it. The behavioral changes will be geared towards development of goals coupled with training and continues education to ensure problem-solving skills when faced with barriers to compliance and adherence.

In lieu with this, it cannot be denied that the attributes of health promotion refer to the establishment of self-care and autonomy among patients with diabetes. The autonomy allows them to participate and take part in the management of their own health and disease without being obligated to just do what they are told. The concept of health promotion, in its entire context, speaks volume on the need to educate and assist the patients with diabetic nephropathy to take charge on their health, work on managing it, and collaborate with health care workers in order to achieve optimum health and mitigate the complications cause by the disease.

Model Case

A model case in this concept analysis will be incorporating all the attributes of the concept of health promotion among individuals who have diabetes nephropathy.

J.W is 40 year old man who was diagnosed with type 2 diabetes 5 years ago. He is a chain smoker who smokes about 1 pack per day. J.W’s medical background and history revealed that his father died of diabetes at the age of 65. When J.W was diagnosed with diabetes, he was introduced to a nurse that specializes in diabetes. A treatment plan was made and he was given diabetes classes to attend to further educate him as to what needs to be changed in his lifestyle, diet and as to how to properly manage the disease. Further laboratory tests revealed that his kidneys are also failing due to diabetes. He was given medications and insulin as part of his treatment plan. He was also referred to a nutritionist to help him plan his meals and special diet. Furthermore, he was taught how to check his glucose level and the nurse was very helpful in suggesting various exercises that he can do in order to manage his diabetes. The overall education that was afforded to him tackles all the basic of diabetes, the disease progression, the possible complications and how to manage it. He was also given information on the community resources that he can utilize to further his knowledge about the disease and to get the social support necessary for his well-being. In addition, the fact that J.W is a low income individual, he was also given information on how to qualify for free clinic, free medications and basic check-ups that will help him improve his overall health. J.W followed the treatment and management plan that he established together with the nurse and just after a few months, he felt more energize, his glucose level is on the right track and he has lost a few pounds of weight as he exercise regularly.

Contrary Case

The contrary case is the embodiment of what the concept of health promotion is not. It is a sample case that does not contain all the attributes of the concept.

C.S has been having spells of dizziness, excessive thirst, frequent urination, unexplained fatigue and blurry vision. He got really worried about his condition so he went to see a doctor. After a series of tests, the doctor diagnosed him with diabetes and told him to watch his diet and was written a prescription for insulin. C.S bought the insulin but did not ask for any other resources that he can use to improve his health. On his way home, he also bought some potato chips and frozen pizza for his dinner. He continued on with his everyday tasks and job and did not pay attention to what he is eating. He did not bother to exercise. And he did not look for more detailed information on his diagnosis. His sugar level is through the roof and he did not care. He would everything he wants to eat although his friends reminded him that what he is doing is bad for his health. Then one day, C.S noticed a swollen cut on his left ankle. He went to the doctor to get it checked. The doctor said that the wound is inflamed and infected and that he needed to take antibiotics. He was asked about his diet since his diagnosis. He told the doctor that he has not been paying particular attention on his diet and has been eating unhealthy. The doctor tested his blood sugar and he was told that his sugar level is alarming. He was put on a strict diabetic diet and was referred to a diabetes nurse. Instead of following the diet, C.S did exactly the opposite of what was recommended by the doctor. His health deteriorated and he developed further complications from diabetes.

Antecedents and Consequences

Based on the various literatures on the concept of health promotion, some antecedents can be identified. One of the identified antecedents is the attitudes of the patients towards the disease. It cannot be denied that regardless of how the physicians, nurses, social workers and other health care workers push for the improvement and proper management of diabetes, it is still dependent on the attitude of the patients. They can easily disregard and refuse to comply with the recommendations and treatment plan and there is nothing that the health care workers can do about it. Also, if the patients do not feel threatened about the disease or when the patients do not think that their illness is something to be worried about, they will not adapt to the changes that is recommended by physicians. Hence, the perceptions of the patients are also one of the antecedents to the concept of health promotion.

Undeniably, lifestyle is the most common antecedent to the concept of health promotion. This is due to the fact that when there is a diagnosis of diabetes, the main challenge is the lifestyle change. There is urgency for a person to change the lifestyle form eating unhealthy food to a stricter diet. Not to mention that everything changes once there is a diagnosis. For example, if a patient likes chocolate, the diagnosis of diabetes will limit the intake of chocolate and sweets in general. There are also health challenges that come with the diagnosis and it is not an easy thing for the patients to face. The diagnosis affects not just the lifestyle of a patient but also the mental, emotional and physical well-being of a person.

Empirical Referents

The attributes presented in this paper can be used in analyzing the concept of health promotion among individuals with diabetes nephropathy. The attributes can be used as measures to define the effectiveness of the health promotion and its importance. In this case, surveys and questionnaires can be used as empirical referents in order to measure the concept of health promotion. In this way, people can gauge whether or not the health promotion strategies and action plans that are being recommended by physicians and health care workers in trying to help patients are effective. There is a need to utilize scoring sheets to tabulate and come up with a more concise and quantitative data that can be used to analyze the concept and create a feedback loop. This is important in the field of health care to give the health care workers guidance in addressing the needs of their patients.

Conclusion

With all the foregoing, it can be said that the importance of health promotion in the field of health diagnosis, treatment, and maintenance should not be taken for granted. There is a need for an analysis of the concept of health promotion in order to understand and identify the weak aspects of it and make room for improvements. It is important to comprehend the concept in order to help the health care workers to better serve the patients and assist them in attaining optimum health.

References

Bennett, C., Perry, J., & Lawrence, A. (2009). Promoting health in primary care. Nursing Standard, 23, 48-56.

Bury, M. (2005). Health and Illness. Malden, MA: Polity Press.

Fawcett, J. (2005). Contemporary Nursing Knowledge: Analysis and Evaluation of Nursing Models and Theories. Philadelphia, PA: F. A. Davis Company.

Simmons, S. (1989). Health: a concept Analysis. International Journal of Nursing Studies, 26, 155-161.

Wilson, J. (1969). Thinking With Concepts. New York: Cambridge University Press.