Phsychosocial Self Management skills

Running head: NURSE8732 -2020 NS2
NURSE8732 -2020 NS2
Literature Review
Assignment 1
Kerry Green
2185545
Strategies to Improve Psychosocial Self-Management skills of Adults with Type 2 Diabetes living in Rural Australia

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Introduction:
Introduction and background
The aim of this review is to explore information from selected literature about different strategies that may improve
psychosocial self-management skills in rural and remote areas of Australia and best practice for the clinician to improve the client
health outcomes.
Type 2 Diabetes is a chronic disease which requires daily self-management from the client and ongoing guidance and support
from the health care team including the General Practitioner. Type 2 diabetes has been highlighted by the National Diabetes Service
Scheme (NDSS) to be a progressive illness that represents 85-90% of all diagnosed types of diabetes.
The prevalence within the Aboriginal and Torres Strait Islander (ATSI) communities is 3 times greater than in the general
Australian population (Burrows & Ride, 2016). It has been well documented by Dunning (2014) that long-term complications of Type
2 Diabetes can develop with poor health outcomes including cardiovascular disease, kidney disease, blindness, neuropathy and
premature death. Being able to self-manage this chronic condition is vital to reducing both the long and short-term complications for
the individual as well as reducing costs on the health system.
The Royal Australian College of General Practice (RACGP 2015 p. 5) explains that people living in rural and remote areas in
Australia are more disadvantaged and have greater risk of developing Type 2 Diabetes. Also, there are significant barriers to effective

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self-management of diabetes in rural and remote areas such as limited services, access difficulties, lack of choice and culturally
inappropriate services for some clients such as Indigenous people (McDermott, Schmitt, Preece, Owens, Taylor & Li, 2015).
The Australian Centre for Behavioural Research in Diabetes website states that a diagnosis of Type 2 diabetes can have a
negative impact on emotions, behaviours and social aspects. Subsequently, this can adversely influence self-care due to the burden of
treatment for diabetes and concerns surrounding health outcomes. In rural and remote areas of Australia this can double the impact
due to the lack of social and economic resources. As identified by Lee et al (2018), client and health care providers require regular
contact to alleviate psychosocial stress and poor health outcomes. Co-morbidities, both physical and psychologically, can negatively
impact on self-management through loss of interest, reduced decision making and fatigue.
Dunning (2014) refers to the psychosocial barriers that can have effects on adherence to the diverse and complex tasks
required for effective diabetes self-care. To optimize the health outcomes, it is vital that psychosocial care is integrated with a
collaborative, patient-centred health care approach and provided to all people with type 2 diabetes. Aitken et al. (2018), refer to a brief
definition of ‘psychosocial’ as ‘pertaining to the influence of social factors on an individual’s mind or behaviour, and to the
interrelation of behavioural and social factors’. As indicated by Dunning (2014) social factors can include many aspects such as
cultural or religious beliefs and practices, education access and levels, effectiveness of family function, social and economic
circumstances and understanding and beliefs about a diagnosis of Type 2 diabetes. Furthermore, Dunning (2014) makes links between
social factors and mental health conditions such as depression, denial and lack of resilience that impact on a person’s ability to

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psychosocially self-manage their health conditions effectively. Dunning (2014) also states that depression acts on physical activity
through fatigue and low motivation that can affect the link with social support. Being aware of different strategies to improve the
psychosocial aspects for effective self-management of type 2 diabetes in these communities will increase the recognition of the needs
of the clients, improve the diabetes services and reduce the impact of this national health priority as documented in General Practice
Management of Type 2 diabetes, (GPMP) 2016-2018.
Research question:
What are the possible strategies by which psychosocial self-management skills of Adults with Type 2 Diabetes living in rural and
remote areas of Australia can be improved?
Aim:
The aim of the review is to explore the psychosocial self-management skills of Adults with Type 2 Diabetes living in rural and
remote areas of Australia and gain strategies to improve psychosocial self-management skills of Adults.
Objective:
The objectives of the review are following:
 To explore the psychosocial self-management skills of Adults with Type 2 Diabetes living in aboriginal Australian
 To explore the best practice for the clinician to improve the client health outcomes

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 To gain the possible strategies to improve psychosocial self-management skills of Adults.
Review framework and Article selection process:
This section of the review will discuss the theoretical framework for presentation of the journal article and article selection
process. In order to the present the review, PRISMA will be used. As discussed by O'Donovan et al. (2019), PRISMA is an
evidence framework that enable authors to focus on the reviews including randomized control that incorporated evaluation of
intervention. In this current context, this theoretical framework would be most suitable framework for obtaining psychosocial aspects
for effective self-management of type 2 diabetes.
Data collection:
In order to address the research question, the most appropriate studies will be both qualitative and quantitative study primary
study that will provide the most relevant strategies. (Brannen, 2017). For obtaining the articles, the literature search was conducted a
range of databases such as CINAHL, Medline, and PubMed, Online Library and Wiley Online Library. One article selection was
through a scoping search on findit@flinders.
Concept 1 Concept 2 Concept 3 Concept 4
Psychosocial Aspects
Quality of life
Diabetes
Management
Indigenous populations
Rural
Australia

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Patient Education
Community Health
Services
Health outcomes
Diabetes Mellitus,
Type 2
Remote
Indigenous
The key term or concept used for searching the article is provided in the tabular format below. Boolean operators were used
for linking as well as defining the relationship between search terms. Boolean operators such as AND and OR are used for obtaining
the relevant journal. For narrowing the research, AND was used to retrieve the articles from the record whereas OR was used to
broadening the research by connecting two or more synonyms. Inclusion and exclusion criteria were developed which can be used as
a roadmap for obtaining relevant articles. The strategies for the inclusion and exclusion criteria are the following:
Inclusion criteria Exclusion criteria
 Relevant journals published
within last 10 years
 Relevant journal other than 10
years

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 Peer review journal
 Relevant articles published in
English language.
 Relevant papers undertaking
the Psychosocial Aspects of
the Adults with type 2 diabetes
of the rural and remote
Australia
 Relevant paper that undertaken
primary studies.
 Non-reviewed articles were
excluded
 All articles other than English
article
 Relevant paper undertaking research
other than the Psychosocial Aspects
of the Adults with type 2 diabetes of
the rural and remote Australia
 Relevant paper that was undertaken
studies other than primary studies
Data analysis:
906 journals were identified from the databases which further filtered for eliminating duplication. The secondary studies were
eliminated. A total of 110 hits were obtained after the elimination. After entering full text, the generated hit was 45 and after selecting

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10 years, a total of 30 hits was generated. Lastly, for narrowing the research, English and human model was entered which further
generated 27 hits. Further manual search of title as well as abstract provided and a total of 7 papers that will further subjected to the
critical appraisal tool, CASP (appendix 2). After conducting in depth critical appraisal themes were generated from the seven articles
for providing a clear overview of strategy.