Chronic Condition Self Management (PDF)

CHRONIC CONDITION
SELF-MANAGEMENT

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
1. Concept of Self-management approach..................................................................................1
2. Three health behaviour theories..............................................................................................3
3. Enablers and barriers in implementing self-management during adolescence.......................5
4. Practical Strategies for Engaging clients in self-management................................................6
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

MAIN BODY
1. Concept of Self-management approach
Chronic Disease self-management is the range of health enhancing behaviours that a
person with chronic illness can adopt. Self-management of chronic disease is the active
participation by people in their own healthcare. Self-management is very important in preventing
of any disease or illness. It is the management by own self and taking responsibility for own
behaviour as well as well-being. The self-management of diabetes allows people to stay healthy
and prevent costly issues (Chrvala, Sherr & Lipman, 2016). In order to manage the sugar level
the diabetes, Michael can use the approaches of self-management in educating the community
about the ways to prevent diabetes are as follows-
It has been observed that most of the young people are engaged in unhealthy life style
such as limited or negligible physical workout, improper weight management and control and
poor attention to nutritional food intake. These practices are making young adults prone to
obesity at very young age and enhancing their risk of diabetes and related health issues. At this
age, it is very essential for the parents, teachers and families to monitor the life style practices of
adults so that at young age they can recognize the practices of healthy living. It will help them to
control and manage the prevalence of diabetes.
Regular Work-Out or Exercises are one of the best approach of self-management to get
proper management from rising of diabetes from sugar level. Adults should perform physical
exercise daily that could prevent diabetes. The communities and family members must
encourage adults to bring necessary changes to make their life style more active (Chrvala, Sherr
& Lipman, R. D. (2016). The inclusion of sports and other physical tasks can inspire them to
adopt such practices as necessary part of their routine. It must also be assured that all young
adults are provided with required services such as playgrounds, gym and sports equipment so
that from early childhood as well this practice can be controlled and diabetes can be managed.
One of the effective measure to manage and minimize the diabetic risk among young
adults they must be educated and provide knowledge regarding cause, impact and prevention
strategies for the diabetes. For this purpose, adults must be informed a healthy diet plan which
includes veggies, necessary fluids and activities for encouraging physical exercises and
activeness. Along with the availability of these resources, parents and carers must also monitor
that their child is practising and adopting these approaches. It has been also observed that as
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these young people transit from childhood to adulthood various psychological as well as physical
changes occurs. Thus, they are more prone to emotional imbalance and sensitivity issues. As a
result at this age many young people adopt unhealthy practices such as smoking, drinking and
drug addictions as well. It is the responsibility of carers and individuals that these they must
educate young people to avoid such habits as they make diabetes more worsen. For the
individuals who are in habit of such practices community services or rehabilitation centres must
be used to help them in overcoming these harmful habits.
2. Three health behaviour theories.
The behavioural model which can be used by Michael for the providing diabetic
educations are as follows:
Chronic care model:
This model is highly effective in improving behaviour and clinical aspects in
management and control of chronic conditions. The key elements of this model are health care
systems, self-management, clinical information system, and decision support and community
resources. Unhealthy food habits and obesity is primary cause of the diabetes. Thus, for
encouraging adults communities must provide necessary options for the weight management
programs, healthy food options and playgrounds or events which encourage physical activities.
The model incorporates the various levels such as macro level, meso and micro level to help
adults in diabetes management. At macro level government must develop suitable policies for the
health care service providers and services.
Thus, for the patients of diabetes Michael must inform their clients that what services and
facilities are available for their well-being. These services include psychological counselling,
palliative care, healthy diet plans and low cost medication services. The effective implementation
of these policies is not possible without including family and individuals (micro level) and
healthcare organizations (meso level). It has been also observed that young adults are usually not
aware of the harmful impact of their practices such as smoking or lack of nutritional food. Thus,
Michael must make his students aware that what impact such life style can have on the health.
The diabetes can be managed and controlled more effectively when it is diagnosed at
early stages. Thus parents as well as health organization must identify such young adults who
have higher vulnerabilities and risk of diabetes. The delay of onset of such diseases also lowers
the unnecessary hospital admission as well as severity of the chronic condition. At young age
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when individuals are guided regarding self-care management then they tend to adopt better life
style management practices. The role of parents, communities and health organization is also
vital in motivating young people who are mostly not aware of the diabetes management.
Trans theoretical Model:
Trans theoretical or the stages of change model can also be used by Michael to promote
the diabetes education among his students. One of the most critical challenge for diabetes self-
care among young adults is their resistance towards change. Thus, Trans theoretical model is
beneficial in identifying the preparedness of individuals in adopting and incorporating changes.
Most of the adults do not find any valid reason to review or to change their lives style. The lack
of motivation can be considered as one of the factor for this stiffness towards change. The
educators must work with carers so that they can inspire adults to follow practices for healthy
living.
However, when they are motivated the limited resources can act as barrier to adopt those
changes in practices. For instance many adults desire to quit smoke or to have nutritional food,
but they do not have access to any rehabilitation centres or the availability of healthy food in
their schools or colleges. Thus, along with the motivation individuals must also assure that
necessary resources and settings are provided to individuals so that they can shift towards
healthy living approaches.
For sustaining the effectiveness of the self-care plans health professionals, educators and
carers must also monitor and measure the actions of individuals so that their practices can be
maintained and risk factor of diabetes can be controlled. The motivational interviews are
effective tools for brining change in the perspective and behaviour of adults. The educator and
health service providers must interact with the young adults to determine the factors which make
them more vulnerable.
Patient centred care model:
This model includes informing, involving and listening to patients that will help into their
long term care. So, patient centred model explains providing care which is respectful and
responsible for including patient’s individual care their need, values with ensuring that all
patients’ values are guided with clinical decisions. Thus this model specifically laid down that all
the decisions taken or measurement applied will mainly be done for desired health outcome or
improving their health’s need.
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So the primary goal or benefit of patient centred care is to improve the health outcome of
patient and thus benefiting them. Michael can also use this model by providing better service to
people who are suffering from diabetes into improving care provided to patients.
Social Cognitive Theory:
This is the theory that stated how experience, environment factors, societal factors,
other's actions influenced the behaviour of individual. This theory provides opportunities for
social aid through inculcation expectations, self-efficacy and some other reinforcement factors to
accomplish behaviour change (Barkway, 2013). There are some elements in this theory which
Michael can adopt are as follows-
 Self-efficacy: The personal ability of adults to have a control in the activities. For
example, stop smoking practices, stop consumption of high carbs food etc. Individual
should have self-efforts for controlling diabetes (Aim of Diabetes Control, 2017).
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Illustration 1: Aim of Diabetes Control. 2017
(Source: Aim of Diabetes Control, 2017)

 Behavioural Capability: Adults should be sound mind that they understand what Michael
is proposing. Expectations: Michael should conduct medical check-up on weekly basis and determine
the result of bring change in the behaviour of adults. Expediencies Self-Control: Self-management approaches are important. Observational Learning: Adults will learn from others as Michael will show the health
outcomes of other to encourage those (Rana & Dwivedi, 2015).
 Reinforcement: Michael will organise prizes and rewards for adults who will change
their behaviour.
b) Biomedical of health
Biomedical model in health means person should be freedom from disease, illness, pain
and should have leave a healthy life. It is purely based on biological or medical factors instead of
environmental, social or any other factors (Kuo, Kim & Ohno-Machado, 2017). Thus, to stay fit,
it is quite important that there should be systematic alignment between the above theories and
biomedical of health. Like, it is important take medical treatment as well as tips to manage the
weight.
3. Enablers and barriers in implementing self-management during adolescence.
Enablers
Government Awareness Programmes: Government awareness programmes foster the self-
management in preventing diabetes. For examples, Australian National Diabetes Strategy, Take
Diabetes 2 Heart, Diabetes Australia Victoria. These are the programmes that create awareness
among adults (Grady & Gough, 2014).
Technological Gazette: Technology has plays a great role in preventing diabetes as now there are
many devices that people can use at home to be aware from chronic diseases especially diabetes.
Such as, Accu check, Bayer Cintiru etc. Further, exercise machines also enable the person to do
physical activities at home for example, Trade Mill.
Barriers:
Habits: This is one of the barrier that hinders the adults as they build their habits like this that
ultimately stop them to leave that habit as they feel it is very harder for them to leave.
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Influence of Friends and peers: It has been notices that people are badly influenced by the
surroundings especially adults are highly influenced by group of people (Lorig & et.al., 2013).
4. Practical Strategies for Engaging clients in self-management.
For engaging diabetic clients for self-management, Michael can focus on providing a
time management schedule to make their actions for longer period. It is identified that clients of
Michael follow any type of action only for shorter period.
 Michael can make an effective use of social media platforms by uploading positive
outcomes of his existing clients. By doing this it can make aware to their clients about the
importance of self-management.
 By being in continuous touch with their clients and by giving them attractive rewards,
Michael can engage their clients in self-management. It is identified that there is a lack of
motivation, so by providing both intrinsic and extrinsic, Michael can make engaged.
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REFERENCES
Books and Journals:
Barkway, P. E. (Ed.). (2013). Psychology for health professionals (2nd ed.). Sydney: Churchill
Livingstone Elsevier.
Chrvala, C. A., Sherr, D., & Lipman, R. D. (2016). Diabetes self-management education for
adults with type 2 diabetes mellitus: a systematic review of the effect on glycemic
control. Patient education and counseling, 99(6), 926-943.
Chang, E., & Johnson, A. (Ed.) (2014). Chronic illness & disability : principles for nursing
practice (2nd ed.) Sydney : Churchill Livingstone Elsevier.
Gabriel, E.H., Hoch, M.C. & Cramer, R.J., (2018). The development of the theory of planned
behavior and health belief model scales: assessing behavioral determinants of exercise-
related injury prevention program participation. Athletic Training and Sports Health Care.
Grady, P.A. & Gough, L.L., (2014). Self-management: a comprehensive approach to
management of chronic conditions. American Journal of Public Health. 104(8). pp.e25-
e31.
Kuo, T.T., Kim, H.E. & Ohno-Machado, L., (2017). Blockchain distributed ledger technologies
for biomedical and health care applications. Journal of the American Medical Informatics
Association. 24(6). pp.1211-1220.
Lorig, K & et.al., (2013). The South Australia health chronic disease self-management Internet
trial. Health Education & Behavior. 40(1). pp.67-77.
Montano, D.E. & Kasprzyk, D., (2015). Theory of reasoned action, theory of planned behavior,
and the integrated behavioral model. Health behavior: Theory, research and practice.
70(4). p.231.
Prochaska, J.O., Redding, C.A. & Evers, K.E., (2015). The transtheoretical model and stages of
change. Health behavior: Theory, research, and practice, pp.125-148.
Rana, N.P. & Dwivedi, Y.K., (2015). Citizen's adoption of an e-government system: Validating
extended social cognitive theory (SCT). Government Information Quarterly. 32(2). pp.172-
181.
Online:
Diabetes Self Management. 2018. [ONLINE]. Available through:
<https://www.healthline.com/nutrition/prevent-diabetes#section4>.
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Medication of Diabetes. 2019. [ONLINE]. Available through: <https://dlife.com/diabetes-oral-
medications/>.
Aim of Diabetes Control. 2017. [ONLINE]. Available through:
<https://www.huskyhealthct.org/providers/diabetes_control.html>.
Daily Schedule of Adults. 2019. [ONLINE]. Available through:
<https://www.123rf.com/photo_65744947_stock-vector-the-daily-routine-life-schedule-of-
a-man-from-morning-till-night-sleep-eating-working-and-activities.html>.
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