Chronic Conditions and Person-centred Care

Running head: Chronic conditions and person-centred care
CHRONIC CONDITIONS AND PERSON-CENTRED CARE
Name of the Student:
Name of the University:
Author Note:

Running head: Chronic conditions and person-centred care1
Introduction:
An estimated 6% of the total population in New Zealand (NZ) has diabetes, and the
prevalence of diabetes is increasing every year. Living with lifelong conditions affects the entire
life of individuals with chronic illnesses and their family/whanau (Ministry of Health, 2015). The
essay will be considering the personal information of 65-year old male client with type 2
diabetes (T2DM) and how the illness impact on his daily life. This essay also identifies
comprehensive aspects of T2DM, including its typical onset, pathophysiology, potential
complications and lifespan consideration and critically evaluates how all of those aspects of
T2DM influences on the client and his family. In addition, the social constructions of T2DM and
its impact will be discussed as it has a lot of influences on T2DM management (Conrad &
Barker, 2010). Lastly, appropriate nursing care needs for the current health status of the client
also will be discussed for better health outcomes.
Task 1
Mr. A is a 65-year-old male Bhutanese client with five years of history of T2DM. Since
he settled in NZ 10 years ago, he has not been able to get any paid job for a living, but he has
been provided additional supports from NZ government and his wife and daughter. According to
Mr. A, the Bhutanese community helps Mr. A to lead a stable life, even though adjusting to the
life in a foreign country in his old age was hard. Mr. A found that he had hyperglycemia when he
went to see his general practitioner(GP) for his hypertension management, and two months later,
he showed higher blood sugar level with symptoms of excessive fatigue and unexplained weight
loss. Subsequently, the GP gave Mr. A diagnosis of T2DM with further clinical examinations,
such as hemoglobin A1C test.

Running head: Chronic conditions and person-centred care2
He feels his long-term condition has been affecting both physically and psychologically.
After he experienced feeling faint due to hypoglycemia two years ago, he always worries about
possible complications of T2DM and this fear is increasing over time as he gets older. In
consideration of the psychosocial stage of his age, his diabetic condition has changed his position
in family, and this makes him feel some regret towards his situations relating to living with
T2DM. Also, he stated that his diabetes is limiting the social life of Mr. A and his family
members due to the reasons of diabetes management and cultural aspects. Mr. A believes this
perceived prejudice on living with T2DM affects his overall life and well-being (Mr. A, personal
communication, November 18, 2019). The reason behind this mental sufferings is the concept of
diabetes-related stigma, which is the negative attitude towards the people with diabetes due to
few prejudices.
Task 2
1. Typical onset
, the onset of T2DM is non-specific and gradual, and the majority of people are
diagnosed on a regular checkup for their undergoing treatment of other conditions or routine
blood examinations (Brown, Edwards, Seaton, & Buckley, 2015). In his age of over 60 years, it
is often harder to recognize the development of diabetes because the signs of diabetes are likely
to be confused with the normal ageing process (Kilvert & Fox, 2017). That being said, Mr. A had
presented classic symptoms of diabetes before a diagnosis of T2DM, such as unusual tiredness,
unexpected weight loss and recurrent infection on his mouth, which could indicate possible
hyperglycaemia.

Running head: Chronic conditions and person-centred care3
Since Mr. A had diagnosed hypertension two years before his symptoms of diabetes
presented, his high blood pressure might be associated with the initial stage of the eruption of
diabetes. According to a study, although people with early stage of T2DM are not aware of
typical changes caused by diabetes, some damages on the heart and vascular systems may be
already occurring (Brown, Edwards, Seaton, & Buckley, 2015; de Boer et al., 2017). This is
because poor management of blood sugar decreases functions of heart and blood vessels
significantly by damaging blood vessel walls and thus increasing arterial stiffness (Ma et al.,
2014). Finally, he found that he had a higher level of fasting blood glucose on a regular checkup,
which is one of the most typical indicators of T2DM. As we can see from the case of Mr. A, an
asymptomatic period may be prolonged before noticeable signs associated with T2DM occurs,
and thus careful screening of diabetes-related symptoms is required for early identification
(Sinclair, Dunning, & Rodriguez-Mañas, 2015).
The incidence of T2DM is mainly caused by either insufficient insulin production or
insulin resistance of body cells (Brown, Edwards, Seaton, & Buckley, 2015). Also, a myriad of
risk factors triggers the development of T2DM, including sociocultural status, diet and lifestyle
(Kautzky-Willer, Harreiter, & Pacini, 2016). Importantly, Mr. A’s experience of resettling in
another country could contribute to developing T2DM because immigrants are more likely to be
exposed to different health risks, affecting dietary habit, physical activities and stress level,
which can increase the risk of T2DM (Berkowitz et al., 2016; Tenkorang, 2017). Mr. A also
experienced a rapid shift from traditional Bhutanese low-fat and balanced diet towards a diet that
is higher sugar and salt and meat-based food. Such a nutritional change might have compromised
metabolic functions and therefore contributed to increased development of T2DM (Wangdi &
Jamtsho, 2018).