Chronic Illness Management: Educating Patients for Better Health

This study focuses on educating a patient named Mr. Boulia, who is suffering from type 2 diabetes and hypertension, to improve his health condition and lifestyle habits. The study uses motivational interviewing and health coaching to educate the patient and enhance his understanding of managing his chronic illnesses. The patient's cultural background and the nurse's role in providing patient education are also discussed.

Running head: CHRONIC ILLNESS MANAGEMENT
CHRONIC ILLNESS MANAGEMENT
Name of the Student:
Name of the University:
Author note:

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Introduction
This study will focus on the patient named Mr Boulia, a 47 year old aboriginal man,
who was suffering from the major health issue of type 2 diabetes and hypertension. The
patient had a poor lifestyle that was majorly contributing to his bad health condition such as
consumption of high saturated food and sugar, which would be directly responsible for
increasing his blood sugar level (Hamamura et al., 2017). This study will focus on educating
the patient regarding his smoking habits and his bad lifestyle that could further deteriorate his
health. In the education intervention, the application of motivational interview and health
coaching will be used or implemented to educate the patient regarding managing his health
issues and how this educational program can assist him in improving his health condition
(Soderlund, 2018). Gibb’s reflective cycle is used for writing a detail reflection regarding the
culture, attitude and value of interaction between the nurse and the patient.
Overview of the patient
This study will focus on the patient named Mr Boulia, a 47 year old aboriginal man,
who was presented to the Aboriginal Community Controlled Health Organisation (ACCHO)
with the issue of central radiating chest pain. The patient was experiencing sharp chest pain
that is also termed as Pleurisy and is defined as the condition of irritation or inflammation
within the chest and lung lining (Low et al., 2016). The patient was majorly suffering from
the health issue of type 2 diabetes, and it could be highly possible that his chest pain was due
to high level of blood sugar. The life style of Mr Boulia can also be responsible for his bad
health condition as he used to smoke and consume food that were rich in sugar and saturated
fats. Type 2 diabetes is considered as the heterogeneous illness that is majorly characterized
by the condition of insulin resistance. The poor lifestyle of the patient had resulted in the
decreased sensitivity of insulin, thus the beta cells are triggered to secret insulin in the patient

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body, leading to the condition of hyperinsulinemia (Lycett et al., 2015). Sometimes this
condition leads to the impaired glucose tolerance and hence result in the development of type
2 diabetes mellitus. Hence, Mr Boulia, was suffering from type 2 diabetes due to his poor
lifestyle and eating habits.
Description of potential health concern of the patient
The primary health concern that was identified from the scenario was type 2 diabetes
mellitus. The patient was also experiencing chest pain that could be responsible for his high
diabetic condition. From the vital sign assessment, it was evident that the blood pressure of
the patient was high (150/90 mmHg) and the blood glucose level (BGL) was also high (15.5
mmol/L) (Oh et al., 2016). The patient was experiencing moderate pain as reported from the
self-reporting numeric scale of pain measurement that measures the level of pain. The
condition of type 2 diabetes mellitus was one of the major health concern that was affecting
the patient and his overall health. The bad lifestyle of Mr Boulia, was adding to his
deteriorating health issue, as he used to smoke, consume high saturated foods and high sugar
intake (Rewers & Ludvigsson, 2016). Mr Boulia used to consume high saturated food that
has a minor yet immediate affect on the blood glucose level, as consumption of such food
will reduce the process of digestion and the efficiency of insulin will decrease that will
eventually result to high rate of blood glucose level. There rate various risk factors that might
enhance the threat of type 2 diabetes in the patient namely age, high blood pressure, poor
lifestyle and smoking. Hence, it is established that the patient was suffering from one of the
major potential health concern associated with type 2 diabetes mellitus (Rawshani et al.,
2018).

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Topic of patient education:
Client education is the part of the healthcare teaching, which enhances the
understanding the knowledge of the patient regarding the risk factor, prevention, diagnosis
and treatment of the disease (Chemutai & Jepkemei Kirui, 2017). Client education or the
health education enhances the knowledge and learning of the patient and their family and
encourage them improve their lifestyle and behavior (Jotterand, Amodio & Elger, 2016). For
the effective client education, nurses play an essential role. Nurse implements health
education in the patient by proper assessment of the patient’s condition.
Coronary heart disease is a heart illness, which is caused due to the narrowing of
the artery in the patient. According to Zipes et al., (2018), the risk factors which are
responsible for the occurrence of coronary heart disease in case of Mr. Boulia is smoking,
type 2 diabetes, hypertension and high cholesterol diet. If the patient does not change his
healthy living habits, it will lead to further deterioration of the health of the patient. Hence, in
order to avoid the further health deterioration, the nurse should educate the patient about the
consequences of continuing smoking and high cholesterol diet.
Education topic 1:
Smoking: Smoking can give rise to multiple diseases if continued for the long time. In the
case of Mr. Boulia, it can be considered as the risk factor coronary heart disease which is
considered as the primary concern of the patient. If the patient will not quit smoking, it might
give rise to other health complications (Barth et al., 2015). Hence by considering the
consequences of smoking into the patient, it is chosen as the topic for the client education.
In order to reduce the effect of smoking into the patient, awareness regarding the
different smoking cessation strategies is created among the patient. Smoking cessation is the
process of quitting tobacco. The patient should be educated about the nicotine replacement

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therapy. Nicotine replacement therapy is clinically approved therapy to reduce the use of
tobacco among the individuals. In this therapy, the patients are advised to replace nicotine by
gums, inhaler, lozenge, transdermal patch and spray.
Strategy fir patient education:
Health coaching: Another strategy that can be used for the education of the patient is the
health coaching. Health coaching is a patient centered process that can be used to motivate or
educate the patient suffering from any illness to change their life style. As it is a patient
centered process, the nurse should formulate patient centered strategies to educate the patient
and intervene accordingly (Dufour et al., 2015). In the health coaching, the patient and the
family of the patient both are educated about the risk factor, causes and the prevention
strategy of the illness.
Justification of the strategy:
To aware the client about the adverse effect of smoking, health coaching is used
because it is an effective method to create awareness among the patient and their family
members. Health coaching is frequently used in the healthcare setting by the nurses to
educate the patient and their family members about each and every detail of the disease.
Education topic 2:
High cholesterol diet: Other topic which is chosen by observing the case study Mr. Boulia
that requires client education is the consumption of the high cholesterol diet. High cholesterol
diet is one of the common causes of hypertension and hypertension is the risk factor for
diabetes and coronary heart disease (Jiang et al., 2016). Therefore y observing the medical
condition of the patient, it can be said that consumption of high cholesterol diet for a person
who has already been suffering from type 2 diabetes, hypertension and coronary heart disease
is harmful and if not discontinued, it might increase the risk of the heart attack (Levine et al.,

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2017). Hence, to avoid the chance of any further complication, complications due to the high
cholesterol diet is chosen for the client education.
To avoid the harmful effects of high cholesterol diet, the clients are educated about
the Healthy Dietary Option. The clients are educated about the DASH diet eating plan which
includes, diet rich in vegetables, low fat, non-fat dairy and fruits. To provide education to the
client regarding any heath related topics, it is important for the nurse to maintain an effective
rapport with the patient, which can only be achieved by the effective communication between
the patient and the nurse. The diet includes meats, whole grains, fish, poultry, beans and nuts.
The diet will help to reduce the cholesterol and will decrease the risk of chronic illness.
Strategy fir patient education:
Motivational interviewing: In the motivational interviewing, the client is interviewed by the
healthcare professional in order to gather knowledge regarding the habits and life style of the
patient (Lindson‐Hawley, Thompson & Begh, 2015). In this case, the nurse should interview
Mr. Boulia, regarding their diet and other aspects of his life style. After, interviewing the
patient, the nurse should educate the patient about the consequences of their unhealthy life
style. Along with informing about the risk factor of the disease, the nurse should also
motivate to change their life style. The nurse should discuss about the barrier that can hinders
the patient motivation to change and the strategies to overcome such barrier.
In this case, Mr. Boulia is educated about her health condition and the risk factor
which is responsible for health condition. The patient is educated about the adverse
consequences of having high cholesterol diet on his health and about the strategies to
overcome the issue.

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Justification of the strategy:
Motivational interviewing is used to educate the patient about the healthy diet as it
is one of the most common and effective strategy that is used in the healthcare setting for
motivating the patient to change their existing life style in order to enhance the health
outcome of the patient (Lindson‐Hawley, Thompson & Begh, 2015).
The nurse should use different strategies to provide the appropriate information to
the patient such as, verbal discussion, posters and charts, videos and demonstrations. These
strategies will help in better understanding of the concern. One of the most common is the
verbal discussion between the patient and the health care staff (Masters et al., 2017).
Reflection
This reflection will follow the Gibb’s reflective cycle that will help me to express my
feelings while dealing with the patient and managing his health condition. The patient was
suffering from chest pain which was due to his high blood sugar level, as diabetes directly
affect the nerves and blood vessels which is responsible for regulating the heart and the blood
vessels. I was aware of the fact that type 2 diabetes mellitus is common yet serious health
condition and is also associated with other different major health issues. The patient belonged
to the aboriginal community and I was born in Australia and had no background knowledge
of the patient. My cultural heritage was different from the patient which was making me
anxious as well as nervous regarding managing the patient. I can recognize that I had a biased
perception towards the patient with chronic illnesses which have been deteriorated or
triggered due to their individual lifestyle adoptions. However, I noticed that I have strengths
which could be of positive value for nursing the client. I am an obedient and competent
practitioner and I also have a habit of updating myself with the client’s improvement and
which areas I should focus to further enhance the patient’s health condition. I am also focused

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and have established a therapeutic relationship with the patient and focused to understand his
cultural aspect that would enhance my evidence-based practice and build a healthy rapport
with the client. I am also aware of the teaching techniques and multiple resources which will
help me to provide relevant education to the client and improve his daily lifestyle habits.
Conclusion
From this study, it can be concluded that since the patient belonged to a different
cultural background, educational intervention would be beneficial for him to understand his
major health issue of diabetes and adapt the strategies that is taught to him regarding
management of health condition. Motivational interview and health coaching was used to
educate the patient regarding the management the chronic condition and improve the lifestyle
habits of the patient. The aim of educating the patient will be increase their awareness
regarding his lifestyle habits and his smoking habits, which will guide him to lead a healthy
life and reduce the risk factors that will further deteriorate his health condition.

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