Diabetes Care: Cultural Competency & Patient-Centered Approach

This assignment delves into the crucial aspects of providing culturally competent and patient-centered care for individuals with diabetes. It examines the role of cultural sensitivity, communication skills, and individualized treatment plans in effectively addressing the diverse needs of diabetic patients. The assignment encourages a critical analysis of relevant theories, models, and practical strategies to enhance diabetes management within a respectful and inclusive healthcare environment.

Running head: PAEDIATRIC CLINICAL SCENARIO
Paediatric Clinical Scenario
Name of the Student
Name of the University
Author Note

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PAEDIATRIC CLINICAL SCENARIO
Care needs of the child and family
Nutritional needs:
Proper nutrition should be provided to Rohan which will not exaggerate diabetes condition in
him. There should be regular monitoring of the blood glucose level in Rohan. Based on the
blood glucose level, modifications should be done in his food.
Physical needs:
The physical need of Rohan is proper diabetic diet which has been proposed by the doctors.
According to her teacher, Rohan and his family are vegetarian and hence not following the
diabetic plan, which includes meat. Rohan also needs rigorous physical activity and cyclic
insulin uptakewhich will help to reduce his blood sugar level and prevent ketoacidosis. The
physical activities will also help him to perform regular developmental activities which other
kids of his age would be getting(Joslin and Kahn 2012.
Social needs:
The prime social needs of Rohan are love, compassion and generosity. His mother is ill and
suffering from depression and his father is busy and hence Rohan conducts his own glycemic
test and subcutaneousinsulin injection. He is only 9 years old, an age at which children
develop identity, and become independent. He must therefore lead a healthy social life so that
he does not get isolated.
Cultural needs:
Rohan and his family are immigrants and hence the main cultural need for Rohan is a
friendly environment. The depression of his mother is affecting him also, a friendly
environment where he can communicate his thoughts and feelings will be helpful for Rohan
to lead a healthy life(Zheng and Chen 2013).Moreover, the embedded cultural beliefs adhered
by the Rohan’sfamily were to be explained to the clinical staff during the preparation of the
dietary plan. This factor could have enabledthe clinician to provide an alternative to meat
(DeFronzo 2014).

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Three Priorities for Nursing Care
Educate the patient and the family member about the threats of diabetes
Rohanis very young to understand the chronicityof Type 1 Diabetes Mellitus. His mother is
ill and sufferingfrom post-immigrationdepression and his father remains busy all the time.
Here it is important for Rohan’s father to make some time for his family and understand the
problems. Rohan’s teacher who is also concerned about his health must also come forward.
Thecommunity nurse will help Rohan’s father to recover from unfamiliarity and
misinterpretation of the information. The nursing interventions will be evidenced by verbal
statements of concern or misconceptions centringthe disease and development of the
preventable complications(American Diabetes Association 2016). The desired outcomes of
such nursing care are active participation in the learning process followed by generation of
disease awarenessand correlation of the signs and the symptoms of the disease with adequate
explanation.
Educate the family about the risk of unstable glucose level in blood
Rohanis only 9 years old with three younger sisters and hence the lack of adherence of the
diabetes management will solely be directed towards his parents and teachers. The nursing
care will involveblood glucose monitoring, timely intake of insulin, regular physical activity
(Dunning 2013). The desired outcomes of such treatment will help in identification of the
factors leading to the unstable glucose concentration in blood, proper understanding body’s
need and maintenance of normal glucose concentration.
Counselling Rohan’s Mother
The first steps towards delivering the quality nursing care for immigrants are addressing
the heath and the mental needs of the persons. Here, Rohan’s mother with be thoroughly
counselled for post immigration depression and her difficulties with nephritic
problems(Lindsay et al 2012). The desired outcomes will help in overcoming depression via
getting accustomed with the new country, generation of concern and sympathy for the
children and family and capability to express and discuss the problems and gaining
confidence to fight against depression.

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Strategies to engage with the child and family to develop a trusting relationship:
Cultural Safety Theory: Cultural competency care deals with the knowledge, health
practices and learning skills that have been designed to support and care people of different
ethnicity and cultural background (Hawala-Druy and Hill 2012).It will help Rohan to share
his problems to the nurse. Rohanis new to in Australiaand he might be facing a cultural
differences in order to share his thoughts and problems with other. Since his mom is ill and
his father remains busy, Rohan has no one to discuss his problems. A culturally competent,
community nurse will help Rohan to discuss his problem freely.(Lecca et al. 2014).The
community nurse will be well aware of the cultural beliefs adhered to by Rohan family
andshe will explain thesame to the clinical staff during the preparation of his dietary plan.
This factor could have enabled the clinician to provide an alternative to meat
(Majumdar2014).
Family Centred Care Theory: Patient- and family-centered care therapy can be regarded as
an innovative approach to plan, deliver and evaluate the goodness of well being that is
grounded over the pillar of mutually beneficial partnership among the patients and their
family members. Health care professionals who practice such therapy first try to recognize
the vital role that a family plays for the well-being of the children† and the other family
members of all ages. After that, they counsel the family members so that they help each other
and perform like a healthy and integrated family. Family centered care therapy most targets
the mothers and many reported cases have shown that such family centered therapy has
helped the mother to recover from depression and anxiety (Kitson et al. 2013). It will involve
counselling of Rohan’s mother first. Such therapy will eventually help her to get recover
from depression and get accustomed with the new environment of Australia. With the help of
counselling she will gradually understand the importance of family and how her family and
her children (especially Rohan) are suffering from problems. Her mental recovery will bring
sync in the family and will generate trusting relationships between Rohan and other three
daughters(Kitson et al. 2013).Therapy will also encompass his father and three sisters and
will help them to lead a healthy life in unison.
Interpersonal/Communication Theory:focuses on the way the family relationships affect a
patient mental and physical health. The therapy use communication as a principal weapon to

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PAEDIATRIC CLINICAL SCENARIO
develop trusting relationships among the family members. This therapy is very useful for the
treatment of depression and anxiety (Berger 2014).It will help Rohan to freely communicate
with the nurse and discuss his problems with her. Since Rohan is very young, suffering from
diabetes and is being forced to take his own medicine, he is bound to suffer from certain
mental depression as he has no one to share his problems. His father remains busy most of the
time, her mother remains depressed and her three sisters are too young to understand his
problem. Communication therapy will help Rohan to recover from his developmental and
psychological problems(Rogers 2014).Moreover, Rohan also suffers from developmental
defects as he has high level of glucose, the interpersonal therapy will generate
synchronization between the family relationship and such synchronization will assist Rohan
to fight against his developmental problems via taking proper diet, regular attendance in
school, proper physical activity and timely medicine intake.
Plan of care
Educate the patient and the family member about the threats of diabetes
Family holds the sole pillar in the patient’s life. However, if a family member has
encountered with any serious illness, the daily routine and common activities need to be
reshuffled. The family must be educated with the symptoms of the disease, side-effects and
the possible outcomes. By doing this, family can act as an active hand of support to the
patient and will help in speedy recovery by providing mental and physical support. The
family support will help in medication adherence and glycemic control (Mayberry and
Osborn, 2012).
Nursing Intervention and Evaluation
Interventions and Effectiveness of Care
Interventions to the nursing care plan (Educate the patient and the family member about the
threats of diabetes)
Intervention / Assessment (1): Identification of the learner: patient/ family member or care
giver (Chen et al. 2012)
Rationale: In this case, the main learner will be Rohan’s father and his teacher in school.
Rohan lives in a troubled family where his mother is ill and her sisters are much younger than
him. So it is the responsibility of the father to learn and gain about the knowledge. Rohan’s

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PAEDIATRIC CLINICAL SCENARIO
teacher is also concerned with his health however, she is not accustomed with the disease
diabetes and hence she will be the second most important learner in this nursing care model.
Intervention / Assessment (2): Enabling the patient to open up with the previous experience
and health teaching(Inzucchi et al. 2012)
Rationale: Rohan has no one to discuss his problem (both mental and physical) so such
nursing care program will help Rohan to open up and discuss freely about his problems.
Rohan also takes his own insulin and does his own glycemic test and it is very important to
evaluate the kind of thought process he pass through while performing such phobic task alone
and that too at such a young age
Evaluation:
The effectiveness of the nursing care will deal with monitoring of blood glucose level and
prevention hyper glycemic shock. The care will also adhere to proper diabetic medication,
observance of proper dietary plan, participation in active physical activity and spending
quality time with family.

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Reference List
American Diabetes Association, 2016. Standards of medical care in diabetes—2016 abridged
for primary care providers. Clinical diabetes: a publication of the American Diabetes
Association, 34(1), p.3.
Berger, J., 2014. Word of mouth and interpersonal communication: A review and directions
for future research. Journal of Consumer Psychology, 24(4), pp.586-607.
Chen, S.M., Creedy, D., Lin, H.S. and Wollin, J., 2012. Effects of motivational interviewing
intervention on self-management, psychological and glycemic outcomes in type 2 diabetes: a
randomized controlled trial. International journal of nursing studies, 49(6), pp.637-644.
DeFronzo, R. (2014). International textbook of diabetes mellitus.Chichester: John Wiley.
Dunning, T., 2013. Care of people with diabetes: a manual of nursing practice. John Wiley
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Hawala-Druy, S. and Hill, M.H., 2012. Interdisciplinary: Cultural competency and culturally
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Kitson, A., Marshall, A., Bassett, K. and Zeitz, K., 2013. What are the core elements of
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