The Role of Nurses in the Promotion of Health in Diabetes Mellitus

This article discusses the role of nurses in promoting health and managing diabetes mellitus type 2. It explores the strategies used in primary health care, such as building public policy, creating supportive environments, strengthening community action, developing personal skills, and reorienting health services. The article emphasizes the importance of collaboration and a multidisciplinary approach for better healthcare.

Running Head: PRIMARY HEALTH CARE
The Role of Nurses in the Promotion of Health in Diabetes Mellitus
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Running Head: PRIMARY HEALTH CARE
Primary health care functions to prevent poor health and in promotion of health
and wellbeing of people. The World Health Organization (WHO) hosted an International
Conference in the capital of Canada in Ottawa. This was the first International
Conference on Health Promotion in 1986. As a result of the conference, a seminal
document was launched in the name of Ottawa Charter. It described the action plan for
achieving good health care for all and included the five most basic and crucial principles
for primary health care. The key strategies for health promotion as outlined by Ottawa
Charter are to build public policy, create supportive environments, strengthen
community action, develop personal skills, and reoriente health services. Primary Health
Care guiding principles can be applied in the control of type 2 diabetes. This is a
medical condition where the pancreas gland doesn’t secrete enough insulin or rather
the function of insulin in the body is resisted (Powers, et al, 2017). The objective of this
paper is to critically analyze the role of nurses and midwives in relation to diabetes
mellitus type 2 and health promotion strategies.
Diabetes Mellitus type 2
In Australia, 5% of the adult population aged 18 years and above have diabetes
mellitus type 2. This is according to a report by the Australian Bureau of Statistics, of the
period 2014-2015 ( Diabetes snapshot, Type 2 diabetes)
. Gender proportions were similar between men and women (6% and 5%) according to
the National Health Survey. Diabetes mellitus type 2 deaths are majorly caused by
cardiovascular disease. There has to be good glycemic control for the reduction in the
average mortality rate. Despite a significant proportion of the population diagnosed with
the disorder, no cure has been found for type-2 diabetes. However, management of the
disorder can be actualized. Management of type-2 diabetes can be achieved through
good healthy eating habits, loss of excessive weight and good physical exercising. In
extreme conditions of the disorder, insulin therapy and diabetes medication may be
necessary (Whitehead, et al, 2017). The symptoms which manifest gradually and
almost unnoticed in the very early stages of the disorder. They include fatigue,
increased hunger, and thirst, uncontrolled urination, unmerited weight loss, frequent
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Running Head: PRIMARY HEALTH CARE
infections, slow and gradual healing sores, blurry vision, darkened skin in areas like the
armpit and neck, depression, anxiety and so forth (Sun, et al, 2016).
Build Public Health Policy
Building public health policy and advocacy is an aim to ensure that all sectors promote
health in their social and physical environments. Nurses engage in health sensitive
policies both at the local, national and international.The policies to eradicate excessive
fast food consumption and promote nutritious meals and regulate the ingredients used.
Nurses have advocated for a healthy workplace and school policy of incorporating
extra-curriculum activities into the school program with nutritious meals in boarding
facilities. There is fair accessibility to healthcare without discrimination to gender,
ethnicity, age or location (Wakerman, et al, 2017). Nurses policy advocacy efforts have
sealed the protection of the integrity of the nursing profession from commercial groups
that seek to push for drugs that are harmful to diabetic patients (Chesnay, & Anderson,
2019).
Create a supportive environment
Creating a supportive environment addresses the socioeconomic factors and
living conditions that influence the health of the people. For a healthy living in society,
there has to be sufficient healthy food, shelter, sustainable resources, a healthy culture,
and social norms. Type 2 diabetes clients are not an exception to this principle.
(Pirbaglou, et al, 2018) Nurses and midwives have engaged in health promotion
programs to ensure a healthy culture. The intervention of establishing health promotion
centers, integration of fitness centers and treatment centers in the communities. This
would result in weight control, blood sugar levels control and high scores in physical
activity. The registered nurse (RN) initiative to administer self-efficacy programs along
with diabetes education greatly reduces the number of patients admitted into the
emergency wards, the hospitalization rates due to improved self-care. The nurses have
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Running Head: PRIMARY HEALTH CARE
culturally tailored services to the people and ensured accessibility of consultancy
services and diagnostic test to detect the condition at an early stage for a better quality
of life. Self-care needs such as the dietary needs, physical activity, blood glucose self-
monitoring, adherence of medication and measurement of glycated hemoglobin have
been availed by nurses at the clinical setup. The initiatives have been packaged as a
welfare program to help the needy in the society (Pirbaglou, et al, 2018). Intermittent
efforts have been made by nurses to offer frees diagnostic tests and screening of
diabetes mellitus type 2 to society. The nurses have also incorporated technological
innovations in provision healthcare. This has revolutionized the medical field. Nurses
have ensured that it is affordable to the clients, well integrated and accepted into the
people’s culture and way of life. The results is better healthcare (Gonder-Frederick, et
al, 2016).
Strengthen Community action
Strengthening community action as a strategy involves various communities in
Australia in making decisions, health promotion plans and implementation of the set
plans and evaluation of their effectiveness. Community action makes it possible for
customization of the healthcare program. The rationale behind it is that different
communities have cultures. The community has a special role in gathering their
resources in the prevention, control, and management of type 2 diabetes. The
collaboration of the public with medical agencies is important in promoting health. This
helps in ensuring that the initiative for promoting the welfare of the clients with type 2
diabetes and its control mechanisms springs from the grassroots level. Through the
participation of the public, the community takes ownership of their health and welfare
(Epperly, et al, 2019). Diabetic patients need special care from the community. This
calls for communal approach from all the facets of the society, the government,
business, and the organizations in a joint effort to promote the health and well-being of
the community (Saint-Pierre, Herskovic, & Sepúlveda, 2017). Each of these plays a
critical role in ensuring good health.. An Intersectoral collaboration helps in
customization of unique health care services to the different communities. Nurses in
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Running Head: PRIMARY HEALTH CARE
their practice when dealing with diabetes mellitus type 2 ensure a Multidisciplinary
Team (MDT) approach. The Nursing board has supported community efforts of
prevention of type 2 diabetes mellitus through sponsorship of community campaigns,
offering guidance to community groups advocating for the fight against diabetes and
thorough training.
Develop Personal Skills
Primary healthcare addresses individual and social development needs through
the provision of relevant information, training, and education. Awareness is attained
through education relevant to this particular condition. Awareness is a necessity for
prevention, control, and management of type 2 diabetes.Proper education and training
ensure diabetes prevention measures and self-reliance. (Carolan, Holman, & Ferrari,
2015).. Early screening and detection of the condition by nurses ease the management
process. However, through the nurses training, clarifications are made to the community
that the availability of any of the risk factor is not a diagnosis of the disorder.However,
women who have experienced gestational diabetes according to Thomas, (2019) and
polycystic ovarian syndrome are more prone to type-2 diabetes. Through innovations,
the nurses are using technology in monitoring and evaluation of type 2 diabetes patients
according to Hunt, (2015) and improve drug compliance. The nurse using telephone
conversations to offer counseling, monitoring services, and patient education services.
Medical technological devices such as the self-monitored blood glucose, insulin pump
delivery, and the closed loop delivery system are engaged to offer patient-centered
health care,Brummel‐Smith, et al, (2016).
Re-Orient Health Services
Reorienting health services involves an effort by the medical practitioner and the
entire healthcare workforce to shift from the traditional curative healthcare approach to
preventive and health promotion strategies. It advocates for an expansion of the
mandate to incorporate the upstream approach. The principle is that health is not just
the absence of a disease but a prevailing positive state of wellbeing ("Reorienting health
services", 2019) Diabetes mellitus type 2 condition cases can be reduced by adopting
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Running Head: PRIMARY HEALTH CARE
an upstream approach. More attention should be accorded to prevention techniques
and the risk factor control. The nurses through increased research on type-2 diabetic
disorder have shaped the prevention scheme and management. The nurses have
partnered with research centers and other institutions for funding of innovative projects.
This has reduced the research gap and offered more solutions to the medical field in the
prevention, screening/detection, and management of type 2 diabetes. The nurses have
promoted awareness of type-2 diabetes through training camps and education in the
corporate and social media platforms. A field approach has been adopted by the nurses
in dealing with the condition as opposed to the curative clinical setup.
Conclusion
Ottawa strategies for health promotion have greatly impacted on healthcare
service delivery. These principles of healthcare have been used by nurses and
midwives to minimize cases of diabetes mellitus type 2. In summary, it is important for
nurses to collaborate with other health care professional groups to support the risk
factor control mechanisms in all levels of society. More policies should be enacted and
extensive research done to promote better nursing care. The nursing and midwifery
board should enroll more nurses. Other areas that should be highly considered include
training on coping skills to the type-2 diabetic patient and the family. This is a move to
address the psychological and social needs associated with the disorder to ensure
improved quality of life. Also, a well-collaborated effort and a multidisciplinary approach
are recommended for better healthcare.
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References
American Geriatrics Society Expert Panel on Person‐Centered Care, Brummel‐Smith,
K., Butler, D., Frieder, M., Gibbs, N., Henry, M. & Saliba, D. (2016). Person‐
centered care: A definition and essential elements. Journal of the American
Geriatrics Society, 64(1), 15-18.
Carolan, M., Holman, J., & Ferrari, M. (2015). Experiences of diabetes self‐
management: a focus group study among A ustralians with type 2
diabetes. Journal of clinical nursing, 24(7-8), 1011-1023.
De Chesnay, M., & Anderson, B. A. (2019). Caring for the vulnerable: Perspectives in
nursing theory, practice, and research. Jones & Bartlett Publishers
Diabetes snapshot, Type 2 diabetes. (n.d.). Retrieved from
https://www.aihw.gov.au/reports/diabetes/diabetes-snapshot/contents/how-many-
australians-have-diabetes/type-2-diabetes
Epperly, T., Bechtel, C., Sweeney, R., Greiner, A., Grumbach, K., Schilz, J., ... &
O'Connor, M. (2019). The shared principles of primary care: a multistakeholder
initiative to find a common voice. Family medicine, 51(2), 179-184.
Gonder-Frederick, L. A., Shepard, J. A., Grabman, J. H., & Ritterband, L. M. (2016).
Psychology, technology, and diabetes management. American
Psychologist, 71(7), 577.
Hunt, C. W. (2015). Technology and diabetes self-management: an integrative
review. World journal of diabetes, 6(2), 225.
Pirbaglou, M., Katz, J., Motamed, M., Pludwinski, S., Walker, K., & Ritvo, P. (2018).
Personal health coaching as a type 2 diabetes mellitus self-management
strategy: A systematic review and meta-analysis of randomized controlled
trials. American Journal of Health Promotion, 32(7), 1613-1626.
Pirbaglou, M., Katz, J., Motamed, M., Pludwinski, S., Walker, K., & Ritvo, P. (2018).
Personal health coaching as a type 2 diabetes mellitus self-management
7

Running Head: PRIMARY HEALTH CARE
strategy: A systematic review and meta-analysis of randomized controlled
trials. American Journal of Health Promotion, 32(7), 1613-1626.
Powers, M. A., Bardsley, J., Cypress, M., Duker, P., Funnell, M. M., Fischl, A. H., ... &
Vivian, E. (2017). Diabetes self-management education and support in type 2
diabetes: a joint position statement of the American Diabetes Association, the
American Association of Diabetes Educators, and the Academy of Nutrition and
Dietetics. The Diabetes Educator, 43(1), 40-53.
Reorienting health services. (2019). Retrieved from https://www.pdhpe.net/better-
health-for- individuals/what-strategies-help-to-promote-the-health-of-
individuals/the-ottawa-charter-as- an-effective-health-promotion-
framework/reorienting-health-services/
Saint-Pierre, C., Herskovic, V., & Sepúlveda, M. (2017). Multidisciplinary collaboration in
primary care: a systematic review. Family practice, 35(2), 132-141.
Sun, N., Lou, P., Shang, Y., Zhang, P., Wang, J., Chang, G., & Shi, C. (2016).
Prevalence and determinants of depressive and anxiety symptoms in adults with
type 2 diabetes in China: a cross-sectional study. BMJ open, 6(8), e012540.
Thomas, S. (2019). Knowledge and Awareness about Diabetes Mellitus and Gestational
Diabetes Mellitus-Review. Artha-Journal of Social Sciences, 18(1), 31-44.
Wakerman, J., Humphreys, J., Wells, R., Kuipers, P., Entwistle, P., & Jones, J. (2017).
A systematic review of primary health care delivery models in rural and remote
Australia 1993-2006.
Whitehead, L. C., Crowe, M. T., Carter, J. D., Maskill, V. R., Carlyle, D., Bugge, C., &
Frampton, C. M. (2017). A nurse‐led education and cognitive behaviour therapy‐
based intervention among adults with uncontrolled type 2 diabetes: A
randomised controlled trial. Journal of evaluation in clinical practice, 23(4), 821-
829.
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