Community Nurse's Role in Assisting a Type-2 Diabetic Patient: A Case Study

Introduction:
Susan is a 45-year-old woman living in the rural areas and is a single parent to her two
children of age 13 and 15. She is not employed now. She is mainly living on unemployment
benefits scheme. This makes her live on a very tight budget. She is suffering from type-2
diabetes and is currently gaining on weight. She does not like exercise due to lack of motivation
and frequently needs to go to the toilet. Susan eats processed foods. This is mainly because they
are cheap and she does not have to cook. The assignment will mainly portray the various roles
that will be played by the community nurses in assisting her to cope with the disorder effectively.
Moreover, the social and behavioral determinants of the health would be identified and
accordingly the nurses will incorporate motivation interviewing in the care plan. This would be
helping Susan to overcome the various issues she is facing due to her disorder, helping her to live
better quality life.
Impact of diabetes type-2 in Australian women and its effects on Susan:
Reports provided by the Australian Institute for Health and Welfare (AIHW) had shown
that there were about 16,400 deaths in the nation of Australia with about half of the patients
accounting for about 55% mainly due to tupe-2 diabetes (Diabetes snaphot, AIWH, 2018). About
1 million hospitalizations had been associated with type 2 diabetes in the year 2015 to 2016
(Boyle, Saunders & Drury, 2016, pg: 1986). The rates were found to be similar among males and
females with slight differences of males being at 6% and females being at 5%. Age specific rates
for the females were found to be higher than the males for those above 55 years and above
(Rawal et al., 2015, pg: 205). Insulin treated type-2 diabetes were seen to be 1.5 times higher in

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males than that of the females accounting for about 74 in comparison to 49 per 100000
respectively. Some of the immediate impacts of the disorder are increased thirst as well as
frequent urination, increased hunger, fatigue, blurring of the visions, slow healing of wounds as
well as areas of the darkened skin. Often long-term complications are also seen like the
damaging of the large blood vessels of the heart, brain as well as the legs increasing chances of
cardiovascular disorders. It might also affect the smaller blood vessels causing diabetic
retinopathy, kidney disorders (Fenwick et al., 2018, pg: 667). It also causes neuropathy and foot
ulcers. Susan has already started getting complications like excessive fatigue, frequent urination,
stressed as well as others. Therefore, it is extremely important for Susan to take measures by in
order to prevent any form of complications in the upcoming days as that would result in further
suffering of the patient and more expenditure and financial outflow. As she is a single mother,
her children would be also affected, and they would be stressed by the occurrence of such
disorder. Hence, the community nurse needs to provide her comprehensive care that would help
Susan to prevent deterioration of the condition and helping her to cope with the disorder.
Social determinants of health that increase Susan’s risk of developing the disorder:
As per the definition provided by the world Health organization, social determinants of
health are the conditions in which people survives like they are take birth, grow, live, work and
age. They determine the wider set of the forces as well as the systems that help in the shaping of
the conditions where people live (Smith et al., 2016, pg: 360). Out of different 10 social
determinants that had been put forward by the WHO, it has been seen that unemployment is the
main social determinant that had partly affected the occurrence and deterioration of the situation.
She has been unemployed and she has to live under very tight budget. Studies have shown
unemployment to be intricately associated with diabetes stating that unemployment may be one

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of the social determinants that influence many factors which directly causes diabetes (Volaco et
al., 2018, pg: 321). This social determinant is indirectly associated with two other determinants
out forward by WHO these are food and stress. Poor quality food results in increase in calorie
intake as well as lessens the chances of nutritional intake in the individuals. Moreover, poor
quality foods also increased chances of microorganism infection. All these result in poor quality
health. Moreover, lower income and unemployment creates huge amount of stress among the
affected individuals and this stress thereby acts as another social determinants of health for the
development of various chronic disorders. In case of the patient, it was seen that she was
unemployed, and she had to live on tight budgets (Patel et al., 2016, pg: 796). Moreover, she
could not afford quality organic food and only bought processed foods. Processed foods are low
in nutrition and higher in calories and this aspect results in huge calorie gain in the individuals
(Type 2 Diabetes Management GP Guidelines, 2016). Such amount of calorie gain thereby
increases the chance of obesity that is also one of the risk factors for diabetes type-2 (Walker et
al., 2014, pg: 30. Therefore, similar situation might have happened for Susan that had made her
develop the disorder. She is already gaining weight, and this supports the rationale of her
developing chances of obesity and diabetes. Stress is another social determinant that is associated
with diabetes. When individuals develop stress, the blood sugar levels rise. Stress hormone like
cortisol and epinephrine starts acting vigorously to boost energy. Therefore, all these
determinants might have made Susan develop the disorder.
Behavioral determinants that increase Susan’s risk of Type 2 Diabetes:
Researchers are of the opinion health is determined by the complex interactions between
the different social as well as economic factors along with contribution of the physical
environment and the individual behaviors. One of the most important behaviors that is often