Psychosocial Aspects of Diabetes: Intervention, Culture, and Treatment

This report examines the psychosocial aspects of diabetes, focusing on behavioral interventions and their effectiveness in managing the disease. It begins by discussing two diabetes-related health behavior interventions, critically evaluating their usefulness, such as Diabetes Self-Management Educ...Read More

Psychological
Aspect Of
Diabetes
1

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
1 Discuss two diabetes related health behavior interventions and critically evaluate
their usefulness....................................................................................................................3
2 Design a new behavioral intervention to support the psycho social needs of a
patient group of your choice...............................................................................................4
3 Draw a logic model for your chosen intervention........................................................5
4 How ethnicity, culture and religion affect treatment and adherence........................8
CONCLUSION...............................................................................................................................9
REFERENCES............................................................................................................................10
2

INTRODUCTION
Psychosocial approach has been defined as a mixed effect of social as well as
psychological factors on an individual’s mental, physical and the capability to deal and perform
daily functionsi. Various disease and psychiatric syndromes influences the psychosocial aspect
of every person life. Diabetes may have a severe emotional as well as psychosocial outcome
that further make an individual less productive and can negatively affect the power of their self-
management. All types of diabetes have the potential to influence the relationship status,
working life, psychological welfare and mental peace. This report will focus on several
behavioural interventions on assorted age group people who are suffering from different types
of diabetes along with psychosocial aspect of respective disease in various countries. Logic
model will be drawn and the effect of culture, ethnicity and religion on diabetes treatment
method will be discussed in this report.
MAIN BODY
1Discuss two diabetes related health behavior interventions and critically evaluate their
usefulness
From the variety of research, it can be analyzed that many behavioral interventions have
been developed which have greatly contributed in improving the health condition of patients
suffering from diabetesii. The interventions are formed in such a way that it motivates
appropriate behavior and at the same time lower the occurrence of such behavior which are
inappropriate and not suitable of managing the health like harming oneself or other. The
approach may get changed as per the type of diabetes and the way interventions are being
applied by health providers. Such interventions require a complete process of behavior
alteration support that involve any health practitioner to initially build a problem definition which
includes what are the causes of such diseases. The step is followed by setting a collective goal
that play effective role in establishing self-management behavior based on specific and action
oriented plan. Problem solving is another step which decides how to resolve the problems
associated with weak emotions, less support form family or deficiency of good facilities. Once
such steps are managed, an intervention plan is made which has to be made by different health
providers for the patients as per their issues. If a person has poor eating habit that make such
individuals diabetes condition more severe, then the health practitioner provide such
intervention which can overcome such abnormality. Some behavioral interventions are
discussed below.
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Diabetes self-management education (DSME) – Such program has been invented for
the diabetes patients which assist them in understanding the skills and knowledge which are
required for self-managing and caringiii. Insulin is one of the most effective treatment for type 1
diabetes, though type 2 diabetes can be efficiently treated through proper diet and oral
medications. Providing clear instructions and information regarding the disease to the patients is
the duty of dietitians and nurses. It has been observed that nurses are frequently utilized in
delivering DSME, which allow different patients to share their experiences which further help in
making behavioral alteration of patients or their family members. With the invention of medical
nutrition therapy, health practitioner and nurse have become more intrinsic component of
diabetes education system. Practitioners can develop various methods for promoting the
importance of DSME either through digitally or via social media, personal interactions in
hospitals or at some events. Such practice helps the patients who are suffering from chronic
diabetes in developing personal strategies which may involve in resolving their issues,
interacting with such victims and comforting them that later help in stabilizing their behavior.
Enhancing motivation – Patients either facing acute or chronic diabetes must be
encouraged by the health provides frequently for cheering up their mood and making them feel
worthy. Different patients are treated differently as per their behavioral problem associated with
such disorder, some patients are motivated by making them participate in more and more
physical activities. The diabetic patients are tending to get exhausted more often than other
patients, such issue make their participation less effective, thus practitioners have to employ
fresh and new techniques to motivate for overcoming the barriers like health complications. By
making exercise buddies, patients get more cheerful and enthusiastic for doing daily physical
activities together. Some patients may be provided with unique rewards for undergoing physical
i Ashraff S, Siddiqui MA, Carline TE. The psychosocial impact of diabetes in
adolescents: A review. Oman medical journal. 2013 May;28(3):159.
ii Barnard KD and et.al., Psychosocial aspects of closed‐and open‐loop insulin delivery:
closing the loop in adults with Type 1 diabetes in the home setting. Diabetic Medicine.
2015 May;32(5):601-8.
iii Datye KA and et.al., A review of adolescent adherence in type 1 diabetes and the
untapped potential of diabetes providers to improve outcomes. Current Diabetes
Reports. 2015 Aug 1;15(8):51.
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activities daily, they can be given some special food item or outside visitation which make them
motivated. Another approach can be to counsel the patients for making them understand the
benefits of exercising in their lifestyle and behavior. The patients should be motivated to engage
in achieving their passion which can be either painting, singing or many more, such activity aids
in making their behavior more positive and help them to distract from the symptoms and
complications of disease.
2Design a new behavioral intervention to support the psycho social needs of a patient group of
your choice
People during the age group of 25-45 may suffer from diabetes, such individuals are
tending to lose their power of making decisions and thinking more likely as compared to those
who get such disease at the later stage of lifeiv. Due to such evidences the patients who acquire
the disease around this age may get more depressed and stressed, they become frustrated
very easily and suffer from major mood swings. The normal health of such individuals are very
important for the sake of their family as well as their children. Some of the behavioral
interventions for such patients are counseling,
 Feeling lethargic, less productivity, inability to concentrate, loss of appetite, suicidal
thoughts, isolated feelings are some of the symptoms which may be experienced by the
patients suffering from diabetes, due to which depression arisesv.
 Aggressive and depressed action of patients due to diabetes may negatively harm their
work life and reduces their efficiency. Such people should seek help from health
practitioner to deal with their behavioral issues so that they can become more productive
and can realize their self-worth.
 The health providers especially diabetes clinicians are the one who can easily identify
the victims who are depressed but does not have enough resources for treating
depression. Such people should be treated very carefully and proper behavioral
intervention must be employed to these people.
iv Gonzalez JS, Tanenbaum ML, Commissariat PV. Psychosocial factors in medication
adherence and diabetes self-management: implications for research and practice.
American Psychologist. 2016 Oct;71(7):539.
v Hagger V and et.al., Diabetes distress among adolescents with type 1 diabetes: a
systematic review. Current diabetes reports. 2016 Jan 1;16(1):9.
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 Counseling can be primarily adopted for easing the patients from the negative effects of
diabetes. Primary care clinicians and health practitioner should employ different way to
counsel the patients for lowering the depression level.
 The counselors should interact to such patients deeply and must assure that the society
and their family members are in their support. They should have the power to make the
patients realize that the stress and anxiety is normal and they should not panic more and
must concentrate on their future.
 Cognitive behavioral therapy may be provided for short duration for altering the
behavioral distortions and regulating the behavioral outcome of such patientsvi. The
therapy contributes in solving the issues either related to health or personal life and also
promote the chance of regulating as well as maintaining the emotions. Thus, it can alter
the way a person feels and make them healthy mentally.
From such aspect it can be concluded that people belonging to 25 to 45 age group suffer
from diabetes depression. Behavioral intervention like Counseling and cognitive behavioral
therapy can be adopted effectively for improving the behavioral condition and emotional
perspective of such individuals for managing the disease.
3Draw a logic model for your chosen intervention
Inputs Intervention Activities Outcomes Ultimate
Outcomes
 Funding
 Staff
 Time
 Health
 Training
and
Technical
assistanc
e
 Counselling Counselling
 use care
plan
 track
referrals
 improve
communica
tion
 provide
 High
underst
anding
betwee
n
patient
and
counsel
lor
 Improved
quality of
care
 better
clinical
outcomes
 lower
mortality
 reduced
vi Hood KK and et.al., Psychosocial burden and glycemic control during the first 6 years
of diabetes: results from the SEARCH for Diabetes in Youth study. Journal of
Adolescent Health. 2014 Oct 1;55(4):498-504.
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 Patient
and
practice
level data
 Cognitive
Behavioural
Therapy
education
Cognitive
Behavioural
Therapy
 resolve
problems
 develop
personality
 communic
ate at
different
level
 offer after
hour
assistance
 catharti
c
experie
nce
 Enhanc
ed
family
and
patient
bonding
 high
producti
vity of
patient
 high
resolvin
g power
of
issues
 lower
health
cost
stress
 improved
patient
experienc
e
 better
providers
experienc
e
 enhanced
personalit
y
 more
preventive
care
 less
depressio
n
 less
anxiety
Logic model have been defined as a process of representation through graphic which
shows the connectedness between the activities, resources, outcomes, outputs and the impact
of the diabetes program so as to reduce the level of depression in such patientsvii. It
demonstrates the relationship among the health providers as well as the activities which are
being held in such programs. The inputs which are required for the behavioural intervention are
vii Lyons SK, Libman IM, Sperling MA. Diabetes in the adolescent: transitional issues.
The Journal of Clinical Endocrinology & Metabolism. 2013 Dec 1;98(12):4639-45.
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funding, staff, time, health, training, technical assistance, patient and practice level data.
Counselling have been utilised in this program as an effective behavioural intervention,
such approach assists a diabetic depressed people in verbalising and making the thoughts
clearer from the perspective of oneself as well as from the others. Interacting the problems and
the issue either to the health practitioners or to the primary care clinicians whether it is related to
social or personal life helps in lowering the negative effect of depression and further aid in
looking to the positive outcomes. Such sharing may lead to cathartic experience which give the
feeling of relieved and satisfaction and make the mind of people less weight and relaxed. By
utilising care plan, tracks referrals, improving communication and providing education the
diabetes depression can be easily managed in the age group of 25 to 45. The issue such
victims are facing with their families are also regulated form such programs, these methods
make the person realise their worth in their family’s life and make them realise their importance
in their children career and education. The suicidal thoughts and isolated feeling due to diabetes
gets highly managed by such approach.
Cognitive Behavioural Therapy has been popularly utilised as a talk therapy which can
effectively lower the depression level of various people, the stress which are being caused by
diabetes is quite normal and can be mitigated by mutual understanding among the health
provider and the patientviii. The psychotherapy sometimes works more productively by
antidepressant and few drugs which have commonly prescribed by the doctors for regular stress
or anxiety. The therapy helps in identifying the issues more clearly while talking to the patients,
the health providers also become aware of the rational as well as the irrational thoughts which
may be formed in victim’s mind due to the effect of disease. Such therapy assists in
understanding an individual’s actions and behaviour more precisely and constructively. Both of
the behavioural intervention helps in achieving Improved quality of care, better clinical
outcomes, lower mortality, reduced stress, improved patient experience, better providers
experience, enhanced personality, more preventive care, less depression and anxiety.
4How ethnicity, culture and religion affect treatment and adherence
The factors like religion, ethnicity and culture have a great influence on the treatment
and adherence of diabetesix. All the variables determine the risk factors as well as the
probability of having diabetes in an individual. The altering element like ethnic, religion, age,
viii Nicolucci A and et.al., Diabetes Attitudes, Wishes and Needs second study
(DAWN2™): Cross‐national benchmarking of diabetes‐related psychosocial outcomes
for people with diabetes. Diabetic medicine. 2013 Jul;30(7):767-77.
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gender and culture are some of the factors which have an effect on medication adherence. All
the health providers and clinicians must take a serious consideration on the impact of cultural as
well as religious background on the values and beliefs of health which further render extensive
care to the diversified ethnic people so as to deliver better treatment and medication adherence.
Ethnicity
It has been clearly observed that Alaskan Natives, Native Americans and Hispanic
Americans have more possibility of mortality from the diabetes when compared to Non-Hispanic
White due to the occurrence of high strokes and cardiovascular disease due to diabetesx.
Moreover, countries like India, USA and China has highest occurrence of diabetes due to their
irregular eating habits and unhealthy food. Type 1 diabetes has been demonstrated to prevail
less than type 2 diabetes in mostly all cases. Such form of diabetes is more frequent and high
occurring in adolescence and children. It has been suggested that in temperate part of world
Type 1 diabetes are highest in number and lowers drastically towards the equator. Type 2
diabetes on the other hand is widely spread in more than 90% of the population worldwide. The
people belonging to under privileged society and people sharing same language and ancestor
may have trouble in getting treatment and medical adherence. Such people sometimes cannot
afford to pay bills of daily medicines and insulin due to lack of funds and appropriate resources.
The people belonging to ancestor who were more privileged and had access to lots of resources
and facilities are more accessible in terms of treatment. The group of individuals belonging to
under favored community as well as person sharing common speech and ascendant may face
number of hassles in acquiring attention and medical adherence.
Culture
The medical care providers may not work collectively so as to render culturally
competent care, due to which the patients receive degraded quality of care and later results in
more health consequences. The people belonging to culture like Muslim, Latinos, Asian
Americans and African Americans may have reported to receive poor quality of care in context
to their diagnosing, treatments and medications. The perception of doctors as well as the
ix Sieverdes JC and et.al., Improving diabetes management with mobile health
technology. The American journal of the medical sciences. 2013 Apr 1;345(4):289-95.
x Stuckey HL and et.al., Personal accounts of the negative and adaptive psychosocial
experiences of people with diabetes in the second Diabetes Attitudes, Wishes and
Needs (DAWN2) study. Diabetes care. 2014 Sep 1;37(9):2466-74.
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counselors may change due to the varying class of culture and their preferences. The risk
factors are also one of the factor which may be influenced by the culture. People of some
culture have the tradition of eating sugary food and tends to drink alcohol as well as smoke on
daily basis as per their culturexi. Such factors act as an effective risk factor which give rise to the
diabetes and further complicate the welfare of people. Such patients when seek help to the
health care provider may not get better even after proper consultation, this is because people of
such culture are more likely to eat unhealthy and unbalanced diet which later complicate the
health condition and does not benefit in the betterment of disease. Identifying patients culture
and making positive awareness in terms of their lifestyle and habits help in making the situation
better. Cultural belief is very important to be kept by people who are receiving chronic treatment
from health practitioners for diabetes, patient’s acceptance and their subjective beliefs about
health outcomes should also be regarded equally.
Religion
The role of diabetes and religion have been observed from many years, the monks who
are practicing yoga and more religious practices tends to have less possibility of getting
diabetesxii. Even if they acquire such disease they employ practices like daily yoga, eating
healthy diet and coping with the symptoms very effectively that make the treatment more
productive and efficient. Some religious follows such customs which make their eating habits
different from other, like some religion celebrate such festivals which require to eat lots of
carbohydrates, this practice leads in risk factors for diabetes. Some religion has values which
make the injection of insulin not effective, thus hampering the treatment process and
medication. It has been significantly observed that positive religious value and beliefs alleviates
the exposure of patients to psycho social impact of respective disease. While those who have
negative spiritual and religious beliefs drastically lowers their adherence to health care and
support.
xi Tol A and et.al., Empowerment assessment and influential factors among patients with
type 2 diabetes. Journal of Diabetes & Metabolic Disorders. 2013 Dec;12(1):6.
xii Vileikyte L, Gonzalez JS. Recognition and management of psychosocial issues in
diabetic neuropathy. InHandbook of clinical neurology 2014 Jan 1 (Vol. 126, pp. 195-
209). Elsevier.
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CONCLUSION
From the above report it can be concluded that, behavioral intervention plays a very
significant role in improving the condition of diabetes. Diabetes self-management education and
Enhancing motivation are behavioral intervention which are being utilized in treating behavioral
alteration. Cognitive Behavioral Therapy and counseling are used at the age group of 25 to 45
for lowering the depression. Cultural, religion and ethnicity influences the treatment and
medication.
REFERENCES
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