Applying Ottawa Charter: A Nurse's Role in Promoting Diabetes Health

This essay discusses the critical role of nurses in promoting the health of people with diabetes mellitus, utilizing the five major strategies for health promotion as outlined in the Ottawa Charter. It emphasizes the increasing global burden of diabetes and the importance of preventive measures. The essay explores how nurses can contribute to creating supportive environments for lifestyle changes, strengthening community actions, influencing health policies, developing personal skills for self-management, and reorienting health services to address cultural needs. By adapting these strategies, nurses can significantly improve the health outcomes and quality of life for patients with diabetes, focusing on self-care behaviors, community engagement, and culturally sensitive care.

Running head: NURSING
Nursing
Name of the student:
Name of the University:
Author’s note

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Diabetes mellitus is a metabolic disorder associated with high blood sugar level and
manifestation of symptoms of increased thirst, hunger and frequent urination. The burden of
diabetes is understood from the fact that more than 1.6 million deaths globally has been
caused due to diabetes in 2016. Lifestyle factors like weight gain, poor physical activity, poor
nutrition and diet and smoking are some factors that increase risk of diabetes. As it has
become a major public health burden because of increased risk of kidney disease, heart
disease, stroke and limb amputation due to diabetes, taking important preventive steps to
treat diabetes mellitus is critical for improving population health (World Health
Organization, 2018). The Ottawa Charter for Health Promotion can be an appropriate
guideline for planning strategies to promote health of target population group. The main
purpose of this essay is to discuss about the role of nurse in the five major strategies for
health promotion as identified in the Ottawa Charter and use them to promote health of
people with diabetes.
Diabetes mellitus is one chronic metabolic disease that not only affects human health, but
also increases the likelihood and emergence of cardiovascular disease and other chronic
disease. The burden of diabetes mellitus in Australia is understood from the fact that it was
the seventh leading cause of death in 2017. Overweight and obesity was the main cause
behind diagnosis of diabetes mellitus (Australian Bureau of Statistics, 2018). As lifestyle
factors increase the incidence of diabetes mellitus, nurse have a vital in educating patients
about risk factors and supporting them to promote overall health. The five strategies
mentioned by the Ottawa Health Charter is a useful framework for them to engage in health
promotion. These five strategies include building healthy public policy, creating supportive
environments for change, strengthening community actions, developing personal skills and

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reorienting health services (World Health Organization, 2019). Although the nurse do not
have the authority to fully implement the five strategies in promoting health of people with
diabetes, however they can work to use some of the strategies to influence health outcome of
people. Evidence suggests that five action areas of the Health Charter are associated with
health programme effectiveness and it has influences many aspects of health promotion
practice (Fry & Zask, 2016). Therefore, nurses can also gain effective guidance by using
these five actions areas to influence health of people with diabetes.
One of the five strategies for the Ottawa Charter of health promotion is to create a
supportive environment. This involves conducting systematic assessment of the environment
to understand its effect on health. Changing patterns pattern of life, work and leisure are
some part of this strategy (World Health Organization, 2019). This concept can be utilized by
nurse to understand how diabetes patient’s environment and pattern of leisure influence their
health. Pattern of leisure is linked to diagnosis of diabetes mellitus due to increased sedentary
time. People now engage in sedentary activities during leisure instead of vigorous activity.
Joseph et al. (2016) gives the evidence that total leisure sedentary behaviours and television
watching is directly linked with diabetes risk. Therefore, nurses can work to create a
supportive environment for patient by implementing education intervention related to
promotion of physical activity and self-care for this group of patients. By means of
educational interventions, nurse can focus on providing education regarding recommended
level of physical activity, suggestions to engage in sufficient physical activity and extending
knowledge to patients to overcome barriers to physical activity. They can also support
patients to increase physical activity by recommended them to regularly participate in sports
and make changes in their lifestyle (Zandiyeh, Hedayati & Zare, 2015).

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Another Ottawa Charter strategy is to strengthen community actions to promote health.
This involves taking concrete steps to utilize community based resource to enhance self-help
and supports and promote public participations in health matters. This strategy can be
adapted by nurse to promote health of patients with diabetes mellitus by ensuring that they
involve community members during care of diabetes patient (Thompson, Watson & Tilford,
2018). Nurse can collaborate with community members while delivering any public health
interventions. This will ensure that the community surrounding diabetes patients are
informed about risk factors of diabetes and they take appropriate steps to address health and
social conditions of vulnerable population who are most likely to suffer from diabetes
mellitus. By taking the steps to implement community focused solution, they can work to
change patterns and risk of diabetes in diverse population group (Kulbok et al., 2012). Nurses
can successfully adapt this strategy of the Ottawa Charter by adapting the leadership role.
The benefit of community engagement for diabetes is understood from the research by
Litchman, Edelman and Donaldson (2018) which revealed that online community
engagement increased access to practical advice and emotional support for patient. Increase
community engagement was also found to increase the likelihood of achieving better
glycemic levels.
The five actions areas of the Ottawa Charter emphasizes on putting health on the agenda
of policy makers by directing them to take responsibility for health. This involves
coordinated actions so that appropriate policy in the areas legislations, taxation and
organizational changes can be implemented to promote population health (World Health
Organization, 2019). Nursing practice does not have the scope to directly collaborate with
policy makers and provide them data regarding important areas related to diabetes mellitus

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where policy is needed. However, during assessment and work with patients, they can
identify key environmental and social factors that lead to diabetes mellitus and suggest
clinical leaders to adapt innovative methods to rectify loopholes that exist in current care
related to diabetes.
Nurses have the scope to work on the action area of developing personal skills. This
strategy of the Ottawa Charter for Health Promotion explains that developing personal and
social skills is necessary to enhance health. This is an important strategy as it can enable
people to make conducive choices about health and prepare themselves to cope with injuries
and illness (World Health Organization, 2019). In the context of management of patients
with diabetes mellitus, nurse can adapt this strategy practically by working to ensure that all
possible steps are implemented to develop self-care behaviours and self-management skills in
patient. Self-care is important for management of diabetic mellitus because certain specific
self-care behaviours like physical activity, healthy eating, monitoring of blood glucose level,
problem solving skills, coping skills, risk reduction behaviours and compliance with
medicine is necessary to reduce complications and improve quality of life of patients
(Shrivastava, Shrivastava & Ramasamy, 2013). However, despite this, adherence to desired
self-care activity has been found to be low in patient. Hence, nurse role is crucial to ensure
that patient adapt self-care skills and understand possible signs and symptoms that is
indication of complications. For example, they must have clear understanding regarding
blood glucose fluctuations and ways to cope with high blood sugar level.
Research literature gives numerous evidences regarding the action of nurse in improving
self-management skills of diabetes patient. Lawless et al. (2016) investigated about the
efficacy of a self-management intervention delivered by trained nurse educators. The

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intervention consisted of two steps of 12 weekly group based sessions and monthly follow-up
contact with patients. Nurse addressed patient factors like social support, diabetes
knowledge, outcome assessment, self-efficacy and stigma to develop self-management skills
of staffs. This resulted in creating a therapeutic environment for patient. Hailu, Hjortdahl and
Moen (2018) revealed that nurse led diabetes self-management education is associated with
improvement in clinical outcome of patient and reducing HbA1c value for the group.
Positive outcome was also obtained for blood pressure control and anthropometric measures.
These evidence show that nurse have a role in the Ottawa Charter strategy of developing
personal skills of clients. Different strategies like group based education, one-to-one
approach, audio message and video message is used by nurse to deliver such interventions.
The last strategy mentioned in the Ottawa Charter for health promotion is reorienting
health services. This means taking step to engage in shared decision making to modify
existing health services and taking the responsibility to be address sensitive and cultural
needs of patients. The main goal is to engage in proper collaboration with community
members and health service to ensure that attitude and organization of health services are
changes. Cultural preferences influences patient’s ability to adhere with self-care steps like
monitoring blood glucose level and using medications (Rebolledo & Arellano, 2016). Hence,
nurse can play a role in understanding cultural preferences and attitude towards daily self-
care in patient and orient health services according to cultural needs of patient. This will help
dispel treatment misconception and increase the provision for optimal care for the group.
From the discussion regarding the role of nurse in addressing the five strategies of the
Ottawa Charter for Health promotion, it can be said that nurses are better positioned to
address at least four of the five mentioned strategy. From the discussion regarding possible

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ways by which nurse can fulfil each strategy of the Charter, the essay revealed how creating
an appropriate environment for lifestyle change, reorienting health services, promoting self
management skills and community engagement can promote health and quality of life for
patients with diabetes mellitus.

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Hailu, F. B., Hjortdahl, P., & Moen, A. (2018). Nurse-Led Diabetes Self-Management Education
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