Primary Health Care Nursing Role in Diabetes Management

This essay delves into the critical role of primary care nurses in managing diabetes mellitus within the United States, examining the complex interplay of social determinants of health, including access to healthcare, discrimination, and health literacy, which significantly impact the prevalence and progression of the disease. It analyzes epidemiological studies, such as those from the Bangladesh Demographic and Health Survey and the National Health Interview Survey, to illustrate the prevalence and risk factors associated with diabetes. The essay also outlines the responsibilities of primary care nurses in patient care, education, and support, emphasizing the importance of cultural competence in addressing the diverse needs of patients. By integrating cultural sensitivity into care, primary care nurses can improve patient outcomes and promote health equity within the US healthcare system.

Running head: PRIMARY CARE 1
Primary Care
Student’s Name
Institutional Affiliation

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Introduction
Primary health care is the vital care relying on the practical, reliably sound and humanly
convenient approach and technology made universally available to people and households in the
society via their full cooperation and at a cost, they can afford (Bitton et al., 2017). The essay
explains the social determinants of health as well as how they impact the solving of the health
issue and interpret epidemiological studies conducted identifying the issue. Moreover, it analyses
the responsibility of the primary health care nurse in the selected nation and discusses what they
are doing to help solve the issue. Lastly, the essay reflects on the use of cultural competency in
the obligation of primary health care nurses in supporting the issue.
Social determinants of health
Researchers have identified the necessity to regard factors extrinsic to the people which
are the social determinants of health to attain an objective of continuous advancement in health
results. Social determinants of health are described as socio-economic factors that impact
people’s wellbeing. Health equity is a recognized precedence within key US public health
measures (Haire-Joshu & Hill-Briggs, 2019). Since the increase of diabetes to recognize cultural
and socioecological health discrepancies, publicly, attaining health equity at the American
population level will necessitate resolving health equity in people with, and at peril of diabetes.
Access to health impacts the development and progression of diabetes mellitus (Brown &
McBride, 2015). Deficient of health coverage is an obstruction to medical attention that might
elevate the risks associated with diabetes expenses as well as complications. Although high rates
of the people having diabetes face significant difficulties in access to medical services, the
Affordable Care Act is intended to offer access to insurance for formerly not assured people
(French, Homer, Gumus & Hickling, 2016). Moreover, people with earnings under 138 percent

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of the Federal Poverty Level obtain access to Medicaid insurance and those with earnings over
the poverty level in all countries acquire access to private coverage schemes in health coverage.
This factor ensures equity of health services regardless of the socioeconomic status of people.
Exposure to racism and discrimination is linked to poor health outcomes from patients
with diabetes (LeBrón, Spencer, Kieffer, Sinco & Palmisano, 2019). It indirectly increases the
risk of a person’s disorder by limiting access to care, access to preferences of patient’s care as
well as the access to quality of care. For instance, diabetic individuals who are LGBT (lesbian,
gay, bisexual, transgender) experience health disparities because of discrimination. However,
various initiatives have been enforced in this concern which entails offering supportive social
services as well as offering medical students with access to LGBT clients to elevate the delivery
of culturally competent care (Bolderston & Ralph, 2016). These measures promote social justice
because it facilitates the provision of care for these people regardless of sexual orientation.
Furthermore, health literacy influences diabetes mellitus. It is vital for patients with
diabetes to have knowledge about the signs and symptoms of hyperglycemia and hypoglycemia
and how to correctly self-administer treatments to control the disease. Low health literacy is
frequently related to worse insight of diabetes (Reisi et al., 2016). Moreover, low health literacy
and numeracy are related to lower confidence or self-efficacy in controlling the disease and
having a greater BMI. Nonetheless, the American Medical Association has made several
strategies and recommendations available which address health literacy and numeracy limitations
in the health care environment (Watts, Stevenson & Adams, 2017). In this way, health equity is
enhanced since all the diabetic issues of the literate and illiterate people will be addressed.
Epidemiological studies

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Diabetes mellitus is the sixth dominant source of deaths in America and it affects
approximately 25.6 million people of over 20 years (Clark & Utz, 2014). This disease puts the
person at peril for severe indelible problems like cardiovascular disorder, hypertension,
neuropathy, end-stage kidney disorder, and untimely death. The approximated yearly expense for
diabetes and its culminating problems was 245 billion dollars in 2012.
A study that was conducted using information from the Bangladesh Demographic and
Health Survey (DHS) in coordination with the Bangladesh National Institute of Population
Research and Training. Probability cases of males and females were chosen for interviews
utilizing a two-stage stratified cluster sample of families (Akter, Rahman, Abe & Sultana, 2014).
The main sampling units each of which involved 120 families on average were chosen from the
most current poll enumeration regions. Results from the study indicated that people with
diabetics were more probable to originate from a family with tremendous socioeconomic status,
that is, 40.7 percent originated from the affluent quintile while 12.7 percent arose from the scanty
quintile.
Another study was conducted in 2016 and 2017 where the National Health Interview
Survey (NHIS) examined a sample of 319 of 1700 ecologically delineated prime sampling units
in each of the 50 states and the District of Columbia (Xu et al., 2018). Among the people of age
20 and above who had received a diabetes diagnosis, a prevalence of 9.7 percent was diagnosed
with diabetes. The prevalence of type 1 diabetes was 0.5 percent while the incidence of type 2
diabetes was 8.5 percent. Type 2 diabetes was most common amidst males and those having
lower family income and lower education levels as well as higher BMI while type 1 diabetes was
most dominant amid individuals with declined education levels.

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Moreover, a cross-sectional survey data of 1980-2017 from the NHIS were used to assess
tendency in incidence along with prevalence of diabetes prognosis amidst the non-
institutionalized, US civilian people at the age of between 18 and 79 years (Benoit, Hora,
Albright & Gregg, 2019). Before 1997, interviewees were questioned if anybody in the
household had been diagnosed with diabetes throughout the previous 12 months. Commencing in
1997, for interviewees who indicated to have the disease, occurrence cases were recognized by
deducting the interviewee age at the assessment from the age of diabetes diagnosis. The
interviewees having a value of 0 and a half with a value of 1 were regarded incident cases. From
the survey, it was found that the trend in detected diabetes incidence amid demographic
subpopulations as well as education, ethnicity, sex and age groups was equivalent to the general
age-adjusted incidence from 2009 to 2010 through 2017. Besides, grown-ups having more than a
high school education were an exclusion to the tendency as incidence endured to escalate
gradually from 2005 to 2017 (Benoit et al., 2019).
Primary health care nurse in America
Primary health care nurse is a nursing practitioner who works in a primary health care
environment and must be skilled in a variety of daily basic nursing operations. As a primary
health care nurse, one has to face a broad range of medical issues like typically minor illnesses
like allergic reactions and colds. They specialize in general family medicine and look after
patients of all ages (Barber & Mullen, 2017).
The primary health care nurses are the first clinical practitioners that most of the patients
come into contact with even before their first scheduled appointments. They may be in charge of
manning the phones in busy health care institution offices which involves scheduling
appointments and documenting patient's information.

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Furthermore, primary health care nurses are responsible for conducting the initial patient
physical examination which entails measuring and recording things like vital signs, weight, and
height (Barber & Mullen, 2017). Also, they normally listen to and document any symptoms of a
disease and if necessary may collect samples like blood or mucus which be studied later in a
laboratory to help in diagnosing infections and diseases.
Primary health care nurses are often responsible for direct patient care like treating a
patient after a diagnosis has been made depending on the injury or illness which entails changing
dressings or providing medications. Moreover, they are responsible for conducting regular
check-ups and may also be needed to administer vaccinations and aid during health screening
(Barbiani, Nora & Schaefer, 2016).
Understanding how to manage diabetes and maintaining blood glucose in reasonable
standards have become the biggest threat for diabetics indicating the relevance of patients’
education. Primary health care nurses are fulfilling a prominent responsibility in diabetic therapy
and care education as they can provide compelling quality care at lower expenses. Utilizing the
primary health care nurse's expertise in delivering care for diabetes in distinct medical, social and
educational units, benefiting from these nurses in the education program reduces the number of
futile transfers to professionals. Also, it minimizes the cumbersome load of such visits imposed
on the community.
Use of cultural competence in the Primary Health Care nurse role in supporting diabetes
Cultural competence in primary health care is widely exemplified as the capability of
primary health care nurses and facilities to comprehend and integrate factors like ethnicity,
occupation, sexual orientation, language, and gender in the delivery of health care systems. As a
primary care nurse, I recognize that people with chronic diseases like diabetes need more health

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services, thus growing their cooperation with the health care system is vital (Skinner, Gardner &
Kelleher, 2016). If we are not working collaboratively with institutions and systems to offer
culturally competent attention, clients are at increased peril of acquiring adverse health
complications, obtaining scanty quality of care or being displeased with the attention given.
Developing proof regarding culture and health highlights the relevance of considering
and employing cultural concepts as a part of diabetes care and education (Zeh, Sandhu, Cannaby,
Warwick & Sturt, 2016). Including cultural ideas into diabetes care and education that aim
cultural groups lead to greater patient contentment. To be competent in reassuring patients to
make beneficial food alternatives and improve health results, we acquire specific understanding
regarding food behaviours, practices, and preferences for the cultural and tribal groups we see in
our routine operation. From that perspective, patients have the impression that they are
comprehended and their values, attitudes, and beliefs are been appreciated (Zeh et al., 2016).
Conclusion
Diabetes mellitus is very common in America and social determinants of health
contribute to its development or decline its progression. These social determinants include
discrimination, access to health care along with education. When health care services are
accessible to all the people regardless of their socioeconomic status, that improves health equity
and if these services are given regardless of ethnicity or gender, it promotes social justice.
Culturally competent diabetes care is widespread and language barriers are addressed. Moreover,
for primary health care nurses to provide culturally competent care, they must understand the
values, behaviours as well as the beliefs of their patients. In that way, patients will be satisfied
with the services given to them.
References

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