Diabetes Patient Case Study: Endocrinology

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Mr. Xs situation can be analyzed through the lens of social determinants. The first determinant is health care access and quality, which means the utilization of individual health services in a timely manner to get optimum health results (U.S. Department of Health & Human Services, 2021). For Mr. X, this determinant is unfavorable since the nearest clinic for him is in two hours, which prevents Mr. X from visiting it and screening often. However, it is necessary to do it every three months or more for people with diabetes to determine the risks to their health (Woolston, 2022). Next, since Mr. X has already brought up his son and committed himself to the farm, education access and quality are not crucial for the case, as well as social and community context. Yet, a built environment (which is probably rural) might influence the access to healthy food, which is obligatory for Mr. X, while economic stability might not be enough to compensate for this situation. Thus, Mr. X experiences disadvantages in health care access, built environment, and financial stability.

The health priority for Mr. X should be monitoring his wound regularly to prevent complications. According to Villines (2022), many people with diabetes get damages that are sluggish to cure, do not heal properly, or never heal at all. Some bacteria in the injury can affect nearby tissue, bone, and other internal organs (Tchero et al., 2019). Hence, Mr. X must maintain his blood sugar levels in check in order to prevent the risk of sluggish wounds and comorbidities, such as foot ulcers (Better Health Channel, n.d.). Mr. X needs prompt care and efficient glycemic control to have a healthy perspective, after which he should concentrate on preventing infection by appropriate foot care and monitoring of the injury (preferably in the clinic).

The perspective of Mr. X and his wife should be taken into consideration when planning and providing healthcare. In fact, treatment must align with the needs and issues of the environment in which the patient lives. If the living conditions of the ill are not considered and prescribed care contrasts or disrupts the usual activity of a person, they will be reluctant and may ignore the medical recommendation. For example, Mr. X does not have the ability to visit the clinic often since it takes more than four hours each time, and this duration might be excessive for an independent worker. However, it is necessary that the blood glucose level of the patient is checked, as well as the development of his injury.

The other issue concerns the occupation of Mr. X and his wife, who are independent farmers. It is probable that the economic stability of their family depends on both the wife and husband, who participate in work every day. In the research by Loughman et al. (2021), farmers have been recognized as a high-risk demographic since farming has long been recognized as a physically demanding occupation. Thus, it is important to account for Mr. Xs active lifestyle, which sustains his profit, and it is possible that the patient might not want to abandon his work to prevent the complexities caused by the wound.

A nurse can demonstrate that they consider the patients lifestyle, situation, and environment by allowing Mr. X to limit the number of visits to the hospital. This action is possible if Mr. X is required to purchase and use a glucose monitor. Home glucose monitors can assist patients in managing their diabetes and reducing the risk of serious complications (Marcin, 2021). Along with medication, utilizing a home monitor can allow one to discover the factors in their life that cause blood sugar to rise or fall, such as exercise, sickness, stress, exhaustion, and other factors, which is useful for Mr. Xs situation with access to healthcare.

Clinical leadership is similarly essential as a consideration for effective treatment. According to Health Navigator (2022), clinical healthcare workers taking on leadership positions include creating, motivating, and supporting values and vision. Moreover, leadership implies using clinical knowledge and talents to ensure that the care needs are paramount to the organizations goals and performance. For example, a nurse might enact leadership every day by guiding the patient and other nurses in using digital communication to monitor the condition of Mr. X. Since the patient is not inclined to visit the hospital often, encouraging Telemedicine or other forms of remote care might be a beneficial option. The nurse should maintain the correct work of the digital system and ensure that the patients needs are satisfied. Another example of leadership is implementing the care plan for diabetic clients by the national health objectives. As such, the nurse could promote a healthy diet to prevent the problems accompanying the disease.

The next element in the successful health outcome for Mr. X is his advocacy. According to Indeed Career Guide (2021), patient advocacy provides people a voice in their hospital care and keeps them educated about the treatments and procedures available to them. Patient advocates explain everything that occurs on the part of patients. They answer inquiries and advise patients on treatment options. An illustrative example of patient advocacy for Mr. X would be instruction about the measures he must take to prevent complications of his injury. As such, he must protect his feet above all (and, indeed, the injury area) since nerves and tissues there are the most vulnerable. Secondly, Mr. X can be informed that the proposed solutions (including Telemedicine and a home glucose monitor) provide him an opportunity to stay at home and help his wife. However, if Mr. X engages in excessive physical activity, these efforts will be made in vain.

The assessment content has provided me with multiple concepts and practices that I would take forward in my clinical work. For example, I have learned that there is no standard treatment since each patient has unique problems and needs. Hence, patient care should address the situation with the social determinants of health in addition to the condition of the client. As mentioned by WHO (2019), the lower the socioeconomic position, the worse the health, which means that there are factors outside the medical domain that influence health, such as economic status (para. 2). As a result, the condition of a patient cannot be treated without the consideration of their social situation, which might contribute to or negatively influence the health outcome.

Finally, I have learned that not only factors external to the patient are essential (such as mentioned earlier), but the personal situation of the client determines the most appropriate treatment decision. As such, it is valuable to take into account the occupation of the client and its influence on their everyday activities, and, moreover, lifestyle is crucial to consider. As a result, a nurse should approach the treatment from a leadership and advocacy perspective so that to be a guide and a listener of the patients needs.

References

Better Health Channel. (n.d.). Diabetes  long-term effects.

Health Navigator. (2022). What is clinical leadership? Health Navigator New Zealand.

Indeed Career Guide. (2021). Patient advocacy: Definition, types and examples.

Loughman, T. M., Flaherty, G. T., Houlihan, A., & Dunne, D. (2021). A cross-sectional analysis of physical activity patterns, aerobic capacity and perceptions about exercise among male farmers in the Mid-West region of Ireland. Journal of Agromedicine, 27(1), 8797.

Marcin, A. (2021). 7 great glucose monitors and meters. Healthline.

Tchero, H., Kangambega, P., Fluieraru, S., Bekara, F., & Teot, L. (2019). Management of infected diabetic wound: A scoping review of guidelines. F1000Research, 8, 737.

U.S. Department of Health & Human Services. (2021). About social determinants of health.

Villines, Z. (2022). How does diabetes affect wound healing? MedicalNewsToday.

WHO. (2019). Social determinants of health.

Woolston, C. (2022). Summary of guidelines for patients with diabetes: Checklist for your doctor visits. Consumer Health News.

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