In adults aged 65 and above with type 2 diabetes in a rural community in Miami, Florida (P), does the implementation of a community-based diabetes self-management education program (I) compared to standard care (C) result in improved glycemic control, reduced diabetes-related complications, decreased healthcare utilization, and enhanced quality of life (O) over a 12-month period (T)?
CAPSTONE PART 1
Poor Glycemic Control in Diabetes Mellitus Type II
Introduction
The practice problem is essential in addressing inadequate glycemic control among individuals aged 65 and above who have been diagnosed with type 2 diabetes and live in a rural community in Miami, Florida. The primary objective is attaining enhanced glycemic control, reduced incidence of diabetes-related complications, low use of healthcare services, and enhanced quality of life among adult patients who have Type 2 diabetes within a span of 12 months (Almutairi, et al., 2020). This matter holds significant significance within the realm of nursing practice, as nurses play a pivotal role in educating and providing support to patients diagnosed with diabetes (Mamo, et al., 2019).
PICOT
In adults aged 65 and above with type 2 diabetes in a rural community in Miami, Florida (P), does the implementation of a community-based diabetes self-management education program (I) compared to standard care (C) result in improved glycemic control, reduced diabetes-related complications, decreased healthcare utilization, and enhanced quality of life (O) over a 12-month period (T)?
The vulnerable Population
The practice problem that has been identified is of great importance, as it focuses on the issue of inadequate management of blood sugar levels among individuals aged 65 and above who have been diagnosed with type 2 diabetes in a rural community in Miami, Florida.
This case examines adult populations who are above years diagnosed with diabetes 2 and living in rustic areas. This is one of the populations considered to be vulnerable due to a combination of risk factors. These individuals often need help with various obstacles, such as the restricted availability of healthcare services, especially in geographically isolated regions where healthcare facilities may be scarce or situated at a significant distance (Almutairi, et al., 2020). Lower socioeconomic status is a commonly observed risk factor, as it can hinder individuals’ capacity to financially afford crucial medications, routine medical examinations, and essential lifestyle adjustments.
The presence of limited health literacy poses additional challenges, as it impedes individuals’ comprehension of strategies for managing diabetes and their capacity to comply with prescribed treatment regimens. Furthermore, the limited accessibility of specialized resources for diabetes care, such as healthcare professionals possessing extensive knowledge in diabetes management, is frequently restricted in rural regions. The combination of these factors collectively contributes to disparities in health within the population, resulting in elevated rates of complications and heightened utilization of healthcare services among this susceptible group.
Proposal
Components of the education program
Diabetes Basics: This program will start by providing an overview of Type 2 diabetes, its causes, the risk factors, and the importance of glycemic control. The program participants will understand how diabetes affects their bodies and the potential complications of poorly managed diabetes.
Blood Sugar Monitoring: Participants will be educated about the importance of monitoring blood sugar and how glucometers are used accurately. They will be educated on how to interpret blood sugar readings and identify patterns to make informed decisions on managing diabetes.
Nutrition Education: healthy eating habits and the role of a balanced diet will also be included in this program as an essential part of helping manage blood sugar levels. Participants will learn about carbohydrate counting, portion control, and making healthier food choices.
Physical Activity: regular physical activity in diabetes management is an important aspect and will be emphasized in this program.
Medication Management: adhering to prescribed medications and understanding the effects of medications on blood sugar levels is an essential component that will be covered in this program. The Participants will be educated on the potential side effects and the significance of timely medication intake.
Stress Management: Stress impacts blood sugar levels, so participants will be taught stress management techniques. Relaxation techniques, mindfulness exercises, and coping strategies will be introduced to help manage stress effectively.
Self-Monitoring and Goal Setting: Participants will be educated on monitoring their progress regularly and setting realistic goals for their diabetes management.
Peer Support and Networking: Group sessions will allow participants to share experiences and support one another. Peer support and networking can foster a sense of community.
Self-Management in Diabetes: This can be defined as people’s active participation in managing their condition to help achieve optimal health outcomes. This will include blood sugar levels monitoring, prescribed medication adherence, healthy lifestyle choices, and ensuring timely medical care. The Participants of the education program will help in empowering them with knowledge and skills that will help in controlling diabetes and making informed decisions that will help improve the patient’s glycemic control.
Research
The research for this capstone project will involve scholarly journals with evidence-based interventions addressing the problem of “poor glycemic control in type 2 diabetes” (Almutairi, et al., 2020). The research will use peer-reviewed research articles not older than five years. This will help in supporting the discussion and proposed intervention.
Proposal
The proposed intervention is the implementation of a community-based diabetes self-management education program in the selected population and setting. This intervention will require resources such as educational materials, trained healthcare professionals, community partnerships, and access to appropriate technology. Feasibility for a nurse in an advanced role involves coordinating and leading the program, collaborating with community stakeholders, and providing ongoing support and education to participants. A timeline for the proposed intervention will be outlined to ensure efficient implementation and evaluation. The implementation of an education program empowers individuals to take control of their health, equipping them with the necessary knowledge and skills to effectively manage their condition, resulting in improved health outcomes and overall well-being.
Theoretical Framework/Nursing Theory
For this capstone project, Health Belief Model will be serving as the theoretical framework. This model explains and predicts health behaviors of people based on their beliefs about various issues. Some of these issues include “susceptibility to a health problem, the severity of the problem, the benefits of taking action, and the barriers to change” (Anuar, et al., 2020). By applying this theory, the project aims to address the significance of poor glycemic control, promote self-management behaviors, and increase the uptake of the proposed intervention. The Health Belief Model provides a foundation for understanding the factors influencing health behavior change in the targeted population.
There are various prospects for future research, encompassing the evaluation of the enduring effectiveness and cultural suitability of a community-based diabetes self-management education program targeting a diverse population of elderly adults residing in the rural Miami region. Additionally, it is imperative to conduct a thorough examination of the integration of technology, as well as a meticulous evaluation of the impact of peer support and health literacy on glycemic control.
References
Almutairi, N., Hosseinzadeh, H., & Gopaldasani, V. (2020). The effectiveness of patient activation intervention on type 2 diabetes mellitus glycemic control and self-management behaviors: a systematic review of RCTs. Primary care diabetes, 14(1), 12-20.
Anuar, H., Shah, S. A., Gafor, H., Mahmood, M. I., & Ghazi, H. F. (2020). Usage of Health Belief Model (HBM) in health behavior: A systematic review. Malaysian Journal of Medicine and Health Sciences, 16(11), 2636-9346.
Mamo, Y., Bekele, F., Nigussie, T., & Zewudie, A. (2019). Determinants of poor glycemic control among adult patients with type 2 diabetes mellitus in Jimma University Medical Center, Jimma zone, south west Ethiopia: a case control study. BMC endocrine disorders, 19, 1-11.
Tefera, Y. G., Gebresillassie, B. M., Emiru, Y. K., Yilma, R., Hafiz, F., Akalu, H., & Ayele, A. A. (2020). Diabetic health literacy and its association with glycemic control among adult patients with type 2 diabetes mellitus attending the outpatient clinic of a university hospital in Ethiopia. PLoS One, 15(4), e0231291.
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