From the above literature review, it is evident that nurses play a significant role in the management of diabetes. One of them is that nurses Offer support services to the diabetes patients since self-management is a complex process which requires professional input. According to Bostrm et al (2014), the role of the professional nurse has been altered in order to offer a patient-centered care to the diabetes patients.
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It asserts that the role of the nurse has been subdivided into two main distinct categories which include ambivalence towards practicing patient-centered care and bolster relationships with the patient. This was based on three themes which include withdrawal from expertise, inconveniences of altering the routines as well as the insights that patient-centered care is hard to partake but it is possible to attain its objectives.
Furthermore, the authors indicated that nurses enrich diabetes patients with the courage to openly discuss the adverse effects of diabetes and ensure that there is close engagement between the patient and the nurse on a daily basis. Also, Moser et al. (2008) assert that self-management among the diabetes patients is a dynamic and complex process that is highly dependent on the unique life situation of an individual. Therefore, in order to achieve a better health outcome among the diabetes patients, there is a need for the diabetes specialist nurses as well as the caregivers to support the patient in self-managing diabetes condition. This helps in attaining quality health outcome among the diabetes patients due to the close relationships established.
Nurses also play a critical in educating the patients and other family members especially for the children with diabetes type 1. Children who are diagnosed with diabetes are hospitalized where the family members and the children will get initial diabetes education while in the hospital setting (Sy, V. (2016). As cited by Sy (2016), Nettles (2005) indicated that when the blood glucose of the children have been stabilized and acidosis corrected, the patient can be allowed to go home specifically after three days.
Due to the limited time between the nurse, the patient and the family members, it makes it hard to achieve the desired education that ensures effective self-management. The patient will, therefore, go home without adequate support hence making the transition to home difficult (Sy, 2016). Furthermore, according to Lawton (2009), it was not easy to achieve holistic acre among the diabetes patients as they perceive nurses as not always present for other health illnesses. This makes the patient not to take much attention to the guidelines given by the nurses since the reassurance by the healthcare professional helps them believe that their condition is well controlled.
Since the clinical nurse specialist is the only healthcare practitioner that is relied on for providing education to the patient and the family members, it makes it hard to achieve the specific health care goals which include adequate support and smooth transition to home. However, given the challenges that are faced by the patients in transiting to home and inadequate support from the nurses, most of the nurses have been trained on multidisciplinary collaborations especially on the aspect of the protocol. The clinical nurse specialists, therefore, have come up with the diabetes resource cart that comprises all the necessary tools for diabetes education (Sy 2016). These materials are made available to the nurses and are outcome oriented. It is through this that nurse confidence in the treatment of diabetes will increase.
While it is hard for many people to achieve the treatment targets if diabetes which makes it at a higher risk of complications, there are various methods that can be applied by the nurses to address these challenges. Diabetes is one of the chronic diseases which requires the use of advanced therapy and effective communication and feedback to ensure successful self-management (Ceriello et al2012). Furthermore, the authors indicated that nurses can use the individual profile to enhance adherence to therapy among the diabetes patients to improve outcomes of treatments.
The suggested approaches include the use of the six-step cycle for the personalized self-management of diabetes as well as the collaborative use of the structured blood sugar data. Nonetheless, nurses can use the electronic health solutions which allow for effective communication between the nurse and the diabetes patients in the remote areas which cannot be reached easily. Also, other facilitators that help nurses attain self-management of diabetes include algorithms and support tools which help them in making informed decisions regarding the condition of the diabetes patient.
In as much as nurses play a significant role in various aspects regarding the diabetes care, there is a gap that exists in the inpatient diabetes. In this regard, there are no clear relationships between the clinical specialties, employment status, age, level of education and the knowledge score (Modic et al., 2014). This means that nurses do not have confidence and are not fully prepared to make decisions regarding the patient care or even offer survival skills for those patients suffering from diabetes in the hospital. It is through this that will affect the self-management of the patients with diabetes in the sense that nurses are not fully prepared to address the challenges that face them. This results in low health outcome among the diabetes patients which makes it hard to manage.
However, treatment of hypertension, hypercholesterolemia and hyperglycemia can help reduce the mortality and morbidity in the people affected by diabetes (Zgibor et al 2014). Moreover, the authors indicated that the certified diabetes educators can help in offering a cost-effective strategy for managing diabetes. The tool, therefore, ensures timely diagnosis of type 2 diabetes which prompts the application of effective strategies which include education and support for the patient hence a better healthcare outcome.
The interventions applied by the nurses offer better improvements as compared to the normal care for the smoking cessation, serum triglyceride and HbA1c apart from enhancing the independent role of professional nurses in the management of diabetes (Daly, Tian & Scragg, 2017). In this case, nurses have played an important role in the management of diabetes which includes educating patients about the condition and lifestyle changes that they should take into consideration for effective management of the condition.
Nonetheless, nurses also guide patients in the self-management of the condition to eliminate the risk factors which are associated with the diabetes complications (Daly, Tian &Scragg, 2017). Alotaibi et al (2017) indicated that an actual knowledge among the nurses helps in the management of diabetes as compared to the perceived knowledge. It is so because the indicators of high levels knowledge provide ways in which nurses can teach people how to manage diabetes.
Nurses help in empowering the diabetics. This is through the enhancement of glycemic control as well as the life of the diabetes patients which necessitates a mix of education and treatment methods that can help in the management of the disease (Peymani et al., 2008). Several studies (Peimani, Monjamed & Asgharpoor, 2006) indicates that the dimensions of life quality specifically the physical activity, as well as the feeling of wellbeing, is worse for the diabetics as compared to those that are healthy. Therefore, nurses require adequate knowledge to assist in providing adequate care for the diabetics or those that are at high risk of getting diabetic.
Due to this, nurses play an important role in ensuring that diabetics are empowered to manage diabetes effectively by offering appropriate information to the patient and the family members through consultations (Fireman, Bartlett & Selby 2004). According to Khoshniat et al, offering proper education to the healthcare providers will not only enhance perfection and knowledge of the children about diabetes but instead, it enhances the quality of care provided at healthcare system (Khoshniat et al 2007). Finally, some studies have indicated that nurses are the major contributors to the enhanced quality of care accorded to the diabetics in the last two decades (Rafique & Shaikh 2006).
Given the important roles of the nurses in the self-management of diabetes among the patients, it is imperative to have a better understanding of the challenges that affect nurses in ensuring effective delivery of their services to the patients. To properly deliver quality care to the patients, there is a need for the nurses to be open minded so that issues such as cultural practices and beliefs do not adversely influence their role in the management of diabetes. Given the increased cases of the lifestyle diseases, there is need to empower nurses in various ways to enable them to educate and help patients with diabetes. By so doing, it will ensure a society that is free from diabetes and other lifestyle diseases which can be avoided by empowering nurses.
In the light of this literature review, there is strong connection between the theoretical framework themes of this study and the findings of reviewed articles. For instance, the study that is conducted by Moser et al (2008) correlates with one of the main components of Pender?s model and Orem?s self-care theory. The findings by Moser et al (2008) show that participants experience their autonomy, which is an essential component in both theories, through performing their diabetic self-management. Self-management is a set of activities that enables health care providers to understand and support patients autonomy.
Also, Moser et al (2008) stated that self-management is divided into three main categories accordingly to the findings. Daily self-management (daily routine of self-care) and Off-course self-management (actions in case of acute complication of diabetes) could fit under Orems self-care theory because these actions enable patient to maintain their daily functioning and meet their self-care demands.
However, the third category, Preventive self-management, embodies Penders model of Health promotion which focuses on prevention of any complication by changing certain behaviors in favour of optimal outcomes and maintaining the commitment to take action against any decrease in persons life quality. All articles insisted on the importance of patient education in self-management of diabetes as well on necessity of implementing patient-centered care. In this regard also both theories put self-care and continuing patient education as an optimal mechanism to enhance individual?s life quality.
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