Nutrition and Diabetes

Type two diabetes is a chronic disease caused by different lifestyle factors, with a focus on diet, and is the leading cause of morbidity and mortality in Australia (Ball, 2016). Many patients who are diagnosed with type two diabetes manage this by seeing a primary health care provider. Since diet plays such an important role in the progression of this disease it is vital that these patients maintain a healthy, balanced diet. The United Kingdom Prospective Diabetes Study has shown that establishing short-term optimal glycemic control in the early stages after diagnosis reduces the risk for both macrovascular and microvascular complications, as well as all-cause mortality 10 years after diagnosis (Murray et al 2010). After diagnosis patients receive nutritional care from their doctors or nutritionists. Ensuing these interventions patients typically modify their diets but, the changes were short-lived. In this article the reasons for the temporary modifications are analyzed. The method used for this study was a longitudinal, qualitative design with the goal of describing the perceptions and experiences of patients who were recently diagnosed with type two diabetes. All the chosen individuals were involved in three telephone interviews; one at baseline, 3 months, and 6 months. Each interview lasted between 30 and 60 minutes, were semi structured, and probative.

Research Article

There are a couple of problems that this research was focused on. The main concern was the lack of adherence to diet modifications after diagnosis of type two diabetes and nutritional guidance. The other issues involved open communication with health care providers and patient relationships which then lead to the decrease in ongoing engagements with healthcare providers. The purpose of this research was to explore patients’ perceptions of their diagnosis of type two diabetes mellitus, understand their experiences of dietary adjustments, and explore their views on how healthcare providers can support long term dietary changes. Because diet has such a big role in self-management of diabetes it is important for healthcare providers to understand the experiences of their patients. These three topics are important to address because it has a direct impact on the patients’ success in handling their chronic illness in the future. The nursing intervention that was the focus of this article was open communication and relationships with their patients.

The findings of this article were broken down into three categories; adjusting to diagnosis, modifying dietary behaviors, and receiving support from healthcare providers. In the adjusting to diagnosis category patients described feeling “shocked and surprised at being diagnosed with T2DM” (Ball 2015). After those feelings of shock went away they then had negative feelings toward diet because they considered themselves to have eaten a healthy diet. In the modifying dietary behaviors category, the experiences of the patients during diet changes were addressed. Some experienced emotional and food preparation challenges in the beginning, then progressed to having little issues keeping up with the diet modifications, which then halted because the participants felt restricted with their diets. The last category, receiving support from healthcare provider, seemed to have the most issues. Many participates expressed feeling overwhelmed by the information they received as well as having challenges within interactions with the dietitians because of the instructional nature of the care provided (Ball, 2015). In this situation the participants began to feel as though they were an item on the list of things to get done. They also felt as though there was no room for individualization for their dietary changes. The biggest issue for patients seemed to be that they felt rushed and not heard in consultations because open communication was not always achieved (Ball, 2015). The participants felt like they weren’t heard and therefore had limited engagements with healthcare providers in the future.

Reflection

Nursing care is composed of several different things such as building therapeutic relationships and open communication. While building a therapeutic relationship, it is important that we establish rapport and trust with our clients. I think that those are the building blocks which eventually lead to an increase compliance with all treatment modalities. Better adherence and compliance leads to better outcomes for the patient. Another important way to view building therapeutic relationships is that now there is a partnership and the patient doesn’t have to feel like they are alone when it comes to their healthcare. As Ball stated in the article, patients began to feel overwhelmed with the information they were receiving from different sources, so it is our responsibility to help them, but we can’t do that without first establishing a relationship. With patients, especially those who were recently diagnosed with a chronic condition, building a relationship is extremely important.

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