According to Husband (1988) planning is the most crucial phase where a nurse looks into all the aspects, concerns and/or problems are identified, and information is shared concerns and/or problems are identified and information is shared. Diabetes is a chronic issue and stressor is one component that an individual has to continually adjust. It is also stated that diagnosis of strengths of the patients is equally important than the problem.
Strengths are available resources to the patients are important in overcoming future problems. After reviewing the studies done by various authors it is certain that patient compliance with the self-care regimen can be increased through mutual goal setting and joint planning between the patient and nurse. Nurse should acknowledge the stressor because after discharge patients feel alone and they should have proper resources (Husband, 1988). Self-care is human behavior and it is one of the component of diabetes care. Self-care is self-directed. As a nurse it is our responsibility assess patient carefully and depending on individual need create a nursing diagnosis and nursing care plan.
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Another theorist Dorothea Orems has pioneered a theory that is known as Self-Care Deficit Nursing Theory (SCDNT) which has been used in nursing and helps to guide the nursing process and improve patient care with measurable results. According to Wagnild et al. (1987) Orems model may not be useful if a nurse is not able to adapt it to their settings. Nurses responsibility is to assist patients in self-care through encouragement, looking into the whole person, patient teaching and prioritized early discharge planning. To achieve the goal of self-care, Orem identifies two-step nursing process such as first nurse need to identify the deficit, patients unmet selfcare needs and then mutually plan on compensating the self-care deficits.
Research by Wagnild, Rodriguez, and Pritchett (1987) shows that this self care theory can also be implemented in acute care and hospital settings. Our institution in med-surg unit will be highly benefitted if this self-care theory has been implemented. Todays health care system encourages patient dependency which may conflicts with Orem’s SCOT. One is the nurse’s lack of orientation to the self-care concepts.
A study by Sarkar, Fisher, and Schillinger (2006) looked into low income patients with diabetes and there were significant barriers to the diabetes management such as cost of treatment, cultural belief, limited health literacy, comorbid conditions such as depression or chronic pain, patient-physician communication problems, economic barriers such as the cost of glucose test strips or medications worse glycemic control and poor knowledge of diabetes management as well as external barriers such as lack of safe space to exercise and accessibility of fresh foods. It is also noted that self-efficacy was significantly associated with diet, exercise, self-management of blood glucose, and foot care (Sarkar, Fisher & Schillinger, 2006).
Another study by Surucu, Kizilci, and Ergor (2017) shows that self-care deficit nursing theory (SCDNT) based nursing education has significantly lower HbA1c scores among the participants with type II diabetes. Thus, SCDNT was a good guide in planning the study and for the self-management education.
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