Dimensions of patient-centered care

The type 2 diabetes develops due to the high blood glucose level in the body. High blood glucose level can result in serious damage in the body organs. The effects and complications of type 2 diabetes one to be keen and work hard to keep his/her blood sugar levels under control. Patient-centred care practice is a useful practice which is crucial for type 2 diabetes patient and his/ her family in valuable and meaningful ways to the patient. As in the case study, the patient has almost lost hope to adhere to the medication due to family status, expenses and lack of improvement. Patient-centred care involves giving the patient responsive and respectful care to the client’s values, preferences and needs and ensuring the client’s values follows all the clinical decisions.

Dimensions of patient-centred care

Patient’s Preferences

The patient is involved in decision making while respecting his/her unique values and preferences. It involves treating the patient with respect, dignity and recognizing his/her cultural autonomy and values (Anhang et al,2014). While providing care to John, I could respect his family status, the relaxing activities in socializing with his son in law in drinking wine and smoking cigars. However, I would caution John and show both of them the effects of cigars and wine to the body especially to diabetic patients.

Integration and coordination of care

A nurse should ensure proper coordination of care to the patient, especially where the patient expresses powerless and vulnerable feelings due to the status of their illnesses. The appropriate integration of care can alter such feelings. Through experience, I could offer well-integrated care to alleviate John’s believes that his blood sugar is beyond control. Properly coordinated care will help John to take his blood sugar frequently and adhere to the clinical decisions and appointments (Powers et al, 2017).  

Education and information

In order to counter the patient’s worries that they are not fully informed about their condition, hospitals focus on three communication types; the caring process information, information of disease progress, prognosis and clinical status (Gorrindo et al, 2014). John, his son-in-law and his family, require much education about how to take care of John’s health especially in eating habits and other diabetic assessment like frequent monitoring of the glucose level. As the health practitioner, I could inform and offer enough education to John concerning his illness.

Physical comfort

Physical comfort is essential to the patient is several areas such as; during pain management, assisting in activities and daily living needs and while in the hospital environment and surroundings. John requires physical comfort due to his knee amputation, failing health and eyesight problems. Due to John’s knee complication, I could pay close attention to physical support to avoid falling, assist in movement as well as driving him to the hospital for doctor’s appointments.

Emotional support

Emotional support is crucial for relieving fear and anxiety which are associated with illnesses. I could concentrate the attention on the patient anxiety over treatment, prognosis, physical status, illness’s impact and also on financial impact. John needs emotional support to alleviate fears and anxiety due to his financial status where he finds it difficult to continue with medication which is expensive for him. John also is anxious over his blood sugar levels which seem to remain very high although he is under medication.

1. Patient’s Preferences

Family and friends’ participation

This dimension involves the role of friends and family in providing patient-centred care to the patient. Family and friends’ contribution can be through the provision of accommodation, involvement in decision making, supporting as caregivers and recognizing the friends and family needs (Elwyn, Dehlendorf, Epstein, Marrin, White & Frosch, 2014). John family is very close to him as they live together, as a health professional, I would strengthen the family bonds through holistic participating in their daily activities and involving them in decision making towards helping John.  

Transition and continuity

A health professional should ensure and respect the patient’s needs and ability to care for themselves after discharge or while at homes. Thus one must be understandable in regards to the medication details, dietary needs, physical limitations, appointment plans and other services after discharge (Graffigna, Barello, Libreri & Bosio, 2014). John required proper and clear information concerning medication and showed him the importance of the doctors’ appointments which could solve the problems where he was complaining of the drugs that were unable to change his disease state.  

Access to care

Patient has to be informed that he/she can access care services whenever it is required. I could inform John on an easy way to get to the hospital for an appointment or when the condition is worse. When the medication fails to improve John’s situation I could organize on how to get a specialist who gives him more knowledge on how to handle his diabetic condition.

Models of Care

Biomedical model

In the biomedical model of healthcare, the biological and physical aspects of the illness are focused on. This model of care involves medication which is mainly practiced by many health professional and doctors. The model is associated with cure, diagnosis and the treatment of the disease (Shameer et al, 2016). The biomedical model involves;

• surgery to remove or replace a certain part of the body
• medication to lower the blood sugar or the blood pressure
• diagnosis of fractured bones through x-rays

As the biomedical model of health is always the first thing people think of regarding healthcare, John is in a situation where the doctor suggested him to use medication for diabetes to try to control his blood sugar (Zoungas et al, 2014). Biomedical model is the most appropriate model of health, as a doctor to use primarily to diabetic patients’ who are diagnosed for the first time. This model plays a major role in exposing the state of the disease within the patient body, so it is appropriate to be used before applying the social model of health to the diabetic patients’ like John (Scholl, Zill, Härter & Dirmaier, 2014)

Advantages

• Improves the quality of lives of people especially with chronic diseases.
• Creates advances in research and technology
• Prolongs life expectancy
• Enhances the effective treatment of several body complications (Wu et al, 2014)

Disadvantages

• The model relies on technology and professional health workers, thus costly
• Does not always endorse good health
• Expensive
• It does not treat all the conditions as in John’s state

Social model of health

The approach addresses broader influences on social, environmental and cultural determinants of health rather than the physical and disease itself. This model recognizes the relationship between health status and the social determinants of health. It considers the vital aspects such as healthcare accessibility, socioeconomic status and social connectedness towards improving the health status of an individual (Brett et al, 2014). According to the case study, this model of health is very beneficial to John due to his socioeconomic status and futility of the drugs. The failure of the drugs which were also expensive for John were the major influences on his psychosocial health.

2. Integration and coordination of care

The social model involves several programs and campaigns within the community which are of great help in maintaining and improving the health status of the people of Australia. These programs based on this model of health could help John to alter some non-beneficial believes through socializing with outsiders rather than only his family and get more knowledge concerning his health status (Young-Hyman et al, 2016).

Advantages

• The model assists in disease prevention and promotes good health
• It is cheap as one can acquire directly from close friends or relatives
• Involves sharing of health responsibilities
• The knowledge can be passed from one generation to another
• Focuses on the vulnerable populations and improves the overall wellbeing

Disadvantages

• Public ignorance of the health promotion campaign
• Cannot prevent all the conditions
• Does not venture on the development of medical knowledge and technology
• Does not aim to individual concerns at a time (Kelley, Kraft-Todd, Schapira, Kossowsky & Riess, 2014)

Conclusion

  Type 2 diabetes is a disease that requires tight patient-centred care for improvement and good result. The type 2 diabetes which is accompanied by the rise in the glucose level in the blood can result in different complications in the body if not handles appropriately. The illness requires a well-coordinated, and integrated interventions for it is a long-term condition which is common to the older population. A nurse or a health practitioner handling the patient with type 2 diabetes require to utilize the seven dimensions to prove the most effective care to the individual. Both the biomedical and the social model of the health of significant benefits and are necessary during the treatment of a patient with type 2 diabetes.

References

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Gorrindo, P., Peltz, A., Ladner, T. R., Miller, B. M., Miller, R. F., & Fowler, M. J. (2014). Medical students as health educators at a student-run free clinic: improving the clinical outcomes of diabetic patients. Academic Medicine, 89(4), 625.

Graffigna, G., Barello, S., Libreri, C., & Bosio, C. A. (2014). How to engage type-2 diabetic patients in their own health management: implications for clinical practice. BMC public health, 14(1), 648.

Kelley, J. M., Kraft-Todd, G., Schapira, L., Kossowsky, J., & Riess, H. (2014). The influence of the patient-clinician relationship on healthcare outcomes: a systematic review and meta-analysis of randomized controlled trials. PloS one, 9(4), e94207.

Powers, M. A., Bardsley, J., Cypress, M., Duker, P., Funnell, M. M., Fischl, A. H., … & Vivian, E. (2017). Diabetes self-management education and support in type 2 diabetes: a joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. The Diabetes Educator, 43(1), 40-53.

Scholl, I., Zill, J. M., Härter, M., & Dirmaier, J. (2014). An integrative model of patient-centeredness–a systematic review and concept analysis. PloS one, 9(9), e107828.

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Young-Hyman, D., De Groot, M., Hill-Briggs, F., Gonzalez, J. S., Hood, K., & Peyrot, M. (2016). Psychosocial care for people with diabetes: a position statement of the American Diabetes Association. Diabetes care, 39(12), 2126-2140.

Zoungas, S., Chalmers, J., Neal, B., Billot, L., Li, Q., Hirakawa, Y., … & Cooper, M. E. (2014). Follow-up of blood-pressure lowering and glucose control in type 2 diabetes. New England Journal of Medicine, 371(15), 1392-1406.