TYPE II DIABETES CAPSTONE PROJECT CHANGE PROPOSAL.

Background

The improvement of quality of life, and gains in medical technology means that more Americans are living, as compared to previous decades. However, the positive trends do not discount the fact that more people are living unhealthier lifestyles, as indicated by the research in 2016 that indicated that eight in 10 Americans live with at least one chronic health problem such as type II diabetes, hence there is call for dietary and lifestyle changes to address the growing problem.

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Problem Statement

Type II diabetes is caused majorly by poor lifestyle such feeding habits, lack of physical exercise and sedentary life. To address the challenge, healthcare experts recommend a number of lifestyle changes such as exercising more and eating healthier foods. Also, to implement the changes, patients are encouraged to sustain the change process to realize better health outcomes, a far as diabetes and other lifestyle diseases are concerned.

Purpose of The Change Proposal

The main purpose of the change proposal is to encourage diabetic patients to assume an active role in addressing the medical complication by engaging more practices that promote a healthier living such as physical exercise, eating healthy, encouraging behavior change such as quitting smoking and excessive drinking. The change is geared towards helping diabetic patients in the community to realize the benefits of living a healthier life and help in managing diabetes.

PICOT

P- Patients who have diabetes.

I – Implementation specifically on dietary and lifestyle changes.

C- Comparisons of levels before and after lifestyle and dietary modifications.

O- Outcome whether there will be a reduction in levels.

T- The time frame is usually three months after initial diagnosis

PICOT Statement: Diabetic Condition in Patients.

Literature Search Strategy Employed

A literature search strategy a structure of keywords to look up a database. The search strategy integrates the primary concepts to search the PICO question to retrieve relevant and accurate results. For this proposal, there are key terms and phrases that are related to the question, and aids finding relevant literature (see Appendix)

Evaluation of The Literature

Several scholars have dwelled on the need for management of diabetes through lifestyle changes such as physical exercise, and healthy living, and dietary practices (Glechner et al., 2018; Gehlawat et al., 2018; Ryninks et al., 2015; Worku et al., 2015). The issue of lifestyle changes has been a focus for years due to its measurable success, and the minimal resources it requires to implement the change process. The need to adequately focus on behavior change is undeniably sufficient to argue in favor of the same due to the increasing focus on the strategy for diabetes management. Hoverer, the available literature on this important topic needs to rethink the issue of sustaining the change process, rather than solely focusing on the outcomes.

Applicable Change

Patient education about the need for lifestyle and dietary change has been proposed by multiple health experts, who argue that patient education has the potential to influence behavior change in the long-term. Also, patient education, promotes a patient’s understanding of diabetes, and factors that contribute to it such as poor eating habits, sedentary life, excessive smoking, and lack of physical exercise (Schneider et al., 2014).

In addition, Willis-Shattuck et al (2008) argue that that increasing doctor reimbursement, as part of the efforts to implement change process, is one of the changes needed in the health care sector to promote the implementation of care process for patients with diabetes. Such care processes may include renal assessment, and blood and weight measurement on a bi-annual basis. Also, the role of healthcare professional in promoting care change such as teaching diabetic patients about the need to go for eye checkup at least a year may help in preventing new cases of diabetes in the community. Hence, patient education is the most viable primary health care practice, and aids in the implementation of lifestyle and dietary change among diabetic patients.

Proposed Implementation Plan with Outcome Measures

Sustaining behavior change for diabetic patients is essential in delivering positive healthcare outcomes. Numerous findings have discovered the interrelationship between lifestyle and dietary changes and the time taken to show signs of health improvement. To achieve measurable success in terms of behavior change, patients are enlightened about the importance of behavior change sustainability. However, Schneider et al (2014) posit that, behavior change is partly determined by how the recent a patient has been diagnosed with the disease, and how early diagnosis is help change behavior change in a diabetic patient.

In addition, Pen et al (2008) argue that patient’s behavior sustainability is shaped, in part, by the time of diagnosis – if it is most recent, or the patient have been made aware if the disease. Diabetes experts argue that, early diagnosis of the disease if the reason why some of the patients will make it a priority to adopt lifestyle changes in order to contain the problem. Hence, implementing behavior change to include lifestyle and dietary change needs to start with engaging the patient in knowing the health status in advance, and to begin the process of measurable process of behavior change.

Potential Barriers to Plan Implementation, And How to Overcome Them

Implementing the change process is complex undertaking, which requires dedicating sufficient resources to monitor behavior change in diabetic patients. while some patients are committed to behavior change, some may find it difficult to relapse and go back to the old ways of living such as alcohol drinking, smoking and other poor lifestyle choices. To overcome barriers to change, healthcare professionals need to be part of the change process by providing necessary moral support, and ensuring that patients under the change program are carefully monitored to prevent revisiting the old behaviors, and end up not sustaining the change process. Also, changes such as healthy eating be challenge to diabetic patients as their bodies try to adapt to the new changes. To promote change sustainability, a patient, therefore, need a demonstration of the benefits of lifestyle and dietary for the sake of their health.

Conclusion

The policy framework of addressing the growing problem of diabetes, and the need for health care professionals the importance of behavior change, and especially dietary and lifestyle changes. For patents with type II diabetes, achieving the desired medical outcomes is the ultimate goal, even though the process is time consuming and requires dedication, and energy. Sustaining the change process, however, could be the biggest challenge because most of the patients will drop out in the process. Dietary and lifestyle changes, are the two important behavior change in the management of diabetes.

References

Glechner, A., Keuchel, L., Affengruber, L., Titscher, V., Sommer, I., Matyas, N., … & Gartlehner, G. (2018). Effects of lifestyle changes on adults with prediabetes: A systematic review and meta-analysis. Primary care diabetes, 12(5), 393-408.

Gehlawat, M., Naik, B. N., Lakshminarayanan, S., & Kar, S. S. (2018). Dietary practices and barriers to dietary modification among diabetics and hypertensives in a rural health service area of Puducherry: A qualitative study. International Journal of Health & Allied Sciences, 7(3), 139.

Penn, L., Moffatt, M. & White, M. (2008). Participants’ perspective on maintaining behaviour change: a qualitative study within the European Diabetes Prevention Study. BMC Public Health, 8:235

Ryninks, K., Sutton, E., Thomas, E., Jago, R., Shield, J. P., & Burren, C. P. (2015). Attitudes to exercise and diabetes in young people with type 1 diabetes mellitus: a qualitative analysis. PloS one, 10(10), e0137562.

Schneider, K., Andrews, C. & Hovey, M. (2014). Change in physical activity after a diabetes diagnosis: opportunity for intervention. Med Sci Sports Exerc, 46:84–91

Willis-Shattuck, M., Bidwell, P., Thomas, S., Wyness, L., Blaauw, D., & Ditlopo, P. (2008). Motivation and retention of health workers in developing countries: a systematic review. BMC health services research, 8(1), 247.

Worku, A., Abebe, S. M., & Wassie, M. M. (2015). Dietary practice and associated factors

among type 2 diabetic patients: a cross sectional hospital based study, Addis Ababa, Ethiopia. SpringerPlus, 4(1), 15

TYPE II DIABETES CAPSTONE PROJECT CHANGE PROPOSAL.