Soto, a fifty-two-year patient is part of a population that is most affected by lifestyle diseases such as pred iabetes or heart conditions. Raghupathi and Raghupathi (2018) identify that older adults in the US population are diagnosed with more than one lifestyle disease. As a patient with prediabetes, it is necessary that the condition is managed before it advances. With an effective intervention plan in place, Soto can manage to bring her blood sugar levels to normal and avoid type II diabetes entirely. Focus on the problem is prompted by the immense lack of knowledge on prediabetes as a condition existent in many individuals. The condition may not be as easy to detect and patients will eventually seek medical attention after it advances to type II diabetes. Therefore, working with the current patient helps in providing insight into working with prediabetics.
The problem affects a significant number of patients in the population and frequent interaction with it provides the opportunity to gain as much experience. It will ensure that eventual contact with prediabetic patients is addressed through quality care as enabled by interactions with the current patient and many others. It will also enable the provision of information and strategies for care to the patient and her family. Both parties are highly likely not aware of prediabetes as a lifestyle condition and they may not know that they can prevent it from advancing into diabetes.
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Proposed intervention
Primarily, prediabetes can be managed and eventually eradicated through a change in the patient’s lifestyle. She has adopted a sedentary lifestyle which means that her physical movement and exercise are greatly limited. Also, her food choices are greatly wanting and unhealthy as she mainly eats out every weekend which means that she may not opt for healthy food options while eating out. As a former police officer and able to engage in light exercises, it would be easy to develop lifestyle change strategies that would incorporate adjustments in her diet and physical exercise.
A root cause analysis of her problem indicates that the primary cause of her problem is the sedentary lifestyle she has adopted. She is retired, which means she currently engages in little to no work activities. Also, her lifestyle contains little to no physical activity with wrong eating habits. These factors in her life present fertile ground for the development of prediabetes and eventually diabetes.
Her lifestyle change needs to include the identification of light work she can engage in to ensure that she is occupied and moving around most of the time. With her experience in the police force, an example of a good and less demanding activity she can engage in would be the neighborhood watch. As part of a group that looks to keep the neighborhood secure, Soto will often be engaged but not to the extent that risks her physical well-being as prompted by the spinal injury. Since she can still walk and engage in other lighter forms of exercise, the neighborhood watch will encourage these activities. She can also have other light exercises outside her responsibilities to the neighborhood. These can include light household chores, light yoga or swimming. The best intervention plan for lifestyle changes for Soto is outline below;
Soto needs to identify varied light work activities she can engage in as aforementioned. The neighborhood watch would be a good example, she can however identify what she feels would fit her best or what she would enjoy doing.
It would be necessary she and the family are educated on the varied options she has and what the family can do to encourage her to participate in these activities.
Developing a food log would be one of the initial steps as she would need to note down her food choices for a few days to get a picture of what she eats on a daily basis.
With a food log in place, working on healthier options and supportive environments would help improve her eating habits. The inclusion of a nutritionist would not only help provide her with healthy food options, she can get recommendations on healthy and light exercises she can engage in as determined by her physical wellness and capability.
The family would play a critical role in providing a healthy environment where she can enjoy healthy meal options at home or even when she decides to eat out. The company of family or friends would ensure that she maintains healthy food options.
She would be required to keep logs, written or recorded, of her progress in her work activity, healthy food options and exercising. She would also need to note down changes in weight and in the complaints she reported during her visit to the doctor.
The physician and the family would provide an always available support system that Soto can reach in instances she feels stuck. Changes in one’s eating habits and physical activity may not be as easy to follow through and she would need to have a support system in case she needs reassurance.
Nieuwboer et al. (2019) identify that when leadership in healthcare embraces change as team players, coaches and role models, it becomes easy for patients to view the proposed change as healthy. Therefore, Soto needs to see the place of her care provider in the proposed change for her lifestyle. Participation would include engaging in varied group activities that promote health including communal physical exercise activities such as swimming or community walks. When she experiences the role played by her care giver, she would easily adopt the proposed change.
Wittenberg et al. (2018) proposes that communication strategies that work best for patients and their families involve more than the passing along of information. There needs to be room for the discussion of a range of topics touching on dieting and physical exercise. Soto and her family need to be allowed to share their feelings and fears concerning the illness and identified interventions. This creates the possibility to address such feelings and makes the intervention implementation process smoother. The communication process needs to be guided by the patient’s story and overall lifestyle. It needs to include orientation to the problem and a discussion on the options at the disposal of the patient and their family ( Wittenberg et al., 2018) . It should also include family aspects such as communication patterns therein, communicating with caregivers and also addressing their need. Encouraging team processes in addressing the problem by including the physician, the patient and their family.
At the state and local levels, stakeholders have promoted policies towards improving physical activity in neighborhoods through improvement in infrastructure. As Soto’s lifestyle change is highly dependent on engaging in exercise to encourage weight loss, access to infrastructure that encourages this promotes the proposed intervention. The availing of recreational areas, cycling and walk ways and parks means that Soto has easy accessibility to the resources she needs to engage in physical exercise and improve her overall well-being (Chalhoub et al., 2018) .
The proposed intervention includes the involvement of various physicians whose focus is to see Soto’s health improve. Therefore, the input of nurses, doctors, nutritionists and other care providers means that the patient will get holistic care at reduced costs. Further, a lot of the activities she needs to engage in are free which means that her wellness will be restored at little to no costs. M any strategies that work in lifestyle changes and management involve the delivery of holistic interventions that do not only address the problem at hand but include relapse prevention methods. Many of the involved strategies are delivered in environments that are easily accessible to the client. Here costs are greatly reduced as she does not need to pay for many of the services she needs. Also, pharmacological intervention is greatly reduced as the patient does not require a lot of medication to manage their problem.
Technology plays a crucial role in the current intervention. She needs to access resources that will help improve her physical activity and these can be accessed through the internet. Technology such as smartwatches will be helpful in achieving the patient’s goals as they help in keeping track of physical activity and changes in her body. Some applications that encourage fitness and meditation will also be helpful in promoting the intervention ( Afshin et al., 2016) . It is expected that Soto will engage in various community activities that will help promote a more active lifestyle. Some propositions include being part of the neighborhood watch or swimming classes. She can also engage in communal exercises organized in recreational parks across the community. As a holistic approach, the intervention will need the involvement of varied care providers and other parties including the family and community at large. Therefore, these parties need to be well-organized and cooperative in ensuring that the intervention process is smooth and results are achieved as expected. Overall, the intervention will be effective if all parties involved play their part including the patient, health care institutions and the community at large.
References
Afshin, A., Babalola, D., Mclean, M., Yu, Z., Ma, W., Chen, C. Y., ... & Mozaffarian, D. (2016). Information technology and lifestyle: a systematic evaluation of internet and mobile interventions for improving diet, physical activity, obesity, tobacco, and alcohol use. Journal of the American Heart Association , 5 (9), e003058.
Chalhoub, T., Twomey, M., & Rogombe, R. (2018). Public Policies Promoting Healthy Eating and Exercise - Center for American Progress . Center for American Progress. Retrieved 1 April 2021, from https://www.americanprogress.org/issues/healthcare/reports/2018/11/27/461418/public-policies-promoting-healthy-eating-exercise/ .
Nieuwboer, M. S., van der Sande, R., van der Marck, M. A., Olde Rikkert, M. G., & Perry, M. (2019). Clinical leadership and integrated primary care: a systematic literature review. European Journal of General Practice , 25 (1), 7-18.
Raghupathi, W., & Raghupathi, V. (2018). An empirical study of chronic diseases in the United States: a visual analytics approach to public health. International journal of environmental research and public health , 15 (3), 431.
Wittenberg, E., Reb, A., & Kanter, E. (2018). Communicating with patients and families around difficult topics in cancer care using the COMFORT communication curriculum. In Seminars in oncology nursing (Vol. 34, No. 3, pp. 264-273). WB Saunders.
