Chronic Health Problem
Select a patient that you have encountered in your clinical practice with a chronic health problem. (I selected DIABETES MELLITUS TYPE 2)
Interview the client/family members.
Include the following information
Setting: Community clinic, Private practice, Skilled nursing facility, home health
Clinical information:
- Chief complaint, HPI, PMH, PSH, FH, ROS, PE, Diagnostic Testing, Medical Decision Making, Diagnosis/Clinical Impression,
- Plan/Interventions, Recommendations, Education, Health promotion
Use of Research Findings and other evidence in Clinical Decision Making
Choose 2 EBP resources influencing the care provided to your client. Discuss the similarities and differences that you read for those two EBP peer-reviewed articles.
Submit scholarly paper, with writing style at the graduate level, including all the following:
- Reviews topic and explains the rationale for its selection in the context of client care.
- Evaluates key concepts related to the topic.
- Describes multiple viewpoints if this is a controversial issue or one for which there are no clear guidelines.
- Assesses the merit of evidence found on this topic i.e., soundness of research
- Evaluates current EBM guidelines, if available. Or recommends what these guidelines should be based on available research.
- Discusses how the evidence did impact/would impact practice. What should be done differently based on the knowledge gained?
- Consider cultural, spiritual, and socioeconomic issues.
Sample Paper
Chronic Health Problem
Setting
The clinical setting in this case study is a community clinic. The patient is a fifty-five-year-old female patient who presented to the community clinic by herself with diabetes mellitus type II.
Clinical Information
The most common complaint as per the patient was “increased thirst, slow-healing wounds or cuts, frequent urination, numbness or tingling in the hands or feet, and intense hunger”. When asked about the commencement of the complaints, she stated that some began two months ago while others were just a week old at the time of the interview. Upon being quizzed about her medical history prior to the current sickness, she revealed that both of her parents were diabetic. In her statement, the woman claims that she has not had any cardiac difficulties. The patient, on the other hand, complains of spells of fever and hypertension. Type 2 diabetes is characterized by the body’s inability to efficiently utilize insulin to transport glucose into your cells. Consequently, the body must rely on alternate energy sources found in tissues, muscles, and organs to function properly. This is the start of a chain reaction that might result in a wide range of symptoms.
Evidence-Based Practice Articles
Pivari et al. (2019) did research on the prevention and treatment of diabetes type two. According to the article, type two diabetes mellitus a preventable condition. However, the article also provides several treatment options for type diabetes which include lifestyle modification and drug therapy. The most common drug recommended by the article is curcumin. The rhizome of the Curcuma longa plant, also known as turmeric, contains curcumin, a bioactive molecule. Researchers have found that curcumin has numerous biological and pharmacological effects that can help alleviate the symptoms of type 2 diabetes. Similarly, Xu et al. (2018) discussed the use of natural products such as hypoglycemic and lipid-lowering agents and other drugs in the treatment of type two diabetes. Xu et al. (2018) also emphasize on lifestyle modification including diet control and moderate exercise. However, whereas Pivari et al. (2018) focus more on synthetic drugs agents as the standard treatment guidelines for type two diabetes, Xu et al. (2018) defend natural products against the same infection. In light of the etiology of type 2 diabetes, natural products have emerged as major sources of bioactive molecules for the creation of drugs to combat the disease. Increasingly natural components have been discovered to have anti-diabetes-type-two characteristics recently, and several efforts have been made to uncover the mechanisms involved.
Topic Review and Rationale
In people with type 2 diabetes, the body’s ability to regulate and utilize sugar (glucose) as a fuel is impaired. Because uncontrolled type 2 diabetes can cause dangerously high blood glucose levels and a wide range of symptoms and complications, the choice to focus on this problem is significant. Type 2 diabetes cannot be cured, so early treatments like weight loss, a healthy diet, and exercise can help control the disease (Mayo, 2021). In this case, understanding the patient’s signs and symptoms will attract the appropriate treatment to prevent more advance conditions like paroxysmal sympathetic hyperactivity and hypertension.
Key Concepts Related to the Topic
Although the patient has a history of diabetes, no prior surgical procedures have been performed on her. Her parents had diabetes and died as a result. Paroxysmal sympathetic hyperactivity and heart problems have been ruled out in this patient. The cardiovascular, gastrointestinal, endocrine, and neurological systems are functioning normally. The temperature was ninety-seven degrees Fahrenheit and the body mass index was eighteen. Glycated hemoglobin, random plasma glucose, as well as fasting plasma glucose, were requested for the assays. Lifestyle changes, including food, exercise, and the use of synthetic and natural dietary supplements, were discussed with the patient.
Multiple Viewpoint
There is no clear cure for type two diabetes. However, evidence-based practices have shown the effectiveness of both natural and synthetic therapists. According to Pivari et al. (2018), synthetic drugs like curcumin has the ability to combat type two symptoms. On the other hand, Xu et al. (2018) support the use of natural supplements with anti-type two diabetes effect. The controversial issue which of the two have a greater effect. However, others believe that the use of combined natural and synthetic intervention has a greater effect. Therefore, patients tend to use both synthetic drugs and natural supplements as well as behavioral modifications as part of the treatment plan.
Soundness of Research
Diabetes has an impact on the entire body. In order to receive the best treatment for diabetes, the patient must take steps to keep the risk factors under control and within the normal range. These steps will include maintaining blood sugar levels as close to normal as possible by taking prescribed medications, increasing physical activity, and following a diet plan (Ong et al., 2018). Blood cholesterol and triglyceride levels should be kept as close to normal as feasible with suitable medication, and the blood pressure should be kept under control as much as possible with appropriate treatment.
EBM Guidelines
There are no specific guidelines for type two diabetes treatment. However, the American Diabetes Association recommends the use of several interventions including diabetes medication or insulin therapy, healthy eating, blood sugar monitoring among others. It’s a common misconception that there is a special diet for people with diabetes. In order to maintain a healthy diet, it is necessary to follow a regular meal and snack schedule, eat smaller portions, and include whole grains and more high-fiber foods like fruits, vegetables (Kim et al., 2019). Patients will also be advised by their healthcare practitioner on what frequency they should check their blood sugar level to ensure that it is within their desired range. Metformin is one of the most commonly prescribed medications for people with type 2 diabetes.
Impact of Evidence on Practice and What should be Done Differently
Even though there are no guidelines or recommendations that should be followed when managing type two diabetes, there are some general principles to keep in mind. As a result, the majority of the time, the therapists build their treatments. In the treatment of type 2 diabetes, standardized procedures and guidelines are necessary to reduce the likelihood of missed steps and other errors that could have significant effects on the treatment quality. International guidelines for type 2 diabetes treatment are needed, and they should be developed.
Cultural, Spiritual and Social-Economic Issues
Nurses must deal with a variety of cultural, religious, social, and economic issues that can have a substantial impact on their procedures. There are several societies that prohibit individuals from communicating their problems with other people. As a result, some patients decide to discontinue their treatment. Religion does not have a significant impact on type 2 diabetes treatment, but people’s socioeconomic circumstances have a significant impact on their ability to pay for diabetic care. According to Ong et al. (2018), those who are in a bad social and economic situation are more prone to drop out of treatment and therapy, which may be of limited efficacy among the impoverished population.
References
Kim, M. K., Ko, S. H., Kim, B. Y., Kang, E. S., Noh, J., Kim, S. K., … & Park, K. S. (2019). 2019 Clinical practice guidelines for type 2 diabetes mellitus in Korea. Diabetes & metabolism journal, 43(4), 398-406. https://synapse.koreamed.org/articles/1142376
Mayo Clinic. (2021, January 20). Type 2 diabetes – Diagnosis and treatment. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/diagnosis-treatment/drc-20351199
Ong, S. E., Koh, J. J. K., Toh, S. A. E. S., Chia, K. S., Balabanova, D., McKee, M., … & Legido-Quigley, H. (2018). Assessing the influence of health systems on type 2 diabetes mellitus awareness, treatment, adherence, and control: a systematic review. PloS one, 13(3), e0195086. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0195086
Pivari, F., Mingione, A., Brasacchio, C., & Soldati, L. (2019). Curcumin and type 2 diabetes mellitus: prevention and treatment. Nutrients, 11(8), 1837. https://www.mdpi.com/2072-6643/11/8/1837
Xu, L., Li, Y., Dai, Y., & Peng, J. (2018). Natural products for the treatment of type 2 diabetes mellitus: Pharmacology and mechanisms. Pharmacological research, 130, 451-465. https://www.sciencedirect.com/science/article/abs/pii/S1043661817315190
