Diabetes is a chronic issue and stressor is one of the components that an individual has to continually adjust. The nurse should acknowledge the stressor because after discharge patients feel alone and they should have proper resources (Husband, 1988). It is also stated that diagnosis of strengths of the patients is equally important as finding the problem/barriers. Strengths are available resources to the patients that are important in overcoming future problems.
After reviewing the studies done by various authors it is certain that patients compliance with the self-care regimen can be increased through mutual goal setting and joint planning between the patient and nurse. Self-care is a human behavior and it is one of the vital components of diabetes care. Self-care is self-directed. A research by Surucu, Kizilci, and Ergor (2017) shows that Orems self-care deficit nursing theory (SCDNT) based on 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. Another study by Wagnild, Rodriguez, and Pritchett (1987) shows that this self-care theory can also be implemented in acute care and hospital settings. Our med-surg unit will be highly benefitted with this theory.
Uncontrolled levels of blood glucose are the basic problem in patients who admit to our unit. Many related to lack of knowledge of diabetes management, self-care deficit of various causes, sedentary lifestyle, food choices and personal belief. This tells us that when we look into a patient in the hospital a nurse needs to take everything into consideration and make a care plan accordingly. Nurses need to be non-judgmental and see what factors may limit patients abilities to follow lifestyle recommendations. According to Wagnild et al. (1987), Orems model may not be useful if a nurse is not able to adapt it to their settings.
Borji et al. (2017) emphasize that Orems self-care model provides a good clinical guide for the nurses as a facilitator and change agent on planning and implementing self-care and providing educational support to the patient. 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 self-care needs and then mutually plan on compensating the self-care deficits (Wagnild et al. 1987). According to Skinner, Cradock, Arundel, and Graham (2003), an open, honest, and complete picture of the disease process should be given to the patients. Along the way, patients should be supported in processing, developing and managing their own diabetes.
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