Case Study: Diabetes Self-management Education (DSME)

Case Study: Diabetes Self-management Education (DSME)

Case Study Diabetes Self-management Education (DSME)

Diabetes is a chronic disease that requires the active involvement of both patients and nurses in the care process for proper management and positive outcomes (American Diabetes Association, 2017). Patients need to perform complex care activities and numerous daily management decisions to ensure their daily wellbeing. Since diabetic patients may not know all the activities they are required to do and how to do them, patient education has been adopted to enable patients to acquire the required knowledge concerning self-management. Self-management education is normally provided by health professionals who are well conversant with diabetes. However, these professionals often face challenges because they often meet various patients with varying risk factors and situation which are only specific to them. This requires educators to keep adjusting their approaches for the education programs to suit their clients. For a better understanding of the whole situation, the paper will give a case study of a 54-year-old man, Daniel Old Coyote suffering Type 2 DM and how a nurse can provide patient education to him.

The Case

I am a diabetic nurse educator at a Native American Health Service clinic and Daniel Old is my client. Daniel is 54 years old and was diagnosed with Type 2 DM 6 years ago. His wife Nesa has been very vital in helping him to manage the disease unfortunately, she passed on 2 months ago. Daniel has been forced to make adjustments and take care of himself or accept the aid of house helps since their only son, Jeri who is a pilot is always busy with work and is rarely at home. As a nurse, I have to make sure that Daniel is able to manage his diabetes and avoid the stress from his loss.

Intervention

My approach was to offer patient education to Daniel to enable him to manage his diabetes and health adjustment with the loss of his wife. The objective of the education was to reestablish the knowledge of Daniel on self-management, to teach him what he doesn’t know, check on his motivation on self-care, and help him cope with the loss of his wife. Additionally, the strategy was also aimed at ensuring that his blood sugar levels were kept on check during his grief and the training period.  With this, it is expected that by the end of the training, Mr. Coyote will be able to take his medication as required, monitor his blood glucose, undertake exercise, and take the recommended diet.

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I adopted a participatory approach for the training whereby all of us, Mr. Coyote, his house help, and I were involved in the caregiving

process. I would demonstrate and also instructed Mr. Coyote and the house help to follow. We would cook together and go to the gym together to ensure everybody follows the manual that had been pre-prepared to guide on food, medication, and exercise. During medication, I gave both Mr. Coyote and the house help instructions before I allowed them to try and follow. This enabled me to monitor their progress and also make corrections in case a procedure was wrongly performed.

Rationale

According to Hilliard et al. (2016), emotional stress is one of the major risk factors of Type 2 diabetes since it can lead to lowering or raising of the levels of blood glucose. Distraction and escape from the present environment are some of the ways to manage emotional stress (American Diabetes Association, 2017). Therefore, involve Mr. Coyote in activities such as shopping cooking, physical activities offered the best way of addressing his situation compared to other strategies. I gave a specific focus on the diet. I developed a meal timetable which includes foods such as fruits, vegetables, lean meat, fish, poultry, low-fat dairy products, and whole grains as recommended by Powers et al. (2017). This strategy enables quick learning and stress management of the client. However, it demands too much commitment to the nurse and is relatively expensive.

The selected learning method I adopted is in line with the cognitive learning theory. This is because Mr. Coyote and the house help me learn the knowledge and skills I taught from what I said and did. Cognitive learning theory normally occurs through the following action and doing it (Akdeniz et al. 2016). I evaluated the effectiveness of the process by monitoring what Mr. Coyote and the house help did. I record their weakly progress in mastering and following instructions on food and medication. I also recorded Mr. Coyote’s blood glucose regularly for any observable changes. It was easy to evaluate Mr. Coyote’s understanding by listening to him giving instructions to his house help on his medication and how his food should be prepared. He would also tell me his daily programs and the time he should be available for medication. He could also take his blood sugar measurements by himself. Mr. Coyote was an egalitarian who loved challenges. I motivated by inviting him by inviting to activities such as cooking, shopping, cooking competition, singing which he freely obliged.

Diabetes self-management education (DSME) is very important for dietetic patients. Diabetes is a chronic disease that requires close management by the patients. As such, patients need to acquire the necessary skills and knowledge required for management. This necessities nurses to offer education to patients on diabetes management to increase 1 chance of success of the process.

Question 1
Theory is an essential component of nursing as a scientific discipline. Scope and
standards of practice guide the role, standards, and practice of the Master-prepared
nurse. Based on what you have learned at Aspen and your personal experience, discuss
all three (3) areas:
1. How your specialty role’s standards and competencies influence practice
2. How nursing research, theory, law, and ethics apply to practice
3. How nurses can provide culturally sensitive care.
Make certain to use scholarly sources and personal practice examples to support your
analysis.
Question 2
You are a diabetic nurse educator at a Native American Health Service clinic. On your
appointment sheet, you see that you have a two-hour slot for 54-year-old Daniel Old
Coyote. Daniel was just diagnosed with Type 2 DM and requires health education
regarding his disease and disease management. On the intake assessment form, you
notice that the nurse has noted ONE of the following risk factors (select which one is
most interesting to you): homeless, 4th grade reading level, grieving recent loss of
spouse, hemiparesis secondary to head injury, impaired vision, or some other risk factor
that is of interest to you). You do not have to accomplish all of the diabetic teaching in
this 2-hour block, but you would like to initiate some instruction on a single topic (i.e.
oral anti-diabetic medication, diet, foot care, glucose monitoring, etc.).
Determine one or more teaching objective(s) or outcomes, and discuss the specific
teaching strategies you would implement and supplemental materials you might use to
address this educational need. Explain the rationale for your teaching strategies, and why
these strategies were selected in favor of other alternatives. What are the advantages and
disadvantages of your selected teaching methods? What teaching-learning theory or
philosophy underpins your selected teaching method(s)? How will you evaluate the
effectiveness of your teaching? How will you stimulate Daniel’s engagement and
motivation? How would you evaluate his understanding? Be sure to use scholarly
references/citations to support your lesson plan.

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

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The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

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I do not accept assignments that are two or more weeks late unless we have worked out an extension.

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Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

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Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

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Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

• Your response needs to be a minimum of 150 words (not including your list of references)
• There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
• Include in-text citations in your response
• Do not include quotes—instead summarize and paraphrase the information
• Follow APA-7th edition
• Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

• A minimum of 6 responses per week, on at least 3 days of the week.
• Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
• Each response needs to be at least 75 words in length (does not include your list of references)
• Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
• Follow APA 7th edition
• Points will be deducted if the above is not followed
• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• Student paper example
• Citing Sources
• The Writing Center is a great resource