Introduction
A.B. is a 69-year-old male, a retired diabetic with type 2 diabetes of five-year history. He was diagnosed with Type II Diabetes in 2019 due to having symptoms indicative of hyperglycemia for almost two years before that. Although Abraham used to have fasting blood glucose levels of 118–127 mg/dl, called “borderline diabetes,” he did not get any treatment until his family doctor referred him to a diabetes specialty clinic because of recent weight gain, poor glycemic control, and foot pain. When showing up, A.B. mentioned his attempts to cope with diabetes, such as losing weight and being physically active daily, but it did not help. He had been given glyburide previously to deal with his diabetes, but he stopped taking it after experiencing side effects. Furthermore, he takes atorvastatin for the disease of high cholesterol, and he has been playing with various herbal supplements in seeking to improve his control of diabetes but without any significant success.
In contradiction to his medical history and treatment strategy, A.B. exhibits disbelief in monitoring his blood glucose levels and has limited understanding regarding diabetes self-care management. He blames his diabetes on the absence of sugar in his diet and has been helped by his wife’s recommendation of different treatment options that are available online. A.B. is at this moment diagnosed with multiple comorbidities such as obesity, hyperlipidemia, hypertension, and peripheral neuropathy. His recent weight gain, high carbohydrate intake, and intake of a distinct exercise routine play a role in poor glycemic control, as described by his increased fasting blood glucose levels and elevated hemoglobin A1c. The hypertension diagnosis from his blood pressure readings poses an additional risk of cardiovascular complications. Type 2 diabetes case provides complex problems that a person with this condition must deal with to manage it successfully. Integrating systems between healthcare providers, dietitians, and educators is imperative for A.B.’s treatment and achieving better health outcomes.
Primary and Secondary Healthcare Needs
A.B. features a vast network of healthcare challenges that include the physical, psychological, economic, social, and spiritual aspects. In the physical aspect, he deals with inconsolable diabetes, obesity, hyperlipidemia, hypertension, and peripheral neuropathy. These conditions should occupy our attention to avoid the onset of diseases like cardiovascular disease, diabetic neuropathy, and others. Psychologically, A.B. shows deficient awareness about his diabetes as well as the management of that disease, making the deficiency of education and support apparent, which would help improve health literacy and self-care behavior. Financially, the person in question may face hindrances to health care, for example, if it involves an out-of-pocket cost or is not insured. Socially, A.B. can also be helped by social support and possibly by getting more involved in community activities that will help reduce the amount of loneliness and bring about healthy behaviors. Spiritually, the situation does not necessitate addressing A.B.’s spiritual welfare; it lays the foundation of his integral health and strength.
A.B.s life contains several supporters – his 48-year-old wife and two married children. However, his spouse’s preferences for alternative medicine may be both positive and negative side, as his spouse leans toward alternative treatments that may go against that based on evidence-based medicine. Additionally, A.B. has an advantage in using the medical establishment of diabetes management, such as the Diabetes Clinic and nutritionists, who are fully capable of supplying the right information and training. Despite these prevailing problems of low literacy and healthcare expenditure, he cannot access these vital services. The primary care course for the patient mentioned above is maintaining the hemoglobin values within normal limits, directing dietary adjustments, increasing physical activity, and managing hypertension and hyperlipidemia to prevent risk factors. Other secondary health needs are educational programs and support to facilitate his mastery of diabetes self-care, such as routine self-testing of blood glucose and foot care related to prevention. After that, it is time to address psychological elements, such as social support and coping skills, which substantially influence well-being and adherence to the treatment plan. Healthcare providers, teachers, and support service agencies will provide a multidimensional process to manage his health problem.
Analysis of the Patient’s Health Beliefs
Person A.B.’s health beliefs are crucial in shaping his health behavior and adherence to the recommended treatment regimen. He has plenty of wrong beliefs about diabetes; the clearest is probably that sugar is the main cause of its appearance and that he does not know the nature of diabetes. It could be possible that the result of the small amount of information on diabetes management was this error. Besides, Dr. A.B. doubts the value of blood glucose monitoring, which might indicate his ignorance of self-monitoring as an essential activity in diabetes management. His use of herbal remedies and supplements provides insight into an alternative approach to health care he could be taking, influenced by his wife and his research on the Internet.
His beliefs could mean a lot as they affect how much he follows the set medical protocols and lifestyle changes. The low level of trust in traditional medication and his strong belief in alternative therapies may lead to not following the schedule of glyburide among patients. Dizziness, not only a reported side effect, makes him less likely to follow the medication schedule. Thus, his hesitation in starting anti-hypertensive medication could be part of his wider dislike of drugs, which is motivated by the aim to avoid having to take many different kinds of medicines. Apart from this, A.B.’s faith in diet and physical activity has a significant role to play when it comes to the adoption of his lifestyle, which is increasing his obesity and uncontrolled diabetes. His high carbohydrate diet, mainly bread and pasta, is aligned with cultural dietary preferences; however, it triggers the level of his glycemic control. To complement, the haphazard physical exercise, mainly seasonal, is an indication of irregular exercise that is very basic for the management of diabetes and the promotion of overall fitness.
Confronting A.B.’s health beliefs is critical for successful behavior changes and positive health consequences. Education as a means of debunking misconceptions about diabetes and emphasizing the use of validated medical options is of paramount importance. Getting A.B. involved in shared decision-making processes regarding treatment options, demonstrating the benefits of medication compliance, and suggesting dietary and exercise regimes customized to his cultural preferences are among the ways those health promoters can increase his motivation towards adopting healthy behaviors. Not only can he include his support group, including his wife as well, in educational meetings and treatment planning, but this can also help to have a cooperative approach to managing his health.
Patient’s Health History and Interview Data
The A.B.’s health history and interview data already provided valuable insights into his health status, goals, and obstacles, which would help us create a holistic care plan. His long period of uncontrolled type 2 diabetes, obesity, hyperlipidemia, and hypertension suggests the necessity to fight against these chronic conditions in a timely; this will help to prevent the development of complications in the future. During the clinical interview, we learned he is experiencing impaired diabetes self-care, he prefers alternative medicine, and he has questions concerning the reliability of the diagnostic procedures. Hence, the need for individual advice and support is obvious. Furthermore, the food plan, low in carbs with no active physical exercising, credits the lifestyle changes (Hong et al., 2020). In light of peripheral neuropathy and blood microalbumin cases, foot care and renal treatments should become more preventive. In this situation, healthcare providers must utilize this information to prepare an individual plan for A.B. to incorporate his special conditions to achieve the best results in healthcare promotion.
The treatment strategy for A.B. entails the application of several disciplines, such as adopting a healthy lifestyle, normal glycemic levels, managing hyperlipidemia and hypertension, and preventing complications that might arise. There is no question that education is a key starting point to provide the right details about diabetes and the daily blood sugar management that is A.B.’s necessity. Partnering with a registered dietitian, the diet program would design a tailor-made nutritional plan for Toronto that addresses healthy, balanced eating and culturally authentic foods to nourish more sustainable eating habits. The patient-centered solution is convincing A.B. to understand why drugs might be bad or good for him. Also, this solution gives the patient more autonomy to decide based on the autonomy principle (Güner & Coşansu, 2020). Starting the metformin therapy will also be a time to monitor the glycemic parameters and side effects closely, and follow-up will be used to tailor the dosages as necessary. In addition, the importance of preventive foot care, which includes daily inspection of one’s feet and wearing appropriate footwear, will also be taught to reduce the risk of ulcers.
Health Promotion Model
Nola’s Health Promotion Model (HPM) is a theoretical framework developed under the idea that the emotions and thoughts of an individual cannot be separated from the surrounding environment, thus generating health behaviors. This model involves a patient who is actively involved in caring about their health with the doctor. Such details may hinder healthy eating, including health, self-efficacy, and social support. The Health Promotion Model (HPM) will be my choice in managing A.B.’s health concerns, which is a patient in our case study since the model considers biopsychosocial factors and the primary prevention of diseases involving modifying health behaviors. B.F. suffers from chronic multidisciplinary diseases seen as complex medical conditions that include poorly controlled type 2 diabetes, obesity, dyslipidemia, and hypertension (Tanaka et al., 2020). According to the HPM, the two determinants circularly influence each other. The theory is a virtuous tool for analyzing A.B.’s health behaviors, consequently leading to positive health outcomes.
HPM will empower A.B. by managing the needs for change, health behavior, and intervention adaptation due to the personality, attitude, and surrounding environment. First, HPM is about self-efficacy, which encompasses faith or belief that one can conduct healthy behaviors (Cosentino et al., 2020). Education, skills, and social support will have given him the self-confidence he needs to take on his life, including having a good diet, physical activity regularly, and adhering religiously to his medications. The last key feature highlighted in HPM is the role of supposed benefits and barriers in taking an individual to begin a habit change. Faulty beliefs about diabetes and diabetes management about diabetes will be replaced by discussing the (advantages) advantages of engaging in healthier practices, suggesting strategies for tackling the challenges, and strengthening the intention to continue adopting health practices. HPM also looks at the effect that networks and the environment have on behaviors related to health. In addition, the wife of A.B. should be utilized in his therapy as a useful partner and provision of community-based assets such as support groups. Amenability of the environment, which is conducive to changes in behavior and, at the same time, success in the long term, is needed. Through this comprehensive approach, HPM can fulfill the needs of A.B. and hence increase his level of motivation and self-efficacy to create the kind of environment that will ensure lasting changes and improved well-being.
Application of Health Promotion Model in Plan of Care
The Health Promotion Model (HPM) is considered the cornerstone in designing a personalized care regimen that addresses the multifactorial nature of A.B.’s health condition. The plan utilizes the cornerstones of HPM to develop a self-efficacy framework, modify behavior based on perception, strengthen social support networks, and create a suitable environment for sustainable behavior change. A plan is needed to recognize A.B.’s inconsistent exercise schedule and weather-sensitive activities. As a start, an approach that makes a routine is the first step. A.B. and his wife will go for daily morning walks and use the treadmill at home for the walks in bad weather. The idea is to build this time up gradually so it includes at least 30 minutes per day, and these should be activities he likes to encourage his compliance (Swarna Nantha et al., 2022). As side effects are her primary concern, the plan will make every effort to educate and support her as she takes the medications (Tanaka et al., 2020). Mr. A.B. will be given in-depth information regarding the advantages and disadvantages of his antidiabetic medications, namely metformin, and strategies to counteract these drugs’ unpleasant side effects. Routine attendance at follow-up appointments, short tests, and phone consultations will make it possible to deal with any obstacles that may come up regarding medicine intake.
A.B.’s high carbohydrate intake, especially from bread and pasta, will be catered through dietary planning done in liaison with a registered dietitian. Emphases will be placed on portion control, meal planning, and learning carbohydrate ratio counting. In the first month, the plan urges gradual dietary changes, which allow for a higher level of sustainability in the long term, with A.B. keeping a food journal to track his progress and identify areas needing improvement. Finally, A.B.’s wife is a vital social help and moral support source. Part of the plan is to engage A.B. with education and promote joint exercise engagement. B. To share their personal goals and progress. Furthermore, A.B. will be directed to tap into community-based support groups or any other resource he may find valuable for his social support network.
A.B.’s cultural background and personal preferences are essential preconditions for creating a care plan. Artistic sensibility is included as dietary modification recommendations are adjusted to accommodate his Italian heritage and love for eating traditional foods. The recommendations are, however, tailored towards promoting health benefits as well. Furthermore, A.B.’s attributes, including his aversion to drugs and preference for natural remedies, are accommodated through customary education and collaborative decision-making processes, aiming to achieve a matching outlook between his beliefs and values.
Evaluation Plan
The evaluation criterion for assessing A.B.’s treatment plan will be multidimensional, as subjective and objective metrics will be used to evaluate the patient’s health and behavioral changes. During the follow-ups, self-monitoring, labs, and objective evaluations will track the progress and help guide appropriate care plan adjustments. The primary outcome measure will be A.B.’s hemoglobin A1c (A1C) levels, which can be lowered to under 7%. Regularly measuring blood glucose values, especially before and after meals, will provide further clues about the impact of dietary changes and drug effectiveness on short-term glucose dynamics. What can be quantified will be achieved through BMI and body weight reduction. A weight loss target of 1-2 pounds per week will be adopted to have a slow but steady decrease in weight to attain a healthier BMI within the normal range (Mustapa et al., 2022). The frequency and duration of the physical activities, including regular walks and using a treadmill, will be observed to check their compliance with the prescribed exercise schedule. Subjective measures, for example, step counts or exercise logs, may be introduced to track progress and ensure levels of physical activity stay constant (Ernawati et al., 2021). The conformity with the prescribed medication regimen, especially metformin, will be checked by patient reports and medication refills from the pharmacy. Physicians will also review the ability of the patient to follow the prescribed dosage during follow-up visits and offer additional support and education if needed.
The schedule of the monthly follow-up appointments will be established initially, which will include monitoring progress, reviewing self-monitoring data, and making any adjustments to the care plan as per requirements. These meetings will allow A.B. to express worries or issues and receive assistance from the healthcare operatives. They will be at her service. Evaluation of interventions will be based on laboratory test results such as A1C, lipid profile, and renal function tests that will provide information on blood sugar levels, blood lipid levels, and kidney functions (American Association of Diabetes Educators, 2020). Taking patient-specific needs into account, clinical protocols will be used.
Consequently, the quality of patient care will be increased through logical decision-making, improved treatment options, and better patient outcomes. We want to inspect peripheral neuropathy and cardiovascular risks using subjective indicators such as foot examination, blood pressure, and ECG measurements. We will then detect any diabetes-related complications. Through this evaluation, a necessary basis for prevention and early intervention programs will be formed, which are key measures to reduce the risk of disease and promote general health. The care plan will be the hardness of care given by A.B. using a systematic approach through measurable outcomes, follow-up visits, tests, and assessments. Our study explores whether A.B.’s care plan for promoting health behavior change and disease management is useful and effective (Cosentino et al., 2020). This strategy will be innovative, covering special care plan steps, modifications and adjustments, and ongoing support and help, allowing the freedom to improve Mr. A.B.’s life condition.
Conclusion
Overall, the health promotion plan for A.B. stands on the H.P. principles. These are the guidelines that help him deal with several health problems. The strategy is premised on the patient-centered model that includes instructions, modification help, and social support guidance to motivate patients to change their behavior and improve their health. The strategy will subsequently be based on personal interventions aligning with A.B.’s preferences, culture, and personality traits. It will enhance A.B.’s self-efficacy and motivation to make healthier choices. It believes in holistic care through understanding that there is a connection between physical health, mental health, social life, and the spiritual side of life. Creating ongoing contact, conducting periodical examinations, and correcting the program according to the patient’s response to seeing behavior improvements over time is critical for the continued changes and the patient’s headlong-term health and wellness improvement.
References
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