Determinant Of Diabetes Among Indigenous Population: Nursing Intervention Assessment Answer

INTRODUCTION

As chronic disease diabetes not only have an impact on individual health but also their families and community.  Diabetes holds the potential risk factor for many other serious ailments like cardiovascular diseases, chronic kidney disease, stroke, retinopathy and neuropathy. Repeated hospitalization imposes a greater financial as well as the emotional burden on people with diabetes and their families. Diabetes has a large community problem in terms of disease burden, resource utilization and labor force absentee, sick leaves early retirements, disability and high expenditure imposing negative economic impact. Indigenous Australian have notably higher morbidity incidence and prevalence of diabetes as compared to the non-indigenous population. In comparison to their non-indigenous counterpart aboriginal and Torres strait have lower health outcomes. Type 2 diabetes is the major cause of death among the indigenous population. Hence interventional activities are required for targeting various factors to prevent diabetes among indigenous Australia community.

PREVALENCE AND DETERMINANT OF DIABETES AMONG THE INDIGENOUS POPULATION

Social, cultural, economic and ecological determinants of health that affects the indigenous Australian population behaviours are education, income, geographical factors, food insecurities and lack of easy access to healthcare services. The aboriginal and Torres Strait Islanders are at an increased rate of manifesting diabetes due to increase rate of obesity changed in diet due to modernisation ageing population and a lower rate of physical activity. The behavioural risk of the population also predisposes to the prevalence of diabetes. There has been growing evidence that supports aboriginal and Torres Strait Islanders to suffer from hyperinsulinemia and insulin resistance which could be a future pretty tired of suffering diabetes. Disease progression is contributed by factors like exposure to cigarette smoking, sedentary lifestyle, alcohol and alteration in one’s efficient way of living.

Health Literacy and Diabetes Care

In a study conducted in 2019 which an intent to establish the health literacy for aboriginal and street islanders people community found a significant link between chronic diseases and literary abilities of the individual within the community. Health literacy within the individuals of the community led to improve the health outcomes. Health literacy is also critical for the efficient implementation of healthcare policies and their deliveries.

The Barrier to Access to Health

Due to the higher availability of these services within towns and pooling towards the urban area indigenous Australian population living within the remote geographical boundaries experience an increased travel cost or barriers towards easy access to healthcare services. These increased medical and medicinal expenses put added financial burdens to the families which are mostly lower-income leading to withdraw from the healthcare service. Also, in some of the communities, the healthcare system is not perceived as culturally sensitive or save for appropriate patient care which leads to further resistance to healthcare access.

REQUIRED NURSING CONSIDERATIONS AND INTERVENTIONS

As per the Registered Nurse Scope, 2016, nurses’ practice is the evidence-based person-centric approach for preventive, curative, formative, palliative and the restorative element of human health. Nurses can play a huge role in proposing interventions within the community-based programmes for aiming to boost the education to gain confidence among the indigenous Australian population in the remote area (Halcomb et al., 2017). Nurses can play crucial role by focussing on five modes of care that is laboratory tests, physical check-ups, speciality care, counselling for nutrition and physical activity counselling for substance abuse (Schierhout et al., 2016)

Health Promotion and Education

Nutritional education can play an essential factor in the direction of improving the nutrition-related health issues integrating with nutritional programs designed to increase access to healthy food are most effective found interventions for diabetes control (Browne et al, 2017). As per the registered nurse scope of practice 2016, a nurse should communicate effectively, concerning Individual dignity, culture and belief. This particularly allows nurses to engage with the community individuals for a better understanding of their belief and culture for managing the modifiable risk factor through interventions. This is also supported by the professional standard under the scope of ethics 2016 which states that nursing works on the elements like counselling and patient education. The regulation of states for the registered nurse the scope of practice in Australia defines the standard for providing services like health promotion maintenance and restoration of health as well as preventive treatment in palliation of illnesses (Birks et al.,2016). 

Nurses can work in collaboration with the community based and controlled medical centre like AMC and Aboriginal Community Controlled Health Service (ACCHS) to enhance the health literacy and better trusting relationship between healthcare professionals and nurses. Along with this Continuous Quality Improvement programs through Indigenous primary health care services in Australia helps in achieving the goal through integrated partnership (Gardner et al.,2018). Interventions can be developed based on the theme of professional, ethical and legislative considerations of the scope of practice (Bradley et al., 2020). Education should be targeted in netter self-management, self-care, reduce self-discharge, diet modification, lifestyle modification and treatment compliance (Fukada, 2018). 

Effective Primary Health Care Setting

It is a challenging task to screen for diabetes in remote areas where the aboriginal Australian setting is present. An investigation like blood glucose monitoring and HB1AC plays an important role in the effective point of care and management of diabetes. And sufficient accurate method of screening and diagnosing the patient with diabetes helps in better managing of the condition. Effective diabetes management for aboriginal interested islanders depends on their access to the range of services available willingly healthcare settings. This can be only made possible through coordinated interactions between patient and health care providers within the healthcare system this may include early detection of and diagnose diabetes, good quality of primary health care, access to medications prescribed, education for self-management and lastly the tertiary treatment which requires the specialist when the complications develop. Adequate primary healthcare services are required to focus on quality improvement service delivery system. The testing system of the indigenous population regarded as a higher risk for developing diabetes should be revised in a way that it becomes a continuous habitual exercise.

CONCLUSION

Chronic diseases like diabetes are associated with the rising economic burden on the nation due to increased hospitalisation treatment cost and decreased productivity due to disability is and complications. Hence improving the quality of services directed towards diabetes becomes a national goal. The sole purpose of nursing considerations and interventions should be directed to reduce the health gap between indigenous and non-indigenous communities which may require long-term follow-ups, crucial to identify the changes within the community. Nurses must be capable of providing comprehensive care to meet the complex and diverse needs of patient (Fukada, 2018).