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TYPE I DIABETES.
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Paper Abstract:
Discusses nursing interventions. The clinical problem of Type I diabetes in young adults. Cause. Importance of early detection and nursing care. Significance of the problem and implication for nurses. Nursing tasks. Vital element in multidisciplinary teams essential for treatment of diabetes. Proposes a study on effects in young adults.
Paper Introduction:
Nursing Interventions and Type I Diabetes in Young Adults
Introduction
Statement of the Clinical Problem
Armstrong (2002) reported that according to results of surveys undertaken by the National Institutes of Health, the incidence of diabetes in the United States has increased six fold in the past 40 years and, currently, some 798,000 new cases are diagnosed each year in this country. Of the approximately 16 million U.S. residents with diabetes, some 1.6 million have Type I diabetes with the remainder having Type II diabetes. Type I (insulin-dependent) diabetes mellitus emerges for the most part in childhood or in adolescence (Chase, 2001).
Type I diabetes is caused by destruction of cells in the pancreas, which causes the pancreas to produce insufficient amou
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(198 ). Riehl and C. The wellness of the client isuniquely defined by the client and incorporates the relationship of fivevariables: physiological, psychological, socio-cultural, developmental,and spiritual. Neuman (198 ) developed an assessment/intervention tool useful in thepresent study. It helps the diabetic educator/nurse assist patients inadjusting their flexible line of defense to internal and external stressorsand in optimizing their normal line of defense against these stressors(Edelman, 2 ). How do young adults with Type I diabetes mellitus perceive their well-being? Systematic and targeted screening of bothsymptomatic and asymptomatic patients may help to identify individuals atrisk for actually experiencing diabetes. How do nurses determine if Type I diabetes mellitus affects young adults' health-related quality of life? Impact of diabetes screening on quality of life. The study is therefore significant because early detection of Type Idiabetes results in the development of effective interventions and adecrease in the possibility that patients will develop comorbid problemssuch as heart disease (Ashraf, 2 ). Journal of Diabetes Nursing, 6(2), 56-6 .Edelman, M.A. Further, says Cradock (2 2), the nurse who gains greater insightinto the care and treatment of Type I diabetes can function as part of amultidisciplinary healthcare team that addresses care from a holisticperspective. Cradock (2 2) believes that the nurse consultant, clinical nursepractitioner, or registered nurse is in an ideal position to assist youngadults and their families in coping with Type I diabetes. For the nurse charged with providing careand educational as well as supportive services to the adolescent with TypeI diabetes, a thorough understanding of the patient's symptoms, lifestylechoices and behaviors, medication, dietary and exercise regime, andreaction to treatment interventions is especially important (Craddock,2 2). More than the sum of its parts. The Betty Neuman health-care systems model. (2 ). Roy (Eds). The Neuman Systems Model is a wellness model that supports andenables a holistic view of individuals with diabetes mellitus. residents with diabetes, some 1.6million have Type I diabetes with the remainder having Type II diabetes.Type I (insulin-dependent) diabetes mellitus emerges for the most part inchildhood or in adolescence (Chase, 2 1). Part of the task of the nurse working with adolescent populations isto perform diabetic screening as part of an overall health and quality oflife assessment. To that end, an empirical or quantitativeresearch design will be developed. The specific research hypothesis to be tested is: young adults diagnosed with Type I diabetes mellitus will perceive their physical health and their quality of life to be negatively affected by their primary presenting problem.A related but secondary research hypothesis is: nurses who use the Neuman(198 ) assessment-intervention tool to assist young adults with Type Idiabetes mellitus in identifying issues critical to their condition will beable to offer more effective services and education to their patients thannurses who do not use the Neuman (198 ) assessment-intervention tool. Because nurses in the primary care setting are more often thannot responsible for initial assessments of symptoms and case histories,they are in a unique position to exert a positive influence on diabeticpatients and to assist physicians in identifying Type I diabetes or itsmany symptomatic manifestations. Journal of Cardiovascular Nursing, 16(2), 86-95.Ashraf, H. (1998). Research opportunities in diabetes. The Lancet, 356(9231), 741.Chase, H.P. At the same time thatinsulin is the treatment of choice, Chase (2 1) stated that a patient andhis or her family can do a great deal to control blood sugar levels viadietary modifications and exercise regimens. Nursing Times, 94(35), 72-75. (2 2). (2 2). Clinical Reference Systems, Annual, 2 96+.Cradock, S. Edelman, Olsen, Dudley, Harris, and Oddone (2 2) arguedthat systematic disease screening has the potential to improve short-termhealth-related quality of life. Thus, the clinical problem investigated in this quantitative researchproject is focused on the ways in which nurses providing care toadolescents and young adults with Type I diabetes first asses symptomologyand quality of life issues, and secondly determine if the treatment orintervention being provided to patients is adequate to their needs. Itis anticipated that the qualitative review of literature, coupled with aquantitative quasi-experimental research effort will provide support forboth of the research hypotheses and answers to each of the three researchquestions. ReferencesArmstrong, N. Conceptual Models for Nursing Practice. A diabetic educator's use of the Neuman systems model. Type I diabetes is caused by destruction of cells in the pancreas,which causes the pancreas to produce insufficient amounts of insulin, ahormone that helps sugar enter the cells and which also controls the levelof sugar in the blood (Chase, 2 1). The tool is an interview guide to obtain data essential todetermining and providing appropriate care. Early detection of heart disease in patients with Type I diabetes. Inaddition, systematic assessment supports holistic care, more accuratenursing diagnosis, and more effective interventions (Edelman, 2 ). Type I (insulin-dependent) diabetes mellitus. With proper treatment via insulin shots or other forms ofinsulin, blood sugar levels can be controlled. This instrument, to bediscussed in greater depth in subsequent chapters of the study, obtainsbiographical data, identifies stressors as perceived by the client andcaregiver, identifies inter-, intra-, and extra-personal factors impactingon the client and permits the client and nurse to develop a set of goalsand an intervention plan (Neuman, 198 ).Statement of Research Questions and Hypotheses The research questions guiding this study are: How does Type I diabetes mellitus affect young adults? (2 1). Given that numerous symptoms leadingto ill health and a poor quality of life are often associated with Type Idiabetes, early detection and nursing intervention is of specialsignificance (Cradock, 2 2). Arelated concern is the degree to which young adults or adolescents withType I diabetes perceive their condition to have a negative impact upontheir quality of life and the degree to which such patients follow atreatment protocol designed to enhance quality of life and well being.Significance of the Problem and Implications for Nursing Care Chase (2 1) pointed out that if the problems created by Type Idiabetes are not treated or treated properly, they can become life-threatening. (2 2). Accordingto Edelman (2 ), this model views the patient as an open system incontinuous interaction with the environment. Consultant nurses in diabetes - a developing role. Nursing Interventions and Type I Diabetes in Young Adults IntroductionStatement of the Clinical Problem Armstrong (2 2) reported that according to results of surveysundertaken by the National Institutes of Health, the incidence of diabetesin the United States has increased six fold in the past 4 years and,currently, some 798, new cases are diagnosed each year in this country.Of the approximately 16 million U.S. New York: Appleton- Century-Crofts, 118-129.Sumner, J. In J. The results of the study will add tonurses' knowledge of how care and the nursing practice can be improved forpatients with Type I diabetes.Theoretical Framework The study is conducted within the theoretical framework provided bythe Neuman Systems Model. Diabetes Care, 25(6), 1 22-1 26.Neuman, B. By serving as acase manager and care deliverer, the nurse can educate diabetic patientswith respect to all aspects of behavior and lifestyle as well as medicationuse. The model provides a framework to systematicallyassess person-environment interactions and to develop interventions basedon the person's response to environmental and internal stressors. Working with this population todevelop personally proactive behaviors and lifestyle choices can alsoresult in improvement in symptomology prognosis.Statement of the Purpose The purpose of the present study is to provide answers to a set ofresearch questions addressing the effects of Type I diabetes on youngadults, the perceptions of young adults with respect to these effects, andtheir overall well-being, and the roles of nurses in providing bothassessments and interventions. Assisting young adults with Type Idiabetes in identifying their own physical and emotional or psychologicalstates can lead to more effective treatment and interventions and toimprovements in perceived quality of life. (2 ). Nursing Diagnosis, 11(4), 179-182+.Edelman, D., Olsen, M.K., Dudley, T.K., Harris, A.C., & Oddone, E.Z. Sumner (1998) believes that nurses are a vital element in themultidisciplinary teams that are essential for the care and treatment ofdiabetes because of the large number of illnesses that can result from thedisease.
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