The Structural Component
Discuss about the Diabetes in Australia for Health Management Problem.
In keeping with the changing trends in the socio-economic, lifestyle profiles of modern times, the incidences of metabolic syndromes and lifestyle disorders have surged proportionately. Among the prominent lifestyle health disorders, the clinical condition of diabetes may be mentioned as a major concern in developed nations as Australia. The issue of diabetes has been recognized as a grave threat to the ever increasing and vastly diversified population in Australia impacting their daily lives to a great extent. Diabetes, a common metabolic syndrome is generally characterized by excessive thirst, increased hunger, frequent urination, blurred vision, reduced wound healing time and general symptoms of fatigue and weakness. The presence or absence of the endocrine hormone of insulin determines the type of diabetes. Type 1 diabetes occurs when insulin is lacking in the body due to immunological destruction of pancreas responsible for producing the hormone and is generally prevalent among children, therefore named as juvenile diabetes. Contrarily Type 2 diabetes is attributed to deficient or insufficient insulin due to pancreatic malfunctioning leading to insulin resistance and commonly occurs in adults. Type 1 and type 2 diabetes are termed as insulin dependent and non-insulin dependent diabetes respectively. Obese or overweight people with familial tendency of diabetes, habituated to sedentary lifestyle, history of hypertension and other associated cardiovascular abnormalities are predisposed to type 2 diabetes. Type 2 diabetes may be effectively managed and prevented through appropriate lifestyle interventions and modifications, while type 1 diabetes is unpreventable. Lifelong insulin therapy is to be provided to persons suffering from type 1 diabetes due to its chronic nature of prevalence, however type 2 diabetes does not account for such long term and lifelong therapy, case appropriate medications and changes in lifestyle may be sufficient to mitigate the problems. In the Australian context, the healthcare facility encounter much challenges to adequately tackle the diabetes scenario among its current population of mixed origin and demographic background. Studies pertaining to the Australian population over the last decade indicate an overall decline in all cause mortality rates in both the men and women attributed to improved treatment modality (Harding et al., 2014). Continued and dynamic healthcare service attempts are in progress to deal with the complications arising out of this debilitating diabetic condition, but a lot more still remains to be done to address and evaluate the outcomes of people suffering from diabetes. The conditions pertinent to diabetes in the Australian context shall be analyzed on the light of four different frames of reference such as the structural, human resource, political and symbolic which is as follows.
The Human Resource Aspect
The structural component of the healthcare setting provides an overview of the working pattern and the policies adopted longitudinally in the relevant field of investigation. The problems due to diabetes are generally rampant within a varied population of Australia ranging from children, adolescents, women during their gestational period as well as adults. Type 2 diabetes has been recognized as a health priority in Australia since quite a long time. A behavior change intervention program funded by the Victorian department of Health consisting of six group sessions over 8 months period was conducted to assess the efficacy of the proposed method in recruiting workforce, training and infrastructure building based on the experience gathered from the Greater Green Triangle diabetes prevention implementation trial. Collaboration between policymakers, developers and examiners of the assessment was promoted in the study (Dunbar et al., 2014). Conflicting reports based on a community setting of preventive measures to encourage weight loss mechanisms among the affected people implicated no positive clinical outcomes. Further the study supported that prevention or delay of the onset of the disease was impossible through community interventional strategy and therefore neither public fund nor any national initiatives should be invested in this regard (Kahn & Davidson, 2014). Another major concern of the diabetes occurrence is among the prospective mothers during their gestational phase when the blood glucose concentrations escalate suddenly without any proper causative factor. Gestational diabetes mellitus (GDM) occurs during pregnancy in women glucose intolerance becomes evident. Post GDM women have a higher propensity of developing type 2 diabetes (T2D) with respect to their normal condition in absence of pregnancy and therefore efforts to curb the relevant problem are in practice. One such effort considers study protocol applicable through a randomized controlled trial in the form of Mothers After Gestational Diabetes in Australia Diabetes Prevention Program (MAGDA-DPP) post natal intervention and the investigations results predict the future for similar research studies to be adopted for this population (Shih et al., 2013). The psychological and behavioral aspects of the diabetic clinical condition was extensively studied by virtue of a national survey in the Australian circumstance among the adults having type 1 and type 2 diabetes to obtain an insight regarding the mode of lifestyle, the therapeutic regime they follow, the service they receive from the healthcare setting as well as the effects of diabetes in their routine lives. The data procured validated the future implications from similar practices (Speight et al., 2012). Queenly Community Health Service (QCHS) operating in the Australian region offers a wide range of facilities within their structural framework achieved through collaborative approach from all competent authorities involving the clinicians, registered nurses and other associated staff of the healthcare setting. The referral to the specialist doctors essentially follows a hierarchic approach, with the basic healthcare workers handling the situation primarily. The patients are generally fixed appointments according to the intensity of their clinical manifestations and case histories. After that, definite interventional treatments are optimized for them as per the situational demands. Thus the pillar of the health service lies on the shoulders of the organizational line up and proper job distribution among the workers.
Challenges in Management and Prevention
Another important aspect of the healthcare management problem belong to the human resourcing based on the perceptions and notions affecting the interactions and relationships among the people both at the giving and receiving ends. The experiences and opinions of the concerned people are considered in this respect to identify specific issues for particular clinical condition to effectively address the situations. In the context of diabetes, the people affected by this brimming health problem intruding their personal space due to adverse outcomes are of prime importance to better the way of living. Data pertaining to severely obese people in Australia with type 2 diabetes were found to possess cumulative stressors associated to health, socio-economic, demographic factors, disability, and express impaired well-being in such patients. Thus the knowledge gained from this study further implies the vital psychology of the affected population irrespective of their gender (Dixon et al., 2013). Sinusoidal variation in the instances of childhood type 1 diabetes among the Australian inhabitants was observed on inspectional study carried between the time periods extending from 2000 to 2011. Environmental triggers were found to be the etiological factors culminating in the development of childhood diabetes. No linear but a cyclical pattern of increase in the annual overall instance of juvenile type 1 diabetes was observed and the findings further corroborated with the results reported from Western Australia (Haynes et al., 2015). Negative appraisal of insulin therapy was noted in the young adult Australians with type 2 diabetes using insulin, evident from survey conducted on the targeted population. Decreased satisfaction with blood glucose examination, reduced diabetes based self efficacy in conjunction with declined diabetes specific emotional well being prompted the negative appraisal of the insulin therapy (Holmes et al., 2015). The transition from childhood to adult healthcare services is noted in case of individuals affected by type 1 diabetes, but dearth of literatures have impeded further scope for studying. Preliminary evidence suggests positive outcomes due to structured transition programs. The obstacles hindering the progress in case of the diabetic patients need to be properly identified to foster better health implications in such patients. Declining clinical attendances lead to the transition of the healthcare facility. Thus better communication and understanding of the affected persons during this transitory phase is imperative to ensure better treatment strategies and bridging the gap between the patients and healthcare activists (Sheehan, While, & Coyne, 2015). Therefore evidences available from the relevant articles and research studies emphasize on better interaction and communication among the diseased patients and the healthcare professionals. Individuals have distinct needs, potentials, skills, feelings, fears and prejudices and therefore each distinct case require unique attention to tackle the situation. Engagement of wide number of healthcare personnel to address the repercussions and evaluate and implement novel therapeutic interventions may suffice the needs of the hour. A holistic approach from all the ends concerned will facilitate speedy recovery and preventing the onset of certain lifestyle disorders such as diabetes. QCHS has enough working force to effectively deal with the health conditions and therefore offer hope to cater to the needs of the patients.
Conclusion
The other aspect of the organizational framework is the political one where the focus is directed towards power, competition and utilization of scarce resources. In the QCHS, although the demand and supply chain is not enough to fulfill the requirements of the patients, yet a positive sign is revealed from the increase in the workforce cost each year. Financial constraints are a major issue in this regard as well. Diabetes epidemiology has been extensively studied in the Australian context over a number of years. Studies pertaining to diabetes are looked upon from several angles where the association between dietary intakes and possible outcomes in the diabetics has been investigated. Incorporation of dairy food in the diet of diabetic patients proved to be beneficial in case of the male Australians in addition to the positive outcomes for the obese persons as well. The Australian Diabetes Obesity and Lifestyle Study (AusDiab) was a national, population based investigation carried over 5 years duration that indicated these positive implications due to increased dairy intake in the regular diets (Grantham et al., 2013). The costs of the treatments for diabetes in Australia as per research studies have been attributed to increased complications in specific diabetes cases. Thus, mitigating the associated complications due to diabetes or delaying the onset of the disorder may provide respite to curb the expenditure due to costly interventional procedures (Lee et al., 2013). Other relevant studies brought to the forefront certain dietary modification strategies that substantially improved the patient outcomes in patients suffering from type 2 diabetes. A low carbohydrate diet complemented with low saturated and higher unsaturated fats have been recommended in this respect to harbor good outcomes in the patients (Tay et al., 2014). Further studies suggest the higher risks of macrovascular events associated to varying levels of glycosylated hemoglobin (HbA1c) in patients suffering from type 2 diabetes mellitus. Therefore assessment of the appropriate glycemic targets for type 2 diabetic patients might resolve the problems (Zoungas et al., 2012). Another study highlights on the follow up session due to lowering of blood pressure and blood glucose control in case of type 2 diabetes. Patients with long term type 2 diabetes undergoing blood pressure lowering treatment were found to generate positive outcomes in the long term situations. However blood glucose lowering agents did not produce any long term benefits (Zoungas et al., 2014). Nephropathies are common complications related to diabetes. Paucity of effective tools to predict the susceptibility of diabetic individuals at the risk of developing kidney complications emphasizes on the development of futuristic models to assess the actual scenario. Risk scores in connection to variables such as estimated glomerular filtration rate (eGFR) and urinary albumin creatinine ratio (ACR) alone or in combination have rendered valuable predictive models to evaluate the nephropathy complications in the type 2 diabetic patients (Jardine et al., 2012). A consensus is to be obtained for the gestational diabetes mellitus testing in the Australians in terms of fostering positive benefits among the patients (Ross & Callaway, 2013). The political aspect can be accessed through building coalition, negotiation, bargaining, setting agenda and cooperative approaches achievable through skillful leadership qualities.
The final aspect of the organizational framework considers symbolism to foster equipped and quality healthcare services. The processes and management strategies that are in effect to address the health concerns in people are much more emphasized rather than the productivity of the organization. The efforts put up by the QCHS may be mentioned in this regard where ensuing clinical practice facility involving a number of healthcare professionals is evident through the counseling services. Many such efforts and researches pertaining to the nagging health condition of diabetes are relatable to the Australian context. The measurement of diabetes distress may be assessed by virtue of Rasch analysis to detect the psychometric validity of the Diabetes Distress Scale. Cautiousness is recommended to use the Physician related and Interpersonal distress subscales obtained through suboptimal precision (Fenwick et al., 2016). Recent research proposes the usage of the metformin monotherapy as primary mode of treatment for patients with type 2 diabetes mellitus and choice of other adjunct therapies depending upon patient specific outcomes. The efficacy of other glucose lowering drugs was also assessed in clinical trials and the findings suggest metformin to be the most suitable for diabetic patients (Palmer et al., 2016). Extensive demographic studies underpin the increased number of type 2 diabetes incidences among children globally in many nations. Indigenous people and persons belonging to ethnic minorities were particularly vulnerable to the development of type 2 diabetes (Patterson et al., 2014). Therefore the global burden of clinical condition of diabetes need to be addressed from multidimensional angles so as to meet up the specific requirements of individuals affected with the metabolic syndrome of diabetes. Symbolic aspect of the organizational infrastructure may be helpful in this regard to satisfy the concerns of the affected individuals through infusion of a sense of passion, encouragement and professionalism in case of the healthcare givers.
Inference may be drawn from the above mentioned discussions with respect to diabetes as a simmering health problem affecting a vast population globally. Situation in Australia is no exception to this global phenomenon. However dynamic and case appropriate methods, assessment protocols, preparatory models are constantly revised and innovated to tackle this growing menace effectively. Definite changes pertaining to lifestyle modification through therapeutic interventions in the forms of exercise and other medications have been recommended in this matter. Studies have highlighted the benefits of including vigorous resistive exercises in the daily routine of type 2 diabetic persons to mitigate further exacerbation and associated cardiovascular or neuropathic hazards due to the metabolic disorder of diabetes and all the exercises are recommended to be practiced under the supervision and subject to prior training from the expert professionals (Horden et al., 2012). Alteration in food habits have been indicated as another mode of managing diabetic health problem. Lowering the intake of carbohydrate rich food and increasing the dietary intake of unsaturated fatty food have generated positive outcomes in type 2 diabetic patients. Although adequate attention has been given to research oriented to type 2 diabetes, dearth of research is evident for studies relevant to juvenile diabetes or type 1 diabetes. Therefore novel strategies in conjunction with the existing ones should be improvised suited to implement in the healthcare setting. Surpassing all other factors considered in order to managing diabetes issue, collaborative, pragmatic and skillful participation of the healthcare workers in addition to suitable interventional strategies and development of policies should be emphasized to curb the diabetes associated issues among the patients. A holistic outlook towards the diabetes affected patients through mutual interaction and understanding from the healthcare providers’ ends is essential to promote better disease outcomes and improved quality of life in such individuals.
References:
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