Diabetic, Secondary Prevention/ Screening for a Vulnerable Population in Long-Term Care Facility
In the United States, approximately 34.2 million adults suffer from diabetes with every 1 out of 5 individuals being unaware of their condition. The statistics of diabetes in adults have more than doubled over the past 20 years. Ranked as the seventh most prevalent cause of death in the US, diabetes leads to numerous health conditions including blindness among adults, amputation of lower limbs, and kidney failure (CDC, 2021). In such a scenario, it is imperative that individuals, especially those most vulnerable, are educated about the importance of secondary prevention. The learning needs of a vulnerable population are wide-ranging. It is significant for them to understand the importance of screening tests for early detection of the disease. Moreover, the high-risk population must be aware of the importance of physical activity and maintenance of healthy levels of glucose to avert worsening symptoms. This paper aims to describe the teaching experience related to secondary prevention of diabetes in a community setting. The paper includes a summary of the teaching plan, the epidemiological rationale for the topic, and an evaluation highlighting the areas of strength and improvement.
Summary of the Teaching Plan
There are various risk factors associated with the development of diabetes. Therefore, the idea of community awareness regarding secondary prevention of this disease was the prime concern. The teaching session employed the use of a two-page pamphlet presentation. This resource was chosen due to its effectiveness in covering various aspects of a topic while including visual media. Also, the aim was to keep the written information brief and to the point and avoid unnecessary distractions. The main objective of the teaching plan was secondary prevention/ screening of diabetics among the vulnerable population of a long-term care facility. As secondary prevention involves early detection of disease followed by adopting measures to control its symptoms, the teaching plan included information about screening tests and lifestyle choices. The teaching plan emphasized the importance of monitoring glucose levels in the blood. It also highlighted the role of physical exercise, diet planning, use of medication, and managing concomitant diseases such as cardiovascular disorder, retinopathy, nephropathy, and foot damage among others. The teaching part was followed by a question/answer session which encouraged the participants to ask questions more specific to their needs.
Epidemiological Rationale for the Topic
Epidemiology is a data-driven approach that aims to study the distribution and the determinants of a disease or a health-related concern. It focuses upon specified populations and employs the study for effective regulation of health problems (Porta, 2014). As mentioned above, nearly 35 million people in the US have been diagnosed with diabetes. The situation worsens because one out of every five individuals is unaware of their condition. In such a scenario, the importance of secondary prevention and screening tests increases. The most prevalent cause of diabetes is often unhealthy lifestyle choices and obesity. Additionally, numerous multisystem complications are associated with this disease. The complications of microvascular endpoints include nephropathy, retinopathy, and neuropathy while the complications of the macrovascular endpoints may result in a stroke, ischemic heart disease, and peripheral vascular disease (Forouhi & Wareham, 2014).
The statistical data shows that in 2019, approximately 1.5 million deaths were caused as a direct result of diabetes while in 2012, another 2.2 million deaths were associated with high levels of blood glucose. The diabetes-related premature mortality rate has been on the rise with a 5% increase between the years 2000 and 2016 (WHO, 2021). The health impact of diabetes includes damage to the heart and the blood vessels, kidneys, eyes, and nerves. The statistics reveal that diabetic adults are two to three times more at risk of stroke and heart disease (The Emerging Risk Factors Collaboration, 2010). Diabetes is characterized as the primary cause of kidney failure and also about 3% of global blindness (Bourne, et al., 2016; United States Renal Data System, 2015).
Diabetic individuals need to comprehend the entirety of suffering from this disease along with the adjustments required to cope with this chronic condition. Requiring immediate alterations to lifestyle especially in terms of diet and physical activity is central to general health enhancement. Also, individuals trained in using the meter and correctly interpreting the readings are more likely to administer self-blood glucose screening, therefore increasing the chance of early detection (Unger, 2013). The morbidity, premature mortality, and diminished life expectancy along with financial and emotional costs associated with this disease render it an important issue of public health and awareness.
Evaluation of Teaching Experience
The preparation of the teaching material involved designing the 2-page pamphlet presentation. To keep the audience interested, the information was kept concise and in form of bullet points. Graphical representation and images were used to make the pamphlets attractive and to facilitate the learning of visuals learners. This educational session was organized at a long-term care facility i.e., the Hillside Manor Rehab. The session was attended by a mixed-gender group of ten participants of the age group 50 – 70 years. A projector was utilized to display the pamphlet to improve visibility. Moreover, printed pamphlets were handed out to the participants as well. Additional pamphlets were made available to share with family, friends, and visitors.
The session progressed from a warm welcome and initial introduction to a briefing about the learning outcomes. From the very beginning, the session aimed at promoting a discussion and encouraged the participants to share their views. The risk factors associated with diabetes were discussed in detail along with the screening tests that can help detect diabetes. The session elaborated the lifestyle adjustments to control the development of other conditions and to regulate the symptoms of diabetes effectively. The session was planned well in terms of time and resource management.
Overall, the teaching experience was quite rewarding. The research to prepare the teaching resource offered a chance to learn about the topic in detail. Teaching this topic to others and holding detailed discussions was in itself a learning experience. It reflects the personal commitment to learning continuously. The participants reflected an appreciable understanding of the content through their questioning and discussion. Conclusively, it can be stated that the learning outcomes of the plan were achieved. However, a single session is not sufficient to reduce the rate of diabetes prevalence. It can be achieved through monthly sessions focusing on the management of glucose levels, and employing interventions such as exercise, a healthy diet, and medication adherence.
Community Response to Teaching
The community teaching session was quite successful as was evident through the participants’ feedback. In terms of organization, participants expressed satisfaction with the venue and the seating arrangement. They appreciated the mode of presentation and the presenter’s knowledge about the topic. The outcomes of the teaching session were formatively assessed through questioning. The participants’ responses revealed successful attainment of session goals. The session feedback tool indicated that participants were satisfied with the amount of information; they also appreciated the professional disposition of the presenter. Participants expressed quite an interest in future sessions for diabetes and other chronic illnesses. The need for a detailed presentation regarding the topic was also highlighted. The willingness and interest displayed by the attendees is an important reflection of community receptiveness to such awareness sessions.
Areas of Strength and Improvement
The teaching session had several areas of strength. Throughout the session, participants were encouraged to communicate openly and the session discussion transitioned quite well from the beginning till the end. The participants were quite comfortable and asked relevant questions during the question/answer session. The pamphlet presentation allowed to keep the discussion very focused by providing concisely-structured information. It proved to be an important educational resource that engaged the attendees very effectively. The attractive layout of the pamphlet included images that made it visually appealing. The session feedback tool was quite helpful in gaining an insight into the participants’ future expectations. The feedback would be employed in planning the subsequent sessions.
This teaching experience also helped in the identification of certain areas of improvement. A project coordinator could have aided in managing the participants to avoid issues related to housekeeping. Moreover, it was assessed that the participants did not have information about the different types of diabetes. Therefore, for future sessions, this must be included as a talking point to avoid conceptual difficulties.
Conclusion
The increased prevalence of diabetes among Americans is a cause of concern and while primary prevention is important to avert disease before its occurrence, secondary intervention can lead to early detection and effective management of the symptoms. Educating the community members about the importance of undergoing screening tests and enlightening them about the lifestyle adjustments to manage the symptoms is extremely important. Reaching out to the high-risk community members especially those in long-term care facilities can make these individuals autonomous in self-care. It can enable them to make informed choices about their health condition. Regular community awareness sessions must be planned by health care workers to promote healthy life choices and to reduce the elevating statistics.
References
Bourne, R. R., Stevens, G. A., White, R. A., Smith, J. L., Flaxman, S., Price, H., . . . Taylor, H. R. (2016). Causes of vision loss worldwide, 1990-2010: a systematic analysis. Lancet Global Health, 1(6), 339-349.
CDC. (2021). Diabetes: What is diabetes? Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/diabetes/basics/diabetes.html
Forouhi, N. G., & Wareham, N. J. (2014). Epidemiology of diabetes. Medicine, 42(12), 698-702.
Porta, M. (2014). A Dictionary of Epidemiology. New York: Oxford University Press.
The Emerging Risk Factors Collaboration. (2010). Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. The Lancet, 375(9733), 2215-2222.
Unger, J. (2013). Diabetes Management in Primary Care. Lippincott Williams & Wilkins.
United States Renal Data System. (2015). US Renal Data System 2014 Annual Data Report: Epidemiology of Kidney Disease in the United States. American Journal of Kidney Diseases, 66(1).
WHO. (2021). Diabetes. Retrieved from World Health Organization: https://www.who.int/news-room/fact-sheets/detail/diabetes
