Strategies for Effective Nurse-Patient Communication in Managing Type-2 Diabetes

Introduction

The nurses during care offer required treatment and intervention by the patients to treat their physical ailments and accomplish emotional needs. Thus, the delivery of appropriate nursing care is required for ensuring quality health and well-being of the patients. During the delivery of effective nursing care, the establishment of proper communication between the nurses and the patient is to be established. This is required for determining the needs of the patients and making them comply with the care offered as well as involve them with nurses in making shared decision regarding their healthcare. In this assignment, the nursing care regarding Andrew, who is suffering from type-2 diabetes and is the sole earner of the family is to be discussed. For this purpose, the initial barriers to be faced by nurses in making therapeutic communication with Andrew is to be analysed to determine the way the barrier is going to impede the interaction between Andrew and the nurse. Moreover, the way barriers are to be resolved through the implementation of effective communication principles is to be explained. The socio-political and psychosocial influences on the daily lives of Andrew is to be discussed. Further, the health and social services to be required by Andrew is to be discussed to ensure his quality health condition and well-being.

Therapeutic Communication between patient and nurse

The therapeutic communication is referred to direct interaction by the nurses with the patients which is focused on improving the physical and mental well-being of the patients (Abdolrahimi et al. 2017). In the present case study, it is seen that Andrew is suffering from stress because of increased work pressure developed at work as a result of staff shortage in the organisation. As mentioned by Paulmann et al. (2016), people suffering from stress are found to misunderstand other people’s intention during communication. This is because during stress the individual’s mind is tensed making the person unable to develop proper thinking for determining the specific meaning of other’s intention while communicating. It indicates that Andrew out of stress may be facing barriers to develop effective therapeutic communication with the nurses as he may be unable to perceive the true intention and meaning of the nurses for trying to develop interaction with him. This, in turn, is going to make him lack focus as well as develop conflict with the nurses during the interaction leading to hindered therapeutic communication. As argued by Yang et al. (2017), people suffering from stress are found to isolate them from the public and avoid interacting with others regarding their mental issues. This is because they feel their emotions would not be understood by others. Since Andrew is suffering from stress, thus it can be determined that he may be facing barriers of avoiding to communicate with the nurses regarding his health concern. This is because Andrew of his stressed condition may perceive that the nurses would be unable to understand his deteriorated emotional and physical condition, in turn, making the nurses unable to determine his health condition and complications.

The case study informs that Andrew is suffering from type-2 diabetes which may create a negative emotional impact on his health condition that in turn may be developing barriers between him and the nurses in developing therapeutic communication. As asserted by Seawell et al. (2016), people suffering from type-2 diabetes develops anxiety which negatively affects their social and interaction abilities. This is because out of anxiety regarding the health condition the patients develop inability to maintain a smooth communication as they face disruption in verbal fluency to properly communicate their needs to the nurses (Sadanand et al. 2016). In case of Andrew, it is seen that he has already faced hypoglycaemia twice in the last six months out of irregularities due to stress at work. This condition of deteriorating health condition may make him anxious which is going to create barrier for him to properly communicate all the required information to the nurses through verbal fluency. Thus, it may lead the nurses unable to determine all the specific physical and emotional needs of Andrew making the nurses feel confusion regarding the nature of care to be delivered to the patients. As argued by Verma et al. (2018), the presence of depression is common among patients with diabetes which impacts to hinder their ability to make proper communication. This is because depressed diabetic patients may develop lot of interruption during communication making the interaction lengthy for the nurses. Since Andrew is suffering from type-2 diabetes and is stressed at work, therefore the person may develop depression out of the negative health and social condition This is going to create barriers for him to take increased time and make long pauses in making interaction with the nurses during therapeutic communication leading the nurses lose track regarding the information being shared by Andrew.

In order to resolve the barriers in communication faced by Andrew during therapeutic communication, the nurses are to develop active listening. This is because active listening by the nurses leads the patients under stress even after making broken interaction develop value and respect which influences them to develop trust on the nurses and to make relaxed and smooth communication to inform their specific needs and demands in a proper way (Joseph and Golden, 2017). The nurses to make effective therapeutic communication with Andrew is to listen to his information with empathy. This is because empathetic listening makes the patient's feel the nurses effectively understand their pain and suffering, in turn, avoiding them to misinterpret the nurse's intention and verses in making interaction (Trikkalinou et al. 2017). Andrew out of anxiety regarding his condition when develops long pauses in communication, the nurse are required to be patient listeners, avoid interruption and urge the patient to speak by making him remember what is mentioned before. This is because it would make the nurses ensure they are actively listening to the person, in turn, helping him to develop confidence in further informing their needs regarding health which is to be considered by the nurses in developing or panning the care.

Psychosocial and socio-political influences on the everyday life of Andrew

The psychosocial and socio-political determinants of health include social, cultural, economic and mental context regarding health (Flaskerud and Lesser, 2018). In the case study, it is mentioned that Andrew who is affected by type-2 diabetes is also suffering from increased mental stress at work. As commented by Marklund et al. (2019), increased stress at the workplace leads the individuals lack focus on executing work and taking proper care of themselves. This is because stress creates hindrance in the systematic emotional functioning of the individual which leads to create deteriorated productivity and develop health issues such as eating disorder, risk of cardiovascular health and others (Marklund et al. 2019). In case of Andrew, the stress is seen to have hindered his everyday life by making him develop irregularity in taking proper meals prepared by his wife which he usually used to take previously. This is because stress may have lead him to properly remember when to take meals in turn negatively affecting his health which is seen as he has recently faced two incidences of hypoglycaemia in the past six months. As argued by Kumar et al. (2020), the presence of prolonged stress leads people with type-2 diabetes to experience high level of blood sugar. This indicates that prolonged stress faced by Andrew may lead him unable to control his blood sugar levels to normal even after taking proper meals and medication, in turn, making him exposed to face risky health condition such as cardiovascular disorder and others related with his condition.

The physical efficiency of people with ageing to work reduces as the body is unable to develop effective renewal of cells that are affected by wear and tear out of stress and physical activity as well as show incapability to develop proper energy (Zijlstra et al. 2016). Andrew is already found to be 62 years indicating the individual has become elderly and the increased age is considered to have made him unable to have effective physical and emotional strength to perform under pressure at work. Thus, this condition may have contributed to increased stress for Andrew as he may be lacking strength and efficiency to perform under pressure created at work due to shortage of staff. As commented by Fianu et al. (2016), the poor socio-economic condition is seen to negatively affect the everyday lives of the individuals. This is because poor individuals have to work hard under pressure irrespective of their mental and physical efficiency to earn finances to have economic stability in leading their lives, in turn, avoiding impact of health condition. In case of Andrew, it is found that the person is from the low socio-economic background and is the sole earner of the family due to which Andrew has to continuously work irrespective of his diabetic health complication making him face hindered health condition each day such as the development of hypoglycemia and others.

In case of Andrew, it is found that his wife Pauline is dependent on him for availing finances required for leading life. In addition, Andrew's eldest son and other children are found to be suffering from various social complication and health disorder in their families due to which they are unable to support Andrew to retain their proper social status. Thus, the hindered social condition within the family has affected the everyday life of Andrew to be involved in working physically at the workplace irrespective of his type-2 diabetic condition so as to earn required finances in supporting their lifestyle. As mentioned by Siddique et al. (2017), the presence of effective awareness education regarding the way to control health complication ensure improved health of individuals. This is because educated individuals follow proper health routine out of the awareness regarding the risk towards health to be faced by violating the activities. Andrew is found to be properly educated of his condition due to which it has affected his daily life to take proper meals and arrange medication so that the health condition remains under control. The healthy behaviours of Andrew of keeping oral glucose always available have affected his daily life to avoid getting adversely affected by the presence of type-2 diabetes and irregular diets. This is evident as in the past six months for the two times when Andrew faced hypoglycaemic condition he immediately took oral glucose ensuring to keep his health steady and maintain proper well-being.

Health and social care for supporting Andrew

In case of Andrew, the initial services to be arranged by the nurses is opportunity for Andrew to perform effective physical activity in controlling stress and type-2 diabetic condition. This is because proper physical exercise stimulates the body to produce endorphins which are chemicals present in the brain functioning as painkiller that acts to improve the psychological functioning of the brain which turn leads to lower stress among individuals (Colberg et al. 2016). In the study by Støa et al. (2017), it is mentioned that involving in aerobic exercise is seen to create anti-anxiety impact on the body. Therefore, nurses are to refer aerobic exercises to Andrew to help him cope with stress and anxiety faced as a result of working condition and deteriorated health. The nurses are to refer anti-depressants to Andrew to help him control the stress faced at work. This is because anti-depressants act to lower the hormonal stress responses that lead to normalise the cortisol level in the body leading the brain cells to be avoided from stress, in turn, making the individual have better mental health (Brieler et al. 2016). In Andrew's case, the nurses are to refer him to the multi-disciplinary team that would include a diabetic nurse and mental health professional who would work collaboratively to determine the way care for Andrew is to be arranged so that his tress at work, as well as type-2 diabetes, remain under control to ensure his effective well-being.

Conclusion

The above discussion informs that Andrew is suffering from stress at a workplace due to work pressure created by the shortage of employees. The stress faced Andrew is going to lead him experience barriers of not understanding or believing nurses responses regarding his health which would hinder in the development of effective therapeutic condition. In addition, the stress and anxious feeling out of the work condition and health is going to make Andrew experience issues with verbal fluency in communicating his needs to the nurses leading to develop hindered therapeutic communication. The nurses are to maintain patience, active listening and others to resolve the barriers experienced in therapeutic condition. The continuous work stress, low socio-economic condition, ageing and other issues are going to affect Andrew in facing negative experiences in everyday life. The nurses to ensure proper care for Andrew are to refer him to the multi-disciplinary team, provide information to execute physical exercise and refer him anti-depressants to maintain proper health and well-being.

References

Abdolrahimi, M., Ghiyasvandian, S., Zakerimoghadam, M. and Ebadi, A., 2017. Therapeutic communication in nursing students: A Walker & Avant concept analysis. Electronic physician, 9(8), p.4968.

Brieler, J.A., Lustman, P.J., Scherrer, J.F., Salas, J. and Schneider, F.D., 2016. Antidepressant medication use and glycaemic control in co-morbid type 2 diabetes and depression. Family practice, 33(1), pp.30-36.

Colberg, S.R., Sigal, R.J., Yardley, J.E., Riddell, M.C., Dunstan, D.W., Dempsey, P.C., Horton, E.S., Castorino, K. and Tate, D.F., 2016. Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes care, 39(11), pp.2065-2079.

Fianu, A., Bourse, L., Naty, N., Le Moullec, N., Lepage, B., Lang, T. and Favier, F., 2016. Long-term effectiveness of a lifestyle intervention for the primary prevention of type 2 diabetes in a low socio-economic community–an intervention follow-up study on Reunion Island. PloS one, 11(1). Pp.23-67.

Flaskerud, J.H. and Lesser, J., 2018. The current socio-political climate and psychological distress among transgender people. Issues in mental health nursing, 39(1), pp.93-96.

Joseph, J.J. and Golden, S.H., 2017. Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus. Annals of the New York Academy of Sciences, 1391(1), p.20.

Kumar, A., Kumari, R., Singh, L.K. and Kumar, D., 2020. Socio-economic Status, Stress and Type 2 Diabetes: An Exploring Link. Our Heritage, 68(1), pp.10565-10574.

Marklund, S., Mienna, C.S., Wahlström, J., Englund, E. and Wiesinger, B., 2019. Work ability and productivity among dentists: associations with musculoskeletal pain, stress, and sleep. International archives of occupational and environmental health, pp.1-8.

Paulmann, S., Furnes, D., Bøkenes, A.M. and Cozzolino, P.J., 2016. How psychological stress affects emotional prosody. Plos one, 11(11).p.23-56.

Sadanand, S., Balachandar, R. and Bharath, S., 2016. Memory and executive functions in persons with type 2 diabetes: a meta‐analysis. Diabetes/metabolism research and reviews, 32(2), pp.132-142.

Seawell, A.H., Hurt, T.R. and Shirley, M.C., 2016. The influence of stress, gender, and culture on type 2 diabetes prevention and management among Black men: A qualitative analysis. American journal of men's health, 10(2), pp.149-156.

Siddique, M.K.B., Islam, S.M.S., Banik, P.C. and Rawal, L.B., 2017. Diabetes knowledge and utilization of healthcare services among patients with type 2 diabetes mellitus in Dhaka, Bangladesh. BMC health services research, 17(1), p.586.

Støa, E.M., Meling, S., Nyhus, L.K., Strømstad, G., Mangerud, K.M., Helgerud, J., Bratland-Sanda, S. and Støren, Ø., 2017. High-intensity aerobic interval training improves aerobic fitness and HbA1c among persons diagnosed with type 2 diabetes. European journal of applied physiology, 117(3), pp.455-467.

Trikkalinou, A., Papazafiropoulou, A.K. and Melidonis, A., 2017. Type 2 diabetes and quality of life. World journal of diabetes, 8(4), p.120.

Verma, R.K., Kumari, P., Maurya, R.K., Kumar, V., Verma, R.B. and Singh, R.K., 2018. Medicinal properties of turmeric (Curcuma longa L.): A review. IJCS, 6(4), pp.1354-1357.

Yang, T., Guo, Y., Ma, M., Li, Y., Tian, H. and Deng, J., 2017. Job stress and Presenteeism among Chinese healthcare workers: the mediating effects of affective commitment. International journal of environmental research and public health, 14(9), p.978.

Zijlstra, E., Hagedoorn, M., Krijnen, W.P., van der Schans, C.P. and Mobach, M.P., 2016. Route complexity and simulated physical ageing negatively influence wayfinding. Applied ergonomics, 56, pp.62-67.

Take a deeper dive into Skills for Nursing Practise with our additional resources.