Holistic Case Study On A Patient With Diabetes Essay

This is an instance commentary about a diabetic patient, with regards to the patient interviewed in a center setting. The case is analyzed in a all natural manner, where medical and non-medical aspects were fully covered. An in depth account of people involved and thoughts are also included.

Patient History

Ms Linda Mogen*, 76, is a retired university teacher who presently lives with her man in the town area. She will pay a visit to the clinic every three months for an overall checkup as well as to obtain her medications, which is principally insulin. Her family is doing fairly well and there is absolutely no financial burden, although she prefers to visit this particular center although it is relatively further from her house because there are no charges for her as an ex-government employee. She looks as a contented sweetheart who’s well-read about her condition.

Aside from that, she also suffered with hypertension, chiefly credited to stress from her prior are a teacher. In the past, Ms Mogen have been identified as having a thyroid nodule in the neck, and a cyst in the breast, that have been both harmless and removed 5 and 8 years back respectively. As a baby, she used have problems with asthma, but as time approved it became less obvious. Holistic Case Study On A Patient With Diabetes Essay

Ms Mogen uncovered her condition because her father and two sisters possessed diabetes too, which were a hereditary disease in her family. She was highly recommended by her sister – who is a nurse- to have a checkup. Aside from her span of insulin (supplement form), Ms Mogen also consumes alternative treatments, such as Barley Green Supplement, and also other supplements. There are rashes ensuing as an allergy to insect bites as well, possibly related to her diabetes.

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*Names changed to keep confidentiality

Biological Aspects

Diabetes mellitus (DM) consists of a cluster of metabolic disorders that displays high unusual degrees of blood sugar, analogous to hyperglycemia (Kumar, 2009). Type 1 DM is triggered by destruction of pancreatic islet B cell primarily by an autoimmune process, resulting in insulin deficiency, where the patient becomes susceptible to expanding ketoacidosis, whereas type 2 DM results from insulin level of resistance and weakened insulin secretion, aside from disproportionate hepatic blood sugar production. Some typically common presenting symptoms of DM are polyuria, polydipsia, weight reduction, tiredness, weakness, blurred perspective, frequent superficial attacks and poor wound treatment (Kasper, 2008). From urine tests, patient would also present with glycosuria and ketonuria. Insulin is liable in revitalizing bone development, thus there might be significant bone reduction in unattended diabetes mellitus (Saladin, 2010). In relation to diet, starchy food needs to be reduced, i. e. rice, loaf of bread, pastries, potatoes and sugars. Ms Mogen was required to significantly cut down on her consumption of grain, as rice is made up of complex glucose and the body has a limit of transforming the glucose to energy. Holistic Case Study On A Patient With Diabetes Essay

Risk factors for type 2 DM includes a genealogy of diabetes, contest or ethnicity, polycystic ovary syndrome or acanthosis nigricans, habitual physical inactivity, weight problems and hypertension (Kasper, 2008). In Ms Mogen’s case, she had a family history of diabetes, where her daddy and siblings were also influenced and also she experienced hypertension, which is now under control. Optimal treatment for diabetes is not only balancing the plasma glucose, but DM-specific difficulties and risk factors for DM-associated diseases should be identified and taken care of with a wide-range diabetes treatment. Generally, treatment for type 1 DM is 0. 5-1. 0 U/kg each day of insulin partitioned into several dosages. Mixtures of insulin prep with adjustable times of commencement and length of time of action should be utilized. Type 2 DM can be managed with diet and exercise together or alongside oral-glucose-lowering agents, insulin, or a combination of dental mediators and insulin (Kasper, 2008).

Hypertension is a serious elevation in blood circulation pressure (>140/90). Most patients are asymptomatic; however, severe hypertension leads to headache, epistaxis or blurred eye-sight. Investigation includes urinalysis for blood vessels, protein and blood sugar, plasma urea and electrolytes, plasma creatinine, plasma cholesterol and ECG (Haslett, 2006). Optimal goal in handling hypertension is by using a single drug when possible, while maintaining nominal side results. First line agencies include diuretics, beta blockers, ACE inhibitors, angiotensin receptor antagonists and calcium antagonists (Kasper, 2008).

The dangers allied with a specified blood pressure will depend on a combo of risk factors in the precise individual, which include age, gender, cultural source, diet, smoking, genealogy, bloodstream cholesterol, diabetes mellitus and pre-existing vascular disease. There are specific special circumstances to be looked at when prescribing drugs. For instance, in diabetic patients like Ms Mogen, the goal blood pressure to be performed is <130/85. First-line therapy should include ACE inhibitors and angiotensin receptor blockers to control blood circulation pressure and slow renal deterioration (Kasper, 2008). Holistic Case Study On A Patient With Diabetes Essay

Ethical Issues

According to Kumar & Clark (2009), doctors have a medical responsibility for patients, where in fact the protection under the law of patients may be specified by the three tasks of clinical treatment: Protect life and health; value autonomy; protect life and health insurance and value autonomy with fairness and justice. Consequently, there are ethical conditions that come in colaboration with this.

Consent

As a patient has his/her own protection under the law of speaking or providing information, it is very important to acquire consent prior to any interviews. As a patient’s given consent is firmly interrelated to legal issues, it must be known that the consent is given voluntarily. The circumstances accompanying the obtaining of consent should be pondered upon.

For example, the moment Ms Mogen sees a person in white coating approaching her; it might not have advised itself to her that we are medical students instead of doctors. At that time, this might have inadvertently created circumstances of head that she is compelled to answer our questions. Also, she might not exactly have wanted to appear as an unfriendly person, hence allowed us to deal with her. If this is true, then it would be unethical to own suggested such a pressure, even if unintentionally.  Holistic Case Study On A Patient With Diabetes Essay

Confidentiality

While creating a rapport between your doctor and the patient, it is observed that when the physician can gain the patient’s trust e. g. patient totally acknowledges that the information they provide is kept secure, an unwavering patient-doctor marriage is effectively built, and this consecutively encourages the patient to offer helpful information without hesitation. Lack of trust prompts a protective and impersonal method of remedies by the clinician and patient, resulting in the deterioration of the grade of patient good care and professional life (Kumar, 2009).

Ms Mogen described that she really wants to consult her standard GP whenever possible, as she sees him amicable and feels free to talk to his advice and will be offering her improvement on the illness. This is relatively attributable to a well balanced base of trust that has been built since the past few years.

Duty of Care

Once a patient consults the doctor, the doctor gets the duty to cure the individual with the best work. He must be empathetic, speak courteously and perform his tasks to the patients. In Ms Mogen’s impression, she feel that a good doctor is one who sets themselves in patients’ shoes and attempts to understand the individual. He must also provide the patient with related information when the patient requires it because this aids in the wellbeing of the individual. Holistic Case Study On A Patient With Diabetes Essay

Legal Issues

In addition of providing help and treatments to the individual, it is essential a doctor abides strongly to legal aspects. Both fundamental aspects that can’t be overlooked are those related to consent and confidentiality.

Consent can be obtained in two ways: either verbally or in dark and white, typically by putting your signature on a consent form; or be implied when the individual accepts the treatment without question, objection or other physical indications that illustrates rejection (Kumar, 2009).

For consent to be officially acknowledged, there are three important requirements, which include:

1) The individual must be competent i. e. has capacity to consent e. g. is able emotionally and in terms old.

2) The individual must be properly informed concerning the risk, benefits, procedures and other issues they are simply consenting for.

3) The patient must consent voluntarily, and not be coerced into accepting treatment against their hopes.

Under certain circumstances, such as life keeping emergency procedures, there may be exceptions to these rules. However, most or all the procedures taken gets the need of obtaining legal consent, as this acts as”insurance” for further matters. Outcome of failure to take action includes being charged in courtroom.  Holistic Case Study On A Patient With Diabetes Essay

Ms Mogen is of legal years to grant consent, was emotionally competent, fully realized the goal of the interview and had not been under any form of pressure by an authorized. She was eager to share her personal experience and information for educational purposes as well.

Information accumulated from a patient is not to be violated without the patient’s consent, except under obligatory use as proof in court. Like a medical student, I have appropriately de-identified the topic or information by exchanging any possible identifiers with pseudonyms and thus have the to discuss the components of this case with my peers.

Sociological Aspects

Every sole patient has a distinctive personality or feature, predicated on different aspects. Hence, it is practical for us to view the sociological aspect of different patients predicated on a particularly useful model, CHESS-C:

C Culture

H History

E Emotions

S Structure

S Community support

C Critique

Within the adjustable CHESS-C mnemonic (Aroni 2009), [record] is one of the sociological aspects that may well make clear Ms Mogen’s attitude towards her condition, and exactly how she accepts it within her life. Since Ms Mogen’s daddy and two sisters have been identified as having diabetes mellitus, she experienced the necessity to have a medical checkup as suggested by her sister. She accepted that may be a hereditary disease in the family.

She have been exceptionally optimistic about her condition when she first found out. It is because she was mentally prepared to get the news. It can be seen that because there is a family member who was simply a nurse, and another was a plastic surgeon, she obtained sufficient amount of information about diabetes, and for that reason has generated a brighter view of her prognosis. Holistic Case Study On A Patient With Diabetes Essay

In conditions of [culture], Ms Mogen possessed determined herself as a strong Catholic who is very into prayers and deems that by being contented and positive, life would change for the better. Along with this, her [feelings] helped her deal with her health problems as she upholds herself a blissful brain, rid of any mental poison in everyday activities. This notably decreases her stress levels, which helps her condition.

Besides that, Ms Mogen possessed significant amounts of [public support] as she experienced a wide social circle – friends whom she realized from church and also her teaching days. Spending time with her friends occasionally retained herself occupied whilst having supportive companions, aside from her partner, whom she spends the majority of her time with.

Self Treatment, Lifestyle and stress

E Education

S Stress management

S Spirituality

E Exercise

N Nutrition

C Connectedness

E Environment

Ms Mogen’s strategy and outlook regarding her health can be detailed using the wellness-based ESSENCE model. [Education] takes on an important role in helping patients cope. Ms Mogen as a professor is fully equipped with common knowledge and is well-educated. She got the initiative to understand and recognize her illness by reading and researching as she became aware that, by knowing the condition more, she lessened her fear and be concerned. The factor that she experienced purchased sufficient knowledge regarding her condition had greatly abridged her worry and subsequently helps her deal with her feelings. Holistic Case Study On A Patient With Diabetes Essay

Besides that, Ms Mogen suits significant amounts of [exercise] in her daily life as she “feels good when undertaking housework or working out in the gym”. She does indeed her own set of exercise, including bending, stretching, weight lifting and other self-improvised routines 5 days weekly for at least half an hour per time.

[Nourishment] is an especially essential factor for diabetic patients. Ms Mogen found herself adapting fairly well to eating little or no rice at all, compared to her old-self, who preferred rice on her behalf meals. She also became very conscious in what she feeds her stomach, which are actually mainly vegetables and fruits. This actually helps boost immunity and increase life span (Hassed 2009). This is combined with her minimal utilization of alcoholic beverages, only during occasions, and hasn’t smoked.

After retirement life, Ms Mogen generally feels that she provides forget about or nominal stress. Her pastimes are inclined on the creative aspect as she likes to read, do flower plans and gardening. Being a “light sleeper” she gets “woken up easily and can sleeping anytime of your day”, but this isn’t a problem to her. Holistic Case Study On A Patient With Diabetes Essay

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Patient’s perspective

As mentioned above, Ms Mogen was somewhat optimistic about her disease before and after having it confirmed. Her family was very supportive as well, especially her partner, who helps her in her everyday routine. Although her life has unquestionably been altered by the finding of her condition, she allows and tries to gather more information from her regular GP, whom she locates easy to talk to and therefore finds herself comfortable writing details with.

Having frequent sessions to the medical clinic had turn into a routine on her behalf thus she will not treat it as a heavy errand. The medical center essentially provided her with the attention she needs although certain specific areas can be improved e. g. the waiting around time was relatively long and the center could open earlier, but overall the surrounding cleanliness was of adequate standard and she was pleased with the service provided. Holistic Case Study On A Patient With Diabetes Essay

Own perspective

This clinical location has generally motivated me to understand patients more, whether currently or soon. It had been a pleasurable interview with Ms Mogen and a good first exposure conversing with an actual patient. She advocates highly for optimism and need for knowledge, and was eager to share with us her life experience, which motivates me to keep a happy head when facing issues.

It occurred to me that every patient has their own experience in the clinic, whether it be their interactions with the GP or service provided by the personnel, therefore a thorough approach is necessary when working with a patient. I noticed that as a medical staff, it is important to connect well with patients and become sensitive to their thoughts and concerns because every patient feels differently. Moreover, building a good romance with other acquaintances rises work efficiency and build sound teamwork. Holistic Case Study On A Patient With Diabetes Essay

Conclusion

The interview with Ms Mogen provided amazing information to a patient’s experience whereas the complete visit generally enlightened our view on a patient’s point of view. Consequently, being given the opportunity to personally talk to the patients and personnel had significantly widened my view in regards to the real life specialized medical settings and interactions. Basically this provided a vast area of debate using a all natural strategy, which is including a variety of aspects: biological, sociological, moral, legal and lifestyle, none which can stand alone. Holistic Case Study On A Patient With Diabetes Essay.