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Social Determinants of Health
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Social determinants of Health refer to the condition in which people grow, are born, life or work socially. These include the factors like education, neighbourhood, socioeconomic status, physical environment, social support networks, and employment as well as related to conditions of health. As said by Hill-Briggs et al. (2021), “the social determinants of Health” (SDH) are non-medical factors which have an impact on health outcomes. These are the condition with which people have born, grow live, work or age. There are mainly five social determinants of health. As opined by Nutbeam & Lloyd (2021), health can be influenced by many factors, which may generally be organized into five broad categories. This main five broad category is called determinants of health. These include Behavioural, genetic, environmental influences and physical influences, and social and medical care factors. In the case of Gaurav as he is dealing with “acute exacerbation of asthmatic bronchitis” for the last two days. He also has problems with asthma, hypertension and type 2 diabetes though he is been smoking for the past five years.
Two social determinants of health that are relevant to Gaurav are genetics and the influence of the Environment.
Genetically factors
Type 2 Diabetes means the body is not using the insulin properly and that leads to an increase in the glucose and sugar levels in the blood gradually, linking with their case scenario, here Gaurav has Type, which has a stronger link with the history of family and genetics play a crucial role to develop type 2 diabetes than might be obtained from his parents genetically (Burström& Tao 2020). His condition of type 2 diabetes leads to an increase in the sugar level in his blood his blood glucose level is currently 14mmol/L. As proposed by Alfurayh (2023), This can be obtained from environmental factors also but genetics is the main cause to develop this diabetes. This condition will attack and destroy their immune system of Gaurav which leads him to fall sick very often. Although it might have been inherited from a family member (Friedrich et al. 2019). For their genetic condition, Gaurav is having so many negative impacts on his health such as high blood pressure of 160/95mmHg.
Figure 1: Genetic factors of “social determinants of Health”
(Source: Friedrich et al. 2019).
Environmental influences
Environmental factors can include the factors related to the place someone works or live, and behavioural influences such as smoking or diet all of these can increase the risk of someone’s stressful situations or disease (Alderwick & Gottlieb 2019). Linking with the case scenario, here Gaurav has relocated to Australia for this he is also having a problem with the language barrier as well as social and cultural differences. However, the problems of the language barrier also affect his professional life, for this, he is not getting the preferable job and doing some casual work, which makes him suffer financially and makes him unsocial, lonely and tense about employment shows affects his income and social problem, education, condition of working life, and job insecurity of unemployment. He is also facing loneliness as he is facing so many differences in the new culture of Australia.
Figure 2: Environmental factors of “social determinants of Health”
(Source: Alderwick & Gottlieb 2019)
General Nursing care
As a registered nurse it is important to provide "diabetic wound care". This care will help diabetic patients to heal their wounds, generally in their feet. And provide basic care to undiagnosed patients who are having diabetes (Friedrich et al. 2019). In this case study Gaurav who has type 2 diabetes can have infections and an imbalance in nutrition, for him as a nurse first step that can be followed is the restoration of the balance of fluids, giving electrolytes and balance in acid and base. On the other hand, it can also be suggested to improve his diet and advice to change in lifestyle to stay out of risk.
Advice to change in behavioural habits
As a registered nurse it will be advised the patient to change their behavioural activities that have shown impacts on the health of diabetes patients. However, in the case of Gaurav, he has some habits that need to change such as smoking, and hypertension that has a very bad impact on his health condition. As a nurse first, these issues need to have look after. Health can be influenced by many factors, which may generally be organized into five broad categories.
Education about Diabetes
Before treating diabetic patients, it is more important to educate them about diabetes and helps to understand the change in their habits which includes making a good food choice, quitting smoking, and exercising. As opined by Wang et al. (2019), In this case, Gaurav needs to quit smoking and need to educate about his condition and the above measure will follow. And give awareness about his condition.
Strategies
Managing type 2 diabetes includes some processes such some steps involve making the level of blood sugar at control and staying healthy so don't get any other complications easily.
Healthy Eating
There is no specific diet for diabetes but it is important to follow a such diet to deal with diabetes. Foods with high fibre are necessary to take, such as fruits, whole grains, and no starchy vegetables. To control the diabetes situation, it's important to lower the intake of processed foods and low-fat meals.
Blood sugar monitoring
To monitor the sugar in the blood it is important to check the level of blood sugar daily. It needs to check the “blood sugar level” and it is important to take insulin a few times a day. Also, blood sugar can be monitored through a blood glucose meter.
Regular exercise
Regular exercise is important to lose weight and maintain a healthy weight as well as it will help to manage the level of sugar in the blood. It is suggested that Aerobic exercise, Limited inactivity and Resistance exercise also help to reduce the level of blood sugar level.
Weight loss
The better way to lose the sugar level in the blood is by losing weight. Weight loss has a significant effect on blood sugar levels. Not only blood sugar but also it will lower triglycerides, and cholesterol and reduce blood pressure. The amount of loose weight helps to lose the level of sugar in the blood also.
Taking Insulin therapy and proper diabetic medication
In case of not maintaining the sugar level in the blood, it will be needed to take prescribed medicine for type 2 diabetes. As said by Lake et al. (2020), This medicine will help to lower the production of glucose in blood levels and helps to improve the body’s sensitivity by using insulin often, and effectively.
Some other medications can be taken such as “Sulfonylureas” that help to secret, more insulin in the body, such examples of medicines are glyburide (Glynase, DiaBeta), Glimepiride (Amaryl) and Glipizide (Glucotrol XL). Glinides will help to stimulate the pancreas which will lead to more production of insulin. “DPP-4 inhibitors” is a medicine that also helps in type 2 diabetes that helps to reduce the level of blood sugar and tends to show more effect on reducing the level of blood sugar.
Insulin therapy
As a registered nurse it is necessary to medicate insulin therapy for a person who is dealing with type 2 diabetes. Different types of insulin are there they vary in the work that how they will show effect, here in that case "long-acting insulin" is important to take as it will help to keep the blood sugar level overnight and keep it stable. Type 2 diabetes is usually can be diagnosed by using the "Glycated haemoglobin"(A1C) test. This report of blood tests indicates the condition of the average range of sugar that is presented in the blood (Riddle et al. 20221). As registered nurse strategies can be followed to deal with the problem of Type 2 diabetes the A1C test is not available some more healthcare providers can be taken as registered nurses. "Random blood sugar test" includes the normal value of sugar in the blood present milligrams of sugar per deciliter that is (mg/dL) of blood. Regardless of eating, at last, the "level of higher (11.1 mmol/L) of blood". "Fasting Blood sugar test"
Some blood samples can be taken to take a proper sample of blood.
As a registered nurse to manage environmental influences on health, one must be followed these tips. To manage environmental influences a registered nurse can provide nursing care by reducing the suffering condition, "restoring the health issue", and many other problems that form problems in a social and cultural barrier. In this case scenario Gaurav is facing this environmental problem due to his language barrier. As a nurse to help from recovering this problem the following things can be done
"Face to Face Interpretation"
As primary care providers nurses can communicate with patients to communicate freely about their health or any physical or mental condition that they are facing. Face-to-face interpretation help in understanding the situation better for the patients and also helps to increase the interest of patients to communicate however, this will help to solve the problem to overcome the situation related language barrier. Offering a "qualified m, medical interpreter" and a person having translated material" will help to work them proficiently.
“Life discussion”
As registered nurse it is necessary to build trust and identify and fill the language gap to help the patient to open up about their situation. To overcome the situation Gaurav can use the translation via google translate to dilute the barrier between the two different cultures. Also, gestures can be used.
“Taking about their feeling”
Many external causes can affect the mental health or wellbeing of a person. In the case of Gaurav here he is facing such factors that are disturbing the condition of his mental health. To talk about this problem to nurses about lower salaries, health issues, and hypertension. And as a nurse talking to the patients about their feelings whether it is good or bad helps them to overcome such situations. As a nurse, it is important to be sympathetic towards them to know and understand how the external factors are influencing them in this condition.
Strategies
Many things a nurse can do or apply many strategies to overcome such a situation where she can help the patients for example to feel them about there worth, that how worth are they, which will help to lift their spirits here, in this case, Gaurav is feeling worthless due to this occupation as he is not satisfied with his work, in that case as a nurse it is a crucial strategy. Being sympathetic towards them also can help them to recover from the situation. As a nurse, it is also important to reduce the barrier among language by using visual methods that help them to communicate. Here Gaurav also can take language classes to overcome the situation this will also help him to learn and he will get the desirable job of his own choice.
To overcome the situation of cultural barriers the patients need to be open-minded to develop a new culture, and it will help to remove the barriers among the cultures and countries. To deal with loneliness here patients need to take some therapies that could be provided by the nurse. Here as a nurse “Cognitive Behavioural Therapy” (CBT) technique can be followed to focus on their thought, problems of emotionally and attitudes and beliefs and to develop skills to deal with different problems (Nikitara et al.2019). Advising them to give up smoking in the case of Gaurav will also be helpful to cope with difficulties and feelings. to reduce the problem of hypertension it will be more helpful to take some limited foods with healthy food and reduce the food with cholesterol and fat will lead reducing hypertension. A nurse to control hypertension, it is needed to provide an action plan to control the situation. And process with the medication treatment and regime.
