Health promotion in nursing practice

Topic: Health Promotion in Nursing Practice focusing on what you would choose to present to gain buy-in of key stakeholders for this proposal with suggested changes and rationales for changes.

The incidence and prevalence of diabetes type 2 among the adolescent Navajo Indians indicate is a strong evidence of the significant health challenge. Hence, there is a need for comprehensive preventive measures (University of Nottingham School of Nursing and Academic Division of Midwifery, 2008).

Prevalence and Incidence 

•Infrequent among the Navajo youths <10years•High incidence and prevalence among older youths•15-19year old adolescents;  15 in 359 Navajo youths  with the disease in 2011 and 23 in 2,542 develop the disease annually •Most is diabetes type 2 although diabetes type 1 is present but more common among younger adolescents •Diabetes type 2 affects more than 1/5th of the Navajo population >20years•The Navajo youths aged 15- 19 year have the greatest diabetes type 2 risk.

Factors contributing to the disease 

Poor glycemic control (40-50% of the youths with diabetes)vImpaired fasting glucose or impaired glucose tolerance vMore metabolic factors linked;•Obesity•Cardiometabolic disturbances and hypertension•Insulin resistance (higher albumin-to creatinine ratio, dyslipidemia, and abdominal fat deposition)

Information on the factors that contribute to the disease is very important since this lays the foundation for the preventive measures that should be taken. As seen, diabetes type 2 has a connection to obesity and cardiometabolic conditions. Hence, adolescents with either of these diseases should receive comprehensive medical attention. 

Factors contributing to the disease 

ØHigher BMI levels, lower HDL cholesterol, and higher triglyceride levels ØSeverely depressed moodØHigh unhealthy behaviors’ prevalence;•Sedentary lifestyles•High-fat diets (University of Nottingham School of Nursing and Academic Division of Midwifery, 2007). •SmokingØLower socioeconomic status 

The information indicates the close link between lifestyle and dietary habits. This information is very important in relation to the use of diet and exercise as preventive measures. 

Impacts of diabetes type 2 on Navajo Adolescents 

•Nerve damage•Blood vessels damage •Eye problems (glaucoma, cataracts, diabetic retinopathy, and retinal detachment)•Foot problems- circulation difficulties- deformities and skin infections •Sexual dysfunction•Kidney disease 

Considering how critical the impacts of the disease are on the adolescents, there is a great need to adjust the lifestyle in relation to diet and exercise. This prevents the disease from getting worse and reducing the vulnerability to complications.

Chronic complications 

•Neuropathy- 13%/1000 person years•9% mortality rate•35% microalbuminuria•6% needed dialysis•45% hypertensive cases that needed treatment•38% of the women who become pregnant suffer pregnancy loss•67%- poor control of blood glucose 

Why prevention is important 

More years- disease burdenüIncreased risk- diabetes-related complications (too early in life)üNeed for;•Primary prevention (University of Nottingham School of Nursing and Academic Division of Midwifery, 2008). •Efforts to delay/ prevent chronic complications’ development.

The incidence and prevalence indicate that the disease is a critical health challenge among the Navajo adolescents. The youths with the disease will have more disease burden years as well as an escalated vulnerability to diabetes-related complications. Efforts should be targeted on primary prevention as well as efforts for delaying or preventing chronic complications’ development among the adolescents with the disease.

Prevention of the disease among the adolescents 

Lifestyle and behavioral factors take precedence over genetics•Abstaining from alcohol•Quitting smoking’•Having a healthy diet •Physical activity•Proper MBI

Diet

Need to avoid;•High-energy foods•High-fat foods•Too much animal proteins•Junk foods•Too much sugary foods (Work group for community health and development at the University of Kansas, 2012). vNeed to consume high-fiber and low-fat diet

The diet that the adolescent Navajo population consumes has a great impact on development of diseases such as obesity and hypertension, which are closely linked to diabetes type 2. Therefore, there is a great need to avoid the mention foods but consume more healthy foods. 

Exercise

Inactivity- obesity and overweightvInactivity results from;•Lower parental education•Higher BMI•Cigarette smoking•Pregnancy•Television viewing- high-energy foods consumptionvThe least exercise should last 30 minutes/ day, 5 days/ week

If the adolescents participate in physical activity, there are high chances that obesity and overweight will be low (Work group for community health and development at the University of Kansas, 2012).  There is a close link between overweight and obesity and diabetes type 2. watching television for long periods is associated with high consumption of high-energy foods, which leads to childhood obesity. 

Management of the disease Specific treatment objectives;•Eliminating hyperglycemia symptoms•Maintenance of a reasonable BMI•Reducing the cardiovascular risk factors (smoking, sedentary lifestyle, microalbuminuria, hyperglycemia, hyperlipidemia, and hypertension)•Overall improvement in the adolescent’s emotional and physical well-being 

Treating  diabetes type 2 aims at achieving the above objectives. For the adolescents with diabetes type 2, there is a great need to manage the disease appropriately. This ensures that the adolescent can lead a good quality life. The treatment therapies include increased physical activity, reduced sedentary behaviors, dietary modification, and pharmacologic interventions. 

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