The focus of Situational Interaction (Either patient/client concern or nurse concern): The client is a Japanese boy aged 7 years and a school-going child. The boy was recently diagnosed with Type I diabetes. The client and his mother were referred to a pediatric clinic for advice on the type of diet the boy should follow and other measures that should be taken to manage the illness. |
Assessment |
Developmental Environment |
Biological Subsystem1. The Nurse:
2. The Patient:
|
Psychosocial Subsystem
|
Spiritual Subsystem
|
Situational Environment | ||
Intrasystem Analysis of Patient/Client | Intrasystem Analysis of the Nurse | |
Detector Function: Knowledge What does the patient/client know about the problem? The patient lacks any knowledge about the problem. He only knows that he feels thirsty and hungry frequently and urinates frequently. He has never heard of the term diabetes before. | Detector Function: Knowledge What do I know about the problem? I know a lot about diabetes, its causes, prevention strategies, management strategies, treatment, symptoms, and symptom management. I have worked with diabetic children before and therefore I am knowledgeable about the disease. | |
Selector Function: Attitudes and Values What are the patient/client’s attitudes and values about the problem? Although the patient has only learned about his illness, his religious orientation has helped him to have a positive attitude about his condition and believes that his illness will be cured in time. He is willing to learn about his illness and how to manage it. | Selector Function: Attitudes and Values What are my attitudes and values about the problem? Having helped other children manage their diabetes, I strongly believe that the patient will succeed in managing his illness and in keeping his blood sugar levels under control thereby preventing diabetes-related complications. My only worry is that the patient needs constant care to ensure control of his blood sugar levels but his mother is always busy trying to make ends meet for her family. I, therefore, believe that the family needs to hire a caregiver who will follow up on the patient when his mother is not at home. | |
Effector Function: Behaviors What skills or resources does the patient/client have to deal with the problem? The patient only has a supportive family and community members to help him deal with his illness. | Effector Function: Behaviors What skills or resources do I have to deal with the problem? I have skills in treating and managing diabetes as well as a wide range of literature about diabetes in children which can be of great help to the patient, his family, and community. |
Analysis | ||
Identification of Stressors
| ||
Coping Resources
| ||
Scoring on Situational Sense of Coherence (SSOC) (high=3, medium=2, or low=1) | ||
Score | Discussion | |
Comprehensibility: About what the patient/client needs to know about the situation, how much is known? | 1 | The patient knows little, if any, about diabetes and how to manage it. |
Meaningfulness: About motivation, how much effort is the patient/client willing to put into resolving this problem? | 2 | The patient is eager to learn about his condition and to take all the measures possible to manage it. However, the patient seems distressed about the insulin injections he will be required to administer to himself. |
Manageability: About resources, what is available to manage this problem? | 2 | The only available resource is willing human resources in form of family and community members who are willing to help the patient manage his condition. |
Nursing Diagnosis: There is a need to educate the patient, his family, and the community about diabetes and how it can be managed by diet and exercise (Hanas, 2007). This is evidenced by the low levels of information and knowledge about diabetes in the patient’s community. |
Implementation (Intervention) |
Mutual Patient/Client–Nurse Goals (made when patient/client and nurse agree) or Nursing Goals(made only if there is no agreementbetween client and nurse)
|
Intersystem Interaction Patient/Client-Nurse Interaction |
Communication of Information Information will be transmitted through different modes: face-to-face interactions between the nurse and the patient, family, and community. The nurse will also give brochures to the patient, family, and community that have information about diabetes, management, and prevention of complications. The brochures will also be translated into Japanese to ensure that everyone in the community understands the information therein. |
Organization of Behaviors (a mutual plan of care)
|
EvaluationScoring on Situational Sense of Coherence (SSOC) | ||
Rescoring on SSOC | Score | The scientific basis for nursing interventions: |
Comprehensibility: About what the patient/client needs to know about the situation, how much did they learn? | 3 | I prepared to learn brochures for the patient, family, and community and translated them into the Japanese language. This is because the patient comes from a different ethnic community and therefore it is important to adopt cultural-competent strategies to enable the patient, family, and community to accept the strategies more easily. This intervention was very effective in instilling knowledge in the patient, his family, and the community about all aspects of diabetes. |
Meaningfulness: About motivation, how willing was the patient/client to accept the challenge of the problem and work to overcome it? | 3 | I conducted several education and training programs for the patient, family, and community members to sensitize them on diabetes management strategies. The involvement of all community members was a motivating factor for the patient because the exercises were fun activities. The family and community members also offered support to the patient and encouraged him to do his best to manage his condition. This intervention was also very effective. |
Manageability: About resources, how adequate were they to manage this problem? | 3 | The resources I provided to the patient, his family, and community including the brochures, insulin pump, diet, and exercise plans were effective in managing the patient’s diabetes. This is because due to the resource scarcity in the patient’s community, I opted to take the resources to the community instead of making them visit the clinic for the resources. This proved to be effective because the majority of community members were able to gain access to the relevant resources. The patient also did not have to make the long-distance to the clinic. |
Comments
In managing diabetes in a small child like the one presented in the above scenario, there is a great need to involve other members of the patient’s family and community. Information also plays a key role in managing diabetes because diabetics need to monitor their blood sugar levels frequently, special diets, and exercises.
Without such information, it would be difficult to manage the illness and the illness may lead too other complications that affect other organs of the body. Educating the patient, his family, and community is therefore an important intervention strategy.
Reference List
Hanas, R. (2007). Type 1 diabetes in children, adolescents, and young adults: how to become an expert on your diabetes. London: Class Publishing.
Loring, G. (1999). Parenting a child with diabetes: a practical, empathetic guide to help you and your child live with diabetes. New York: McGraw-Hill Professional.