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3 1 Assignment 2 Category 1 Diabetes is a significant public health

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Assignment 2 Category 1

Diabetes is a significant public health issue, with Khan et al. (2020) affirming that it affects more than 462 million people globally or 6.28% of the population. Statistics further indicate that type 2 diabetes is associated with a higher mortality rate of up to 10.1%. These statistics affirm the need to design and implement practical strategies to address this public health concern before it alleviates. Public health providers should focus more on patient education, where individuals are taught about lifestyle changes. However, the success of patient education programs will depend on how well the providers incorporate affective, cognitive and affective objectives. These objectives could be formulated to address the case study involving John, a 57-year-old man with type 2 diabetes. This write-up will design clear and measurable objectives addressing the three areas of learning to enhance John’s clinical outcomes.

Cognitive Domain Objective

On completing the lesson, John will explain dietary changes that will lower glucose levels and reduce his weight by 10 kilograms within three months. This is okay.

This objective highlights the centrality of diet in managing high glucose levels and excessive weight associated with type 2 diabetes. The cognitive domain of the learning objective outlined in the session is crucial in enhancing the patient’s intellectual skills. John needs to understand the intricacies of type 2 diabetes, including the relationship between being overweight and a spike in glucose levels, to ensure he is in a better position to manage his condition. Ideally, health providers should understand that the cognitive domain comprises six categories: analysis, knowledge, synthesis, comprehension, application and evaluation (Hoque, 2018). While all these categories are crucial, the health provider should focus more on comprehension, knowledge and application to achieve the above objective. Notably, John must be aware of the importance of dietary changes, emphasizing healthier foods and physical activity to reduce weight. Once he gets the requisite knowledge, John will put it into practice by sticking to a dietary plan.

Healthy living characterized by nutritional changes and physical activities has received significant attention in managing T2D. According to Forouhi et al. (2018), patients suffering from this condition are advised to make the necessary lifestyle changes before seeking psychotherapeutic interventions. The authors, however, lamented that most providers lack background training in nutrition while others think that talking about it is time-consuming. These gaps have informed the cognitive domain objective targeting John, who must embrace a whole new lifestyle to manage his condition. The objective is practical, considering that it is achievable and measurable. The provider handling the client’s teaching and learning session can follow up on John to determine if he is applying the information acquired. Regular check-ups will be crucial to establish if the dietary changes and physical activity effectively reduce glucose levels and weight. 

Psychomotor Domain Objective

The patient should self-administer insulin without being prompted to and engage in physical exercises within one week. This is not part of the scenario – diet and exercise he is type II.

This objective is crucial considering that the healing process is determined in part by the willingness of the patient to demonstrate behavior change. Insulin administration is one of the practices that have been lauded for improving clinical outcomes among patients with type 2 diabetes. Swinnen et al. (2019) affirmed that adequate insulin dosages are associated with controlled hyperglycemia among patients. However, achieving this objective is only possible if the patients understand the best practices in administering insulin. Swinnen et al. (2019) noted that glycemic treatment should be stepwise, meaning initiation should start when AIC is less than 7.0 following two to three months of dual oral therapy. This requirement means that the provider handling John must spend significant time helping him understand the specifications. In particular, the provider would need to demonstrate how the administration is done repeatedly. From here, the provider would request John to demonstrate the process to establish if he has mastered the process. A mastery of the process would affirm that John could be trusted to self-administer insulin without being prompted.

The psychomotor objective related to physical exercises is practical since it is a practical strategy for reducing John’s weight. According to the case study, John is overweight at 180 cm and 100 kg. Ideally, an individual of this height should maintain an average weight of 62 kg as per the BMI chart. The realization that John is overweight means that he has to engage in rigorous physical exercises to lose the excess weight. The provider handling John must ground the lesson on Hamdy et al. (2018), who asserted that reduction in body weight following intensive physical activities improves insulin sensitivity. John must be helped to understand the importance of adhering to an exercise regimen to shed off the excess weight. Once John understands the link between weight loss and insulin sensitivity, he must engage in physical exercises. The provider would need to monitor him and check his weight regularly to determine if the intervention has worked or not.  

Affective Domain Objective

The patient will be able to talk about the benefits of engaging in physical exercises and insulin administration within two months. How will he talk about it- what is the action for this objective from this domain.

The affective domain is crucial in patient education since it addresses their emotions and feelings regarding the intervention used. The provider should understand the patients’ beliefs and attitudes for improved decision-making. This objective aims at helping John to appreciate the benefits of lifestyle changes linked with improved clinical outcomes among type 2 diabetes patients. Galaviz et al. (2018) asserted that evidence shows that lifestyle intervention programs, including physical activity, healthy diets and modest body weight, improve clinical outcomes. However, for these interventions to achieve this objective, patients must embrace them and view them positively. John, for instance, has not shown the initiative to lose weight despite having a 5-year history of type 2 diabetes. The failure to embrace lifestyle change indicates that John has a negative attitude which the objective aims at changing.

The objective outlined above highlights the centrality of behavior modification in improving clinical outcomes. Patients must be convinced that a certain intervention will work before committing to it. The provider, in this case, can achieve this objective by providing John with adequate and evidence-based information. Similarly, the provider may introduce John to support groups which Herrero (2021) noted enhances diabetes-self-care management. Incorporating these strategies would pave the way for John to readily engage in physical activities and administer insulin without being coerced. A realization that John is proactive and is willing to change his behavior would affirm that the objective has been achieved. The provider’s role would be to conduct regular assessments to determine the efficacy of the interventions in disease management.

Conclusion

The case study involving John, a 57-year-old man with a 5-year history of type 2 diabetes, highlights the importance of client teaching and learning. Health care providers handling patients must design and use practical approaches to address patients’ needs. However, to achieve this goal, providers must develop clear and measurable objectives addressing the patient’s cognitive, affective and psychomotor learning domains. Ideally, providers must provide patients will the necessary information regarding the disease and the available interventions to meet their cognitive needs. Once patients interact with the information, they can move to the psychomotor domain, where they practice what they have been taught. For instance, patients with type 2 diabetes could learn how to administer insulin and engage in physical activities. At the same time, patients must demonstrate a change in attitude and beliefs towards interventions in line with the affective domain of learning. Overall, a training plan that incorporates all three learning domains is considered effective in eliciting behavior change among patients for improved clinical outcomes.

References

Forouhi, N. G., Misra, A., Mohan, V., Taylor, R., & Yancy, W. (2018). Dietary and nutritional approaches for prevention and management of type 2 diabetes. British Medical Journal, 361(12), 22-38. https://doi.org/10.1136/bmj.k2234

Galaviz, K. I., Narayan, K., Lobelo, F., & Weber, M. B. (2015). Lifestyle and the prevention of Type 2 Diabetes: A status report. American Journal of Lifestyle Medicine, 12(1), 4–20. https://doi.org/10.1177/1559827615619159

Hamdy, O., Ashrafzadeh, S., & Mottalib, A. (2018). Weight management in patients with type 2 diabetes: A multidisciplinary real-world approach. Current Diabetes Reports, 18(9), 66-84. https://doi.org/10.1007/s11892-018-1030-4

Herrero, N., Guerrero-Sole, F., & Mas-Manchon, L. (2021). Participation of patients with type 2 diabetes in online support groups is correlated to lower levels of diabetes self-management. Journal of Diabetes Science and Technology, 15(1), 121–146. https://doi.org/10.1177/1932296820909830

Hoque, M. E. (2016). Three domains of learning: Cognitive, affective and psychomotor. The Journal of EFL Education and Research, 2(2), 45-62.

Khan, M., Hashim, M. J., King, J. K., Govender, R. D., Mustafa, H., & Al Kaabi, J. (2020). Epidemiology of type 2 diabetes – Global burden of disease and forecasted trends. Journal of Epidemiology and Global Health, 10(1), 107–131. https://doi.org/10.2991/jegh.k.191028.001

Swinnen, S. G., Hoekstra, J. B., & DeVries, J. H. (2019). Insulin therapy for type 2 diabetes. Diabetes Care, 32(2), 253–269. https://doi.org/10.2337/dc09-S318

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