Introduction
Quality healthcare is essential for social and economic development at national and global levels. Type 2 diabetes is one of the most devastating health issues that have significant negative impacts on lives and livelihoods. The condition is associated with the body’s impairment in regulating and using sugar. The failure to effectively use blood sugar leads to increased sugar levels circulating in the body. Diabetes type 2 has devastated the socio-economic developments of Scotland, England, and the world, requiring effective interventions from the medical stakeholders.
Diabetes Type 2 Health Determinants
Quality healthcare services and well-being can help eliminate conditions such as type 2 diabetes among adults. Consequently, there are reduced cases of death due to the health effects of type 2 diabetes among adults. Adoption of effective medical intervention and social care services is crucial for encumbering the devastating effects of type 2 diabetes among older adults (Collins et al., 2022). Therefore, factors determining access to and promotion of health among adults must be considered for effective decision-making.
Income and Social Status
Quality healthcare can be expensive due to the need to acquire insurance policies and pay for regular medical check-ups. A person’s social status involves their rank in society and community based on their income and honor or prestige (Munirah, Malihah, and Ruyadi, 2022). High-income people can afford expensive insurance policies for their health and that of their loved ones (Munirah, Malihah, and Ruyadi, 2022).
Individuals in the lower class are characterized by unemployment and wintry-menial jobs. Consequently, they cannot afford insurance policies and pay for expensive and quality medical services needed for diabetes type 2. Policy formulation and health regulations need to favor the unemployed and those of lower-class social status to promote uniform economic development and wellness.
Physical Environment
Human well-being is dependent on the availability of social amenities and a conducive environment. As a health determinant, the physical environment involves safe water, clean air, safe houses, and healthy workplaces, among other factors contributing to good health. Diabetes type 2 patients need regular medical check-ups and high levels of sanitation (Collins et al., 2022).
Therefore, the patients are more likely to survive in areas with accessible hospitals and clean water and air than those without (Wulandari et al., 2023). Policymakers prioritize the physical environment when allocating resources that promote health. Informal settlements and areas with alarming sanitation levels should benefit more from a country’s healthcare resources than areas with a good physical environment.
Social Supporting Networks
Patients are mostly mentally vulnerable, needing the support of society and those around them. Social supporting networks include family members, friends, and community members (Zhai and Du, 2022).
While patients need financial support during sickness, emotional support encourages them to fight their conditions. Diabetes type 2 is associated with increased stress levels which can be exacerbated by poor family relationships (Nieman, 2022). Therefore, family members need to be emotionally available for their older adult relatives (Bartoli et al., 2022). Social support networks help patients feel recognized by their society, reducing the rate of drug and medical intervention resistance among them.
Genetics
Inheritance is central in determining lifespan, healthiness, and the likelihood of developing certain illnesses. Conditions such as diabetes type 2 can be caused by genetic inheritance and mutations. Inheritance of poor personal behaviors and coping skills can be detrimental to an individual’s health (Zhai and Du, 2022). While it is impossible to prevent the inheritance of genes that exacerbate illnesses, the parents can avoid actions that make them vulnerable to conditions that can be genetically transmitted. The adoption of effective healthcare management approaches and interventions can help reduce the severity of genetically inherited diseases and conditions.
Education Levels
Poor health status and management are linked with low education levels. Through education, individuals learn how to manage their health and adopt effective personal care plans. Meanwhile, uneducated individuals lack confidence and are associated with increased stress levels (Trombetta and Rollè, 2022). Some of the factors that increase stress levels are high unemployment rates and rejection from family members (Bartoli et al., 2022). Consequently, communities with low education levels are more vulnerable to diseases than those who are educated. Improving access to education and making available educational resources can help encumber poor health quality.
Health Services
Treatment and management of type 2 diabetes is a continuous process. Therefore, diabetic patients need access to affordable, quality healthcare services. Healthcare services involve the availability of hospitals, insurance policies, and infrastructure, among other amenities that support the provision of healthcare services (Kanti, Kim, and Mikidadi, 2022). Diabetic patients living in areas without accessible healthcare services suffer and can succumb to the condition. Meanwhile, there are rare cases of diabetic mortality in regions with quality healthcare facilities that are accessible and affordable.
Diabetes Type 2 Prevalence and Socio-Political Factors
Prevalence in Scotland
Scotland is one of the many countries that are being devastated by the rapid growth rate of diabetes type 2. According to the Scottish Diabetes Survey of 2020, the country had about 317,000 individuals diagnosed with diabetes in 2020 (NHS Scotland, 2021). Out of the number of reported diabetes type 2, adults 65 years and above accounted for the highest percentage of 57.7%. In 2020, the number of patients diagnosed with the condition was 16,430 (NHS Scotland, 2021). The rate of diabetes type 2 in Scotland shows insignificant changes with increased effects on the patients, their families, and the country at large.
Prevalence in England
England is another country in the UK with a high rate of diabetes type 2. The country has been recording an increasing number of diabetic patients since 2008 (Ling et al., 2023). In the years 2017 and 2018, England had about 3.2 million people diagnosed with diabetes (Ling et al., 2023). The number had increased by 44% from the year 2008. Out of the total cases of diabetes, 90% were diabetes type 2 with 52.9% being adults 65 years and above (Ling et al., 2023). The diabetic rate in England is expected to further increase in the next years. Unlike, Scotland England’s rate is higher, requiring a quick and effective intervention.
Global Prevalence
Diabetes type 2 is devastating at the global level as in Scotland and England. The global number of individuals diagnosed with diabetes type has been on the rise. According to the International Diabetes Federation (IDF), 536.6 million people were diagnosed with the condition in 2021. The number is expected to go as high as 783.2 million by the year 2045 (Sun et al., 2021). Diabetes type 2 has been identified as one of the major health issues in developing countries. Therefore, the rate of the condition in Scotland is lower than in other developing countries worldwide. The World Health Organization (WHO) estimated the mortality rate of a diabetic was 3% (Knudsen et al., 2022). Out of the total number of globally reported cases, 95% are diabetes type 2. Therefore, diabetes type 2 is a health issue that is detrimental to social and economic growth at the global level.
Major Causes in Scotland, England, and at the Global Level
Although diabetes type 2 is associated with various causes, being overweight and physical inactivity are major causes in England, Scotland, and at the global level. According to the WHO, excess body weight includes conditions such as obesity and the uptake of excess energy from foods. For instance, the obesity rates in Scotland are estimated to have fluctuated from 26 % to 29% among men and from 27% to 31% among women (ScotPHO, 2022). Meanwhile, most cases of physical inactivity are due to poor personal health management (Srinivasu et al.,2022). Other causes of type 2 diabetes are health conditions such as hormonal imbalance, kidney failure, and diseases of the human circulatory system (Takashi and Kawanami, 2022). The global rate and cases of diabetes type 2 are consistent with those of Scotland, and a uniform intervention mechanism can help reduce the condition at both levels.
Preventive and Management Strategies Adopted
The increased rates of diabetes type 2 have led to the adoption of various policies and frameworks by the Scottish and English governments. Similarly, the WHO has adopted mechanisms that can help reduce the condition rates globally. In 2018, the Scottish government adopted a plan titled “A Healthier Future: Scotland’s Diet and Healthy Weight Delivery Plan” (NHS Scotland, 2021). The adopted plan sought to enhance collaboration between the national and local authorities in identifying key priority areas in healthcare.
In England, NHS England has adopted a Diabetes Prevention Program (DPP) that has helped manage the condition across the country. The DPP launched a “Healthier You Program” that identifies individuals who are at risk of diabetes type 2 (NHS Health Check, 2022). The individual is referred to a nine-month, evidence-based lifestyle program.
The WHO has continuously encouraged collaboration between governments and global stakeholders to bring the condition to manageable rates. Consequently, the organization has developed a ‘HEARTS â D module on diagnosis and management of type 2 diabetes’ (Knudsen et al., 2022). The module guides the diagnosis and management of the condition that can be referred to by various stakeholders. The efforts by the Scottish and English governments, and WHO have helped in saving the lives of people from the condition.
Socio-Political Factors and Economic Impacts
Although the Scottish and English governments, and WHO have adopted preventive and management strategies, various socio-political factors determine their success. Diabetes type 2 is a healthcare problem in Scotland, England, and at the global level. Although the Scottish government has made concerted efforts to reduce the effects of the conditions on its economy, various factors can limit the efforts (Khalid, Ashraf, and Aleem, 2022). Security, poverty, national wealth, and social integration are the socio-political factors that influence the delivery and provision of health and social care among diabetic patients.
Healthcare facilities such as hospitals and research institutions must be free from external threats and destruction. The availability of security ensures that healthcare organizations deliver medical services freely without threat. Scotland and England are developed countries with higher levels of security. Consequently, many healthcare providers and hospitals have integrated modern security systems into their premises to protect patients. Diabetic patients in these countries are safe and can access medical facilities at any time without fear.
Management and treatment of diabetes are expensive requiring sufficient finances from the patients and their families. The poverty rate determines the capacity of a family being able to cater to healthcare needs (Sileo et al., 2023). According to the data from the Scottish Government (2022), only 10% of Scots have persistent poverty. The data is consistent with England’s poverty rate in which more than 80% live above the poverty line (Bennett et al., 2022). Therefore, many families in England and Scotland can afford insurance policies and a healthy diet to avoid diabetes type 2.
Although the government can take up the role of helping diabetic patients cope with the condition, its national wealth is crucial in determining its capacity. Unlike developing countries, Scotland is a rich country with the capability of helping diabetic type 2 patients with little strain. Management of diabetes type 2 requires government and community effort. Social integration involvement of community members, regardless of their culture into the social structure (Pathak and Muralidharan, 2022). Discrimination and racism can hinder effective social integration since some members are prioritized over others. Governments must develop inclusive healthcare systems that meet the needs of every member of society.
Economic Impacts
The increased rate of diabetes type 2 among older Scots and Englishmen is detrimental to the governments’ economic progress. For instance, the Scottish government spends an estimated budget of around ÂŁ1 billion each year (Colhoun and McKnight, 2020). The cumulative expenditure for the last ten years has been estimated to be a total of ÂŁ13 billion spend (Colhoun and McKnight, 2020). Meanwhile, according to NHS England (2022), about ÂŁ10 is spent every year on diabetes. The amount is about 10% of the total NHS annual expenditure (NHS England, 2022). Over-expenditure on one condition can be detrimental to the management of other diseases and conditions in the two countries.
The Scottish and English governments have limited development in other sectors due to excess money being channeled to the management of diabetes type 2. The unequal development in various sectors is associated with the failure of the government to meet its mandate. Consequently, sectors such as education and agriculture suffer at the expense of diabetes type 2 management. As the rate of the condition is expected to record exponential growth, the government needs to adopt mechanisms that reduce diabetic cases among the Scots.
Impacts on Families
The economic impacts of diabetes type 2 in the two countries can be felt at family levels. The retirement age in Scotland and England is between 60 to 65 years (McGurnaghan et al., 2022). Therefore, the majority of diabetic type 2 adult patients depend on their family members. The annual cost of managing and treating diabetes type 2 in the UK is estimated at ÂŁ13,800 (McGurnaghan et al., 2022). The amount is too high for families that live below the poverty line. The costs include the purchase of insulin, medical consultations, and hospitalization, among others. The increased costs of treating the condition are expected to be even higher due to the prevailing tough economic situation facilitated by the Ukraine-Russian war and the COVID-19 aftermath.
Many families with diabetic older adults find it difficult to meet their daily basic needs. The families are required to subscribe to expensive insurance policies that can cover type 2 diabetes. Although the government helps Scots and Englishmen acquire cheaper alternative medicines, the families are expected to cater for private consultations that increase the chances of survival. Additionally, diabetic adults are prone to other fatal conditions such as heart and kidney failure. Consequently, they need a family member to take care of them regularly. The members quit their jobs to take care of their ailing loved ones, reducing the total household income. Diabetes type 2 has an economic impact on the government and families, encumbering social development and growth.
Critical Reflection: Role of Nurses in the Management of Diabetes Type 2
Priorities in Healthcare Delivery
The data on the prevalence of diabetes type 2 in England, Scotland, and at the global level reveal significant areas of priority for its management and treatment. Being overweight and physical inactivity are the major causes of the condition. Therefore, the authorities at the local, national, and international levels should prioritize prevention and early detection of the condition. Moreover, strategies that encourage the uptake of a balanced diet and physical activities should be prioritized in dealing with diabetes type 2 at both levels (Adam et al., 2023). Although the Scottish and English governments have adopted various strategies in dealing with the alarming rate of diabetes, collaboration among the stakeholders is key.
Role of Nurses in Quality Healthcare Provisions
Theoretical Approach: Stages of Change Model
Nurses in Scottish healthcare organizations are primal in implementing and realizing the set objectives. The theory of stages of change can be applied in describing behavioral change among patients in the context of managing and preventing type 2 diabetes. According to the theory, individuals undergo six stages: pre-contemplation, contemplation, preparation, action, and termination (Zegers et al., 2022). During the pre-contemplation stage, the patients may not intend to take any action since they are unaware that their actions are problematic and may hinder their well-being. During the contemplation stage, the patients are likely to take action shortly since they have realized that their actions are detrimental to their health.
After contemplating their failure to reduce their body weight and avoid healthy diets, the patients move to the preparation stage. The patients start to take small steps toward healthy behavioral change (Zegers et al., 2022). For instance, they may begin to engage in intense physical activities and eat healthy diets routinely. During the action stage, the patients change their behaviors, intending to carry them forward. They stick to the care plans and health-related advice given by their nurses. The maintenance stage involves the patients sustaining their new healthy behaviors, usually for more than six months. They work to prevent any relapse to earlier stages that may encumber their determination. Finally, during the termination stage, the patients have no desire to return to behaviors that exacerbate type 2 diabetes. Nurses play a significant role in helping patients pass through the six stages.
Roles of Nurses
Nurses are crucial in realizing the proposed frameworks for treating type 2 diabetes. Nurses can help improve healthcare provisions and strategies based on healthcare priorities. Providing care coordination, developing care plans, educating patients and families, and facilitating continuity of care are some of the roles of nurses in realizing quality healthcare provision (Karam et al., 2023). Care coordination involves organizing patients’ care activities and sharing such information with relevant stakeholders (Kalyegira, 2022). The Scottish and English governments are focused on enhancing physical activity and healthy food choices among adults who are vulnerable to type 2 diabetes.
Nurses have a wide knowledge of the right physical activity and healthy foods that patients can eat. They can engage their patients in developing care plans that would lead to the desired outcome. In the care plans, the nurses can eliminate activities and food exacerbating type 2 diabetes. Moreover, nurses interact with patients and their families regularly (Karam et al. 2023). As a means to achieve the government’s goal of reducing the cases of type 2 diabetes, they can integrate awareness during consultations. Through awareness, the nurses should educate the patients on the importance of eating a healthy diet and remaining physically active.
Diabetes type 2 is a continuous process involving regular medical checkups and insulin tablet intake. Nurses can help in facilitating continuity of care among diabetic patients (Adam et al., 2023). Upon diagnosis, the nurses can ensure that the patients stick to the right activities and eat healthy diets that eliminate health conditions associated with type 2 diabetes. Moreover, offering emotional support to the patients and their families can promote psychological well-being among them amid tough economic conditions (Kalyegira, 2022). Therefore, the roles of nurses in the management and prevention of type 2 diabetes should be supported to realize national and international healthcare objectives.
Professionalism in Therapeutic Relationship
Professional values, attitudes, and effective communication strategies anchor an effective therapeutic relationship. The Scottish and English governments have identified the priority areas in the prevention and management of diabetes type 2: excess weight and physical inactivity. The nurses must be guided by professional values when helping patients. Additionally, a positive attitude toward their patients and work can promote commitment to realizing the set objective of reducing the diabetes type 2 rate. Therefore, commitment among nurses augmented by proper communication strategies can help manage the health issue of diabetes.
Professional Attitudes
A professional attitude is multifaceted since it involves how individuals behave and perceive their workplace and those around them. Professional attitudes include how nurses perceive their patients, how they treat them, and how they relate with their colleagues. A healthcare environment has people from diverse cultural backgrounds and different behaviors. Therefore, it is upon the nurses to balance their attitude with that of their patients. The negative attitude among nurses is detrimental to the delivery of effective healthcare services (Isangula et al., 2022). Negative nurses tend to discriminate against their patients and colleagues of race and culture, hampering their effectiveness in healthcare provision.
Meanwhile, a positive attitude among nurses promotes quality healthcare since the patients and other nurses feel safe. Nurses with positive attitudes provide altruistic and compassionate services to their clients. The nurses go beyond their professional scope to ensure that the patients are safe and coping with their medication Kalyegira, 2022.
For instance, a compassionate nurse may make follow-up phone calls to their clients who have adapted to healthy behavior that encumbers diabetes. Such phone calls may help the patients to improve their physical activities and make even healthier food choices. The Scottish government should encourage a positive attitude among nurses to realize the plans and objectives set to reduce cases of type 2 diabetes.
Professional Values
The nursing profession is guided by set ethical principles and core values that nurses must demonstrate at work. The values are anchored on autonomy, non-maleficence, beneficence, and justice principles. The principle of autonomy requires the nurses to let the patients make informed and uncoerced decisions (Isangula et al., 2022).
For instance, when creating a care plan, the nurses can give patients various options and let them decide. Allowing the patients to self-determine their care plans increases trustworthiness in the healthcare system. Non-maleficence is a principle that instills the value of causing no harm to patients. Through the principle, the nurses weigh the benefits and detriments of various treatment options and apply the one with the most significant benefit.
The nursing profession is anchored on the acts of care for patients due to their vulnerability to emotional torture. Beneficence involves charity, mercy, and kindness, intending to do good to others (Isangula et al., 2022). Nurses have a moral obligation to prioritize their patients’ interests regardless of the prevailing conditions. Therefore, they can do things outside their professional scope to ensure their patients receive quality healthcare services (Kalyegira, 2022).
Meanwhile, justice involves treating the clients with dignity and respect as human beings. Additionally, justice involves the elimination of behaviors or activities that may infringe upon patients’ rights such as privacy and expression. Professional values based on ethical principles promote a collaborative working environment for nurses and their patients.
Effective Communication Strategies
An effective therapeutic relationship depends on effective communication strategies among healthcare stakeholders. The government collaborates with local authorities to realize full implementation of the healthcare frameworks and objectives. The local authorities depend on information from medical professionals, including nurses.
Integration of communication technology is vital in making information dissemination easy and effective. For instance, the establishment of an integrated information system that collects data on type 2 diabetes can be helpful. The nurses can enter data collected from the patient into the system, making it easy for the government and local authorities to interpret them.
Moreover, communication can also involve nurses and their patients. Hospitals receive patients from diverse cultural backgrounds, and miscommunication is inevitable. Nurses should be encouraged to work in diverse environments to learn about other people’s cultures and to some extent their language(Kalyegira, 2022). The strategy is crucial for simple communication between a nurse and their patient. Communication strategies that prioritize patients’ needs are crucial in promoting effective treatment approaches. Consequently, healthcare stakeholders should access their community needs before deciding on a primary medium for communication.
Conclusion
Diabetes type 2 is a health issue that has negatively impacted the English, Scottish, and global economies. The condition is associated with increased blood sugar levels due to the failure of the pancreas to produce insulin and poor cellular uptake of the hormone. The condition is majorly caused by being overweight and physical inactivity. Although the Scottish and English governments have tried to prevent diabetes type 2 prevalence, socio-political factors have encumbered their efforts. Therefore, there are increased economic impacts on the condition at the families and government levels. Involving nurses in the provision of quality healthcare by encouraging a positive attitude, values, and effective communication strategies can help reduce the effects of diabetes type 2.
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