Diabetes in Western Australia - Essay Example

Running Head: DIABETES IN WESTERN AUSTRALIA Diabetes in Western Australia Name Course Lecturer Date Table of Contents 1.0 Diabetes in Western Australia 3 1.1 Prevalence 3 1.2 Types and causes 3 1.3 Effects 4 2.0 Health promotion strategy that is implemented to address diabetes in Western Australia 5 2.1 Community awareness and prevention of diabetes 5 2.2 Prevention and early detection in high risk groups 6 2.3 Optimal initial and long-term management 6 2.4 Early detection 6 2.5 Coordinated management and preventions of acute episodes 6 3.0 Western Australian Diabetes Model of Care and the principles of health promotion in the Ottawa Charter 7 3.1 The three basic strategies 7 3.2 Health promotion priority action areas 8 4.0 Effectiveness of the WA Diabetes Model of Care 9 4.1 Review of relevant literature 10 4.2 Consultations with policy makers and providers 10 4.3 Focus groups with a range of people living with diabetes and parents of children with diabetes 10 4.4 Survey of service providers 10 4.5 National stakeholder forum 11 References 12 1.0 Diabetes in Western Australia 1.1 Prevalence Diabetes is one of the most common diseases affecting the Western Australian community. According to some researchers, diabetes is a silent pandemic and the fastest growing chronic disease in the entire of Australia. According to the Australian Bureau of statistics research carried out in 2007/2008, about 30 Western Australians develop and are diagnosed with diabetes everyday and approximately 120,000 have been diagnosed (ABS, 2009). The research also revealed that for every person tested for diabetes, there is another who is not yet diagnosed; which totals to about 1.8 million people. Projections indicate that the prevalence will triple with diabetes expected to affect over three million Australians by the year 2025 (AIHW, 2008). Diabetes has caused a massive financial cost upon the federal government of Australia with the total health cost estimated at $10.3 billion. It is the sixth leading cause of deaths in Australians which has triggered counteractive measures by leading research and consumer advocacy groups as well as government health organizations. Statistics show that Indigenous Western Australians are 1.3 times more likely to develop diabetes than non-Indigenous Western Australians. This is partly due to their kind of lifestyle and partly due their inability to access good health services (Colagiuri et al, 2009). 1.2 Types and causes The two main types of diabetes are prevalent in Western Australia with type 2 accounting for about 85% and type 2 about 25% of the total diabetic population. Type 1 diabetes is typically caused by autoimmune destruction of the pancreatic beta cells responsible for the production of insulin (Steed et al, 2002). This leads to impairment of insulin production thus development of diabetes. This type of diabetes is reported in people of all ages although most cases are reported in children and young adults. Type 1 diabetes is the most common chronic disease in children and the highest rates are reported in Australia. Type 2 diabetes is caused by impaired insulin production, insulin resistance or both. It is mostly diagnosed in people over the age of 40 although recent statistics reveal that it is occurring in children and adolescents as well. It has a strong genetic predisposition which is apparently unmasked by unhealthy lifestyles including lack of exercise and obesity (Colagiuri and Goodall, 2004). 1.3 Effects The effects of diabetes are enormous. It is the leading cause of non-traumatic lower limb amputation, end stage kidney disease and it is associated with several eye diseases particularly diabetic retinopathy. According to Shaw and Cummings (2012), the leading cause of death for people with diabetes is cardiovascular diseases which normally develop as a result of hypertension. Individuals with diabetes report high rates of stress, anxiety and fatigue compared to those without due to tiring procedures involved in coping with the disease. Obesity is the major risk factor for diabetes; obese individuals are three times more likely to develop diabetes than their normal weight counterparts (Grey, 2000). Even with this stunning reality, the number of obese Australians is expected to increase from 20.5% to 33.9% over the next 10 years. As a result, many interventional strategies to eliminate diabetes have focused on reducing obesity by way of encouraging people to engage in exercises and to eat healthy food. According to these socioecological health promotion strategies, reducing the obesity in the population will potentially reduce incidences of diabetes (Moshe et al, 2012). 2.0 Health promotion strategy that is implemented to address diabetes in Western Australia Diabetes Model of care is the current upstream health promotion strategy aimed at alleviating diabetes in Western Australia. Its mission is to provide a framework for accessible, comprehensive and efficient provision of well coordinated management and prevention services for all Western Austrians. Key objectives of the strategy are to ensure delay or prevent the onset of diabetes, improve quality of life of diabetics, reduce progression of diabetes complications and reduce inequalities in diabetes service provision especially for the disadvantaged groups such the Aboriginal people (EHN, 2008). The model is broken down into five major stages: community prevention and awareness, prevention and early diagnosis in high-risk groups, long term and optimal initial, early detection and optimal management of complications and coordinated prevention and management of acute episodes. 2.1 Community awareness and prevention of diabetes Delay and effective prevention of diabetes requires the efforts of the whole population in addition to the specific high-risk groups. The strategy employs a multi-sector promotion of healthy lifestyle and environment that ensures that people live in environments that encourage healthy lifestyles. It also invests in health promotion activities in order to ensure that those vulnerable to diabetes are aware of the risks and have access to relevant information to enable them adopt healthy living. Key strategic actions for promotion of healthy lifestyles as outlined in the Western Australian Health Promotion Strategic Framework 2007-2011 are prevention of smoking, healthy eating, healthy weight, healthy activity, low risk alcohol use and prevention of injury. With the knowledge that about 80% of Western Australians see a doctor each year, doctors are used to disburse information concerning diabetes. 2.2 Prevention and early detection in high risk groups The strategy has developed a model for early diagnosis of diabetes. It contains a system for identification of high risk populations and summarizes protocols for diagnosis of such groups. Through well coordinated accessible, effective and culturally appropriate programs, the program ensures that people are educated on healthy eating and physical activities thus preventing prevalence. 2.3 Optimal initial and long-term management This stage encourages effective and optimally configured specialist services. There are specialist services configured for specific diabetes complications which normally refer back to general practitioners for long-term management. This mainly applies to special groups of people with diabetes such as pregnant women, children, adolescents and those with gestational diabetes. 2.4 Early detection The health promotion educates diabetic patients on signs of long term complications and how they can be prevented. The promotion has also increased the number of upskilled care providers to improve coordination of screening for complications. Clinic and tertiary hospitals in Western Australia have been streamlined and increased to enhance screening of diabetes complications. 2.5 Coordinated management and preventions of acute episodes Health promotion activities educate people with diabetes and their families about signs of deteriorating health of diabetics and how they can manage it. Persons with diabetes are provided with action plans which assist them to manage declining health status including how and when to seek professional help. While the model is designed for application in Western Australia, it effective implementation requires networked solutions at regional and local levels. In addition, innovative strategies need to be incorporated in order to overcome challenges posed by cultural factors, language, remote locations and special needs of vulnerable groups more so the Aboriginal people. 3.0 Western Australian Diabetes Model of Care and the principles of health promotion in the Ottawa Charter According to the Ottawa Charter, health promotion refers to the process of enabling people of a particular community to gain control over and improve their health (Norris et al, 2001). The WA Diabetes Model of Care mission, which is to provide a comprehensive, accessible and efficient diabetes prevention and management service for all Western Australians, was clearly formulated in line with the Ottawa definition. Health promotion goes beyond enhancing the health of an individual but involves improvement of entire being including emotional, financial, educational and emotional aspects. 3.1 The three basic strategies The Ottawa Charter outlines three basic strategies which should form the basis of any health promotion Advocate: The charter recognizes that health is the major source of economic, personal and social development hence a good health promotion should endeavor to promote these factors through advocacy for health. The WA Diabetes Model of Care is party to this as one of its coherently stated objectives is to improve the overall quality of people living with diabetes. Enable: Health promotions should focus on bringing equity in health. Various activities of the WA Diabetes Model of Care are geared towards filling the gap in diabetes service provision existing between Aboriginal people and non-Aboriginal people. Mediate: The Ottawa Charter requires that health promotions act as mediator of involved parties including health and socioeconomic sectors, governments, non-governmental and voluntary organizations as well as the media to ensure the overall promotion of health in the community. WA Diabetes Model of Care works in collaboration with the Australian Bureau of Statistics to obtain the specific facts and figures about diabetes prevalence in order to establish the correct action plans. Besides that, it works closely with healthcare providers to achieve its objectives. 3.2 Health promotion priority action areas The WA Diabetes Model of Action has developed five main action areas aimed at attaining its objectives in accordance with the Ottawa Charter; Building healthy public policy: WA Diabetes Model of Care was birthed by a clinical lead of endocrine networks who realized the gap of the increasing burden of diabetes epidemic in terms of escalating health and financial costs which demanded much greater investment for awareness and prevention. This complies with the Ottawa Charter which states that a health promotion should identify a gap in the health sector and find ways to fill it. Strengthening community actions: WA Diabetes Model of Care has set out priorities which have been adequately implemented. This been chiefly achieved through public education about diabetes whereby members of the public are educated on the causes, effects and ways of preventing diabetes. This has occurred through collaboration with the local government, healthcare providers and other stakeholder. As a result, the people living with diabetes now have better control of their health. This concurs with the Ottawa Charter which requires health promotions to provide community empowerment by drawing the existing human and material resources. Developing Personal skills and reorienting health services: Since the strategy utilizes health professional in various areas of the health sector, it has embarked on training of such persons and has configured specialist services for optimal effectiveness. Besides that the health promotion distributes information resource to ensure that people are well informed about risk factors, signs, importance of diagnosis, ways of reducing the risk and treatment. 4.0 Effectiveness of the WA Diabetes Model of Care The effectiveness of the WA Diabetes Model of Care has not yet been detailed in literature. This is perhaps due to lack of agreement about the goals and expected or desired outcomes of project, which has been characteristic in many health promotion projects across Australia. This lack of consensus has greatly hampered further research in the field and presented obstacles to preventing and benchmarking the quality of services offered by the project to diabetes patients. Nevertheless, there are various methods that can be used to locate evidence of the effectiveness of the health promotion (Muhlhauser and Berger, 2000). 4.1 Review of relevant literature Much of the evidence about the effectiveness of health policies is found in peer reviewed literature. Drawing from this evidence from previous health promotions, it would be easy to determine the expected outcomes of the WA Diabetes Model of Care health promotion. 4.2 Consultations with policy makers and providers Consultations with the Diabetes and Cardiovascular Health and the Health and Ageing (DHA) departments would also provide a good platform for provision of evidence about the project. The explicit purpose of consulting with these people is to assess the extent to which the promotion is upheld by policy maker especially the Member of Parliament. 4.3 Focus groups with a range of people living with diabetes and parents of children with diabetes Focus groups with people living with diabetes, who are beneficiaries of the health promotion, is quite important in providing evidence concerning the effectiveness of the promotion. Focus groups should be selected randomly in different towns in Western Australia in order to provide a fair sample. The focus groups should be formed based on gender, age and the type of diabetes. The purpose of the focus group is to gather the views and opinions of people with diabetes (Snoek and Visser, 2003). 4.4 Survey of service providers Service providers are at the forefront in the implementation of the WA Diabetes Model of Care especially in providing education to diabetes patients. Therefore, capturing their perspectives and experiences with the project would provide good evidence about the outcomes. Interview can be organized with healthcare providers in various part of the region although the information obtained would be rather scanty. Essentially, a workshop with these service providers will provide reliable evidence of the project outcomes about services offered in different contexts and settings. 4.5 National stakeholder forum Stakeholder forum is another avenue for acquiring evidence about the progress of the health promotion. The forum comprises the key stakeholders including diabetes educators, general practitioners, monitoring agencies and health departments. Other participants include Aboriginal diabetes service, dietitian associations and they are all expected to give their experiences with the health promotion (NDSS, 2007). References Australian Bureau of Statistics (ABS). (2006). Western Australian Indicators. Canberra: Australian Bureau of Statistics. Australian Institute of Health and Welfare (AIHW). (2008). Diabetes: Australian Facts 2008. Diabetes series no. 8. Cat. no. CVD 40. Canberra: AIHW. Colagiuri, A, Brnabic, A, Gomez, M, Fitzgerald, B, Buckley, A, Colagiuri R. (2009). DiabCo$t Australia Type 1: Assessing the burden of Type 1 Diabetes in Australia. Canberra: Diabetes Australia. Colagiuri, R. and Goodall, S. (2004). Information and Education for People With Diabetes: A Best Practice Strategy. Canberra: Diabetes Australia. Endocrine Health Network (EHN). (2008). Diabetes Model of Care. Perth: Health Networks Branch. Grey, M. (2000). Coping and Diabetes. Diabetes Spectrum. Volume 13, issue 3, p.167. Moshe, P. and Tadej, B. (2012). Attd 2011 year book advanced technologies and treatment for diabetes. London: John Wiley and sons Inc. Muhlhauser, I. and Berger, M. (2000). Evidence-based patient information in diabetes. Diabetic Medicine. Volume 17, p. 823-829. National diabetes service scheme. (NDSS). (2007). Outcomes and indicators for diabetes education. Canberra: Diabetes Australia. Norris, S., Engelgau, M., Venkat, N. (2001). Effectiveness of Self-Management Training in Type 2 Diabetes: A systematic review of randomized controlled trials. Diabetes Care. volume 24, issue 3, p. 561-587. Shaw, K. and Cummings, M. (2012). Diabetes: chronic complications. Chichester: Wiley-Blackwell. Snoek, F. and Visser, A. (2003). Improving quality of life in diabetes: how effective is education? Patient Education & Counseling. Volume 51, issue1, p. 1-3. Steed, L., Cooke, D. and Newman, S. (2003). A systematic review of psychosocial outcomes following education, self-management and psychological interventions in diabetes mellitus. Patient Education & Counseling. Volume 51, issue1, p. 5-15. Read More