Distress and Depression in Diabetic Persons and Their Relationship With Self-Care Practitioners in Barbados

Discussion

Patients suffering from diabetes understand the effects the disease has on their lives, both in the short-term and in the long-term. This necessitates the patients to seek guidance from health experts on ways they can manage the disease and lead a normal life. As with other health issue affecting the human body, patients who have diabetes lead a distressed life full of depression. However, self-care is one of the most important considerations that health experts advocate when dealing with a patient since it shows their commitment to do what is right for their health. For instance, patients diagnosed with diabetes should take a balanced diet, and they should exercise regularly and take their medication on time and according to the doctors' prescription. Addressing the need to follow medical guidelines and taking healthy meals enable patients to manage their condition, and live meaningful lives. Previous chapters have addressed the management of diabetes mellitus, a literature review, and methods used to collect data from different sources. As a continuation, this chapter will address the summary of findings, conclusions, recommendations, and suggestions for further research.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Save 25%

The sample population was randomly selected from Barbados and comprised of persons clinically diagnosed with Type 2 Diabetes Mellitus (T2DM) and 509 participants took part in this research. Male and female respondents participated in the study and gave their consent before taking part in the study. Demographic information about the participants about their gender, marital status, health condition, and clinical care allowed the researcher group them into distinct groups. The information would be relevant to understanding whether the patients took proper consideration to observe their health patterns like attending clinics and making life adjustments so that they could easily manage diabetes.

The sample comprised of about 30.8% males and 69.2% females. The participants in the study had different marital status, but that did not affect the prevalence of diabetes. However, most of the participants argued that it was easy managing the diabetic condition with a partner that supported them morally and psychologically. For instance, a partner would remind a loved one to take medications or attend clinics that help track the health of a patient. It was also easy to adjust life for a spouse living with a person who had diabetes.

Summary of Findings

For the purpose of this study, it is crucial to highlight that Barbados is a small island in the Caribbean and the sample was taken from that population. Participants used in the study are assumed to represent the entire population of the island. Most Barbadians perceive the management of type-2 diabetes in the region to be different from other areas. The literature is similar to the findings and results of the study as most respondents revealed that the health care system in Barbados was different from other localities, which affected the perception and reception that the society had towards people living with the condition. For instance, in some jurisdictions, amputating limbs of patients with diabetes was the most common norm, which discouraged most individuals as they considered that to be their fate in the long-term. However, patients that had a family history of diabetes were psychologically prepared by being victims of the disease either in the short-term or in the long-term. This vicarious knowledge gave them ideas on how their lives would change if they would be positively diagnosed with the condition (Ting, Nan, Yu, Kong, Ma, Wong, & Chan, 2011). Despite the wide knowledge of ways of managing the condition, most persons stated that they were unwilling to follow the recommendations. Negative feelings crowded their minds most times and most persons found themselves neglecting self-care directives like taking balanced diets or avoiding sugary foods.

Respondents stated that they had undergone through a clinical test to check their diabetes status. The sample of 509 participants had visited health care facilities in the past three years. Individuals diagnosed with diabetes are often expected to accept the condition and make adjustments in their lives that will help them cope with the issue (Fisher, 2007). Some people are still in denial and fear becoming dependent on medication, meaning that failure to take their medicines on time would lead to their untimely death. Patients who live in denial, consider living with diabetes a burden as they felt strained making special consideration for their meals and forgoing things that they considered part of their life in the beginning. This negativity demotivated most patients from taking steps towards the proper management of their health. Other personal issues that affected the patients' ability to manage their health issue was the absence of social support from their families. The distress experienced by patients also triggered over-reliance on medication. Fisher, Hessler, Glasgow, Arean, Masharani, Naranjo, and Strycker (2013) argued that the distress among diabetes patients has been overlooked by medical practitioners. It has resulted in the neglect of patients' feelings which then contributes to the negative feeling of inadequacy among individuals with diabetes.

Despite the clinical and medical advice that patients receive from their healthcare practitioners on ways they can manage the diabetes condition, most of them fail to follow the recommendations so that they can manage and suppress the disease and live normal lives. For instance, one of the participants stated that she felt demotivated since she has no person to motivate and help her take care of herself. Living with diabetes requires a patient to eat regularly and ensure that meals are balanced. The literature is similar to the findings and results of the study which showed that financial constraint is one of the major issues affecting people diagnosed with T2DM in Barbados. Most patients are only able to afford the standard three meals per day. Others are too busy with their job schedules such that they forgo some meals. Some participants also stated that they indulge in unhealthy meals like taking junk and cakes, with the full knowledge that they should not take such foods because of their health. The justifications for doing that is that they miss the junks and giving in to temptation.

The ability to make lifestyle changes and manage the diabetes condition with ease depended on the close relationship that patients maintained with their clinical practitioners as well as the individual's personality. Patients who had a negative perception towards their physician developed a bad attitude and were unable to follow the treatment recommendations. Some participants also assumed that they experienced the negative effects of the medication they were taking because their health care providers were not good, ignoring the fact that practitioners prescribed them medication based on their health, performance and they had little or no control over the ways in which the patients managed their disease.

Some participants stated that the empathetic feelings they received from others had little or no effect in their ability to deal with and manage the disease. This is because a patient had the sole responsibility of watching what they consumed and avoiding stress levels as that would affect the blood pressure, which is not recommended for diabetic persons. However, emotional support from family and friends helped the patients manage the condition better and feel accepted despite the fact they suffered from a chronic condition. It is also important to note that not all patients received emotional support from their family members, but that did not affect their commitment towards taking good care of their health. Negative emotions like anger, stress, and confusion were reported by most participants. More than 55% stated that the negative emotions were provoked by the stress that comes from managing an illness. However, the patients did not have negative feelings on a daily basis.

Participants demonstrated their understanding of living with diabetes as well as the short-term and long-term effects the condition had on their lives. The knowledge motivated them to make lifestyle changes and avoid engaging in activities that triggered a high glucose level. Personal investigations and experiences were some of the ways the patients got information about the disease. Some participants were aware that they needed to take great care of themselves like eating the right quantities of food and exercising right. Managing the disease after following the practitioners' recommendations made it easy for the patients live meaningful lives that were not affected by negative side effects of living with a chronic condition. For instance, eating right helped the patients avoid getting opportunistic infections that are highly prevalent for people living with diabetes.

A deeper and elaborate discussion of the answers presented in the quantitative questions will provide a meaningful explanation of the relationship that exists between diabetes and high levels of distress among patients. All the four questions will be discussed independently.

Discussion of quantitative summary findings for question 1

83.4% of the participants stated that they had little or no distress, and 9.4% argued that they experienced moderate distress while 7.2%had high distress. Fisher et al. (2013) stated that even though diabetic patients have high levels of distress, the level has not reached the depression rates that need medical attention. However, the patients who suffered high emotional distress levels was because they were in constant worry due to their diabetic condition. The Diabetes distress in patients with type 2 diabetes is relevant because the results of the studies show that the point prevalence of high and moderate distress is high recording 45.4% in adults who lived in a community setting (Fisher, Hessler, Polonsky and Mullan, 2012). According to Fisher, Mullan, et al. (2010), The relationship between diabetes distress and poor glycaemic control, managing self and self-efficiency is significant holding clinical depression constant. According to researchers, there are strong reasons for proposing the critical nature of diabetes distress, and an overlooked area of care for diabetic patients (Fisher, et al., 2013). 7.2% of the participants had high distress levels, an indication that patients who accepted their medical condition were in a position to live normal and longer lives. The mean score for the entire sample was less than 2 which is considered a low level of distress. Females showed a higher rate of diabetes distress, and participants that had never married showed high and moderate levels of distress. Diabetic distress (DD) decreased as patients aged and also as the number of years with diabetes increased. The patients were emotionally mature to understand the implications of living with the condition both in the short-term and in the long-term. The results also showed that the perception of the illness among the participants and DD were not directly related. On the dimensions of illness perception, the higher the higher the level of concern, the higher the probability of having DD. However, on coherence dimensions, as the levels of coherence increased, DD decreased. DD was the same for all patients since they did not consider their marital status to be a reference to their comfort in living with the condition. Results indicated that there was no distinct relationship between the level of participants' educa...