Orem's self-care model was developed with the aim of improving nursing quality in the care hospitals and other care centers. It entails various concepts that are interconnected to come up with a different way of looking at a certain aspect. Orem's self-care model, also referred to as the self-care deficit theory is based on certain norms. The first supposition states that people should be self-reliant and responsible for their care. Moreover, they should also care for other individuals in their families who are in need of care. People are also referred to as diverse individuals in this particular model (Hoeman, 2008). On the other hand, nursing is a form of action that can be seen as an interaction between two or more individuals. Primary care prevention and ill health are connected to the aspect of meeting the universal and the development of self-care that is necessary for success in caring for individuals. Additionally, for self-care behaviors to be promoted in people, it is necessary for them to have the knowledge of the possible health problems that they may be facing. Orem's self-care model further assumes that dependent care and self-care are conducts that are usually learned within a socio-cultural framework (DSouza, Karkada, Venkatesaperumal, & Natarajan, 2015).
Diabetes is a self-managed disease. Type 1 diabetes unlike type 2 is considered a lifetime and incurable disease. It has been associated with extreme cases of sickness and early death. African Americans with type 1 diabetes are likely to be faced with an increased risk of premature death as compared to other groups such as Caucasians (Conway et.al, 2015). The disparity has been brought up by various aspects such as alterations in the frequency of difficulties and inadequate details. Most of the African Americans with type 1 diabetes do not have adequate knowledge about complications that are brought up by type 1 diabetes (Washington, 2012). As such, the Orems self-care model can be connected here to initiate the element of self-reliance among the African Americans. It is also evident that there is limited information on dependent care and self-care. This can further be attributed to the high death rates that are recorded among African Americans with type 1 diabetes as compared to whites (Meleis, 2012). It is thus necessary to promote the behaviors of self-care among this population as they will have the relevant knowledge of the health risks that are facing them as they live with type 1 diabetes. In this way, they will be in a position to apply the necessary measures that are required to manage the illness as this significant information will also be advanced to this group of the population. Furthermore, Orem's self-care model depicts that the ability of patients to produce effective self-care shows that they have obtained knowledge or even awareness of themselves and the condition of their disease (Washington, 2012).
Diabetes affects a substantial number of individuals. The costs associated with diabetes are quite high. The African Americans have been faced with various forms of disparities that are related to the effective management of this illness. As such, it is necessary to come up with the administration and even prevention initiatives that will assist this group in dealing with type 1 diabetes ("About Diabetes Disparities | The Alliance to Reduce Disparities in Diabetes," 2011). Most of the African Americans face forms of discrimination concerning employment opportunities and even areas of residence. Living in low-income and poor neighborhoods lead to high rates of obesity and overweight as well. This is as a result of lack of healthy food preferences and even chances to engage in physical activities that are safe (Conway, May, & Blot, 2012). Moreover, there is also limited information available to these neighborhoods on the efficient management of type 1 diabetes. This can further be attributed to the high levels of discrimination that are usually imposed on the areas with a large number of African Americans. The lack of access to sufficient physical activity and good food has further been accompanied by the low form of quality care that are advanced to the minority populations, that is the African Americans. Despite low-quality care being promoted to the non-minority communities, the minority are given a much lower quality ("About Diabetes Disparities | The Alliance to Reduce Disparities in Diabetes," 2011).
There are a series of gaps that exist between the care received by patients and the tests that have been recommended for the appropriate management of type 1 diabetes. The differences have been pointed to be greater among the African-Americans as equated to the non-Hispanic whites. Additionally, African Americans also lack the right information to a significant level of the efficient management and control of type 1 diabetes. Members of the ethnic and racial groups also make up a disproportionate share of the non-elderly who do not have a health insurance. As such, they rarely have access to the right forms of treatment and even information on type 1 diabetes (Mayer-Davis et.al, 2009).
A needs assessment can be conducted among an African American population based in the region of Columbus who have been reported to have a higher rate of mortality as a result of diabetes. The purpose of the needs assessment is to assess the African Americans with type 1 diabetes and determine the challenges they face as they live with the disease. It has been widely depicted that the African Americans and especially in the selected region of Columbus incur various problems in the management of type 1 diabetes. The literature reviewed has generated support for conducting a risk assessment. This will be an efficient public health strategy for the promotion of health and management of the disease as well. Data can be collected through the use of focus groups that will involve African Americans with diabetes. Furthermore, questionnaires can also be applied to a random sample of people with type 1 diabetes who have received services from the Diabetes Association in the region. The staff from the facility can also be used to assist in identifying individuals who have met the criteria for participation in the collection of the required data. The staff will thus evaluate the random sample in an efficient manner.
There are potential challenges likely to be linked to this selected population. The most likely problem is associated with the racial and ethnic disparities. African Americans face a high level of inequality as a result of their race and ethnicity as well. As a result, it has led to health disparities where they lack the relevant information related to efficient management of type 1 diabetes. It is thus evident that the fundamental cause of the variation is linked with the multifaceted issues in the society which are poor access to health, discrimination, institutional racism and inadequate resources in the community. Additionally, their socioeconomic status also results in this form of inequality about type 1 diabetes as compared to other communities such as that of whites.
The challenges identified can be addressed in certain ways. In the first case, it is important to ensure that the access to good health care is a priority for all the communities regardless of their race or ethnic origin. Overcoming discrimination should be the first aspect that will then see other activities flowing in smoothly. Diabetes education is also important as the people will be enlightened regarding what they should do to manage the illness effectively. Furthermore, the health care facilities in these areas should be improved, and this can be done by ensuring they are fully equipped with the right personnel and equipment such as medications for diabetes.
About Diabetes Disparities | The Alliance to Reduce Disparities in Diabetes. (2011). Alliance to Reduce Disparities in Diabetes. Retrieved 20 March 2017, from http://ardd.sph.umich.edu/about_diabetes_disparities.htmlConway, B. N., May, M. E., & Blot, W. J. (2012). Mortality among low-income African Americans and whites with diabetes. Diabetes Care, DC_112495.
Conway, B. N., May, M. E., Fischl, A., Frisbee, J., Han, X., & Blot, W. J. (2015). Causespecific mortality by race in lowincome Black and White people with Type 2 diabetes. Diabetic Medicine, 32(1), 33-41.
DSouza, M. S., Karkada, S. N., Venkatesaperumal, R., & Natarajan, J. (2015). Self-care behaviours and glycemic control among adults with type 2 diabetes. GSTF Journal of Nursing and Health Care (JNHC), 2(1).
Hoeman, S. (2008). Rehabilitation nursing (1st ed.). St. Louis, Mo.: Mosby Elsevier.
Mayer-Davis, E. J., Beyer, J., Bell, R. A., Dabelea, D., D'agostino, R., Imperatore, G., ... & Rodriguez, B. (2009). Diabetes in African American youth. Diabetes care, 32(Supplement 2), S112-S122.
Meleis, A. (2012). Theoretical nursing (1st ed.). Philadelphia, Pa.: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Waki, S., Shimizu, Y., Uchiumi, K., Asou, K., Kuroda, K., Murakado, N., ... & Ishii, H. (2016). Structural model of selfcare agency in patients with diabetes: A path analysis of the Instrument of Diabetes SelfCare Agency and body selfawareness. Japan Journal of Nursing Science, 13(4), 478-486.
Washington, R. (2012). Epidemiology of Type 1 Diabetes Complications in African-Americans (Doctoral dissertation, University of Pittsburgh).
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