Research Article Critique
Diabetes is a chronic condition that affects over 30 million people in the country based on data from the Centers for Disease Control and Prevention (CDC, 2017). While some individuals manage the condition without complications, many cannot. As such, different research studies focus on developing self-monitoring practices for individuals with comorbidities like those living with disabilities as a result of type 2 diabetes. The research in this critique by Gillani et al. focused on how these individuals can enhance their awareness of modification of their diets and barriers that compound adherence to medications. The study by Gillani et al. (2017) relates to nursing since nurse practitioners are the primary source of patient education in healthcare settings. The research addresses the need for education for patients living with physical disabilities due to type 2 diabetes.
Review of Literature
The article identifies essential concepts in its literature. For instance, the authors assert that patients who fail to adhere to their medication may not attain optimal therapeutic results as their hemoglobin A1C may increase or go beyond their therapeutic range. The authors mention that for these patients to achieve glycemic control targets, they require several care approaches that comprise self-monitoring of blood sugars (SMBG) (Gillani et al., 2017). The article also emphasizes that disability and cognitive malfunctioning are the main hindrances to attaining maximum glycemic levels and compliance with medications. The article also recognizes the complex nature of self-care, which becomes more complicated as diabetic patients get older. The authors use references in their literature
Theoretical Model
The authors explain each concept they utilized, including tables that were developed to explain the participants. The research focuses mainly on patients as opposed to nursing interventions since it is about self-care, especially self-monitoring practices. Their responses were founded on limited knowledge tools. The authors also wanted to know if the patients’ economic background impacted these factors. The article also examines other models like awareness of the patent about self-management of their diets (Gillani et al., 2017). However, the study does not have a theoretical framework. The article emphasizes that adequate adherence to medication by the patients and the maintenance of a healthy diet would lead to optimal therapeutic results in the long-term.
Variables/Hypotheses/Assumptions/Questions
The study incorporates one dependent and one independent variable. The dependent factor comprises of the responses to the interview question while the independent variable is the participant. The implication is that the answer to the interview prompts changes based on the response from each participant. The operational definitions of the variables were provided and measured by the researchers. The study does not mention any research hypothesis or questions. Its primary focus was collecting information to ascertain the patient’s knowledge about their physical disability as a result of failing to comply and adhere to their medications (Gillani et al., 2017). The participants’ information tests the need for diabetic patients to have increased knowledge of self-care and management to mitigate the adverse effects of the condition.
Methodology
The study uses a qualitative approach where the authors applied deductive reasoning as they were trying to increase the awareness levels of their participants. For example, the authors wanted to assess the diet and medication adherence of the patients that were already living with disabilities due to non-compliance with medication. The patients were amputees implying that through this research, they would understand that adherence and compliance to drugs would have led to better outcomes as opposed to the current complication. The study was carried out in Penang General Hospital in Malaysia, where 21 participants aged between 35 and 67 took part (Gillani et al., 2017). These included ten locals, seven Chinese, and four participants of Indian descent. The sampling method entailed having a participant whose disability is due to diabetes type 2 and should be 18 years old. Those outside the criteria were not included in the study.
The study employed a non-probability sample as the inclusion criteria were specific to the kind of participants that were required in the research. The study used an individual open-ended interview model as a measurement tool for its reliability and validity. The article also addresses ethical considerations that include before, during, and after the research (Gillani et al., 2017). These include attaining informed consent from the participants, which they gave using their language, and verbal consent for those that could not read and write in their native language.
Data Analysis
The study used prescriptive analysis to analyze the collected data as the research has recommendations and strategies for optimal outcomes. The study presented its findings in tables. While the study has many results, the one that stood out conspicuously was that out of the 21 participants, and ten came from the moderate part of the socioeconomic group implying that they earned between $1000 to $3000 a month. The study also used audiotapes for purposes of getting verbatim transcription (Gillani et al., 2017). The audiotapes were written by the primary investigators to prevent any research bias. The researchers verified the accuracy by the different participants, and after their approval, they carried out an analysis of the study.
Summary & Conclusions
A strong point of the study is that while it was carried out in Malaysia, many can resonate with it and develop self-care and dietary management strategies to mitigate non-compliance events. The study also has a well-rounded data concerning the participants and issues affecting their lives like their socioeconomic conditions and marital status. However, the study’s main limitation was its inclusion criteria, where only participants living with physical disabilities as a result of diabetes complications were included. Secondly, the study notes that another limitation was its focus on patients with help-seeking conduct (Gillani et al., 2017). Further, these patients were not willing to visit healthcare settings to review their conditions, get more medication, and adhere to their care interventions.
Implications & Recommendations
While the study did not implement any assessment related to patients’ responses like body mass index and waist circumference, it demonstrates that adherence to therapeutic interventions is critical to optimal care outcomes as well as enhancing the quality of life for type 2 diabetic patients. The implication is that the general population can use the findings to understand the chronic effects of non-compliance to a medication when one suffers from type 2 diabetes. These findings have implications for nurses in different ways.
Firstly, nurses should educate patients on the critical role of medication adherence and compliance for any condition to avoid adverse effects like the participants showed in the study. The study also indicates the need for diet modification for patients with diabetes. Imperatively, nurses have a responsibility to offer patient foods that are nutritious. As a patient advocate, the nurse should provide increased information on diet modification and the need to follow a self-care plan as well as effective practices.
In its recommendation, the study is categorical and emphatic that patients living with disabilities should be recognized as a particular population for better management and interventions (Gillani et al., 2017). Imperatively, healthcare providers and professionals should focus on enhancing their knowledge and behaviors of this population as opposed to developing treatment plans. The self-monitoring blood glucose tool has limitations. However, through a collaborative approach and involvement of providers like pharmacists and the incorporation of mobile devices, the patient can have a better understanding of the model. The article’s last recommendation is that healthcare workers need to assess their patients’ knowledge and understanding before placing them on treatment plans.
References
Center for Disease Control and Prevention (CDC) (2017). Diabetes Growth Rate Steady,
Adding to Healthcare Burden. Retrieved from https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html
Gillani, S. W., Sulaiman, S. A. S., Abdul, M. I. M., & Saad, S. (2017). A qualitative study to
explore the perception and behavior of patients towards diabetes management with a physical disability. BMC: Diabelotogy & Metabolic Syndrome, 9(58). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5525368/