The Impact of Disease on the Quality of Life of Patients - Term Paper Example

 «The Impact of Disease on the Quality of Life of Patients» Introduction Diabetes is considered one of the most common types of diseases in modern times. This is due to the fact that many changes are brought by modern times into the lives of people. Environmental factors such as urbanisation, mechanisation and changes in lifestyle and nutrition were reviewed to affect the number of type 2 diabetes mellitus since migrants such as Blacks, Hispanics, Chinese, South Asians and others became affluent and urbanized (Misra and Ganda, 2007). From the study regarding type 2 diabetes among Aborigines in Melbourne, Australia, the susceptibility of an individual to diabetes and other diseases was highly connected to family, community and society (Thomson and Gifford, 2000). The implication of this framework according to Thomson and Gifford is that it can be applied in solving major public health challenges due to global socio-cultural and environmental changes. South Asian migrants were found four times more susceptible to develop type 2 diabetes mellitus than those who remained in rural populations (Misra and Ganda, 2007). The determinants of this finding according to Misra and Ganda were found to be nutrition transition, physical inactivity, gene-environment interaction, stress and factors like ethnic susceptibility. Obesity has become epidemic especially in the United States were 31.1% of adults are obese and as the number of obese person increases, the risk of diabetes mellitus also increases (Catenacci et al., 2009). It is clear therefore that changes in the environment brought some significant changes to the life style of every person and thus creating more physical changes that are in line with the current health concern of the world. Diabetes is not an ordinary disease because it is increasing in its number. Diabetes mellitus is a metabolic disease and it is prevailing rapidly worldwide (Hoppener and Lips, 2006). The impact of disease on the quality of life of patients The onset of type 2 diabetes during childhood signals an accumulation of the full range of both micro and macro vascular complications (Shaw and Sicree, 2008). There is also a need to strictly comply with diet and pharmacological therapies. There is also a high risk of long-term micro and macro vascular complications in the adolescent and early adult years. This was supported by a study. Children with diabetes were surveyed again when they reached the age between 18 and 33 years old. Out of 51 subjects, 9% of them died, 6% were on dialysis, one was amputated and 1 was blind. The elderly were also expected to suffer from morbidity associated with diabetic complications as they aged. This implies that the patient needs to carefully look for both minor and major complications that may possibly arise together with the disease. In other words, patients need to carefully look out for their diets which means not enjoying to the fullest their cravings for some delicious foods. Therapies are expected and this means inconvenience or hassles on the part of the patient and with his or her family. Friends are expected to see clear lessons from the patients and this means significant lessons to learn about which could improve their lifestyle further. On the side of treatment the disease, it is not enough that patients will just be given with some therapies; there is a need to educate them further about the disease. Improvement in metabolic control such as integrating insulin therapy within the patient education program is viewed effective way to improve patients’ diabetes-related quality of life (Braun et al., 2008). Psychosocial factors such as support and acceptance of diabetes, knowledge of the disease, perceived difficulty of self-care behaviours and the quality of life were found to play important relationship with each other (Misra and Lager, 2008). It was found that high level of social support and acceptance resulted to positive effect on self-care behaviours. Theoretically speaking, the self-care behaviours were found to influence quality of life and mediated the relationship between social support, acceptance and quality of life. This is the reason why there is a significant need to go for educating the patients about the disease. It is important that they may be able to learn more about it especially on the substantial effects with regards to the onset of the disease and its treatment. This is just to ensure that patients will be given considerable amount of time to understand themselves and the disease more clearly. Families and friends are very important persons that could help the patient fight the disease due to the fact that it is not only the physical aspect of life which is affected by the disease, but together the psychosocial factors. Thus, there is an important role of stay positive since it helps to encourage the patient to fight the disease. However, it is not only the family and friends that must essentially learn to encourage the patient positively. Providers play significant roles in patients with type 2 diabetes mellitus. They can essentially help patients regarding their basic concerns. There is a need for insulin therapy even if patients concerns on it are absolutely clear, but providers can help them by improving their metabolic control and providing information and support so as to give a positive impact on the quality of life (Funnell, 2008). It was found that metabolic control in patients with type 2 diabetes mellitus was not influenced by anxiety, depression and negative thoughts about the illness, but physical and mental functioning (Paschalides et al., 2004). Thus, there is a great deal to keep encouraging the patients in a more positive approach. This is to ensure that the treatment itself would be a success at some point. It cannot be denied that Diabetic co-morbidities and dependence upon insulin have clear impacts to decrease quality of life (Brown et al., 2000). Davis et al (2001) found another important result to support the fact suggesting the effect of insulin therapy on the quality of life on patients with type 2 diabetes mellitus. There were 1290 subjects in the study and 149 of them were able to undergo insulin treatment and the rest were able to undergo non-insulin treatment. The result was remarkable since patients who undergone insulin treatment had greater satisfaction, worry and worse quality of life than those non-insulin treated patients. This result suggests that the effect of insulin treatment lowers quality of life after 1 to 2 years even though the treatment itself may be improved by factors such as increased support and improved hyperglycaemic symptoms to prevent unfavorable aspects of the treatment. Since the most effective way so far for the treatment of the disease has been viewed to be insulin-treatment, it is important that patients will be clearly educated about the best possible options if ever there is available. This is to say that the family or even friends need to significantly know some possible options that may effectively help the patient. On the other hand, study about type 2 diabetes mellitus among Asians revealed ethnicity aside from demographic and socioeconomic as one of the factors to persistently influence health-related quality of life (Wee et al., 2006). Indeed, there are social factors involved in the health related issues and the quality of life of patients. This is to say that the society or the most basic institution which is the family has significant role to play to help patients stand with type 2 diabetes mellitus. Issues faced in rural and remote setting The study about diabetes in India pointed to the fact that there is a need for health policy restructuring and investment just as it is needed in the other developing countries for the future healthcare crisis to come (Bjork et al., 2003). Since the prevalence of the disease is turning to an upward spiral, developing countries especially in their rural and remote areas need to be essentially covered with effective health policies. On the other hand the healthcare system must be essentially studied in order to get effective implementation in the future. The effective implementation must depend on the existing healthcare system and health care policy. Thus, in order to solve some major problems in the future, the rural or remote areas must be substantially provided with the needed attention by the government and other health care providers. The socioeconomic implications of diabetes mellitus are significantly present in both industrialised and developing countries considering that many are still not given with existing therapies which will impact quality of life of patients and healthcare expenses (Home, 2003). This is to say that therapy is very crucial in type 2 diabetes mellitus and this would mean that those who are in rural and remote setting must get substantial attention. Considering that industrialised countries are still faced with the future healthcare crisis, this is an assurance that developing countries needs even more careful preparation. This is to say that the inability or incapacity to combat the disease at its onset stage would be a significant problem to be faced by rural and remote areas in the days to come. Cost involved It is clear that cost associated with type 2 diabetes mellitus is another significant consideration and it is one of the major concerns taken into account by patients and other concerned. This is due to the fact that a significant amount is needed in order to substantially address disease therapy or treatment. In 2002, the cost of diabetes mellitus treatment in the United States reached as high as $91.8 billion (Balkrishnan, 2003). Diabetes care accounts for 2-7% of total national health budgets in Western countries due to the fact that the number of type 2 diabetes is set to increase from 150 million to 225 million in 2025 worldwide (Zimmet, 2003). This is to say that there is a need to essentially cover the essential about the disease since the associated cost of its treatment is not ordinary. Type 2 diabetes mellitus due to its complications and as chronic as it is, becomes one of the most expensive diseases based on the total health care cost per patient (Hoppener and Lips, 2006). In Denmark, it was found that there was no relevant difference in the costs of treatment between patients using long-acting insulin analogues (LAIA) or intermediate-acting human insulin in a basal-only regimen especially on direct health care costs including prescription cost, but ambulatory and insulin pharmacy costs were lower on LAIA and NPH treated patients (Gundgaard et al., 2010). Even though the treatment of the disease may have significant strategy that would involve reduction of cost, in the end, there is still associated large amount of cost to be personally incurred by patient. The treatment is substantially expensive. Though prevention is better than cure, the amount of time needed for prevention program still requires another cost. Thus, cost is essentially associated with type 2 diabetes mellitus. Complications of the disease may ensure additional cost. It was found that the cardiovascular co-morbidity in patients with type 2 diabetes created significant effect on the total and diabetes-related healthcare costs (Mody et al., 2007). From the data gathered in West Virginia state Medicaid, costs for diabetes-related healthcare for patients with type 2 diabetes and cardiovascular co-morbidity reached $4349, $1911 for ER/hospitalization and $740 for outpatient costs which are higher than for those patients without cardiovascular co-morbidity (Mody et al., 2007). Impact on the healthcare system Insulin resistance is believed to be the initial defect in the patient suffering type 2 diabetes mellitus and the failure to produce enough insulin needed for the body will increase the level of blood glucose (Hoppener and Lips, 2006). Understanding the disease requires more meaningful scientific investigation. This is where the evidence-based approach in understanding the disease comes in. The healthcare system needs to be more scientific driven and this means more scientific researches to be needed. More scientific investigations are needed in order to substantially cover all the essentials in understanding the disease including the alternative treatment in a cost-effective yet efficient way. Through relevant scientific findings, healthcare system will be improved and everything down to trial and error experience will be minimised or even absolutely terminated. Issues facing population health and health policy It is a fact that economic and social costs and complications of diabetes mellitus have increased dramatically over time (Park, 2004). This created a significant concern in both population health and health policy. Due to its increasing and rapid prevalence, type 2 diabetes mellitus among children and adults created a need for policy and budgetary considerations to government, health insurance companies, employers, physicians, and health care delivery systems (Ryan, 2009). Prior to creating the intended policy in line with the disease, it is important that the exact number of prevailing conditions must essentially be investigated. This is to ensure that the need to fight the disease is exactly at its alarming stage. Moreover, this will create more scientific approach in line with the creation of essential policy. Various expertise and different bodies of knowledge will need to be essentially tapped by the government and other authorities. Ryan (2009) suggested more coordinated efforts at the national level to combat the increasing costs and rapid prevalence of diabetes mellitus and investment in infrastructure for primary care so as to save about two third of the costs to be incurred. Aside from efficiency, savings is a very important consideration in the creation of a well-established health policy regarding with the consideration of population health. Management strategies available There are many management strategies in line with the fight against type 2 diabetes mellitus. However, the best strategies would remain to substantially address both genetic and environmental factors in order to address type 2 diabetes effectively and efficiently (Park, 2004). Based on literature, there are many strategies available to fight type 2 diabetes mellitus. These strategies were based on the theoretical evidence about the disease. This is the reason why they can be effective strategies. On the other hand, these strategies may not be the best but they are still subject to further investigations. These strategies must be essentially discovered by the government in order to effectively create necessary choices that are well studied using a more scientific-driven approach. Strategies involved in prevention of type 2 diabetes include reduction of insulin resistance, preservation of pancreatic beta cell function into susceptible individuals and life style intervention (Park, 2004). O’Kane et al. (2010) in their study about the relationship between socioeconomic deprivation and metabolic/cardiovascular risk factors in a cohort of patients with type 2 diabetes mellitus found that successful management of modifiable factors can be achieved if they are independent of socioeconomic position. Standard interventions in a multifaceted program to combat diabetes mellitus were found to improve diabetes care (Goderis et al., 2010). Efficient targeting of financial resources in the United States in relation to fighting diabetes mellitus was found to give savings from $35 billion to $72 billion for over ten years (Minshall et al., 2005). Cost effectiveness of technologies in diabetes is important (Bottomley and Raymond, 2007). 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