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Impact of Diabetes on Indigenous Australians and Implication for the Nurses Introduction Albeit diabetes being recognized as a major health problem in Australia since it affects a large percentage of indigenous Australians, the role played by nurses have contributed greatly to minimizing the negative implications of this disease on individuals, families and the entire community. Extensive studies with regard to this issue have revealed that more indigenous Australians are being diagnosed with diabetes as compared to other groups in society (Australian Human Rights Commission 2006). A clear understanding of the factors that contribute to an increased rate of diabetes among indigenous Australians, the effects of this disease among patients and their families in addition to its implications on the community and healthcare professionals can greatly assist in its management (Kirch 2008). This paper through qualitative analysis of published work, article journals and other legitimate sources is going to look at a variety of issues related to diabetes, its impact on indigenous Australians in addition to the implication of this disease on nurses.

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Impact on the individual Research has revealed that diabetes subjects patients to extreme suffering making one’s life extremely uncomfortable (Dunning & Ward 2008). Not only does this disease impact negatively on the lives of the people, but it has also been shown to impact on a variety of other aspects of life of an individual. Health care professionals have made it clear that diabetes impacts on the psychological health of a person, his or her social life in addition to cultural aspects of life. Diabetes has also been shown to lead to deterioration of the general health of a person.

Psychological impact of diabetes A large number of indigenous Australians with diabetes present with a wide range of psychological impacts associated with this disease including denial, depression, anger and embarrassment. Most indigenous Australian diagnosed with diabetes become overwhelmed with their situation and may develop depression that may end up weakening their immunity (Kirch 2008). It is usually hard for these people to accept their condition and as a result they may become angry and hold resentment against other people.

Social impact of diabetes Diabetes has been shown to impact negatively on the social life of indigenous Australians. It has been revealed that these people may become embarrassed to an extent that they cannot actively take part in social activities (Dunning & Ward 2008). The fact that people with diabetes are advised to stay away from certain activities that may aggravate their condition is also believed to negatively impact on social lives of these people.

Cultural impact of diabetes

Effective management of diabetes requires one to do away with some practices, an aspect that has been shown to potentially impact heavily on maintenance of cultural principles. The fact that people suffering from diabetes are advised to keep away from junk foods may lead to increased consumption of traditional foods. This is taken as a positive impact since it leads to preservation of indigenous eating habits (Albala 2011).

Impact on the family The fact that indigenous Australians have a strong link with their families implies that presence of diabetes in one of the family members will impact negatively on the general wellbeing of the entire family in matters relating to health, finances, and social support. It has been shown that when a family member develops diabetes, the psychological wellbeing of other members is negatively impacted (O'Dea, Rowley & Brown 2007). Some family members find it hard to come to terms with the fact that one of their members is suffering from an incurable condition. The reaction of some family members to the news that one of them is suffering from diabetes is believed to have significant implications on the treatment of this disease.

Diabetes also impacts negatively on the social stability of an indigenous Australian family. Recommendation of diabetic patients to refrain from some activities has been shown to harden sharing of duties among family members. As a result, persons presenting with diabetes may be viewed as a huge burden to the family. The financial implications of diabetes on the family are also believed to impact on the psychological capacity of family members, especially the elderly (Dunning & Ward 2008).

The normal challenges associated with a young adult’s family life may become aggravated if a close family member is diagnosed with diabetes as this disease may turn out to be a major source of conflict in the family (O'Dea, Rowley & Brown 2007). Diabetes has been

classified as a killer of relationships in indigenous Australian families. The fact that diabetes may lead to erectile dysfunction impacts negatively on the physical side of a relationship. The other challenge associated with presence of a diabetic member in an indigenous Australian family is the fact that other members are required to adjust their mode of life in order to minimize cases of stress in addition to making life comfortable for the sick person.

Impact on Population The negative impacts of diabetes are not only concentrated in a family, but they are also felt across the wider society. The fact that various aspects of life are interlinked within indigenous Australian communities implies that presence of diabetes among some people may have far reaching effects on almost the whole community. The psychosocial impacts of diabetes in young adults, for instance, are believed to be ubiquitous involving not only the family, but also schools and the community as a whole (Guthrie & Guthrie 2002). A large number of young adults do not have the psychological capacity necessary to make rational decisions with regards to their health and lifestyle. This implies that presence of diabetes among persons in this group may turn out to be a bigger problem than expected. Even though all life-threatening diseases negatively impact on the psychological stability of young people, the effects of diabetes on this group are profound (O'Dea Rowley & Brown 2007). It has been revealed that it is almost totally impossible for young indigenous Australians to accept the fact that they have been diagnosed with a chronic disease (Australian Human Rights Commission 2006). A great deal of counseling is required in order to bring a young person suffering from diabetes to reality. This adds to the complexity of care regimen of indigenous Australian young persons presenting with diabetes.

Guthrie and Guthrie (2002) make it clear that the impacts of diabetes among young people have proved to be a major burden in terms of financial cost and external influences in addition to

misunderstandings. The needs imposed by presence of diabetes among members of this group are also believed to add to the complexity associated with management of this disease.

Implications of diabetes for the role of the nurse The notion that diabetes is a major health condition among indigenous Australians calls for commitment of the patients, health care professionals and the entire community as well in its management. Diabetes has been shown to predispose patients to a variety of other health conditions and as a result the efforts of everyone are required in the management of this disease (Peimani, Tabatabaei-Malazy & Pajouhi 2010). Nurses together with other health care professionals play a major role both in management and prevention of this disease. These health care professionals offer specialized care to various groups presenting with adverse symptoms of this disease. Nurses have been shown to make significant contribution to the quality of care offered in general practice in addition to providing valuable educational as well as clinical support to people living with diabetes as they focus their efforts towards maximum management of diabetes and prevention of complications associated with this disease (Guthrie & Guthrie 2002). Learning the modalities of dealing with diabetes in addition to maintaining blood glucose level within a suitable range have turned out to be a major challenge in the management of diabetes. This challenge points out the essence of education programs as a personalempowerment treatment strategy essential for enhancing the quality of life in diabetic patients (Dunning 2009).

The psychological, social and cultural impact of diabetes on an individual, family members and society at large to a great extent determines the role of a nurse working within the health care system. In order to manage negative implications of diabetes, nurses and other health care professionals are required to teach patients the significance of observance of proper dieting

and other modalities of diabetes management. Nurses are also required to bring in enthusiasm in the management of diabetes among indigenous Australians (O'Dea, Rowley & Brown 2007).

Provision of quality care to diabetic patients in an environment characterized by distinct personal, social and cultural factors, such as those witnessed in indigenous Australian societies, calls for extensive knowledge and concern in addition to commitment from health care providers.

Health care professionals are called upon to provide all diabetic patients with quality care regardless of their ethnic background. International health principles have it that health care providers should offer services to all patients without bias (Johnson & Stoskopf 2010). The cultural diversity of indigenous Australians requires health care professionals working within the Australian health care system to equip themselves with the basic principles of various cultures.

Cultural awareness makes it easier for nurses to plan treatment of a diabetic patient in a manner that will respect his or her personal and cultural beliefs (O'Dea, Rowley & Brown 2007).

Cultural awareness also widens the base on which individual management of diabetes is grounded. Increased cultural understanding together with understanding of the clinical needs of individual indigenous Australians increases the capacity of nurses to offer competent care to diabetic patients.

Nurses working in the Australian health care sector have created a strong framework to assist in the establishment of clinical practice that advocates and promotes the responsibility of team care under the guidance of customized patient approach especially for persons suffering from diabetes (Dunning & Ward 2008). Nurses in the Australian health care sector work in accordance with national and international chronic diseases policies developed to offer an extensive groundwork for management of these diseases. This model is focused on encouraging

the delivery of customized, effective and affordable health care for diabetic patients (Johnson & Stoskopf 2010).

In order to protect a person suffering from diabetes as well as other family members from developing diabetes associated stress, nurses are required to understand that there exists a strong bond between members of an indigenous Australian family and that any issue affecting one of them can negatively impact on the physiological wellbeing of others (Dunning 2009).

Nurses, as a result, provide education and counseling services to as many family members as possible to reduce chances of becoming psychologically overwhelmed by the diabetic condition of one of them (Kirch 2008). In the health care sector, nurses aim to increase awareness, acquaintance and understanding of diabetes together with the most effective strategies of its management to as many people as possible in community. Nurses also advocate and promote Australian cultural practices that are believed to have the potential to reduce the risk of developing diabetes (Albala 2011). They urge people presenting with diabetes to engage in cultural activities that significantly reduce the development of adverse effects associated with this disease. In some instances however, nurses are faced with the challenge of having to deal with a group that totally holds onto its cultural beliefs. Some cultural practices are believed to predispose the people to the risk of developing adverse health conditions. Nurses are forced to explain to indigenous Australians that diabetic persons should not engage in potentially harmful activities due to their ill health (Albala 2011).

Nurses have become aware of the fact that diabetes is a turning out to be a major health disorder among indigenous Australian young adults. It has been revealed that the prevalence of diabetes among Torres islanders and aboriginal people is almost four times higher as compared to that of other nonindigenous communities. As a result, they have employed a wide range of

strategies which are both clinically effective and largely fit the beliefs of these young people (Peimani, Tabatabaei-Malazy & Pajouhi 2010). Diabetes has been shown to place a huge responsibility on both nurses and patients for management through the use of therapeutic regimen that calls for constant decision making together with action in respect of nutrition, exercise and drug intake (Dunning & Ward 2008). The fact that a large number of young adults are not financially stable makes it even more challenging for them to accept their health condition. Nurses are as a result forced to go an extra mile and explain to these people that a lack of finances does not necessarily mean that one cannot live a near normal life despite being diagnosed with diabetes (Dunning 2009).

Its has also been shown that nurses make use of personalized care in the management of diabetes in order to eliminate variations in care present within different health services, the care offered to disadvantaged people and also across people from different localities (Kirch 2008).

Even though a large number of diabetic patients believe that the role of educating them lies solely on the hands of the treating physicians, the role played by nurses in the Australian healthcare sector, as far as management of diabetes is concerned, has contributed to diabetic persons in indigenous Australian communities coming to terms with the type they are provided with (Johnson & Stoskopf 2010).

Conclusion It can therefore be concluded that even though diabetes has been recognized as a major health problem among indigenous Australians, the role played by nurses have contributed greatly to minimizing the negative implications of this disease on individuals, families and the entire community at large. Diabetes has placed a huge responsibility on both nurses and patients for management through the use of therapeutic regimen that calls for constant decision making

together with action in respect of nutrition, exercise and drug intake. The notion that diabetes is a major health condition among indigenous Australians calls for commitment of the patients, health care professionals and the entire community as well in its management.

List of References Albala, K 2011, Food cultures of the world encyclopedia, Santa Barbara, California: ABC CLIO. Australian Human Rights Commission, 2006, Diabetes in indigenous communities, [online] Available at: http://www.hreoc.gov.au/about/media/speeches/social_justice/diabetes_in_indigenous_co mmunities.html [Accessed May 18, 2012] Dunning, T 2009, Care of people with diabetes: A manual of nursing practice, Oxford, OX: John Wiley & Sons.

Dunning, T, & Ward, G 2008, Managing clinical problems in diabetes, Oxford, OX: John Wiley & Sons Guthrie, DW & Guthrie, RA 2002, Nursing management of diabetes mellitus: A guide to the pattern approach, New York, NY: Springer Publishing Company.

Johnson, JA & Stoskopf, CH 2010, Comparative health systems: Global perspectives, Mississauga, Ontario: Jones & Bartlett Learning.

Kirch, W 2008, Encyclopedia of public health, New York, NY: Springer.

O'Dea, K, Rowley, KG & Brown, A 2007, Diabetes in indigenous Australians: possible ways forward, Medical Journal Australia, Vol. 186, no. 10, pp. 494-495.

Peimani, M, Tabatabaei-Malazy, O & Pajouhi, M 2010, Nurses’ role in diabetes care: A review, Iranian Journal of Diabetes and Lipid Disorders, Vol. 9, pp. 1-9.