Management of Chronic Disease in Children â€Myassignmenthelp.Com

Question: Discuss about theManagement of Chronic Disease in Children. Answer: Introduction Type 1 diabetes is chronic illness under which the pancreatic beta cells stop making insulin and are destroyed by the immune system. This kind of diabetes is considered as insulin dependent and prevails in people below age of 30 years. However, this disease can occur at any age. This essay is based on the case study of Lachlan, who is a 14 years old boy and studies in secondary school. Type 1 diabetes was diagnosed in the case of Lachlan at the age of 9 years. Lachlan often misses his lunch in school, but his disease has been well managed, which was followed by the regime of insulin. According to Lachlan his parents have good knowledge of the disease and care required. Lachlan has many developmental issues that could hinder his access to good health, he has lack of peer support and due to seeking independence, self-management is important. This essay will discuss the key issues associate with Lachlan and his family, and will develop the interventions to mange his chronic condition. A ccording to his age there could be many developmental issues and challenges, thus essay will also discuss those challenges and will develop communication strategies for him. This essay will use two models that are family centered approach and child-centered approach for managing the chronic illness. Key Issues Related to the Case Study of Lachlan The key issues is managing the chronic illness can be varied according to the age and condition of the patient. Lachlan is a 14 years old boy and according to his developmental stage, such children seek more independence and want to come out from the dependence to independence. The children between the ages of 12-15 years are considered as being in their early adolescent period. According to the development stage that child requires more independency and start managing with the body changes (Guthrie et al, 2003). This is the stage when children develop a strong sense of self identity. They start understanding the concept between right and wrong and also have the sense of their legal rights. The management of the chronic disease like type 1 diabetes changes from parent management to self management stage (Dashiff, McCaleb, and Cull, 2006). The period of puberty bring many physical as well as psychological changes, due to which the requirement of the insulin increases in this age. This period could also be a transition period for Lachlan and he may have more developed sense of his rights and independence. Children at this stage start detaching from their parents and families and influence of the peers is very strong. The children in this transition period strive to gain importance and to make identity among their peers (Chiang et al, 2014). The rapid biological changes occur in this transition period. Understanding independence and rights is the example of physical, emotional and cognitive development. In the struggle to find their own identity, young children start separating from their families. The risk taking behavior is again a challenge with this developmental stage in the case of Lachlan. The risk taking behavior cans interfere the process of disease management. For the gaining peer acceptance, the children could avoid managing the chronic illness and can avoid taking insulin. According to Silverstein et al (2005), in this age-group, there is a struggle for independence from parents and other adults that is often manifested as suboptimal adherence to the diabetes regimen. The children at this stage are also referred as adolescents, have the fine motor control, which makes them competent enough for the self-management of the disease. Also it seems to be tempting for the parents to turn the management of diabetes to the adolescents. Though adolescents are able for the self management of the disease, still they require support of the parents for decision making, and adjustment of the insulin. According to various studies it has been found that parents, who provide guidance and supervision to their children in management of the chronic illness, such children have better control over metabolism. The involvement of the parents in the management of diabetes can also affect the parent adolescent relationship. The disclosure of the disease in front of peers can be very beneficial for Lachlan. The healthcare professionals can provide education to the trustful peers and can inform them about the management of disease. Independent Behavior Gaining a sense of independence is an important part of transition from a child to adolescent. Due to the significant biological development, the children at this stage want to come out from being dependent on their parents and want to make their decisions independently. Detachment from the parents is the biggest reason, which is influenced by sense of independence. Due to independent and risk taking behavior. Children at this development stage do not want to discuss their illness in front of their peers and often display non-adherence to diet and treatment. They are stigmatized about not being accepted by their peers (Freeborn et al, 2013). According to the research study of Comeaux, and Jaser (2010), anticipation of negative peer reactions to their diabetes care has been associated with higher levels of diabetes-related stress, problems with adherence in social situations, and poorer metabolic control. The metabolic control is also affected by the biological and psychological facto rs. Changes in the psychosocial factors can impact the condition and severity of the disease. According to the developmental stage Lachlan has the responsibility of self-management of the diabetes and adhering to the treatment. The positive self care behavior is important for him because according to the study of Dashiff, McCaleb and Cull (2006), health deviation and universal self-care were significantly and positively related. The child centered approach is very important for Lachlan. This will include the appropriate education and training program for Lachlan as well as his peers to understand the importance of the self-management and treatment adherence. Parental Involvement The family centered approach is the new evidence based practice, which used for the benefit of the patient and improve the patient outcomes. Family is the most important part of an individuals life. Family can play a significant role in care giving and management of chronic disease like type 1 diabetes. Parents of Lachlan contacted school at the beginning of his school year and informed about his juvenile diabetes since the age of 9. The biggest challenge faced by the parents of the adolescent are their adherence to the treatment and self-management of the disease. The poor adherence to the treatment is mainly found in boys. Adherence and glycemic control can be effective with the involvement of the parents. Family centered care is a way of caring for children and their families within health services which ensures that care is planned around the whole family, not just the individual child/person, and in which all the family members are recognized as care participants (Jolley Shield s 2009). It is important for the healthcare professionals to understand the importance of the family in providing family centered care to the patient. Maintaining respect and dignity of the patient can effectively improve the patient outcomes. It is also important to identify the strength and weakness of the family. The family bonding and strength can be used in the case of Lachlan for developing more adherence and self-management of diabetes. Knowledge and problem solving skills of the family can be beneficial in planning appropriate care interventions for Lachlan. According to the given case study Lachlan has explained that his parents have good knowledge and information about the disease, thus it would be easy for the healthcare professionals to involve them in decision making process (Schilling, Knafl, and Grey, 2006). Parents should be provided with appropriate knowledge about the developmental stage of their child. They should be informed that having a sense of independence and for the purpose of developing self identity, children are required to be encouraged for independence. Thus, family centered approach can be very beneficial of managing the disease at home. Peer pressure, fear of difference, desire for independence, and separation from parents can hinder an accurate management of diabetes and cause blood glucose fluctuations (Palmeret al, 2004). Thus, this situation requires the supervision and cooperation of the parents and family members to have better metabolic control. Due to the puberty, the insulin resistance in the body increases, which impact the body metabolism. But according to the study of Cheraghi et al (2015), the family centered approach or applying the family based interventions can control the level of blood glucose in children like Lachlan. If the parent and families provide and encourage independence in their children, it would help in improving the parent child relationship and will develop more trust among family (Dashiff et al, 2005). Lachlan family has stopped being more concern about his treatment. Since last two years he had been administering insulin by himself. Previously his father administered insulin, as his mother had aversion to needles. His mother can administer insulin, but she opts not to do so. This displays that his family members are little unaware about the problems which can occur. They are unaware of their responsibilities and both are more involved in managing their business. This situation can increase non-adherence to insulin and treatment of diabetes in Lachlan. Parents should offer support to Lachlan, so that he may have a sense of security and dependence, which can improve his health outcomes (Cheraghi et al, 2015). Family centered approach is one of the most significant approaches in the pediatric care that helps to increase the knowledge of the parents and emphasize on continuous support and care towards their child. The main aim of this approach is to reinstate the integrity of the families and to provide care to the children suffering with diabetes (Faulkner, and Chang, 2007). The family centered framework includes the concept of parents and family participation in the decision making, caring for their children and identifying the strength of their families. The participation of the families in care and management of diabetes can improve family bonding and strengthening their family values (Schilling, Knafl, and Grey, 2006). Community Access According to the case study and subjective data obtained from Lachlan, it is clear that he is solely managing his disease with the help of a GP and do not have any kind of community based support service. The transition period of the children bring many biological and psychological changes in children. The community based services can provide important education and knowledge to children for developing understanding of the disease, importance of adherence to treatment and successful self-management (Hanas, 2007). During this age as that of Lachlan, the children may face many social, emotional and educational problems that cannot be resolved just by consulting with GP. The community based service provides assistance and support in resolving all kind of problems in this developmental stage of adolescents (Powers et al, 2015). The community based services are also involved in identifying the needs of children and ensure that, when such children enter in adulthood, they may have good health and must be able to manage diabetes on their own (Hanas, 2007). The high quality care is offered by the community based services, which also emphasize on the support of family and peers and to effectively manage the transition period. Conclusion Diabetes type 1 is a chronic illness that can occur in any age, but mainly found in the young people below age of 30. Juvenile onset diabetes mellitus is the diabetes that occurs in children before the age of 11 years. 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