Ogedengbe Kayode Anthony BSc, MSW; MSc
Deputy Director Medical Social Services Department,
University College Hospital, Ibadan
Diabetes is a group of metabolic diseases whereby a person has high blood sugar due to an inability to produce, or inability to metabolize, sufficient qualities of the hormone insulin. Type I diabetics (TID) is the second most common chronic illness in teenagers, trailing only asthma. The morbidity and premature mortality associated with diabetes is a major source of concern. Diabetes ranks among the most common, costly, and significant health problems worldwide. In 2015 diabetes affected more than 422 million adults globally. This resulted in 1.6 million deaths (World Health Organization, 2017). Diabetes complication may include stroke, renal disease, heart disease, blindness, peripheral neuropathy and lower extremity amputations. Reports from the National Stroke Association (2013) reported that people who have diabetes are about 2 or 4 times more like to have a stroke or heart-related disease at an early age compared with those without diabetes. Among individuals with Chronic Kidney Disease, diabetes is most common (National Institute of Diabetes and Digestive and Kidney Diseases, 2016), the reported showed that heart diseases resulting from diabetes were responsible for more than 65% of death among individuals residing in low and middle-income countries like Nigeria.
The cost of care for the most common diabetes (type 2 diabetes) is estimated to be $245 Billion a year, the disease condition demand financial commitment from both immediate family members and also the government. Physical complication associated with diabetes are also common and these grossly impact on individuals’ perception of self, social and professional relationship. (Sanndi, Satavi & Mahmodi, 2011). This disease demands long-term, intense, self-management and psychosocial support.
Along with health effect, diabetes has a major Socioeconomic impact on patient, family, health care providers and the society in general
- These patients are subjected to insulin replacement therapies throughout their lifetimes
- The disease involves a high risk of hospital admission due to severe hypoglycemia or ketoacidosis as well as diabetes-associated illness
- The time dedicated to the care of children with diabetes can be considerable. Hence the burden of and the cost of time spent on informed care can be high
- Families are also likely to spend extra resource (on drugs, private medical visits, monitoring systems, have education, sports activities and transportation) due to the disease
Medical Social Worker’s early intervention skills in Diabetes Management
After diagnosis, early intervention has been acknowledged as an important strategy to minimize the impact and burden of diabetes (Pntley, 2013). This is very important considering the complications that are associated with diabetes as they are connected with psychosocial problems and lack of access to community resources. These psychosocial factors are related to lack of finances, living conditions, social support glycemic problem, employment status and access to community services (Altfeld, 2013)
Social workers serve as liaisons between patients or clients in interdisciplinary teams in hospitals, other health care settings, and human service agencies. In health care settings, social workers often focus on identifying and facilitating clients’ psychological, psychosocial problems, and resource need. In providing early intervention, the goals are to facilitate adjustment to the impact and burden of the disease, reduce the risk of developing other significant health conditions, improve health and social functioning, and prevent progression of the condition, leading to death. Following a diabetes diagnosis, many individuals experience immediate and significant psychological distress, shock, anxiety, and fear (Rankin, 2014). These reactions often result from clients’ lack of understanding of the condition, worries about the cost of medical care, fear of concurrent complications, and concern about the intense daily and lifelong management responsibilities
The intervention of social workers include the following
- Provision of information and expertise that links patients and family members with vital resources
- They are trained to conduct comprehensive biopsychosocial assessments on individuals with a chronic illness that are incorporated into the client’s care plan (National Association of Social Workers, 2016)
- Social workers engage in active listening to clients, concern and provide emotional and psychological support to diabetes patients (Fabbre, 2011). Such services and support may assist the patient with diabetes to adjust to the impact of the disease on their health and social circumstances
- Medical social workers also facilitate meaningful medical, educational and psychosocial interventions in order to foster needed lifestyle changes thereby improve the overall wellbeing of clients (Ciporen, 2012)
- Medical social workers always assist patients with diabetes to obtain medications, ensure adherence, and help the patient to have access to health insurance
Many psychosocial issues pose a lot of barrier to the management and care of diabetes in adolescents and children. In order to achieve a successful intervention in term of management of diabetes, there is a need to recognize the psychosocial problems and help in reducing the damaging effects of this problem on patients.