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Health Needs Assessment for Diabetic Children

Purpose

Diabetes is a chronic disease that influences every aspect of person's life. Diabetes can result in poor health, disability, and even premature death. Type 1 diabetes is known as insulin dependent diabetes.  It develops when the pancreas cannot produce insulin. This type of diabetes is treated by injections of combined with a controlled diet (ADA 2012).

In every part of the world occurrences of diabetes are on the ascent. As a result, diabetes is affecting more and more children of all ages. Type 1 diabetes commonly affects children in infancy, while type 2, which earlier was more often found in older people, is beginning to spread amongst children and young adults. It affects younger and younger people every year. According to American Diabetes Association, as obesity and poor diets spread in the US, 17 children out of 100,000 is developing diabetes type 2 (ADA 2012).

The purpose of this health needs' assessment with the help of comparative, corporate, and epidemiological approach as well as quantitative and qualitative methods is to identify the needs related to proper medical care for children with a risk of having diabetes in city X.

Resources Used to Do the Assessment

Table 1: Data sources

Data source Details
Population estimates Estimates of the 2011 year
Demographics estimates Estimates of the 2011 year
Diabetes statistics Estimates of the 2011 year
Diabetes Meal Plans and a Healthy Diet Recommendations
Clinical Diabetes Researches on psychiatric disorders in relation to diabetes
Diabetes Care Diabetes care standards and guidelines
National Health Survey Risk factors and disease prevalence, estimated from the US survey of 2007 – 2009
Diabetes type 1 Care guidelines for diabetes type 1
NDIC Diagnosed and undiagnosed diabetes among younger than 20 years of age, U.S., 2010

 

 

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Table 2. Statisticsfrom National Diabetes Fact Sheet of 2011(ADA 2012)

Total in the United States of America 25.8 million children and adults have diabetes or 8.3% of the population
Under 20 years of age 215,000, or 0.26% of all people in this age group have diabetes

 

Table 3. Statistics of Children population in 2011 (Child Stats.gov. 2012)

The U.S. population (July. 2011) 313,847,465 All ages
Children (0-17 years old) 73.9 millions 23.6%  of all population the US in 2011

 

Approaches

Epidemiological and Comparative Approaches

In town X, there is extreme lack of medical care and medical facilities. The only diabetic center for children and adults is overcrowded. A patient has on average only 4 minutes of medical personal’s attention. Considering the workload of diabetic center and lack of medical personnel, poor quality of medical services is obvious. Such overcrowdedness not only decreases quality of services provided to patients, but also undermines their right for privacy and confidentiality. The town only provides curative services. It does not have a preventive program. Staff in the center does not undergo training on how to run the diabetic center.

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Strengths of Epidemiological and Comparative Approaches

Epidemiological and comparative approaches allow seeing the situation as a whole picture. This is its strength. These approaches allow making conclusions based on statistics and commonly known facts.

Weaknesses of Epidemiological Approach

Epidemiological and comparative approaches can be biased, misclassified, confound, and may depend on statistical variations.

Corporate Approach

Part of population suffering from diabetes consists of 166,000 people, which is 8.3% of 2,000,000 population of the city. The amount of children (0 – 17 years old) suffering from diabetes in the town X is 39176 children. There are 20 primary health centers in the city, and other 50 outside the city, which provide curative services, immunization, and in some centers screening for diabetes miletus and hypertension are performed. There are only 5 general hospitals and 1 pediatric hospital in the city. However, 4000 clinics are illegal clinics.

Table 4. Medical staff of the only diabetic center in the town

Position Quantity of position’s units
Pediatrician 1
Physician 1
Pharmacist 1
Nurse 5
Administration and Service staff 10
Nutritionist 0
Family doctor 0
Social worker 0
Psychiatrist 0

 

Strengths and Weaknesses of Corporate approach

Corporate approach estimates vast discrepancy between what the town has and what the town needs. Strengths and weaknesses are the same, which have epidemiological and comparative approaches due to availability of only general and statistical information.

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Methods

Table 5. Methods and their Strengths and Weaknesses 

Method Strength Weakness
Quantitative (Statistics data sources) Uses reliable sources. Provides relevant quantifiable data. Provides estimates of age. Allows comparisons in city scale. Only general information, not concerning individual cases.Figures are general and may not reflect actual prevalence. 
Qualitative (Questionnaires and Surveys) Gets data from many people in short period of time. Increases involvement of participants. Is comparatively inexpensive. Provides relevant,up-to-date data. Anonymity encourages honesty. Requires a lot of time to gather data.Inaccurate responses or unwillingness to provide answers. No opportunity to justify. Sometimes provides unrealistic expectations.
Qualitative  (IndependentResearch) Allows retrieving reliable and credible data from industry specialists.Benefits from availability of free information on Internet Received data cannot be directly relevant. Requires a lot of time for analysis. Diverse data from variety of sources can be discrepant.

 

Anticipated Problem with Solution

Studies indicate that people with diabetes are subjected to a greater risk of depression than people without diabetes. People with diabetes can feel frustrated due to all extra work that relates to controlling their blood sugar levels. They can feel that they no longer control their own body. Thus assistance of psychologist is necessary, especially for children. Diabetes is a disease that requires strict diet because special diet provides controlled contents of sugar. Therefore, the fact that the only diabetic center in town does not have nutritionist has very negative effect on the condition of diabetic patients, especially children, whose organism is developing and needs well-balanced diet. Family doctors and social workers are important to make sure that parents follow doctor’s prescriptions and to know that if they fail to keep the disease under control, their child can die. With correct treatments and correct diet, timely glucose tablets, daily exercising, medications or insulin injections the child can have a normal childhood. Parents should make sure that their children eat more protein and less carbohydrate, which also keeps glucose levels under control. Parents should also control their children’s weight and daily exercising.

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Implementation of the Results

After conducting Health Needs Assessment of conditions for diabetes children, the following consequences have been made. The city diabetes center needs to be fully staffed with specialist such as endocrinologist, nutritionist, family doctors, social workers, and psychiatrists. The staff of existing specialists, such as pediatricians, should be increased at least 3 times. Ideally, the personnel that specialize in diabetes treatment should be increased at least 6 times in order to increase the time for medical examination at least to 30 minutes. Medical facilities like diabetes center should work 24/7. Insufficiency of proper medical facilities and medical personnel in the town X is obvious. Insufficiency of legal medical services and presence of illegal services indicate the fact that the level of medical services is extremely low. The conclusion is that town X totally disregards the needs of children with diabetes. The risk of having uncured and uncared diabetes in town X is very high.

 

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