What additional approaches could be implemented to improve compliance with the medication regimen?
Diabetes mellitus type-2 is one of the major chronic illness in which self-management plays a significant role in care. Though, self management plays a significant role in the management of this disease compliance problem is common in the management of this disease as in the case of Johnson. To effectively ensure that Johnson complies with his medicines as prescribed by the doctor, the following approaches should be implemented. The first approach is cultivation of patient centered relationship between Johnson and his doctor which will motivate Johnson to routinely keep up with his medication as prescribed.
The second approach is the provision of continuity interim telephone contacts care between the doctor and Johnson. The doctor should ensure that he or she calls Johnson frequently in particular during specific times of the day or night at which Johnson is required to take medicines (Haynes & Taylor, 2009). This will encourages him to take medicines as prescribed without any delays or forgetting. The third approach is organization of patient talks between Johnson and his doctor in which the doctor will provide counseling sessions on the reasons as to why Johnson should take medicines as prescribed and the health benefits of taking medicines as prescribed. In these sessions, the doctor or the care giver should ensure that he or she encourages Johnson to take medicines routinely by talking to him collaboratively about treatment rationales and goals of taking medicines as prescribed (Kurtz, 2008).
Additionally, Johnson should be given a care giver who should ensure that Johnson’s takes his medicines as prescribed and strictly follows the routinely written instructions. Since, Johnson is not married and lives alone he lacks social support to ensure that he takes his medicines frequently and has a will to live; social support reinforcement should be provided through self-monitoring programs.
How could the nurse help Mr. Johnson decrease his “sweet” intake and motivate him to increase his activity?
In any health care program, patients are entirely responsible for their own personal decisions and self care behaviors. From the case study Johnson seems to like sweets and eats food with high sugar content which is not required for a patient who is suffering from diabetes. In order to motivate Johnson to decrease his sweets intake and do more exercise it will require a behavioral change approach. Using this approach the nurse should ensure that he or she cultivates a collaborative relationship with Johnson by communicating clearly the benefits of eating a healthy diet and doing regular exercise. The nurse should give directives to Johnson and ensure that he strictly follows them by drawing up an exercise program which is flexible for Johnson.
To motivate Johnson to frequently take part in exercise, the nurse should sit down with Johnson and discuss on the kind of exercises that suits him well a part from the regular walking exercise (Haynes & Taylor, 2009). The exercise program should include a variety of exercises which will effectively help Johnson reduce the levels of sugar content in his body. The nurse should regulate the diet of Johnson, by making sure that he does not take food with high sugar and fat content, rather he eats healthily by putting up a health diet program for Johnson. The nurse should put in place a self monitoring progress report in which Johnson evaluates himself on the food intake and the kind of exercises he does as well as the benefits associated with the lifestyle change over a given period(Kurtz, 2008).
Haynes, R., B, & Taylor, D., W. (2009). Compliance in health care. New York: Johns Hopkins University Press.
Kurtz, S. (2008). Adherence to diabetes regimens: empirical status and clinical applications. Chicago: Wiley and Sons.