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In this assignment, the health determinant of Gulcin Ozdemir will be identified using the Canadian Determinant of Health Model to restore her condition at an optimal level. She is diagnosed with type 2 diabetes recently after conducting several tests on her. She has a problem of urinary incontinence, which is worsening day by day due to her neglecting behaviour. She is consulting a general physician, Simon Cross. Since she is consulting a male doctor, she is uncomfortable to discuss the personal and private problems with him. As a result, the problem of urinary incontinence is being undiagnosed. It is required to identify her health determinants and health needs considering all the factors. The factors that need to be analysed in her case are the social support network to which she belongs, social inclusion, educational background, knowledge, health services that she requires, gender about the disease she is suffering, working conditions, health practising, coping ability and cultural background of Gulcin. A care plan needs to be evaluated for her that will support Gulcin socially and mentally to be able to reinstate her health condition to an optimal level.
Canadian Determinant of the health model includes several strategies that aim to address the social and health determinants that help in restoring healthy condition of an individual. It is used to prevent the effects of chronic diseases (Raphael, 2009). Gore & Kothari (2012) suggested that on addressing the underlying effects of chronic disease with the help of preventive strategy it is an effective way to reverse the effects of the disease. The factors include in the Canadian Determinants of the health model are the income and social status of the patient, social network, educational background, working conditions, social environment, physical environment, social inclusion, cultural background, gender, personal health practices, coping ability, development of patient’s children, biology and gender endowment (Viner et al. 2012).
The only social support system that Mrs Gulcin Ozdemir has in Melbourne is her husband, Ergun Ozdemir. After their marriage, they have shifted to the western suburbs of Melbourne, Australia around nine years ago from Turkey. They were living with an uncle in Australia however, three years ago he passed away leaving them alone. Gulcin cannot speak in English thus; a language barrier is created that do not allow her to extend her social network. It can be observed that she and her family are socially isolated in Australia.
Gulcin and her family can join a Turkish group that will help them to align with the western suburb council, Turkish group. Gulcin resides in Melton city council of Melbourne. Thus, a Turkish group around this area will be apt for them. The Turkish language Meetup in Melton is a network of local Turkish people. The aim of the group is to improve themselves or their communities. The Ozdemir family can join the group that will help them to socialise and increase the network. By this way, she will be able to get help from other Turkish people and can learn English that will help her to communicate with people of other communities and increase her business associate (Meetup.com, 2016).
Gulcin is a kind of conservative woman. She cannot social with men easily. Thus, she needs to join a Turkish woman group for sharing all her problems. She resides in the area of Melton; a woman group near this area is Broadmeadows Women's Community House. It provides opportunities to develop their skills and confidence and strength in woman. The organisation addresses the cultural, social and geographical isolation of women. There is no admission fee for joining the group. It will be a good opportunity for Gulcin to extend her social network and share all her feelings with another Turkish woman (Anglicarevic.org.au, 2016).
Gulcin has four children. The ages of the children are 7 years, 5 years, 3 years and 18 months. They are not so big that they can take care of themselves. Due to her illness, Gulcin feels tired and weak all the time. Thus, the children need to be admitted in a nearby playschool for their healthy physical and mental health and development. The nearest playschool is Melton West Preschool. The preschool provides a homely environment to the children and involves primary caregivers for taking proper care of the children. The preschool prepares the children for the future pathway. On admitting, the three children in this preschool will ascertain Gulcin that the children are safe and are developing mentally. Thus, her stress about the children will lessen (Elaa.org.au, 2016).
For increasing the social support network, she can go to church. Church is not only for worshipping God. Many people go to church and it is the best place for her to forget her problems and be at peace. The nearest church for Gulcin is Melton Uniting Church. The time of worship service is flexible that help her to visit the church anytime she wants (Muc.org.au, 2016).
The youngest child of Gulcin is only 18 months. For the care of the child, Gulcin needs to take the help of family day care. There are a number of family day care service providers such as Little Genius Daycare, Samantha's family Daycare, Care4child, Ray's family Daycare, Yashi family Daycare, Little Me Family Daycare. The Samantha's family day care is nearest to Gulcin's house and she should opt for their services. They provide service according to the client's requirement. The service can also be included to pick up of other children from school and in the case of emergency; the service can extend at nighttime (Gumtree.com.au, 2016).
Gulcin Ozdemir belongs to Groeme Valley of Turkey. Her husband is a truck driver. They mitigated to Australia for better earning. On analysing this, it can be assumed that she do not have a higher level of educational qualification. She is unaware of the significance and effect of the disease she is suffering from. She needs to obtain all the knowledge about type 2 diabetes and urinary incontinence. Without the knowledge, she will not know the severity and harmful effects of these diseases. Arterburn et al. (2013) commented that Type 2 diabetes is a progressive disease that increases the risk of cardiovascular disease. Inzucchi (2012) stated that the cause and preventive measures of type 2 diabetes are not easy. Early and proper diagnosis is required. The disease is associated with genetic factors and depends on the lifestyle of the individual. The main cause of the onset of the disease is the inefficiency of the body to utilise the glucose produced in the body. DeFronzo et al.(2014) suggested that the condition makes the body weak due to lack of energy produced when the breakdown of glucose. The negative impacts of type 2 diabetes mellitus are neuropathy, hearing impairment, Alzheimer, skin disease, kidney damage, heart and blood vessels disease and overweight. Another problem faced by Gulcin is urinary incontinence, which is the involuntary flow of urine from the body. A report says that 30% of women worldwide suffer from urinary incontinence (Auanet.org, 2016).
Nilsson (2013) opined that the causes of the disease are stress, confusion and dementia, the problem in eyesight, loss or poor mobility. The risk factors are obesity, smoking and disease such as diabetes, stroke and prostate disease.
Gulcin cannot speak English so she is having a major language barrier in Australia. For this reason, she cannot properly express herself to her doctor. An interpreter is required that will help her communicate with her doctor. This will aid in proper diagnosis and treatment of her condition. She even requires a diabetic nurse educator who will inform her all about type 2 diabetes and help her take measures to combat her disease. It can be observed that she has recently gained weight. Kahn, Hull & Utzschneider (2006) opined that obesity is harmful and has an effect on type 2 diabetes. Thus, she requires a dietician that will help her to plan her diet and to control the lifestyle that can have a negative impact on her health. A nutritionist will help her to inform her about the nutritional content of the diet and will help in planning her diet. For both the services, she can opt for Impromy Program. The program helps in losing weight by managing the diet and planning her diet (Chemmart.com.au, 2016).
Another important measure is to change her doctor. It can be seen that she is uncomfortable in discussing her private problems with her male doctor, Simon Cross. Thus, she needs to consult a female doctor. The medical centre where female doctors are available is Sydenham Medical Centre in Melton. In a way she will be more comfortable and can discuss the entire problem clearly, that will help in the proper diagnosis of her condition and better treatment (Sydenhammedical.com, 2016).
Gulcin contributes to the family income by making lampshades on a small machine at her home. She is saving money so that one day she can visit her hometown in Turkey. Though the working condition is isolated as she works from home, however, it is comfortable and convenient for her. She has the flexible work hours, as it is her own business. However, she does not have a driving licence so it is difficult for her in delivering the products. The most convenient mode of transport service for her is railway service. It is a cheap service and affordable for Mrs. Gulcin. The railway service connects all parts of Australia to Melton (Ptv.vic.gov.au, 2016).
Before the diagnosis of the diseases, she used to go around for shopping every day taking along her children. However, later on, due to urinary incontinence, she prefers to be at home. This has made her more worried due to mental stress and unhealthy. For a healthy lifestyle, she needs to go out. She is not living her fulfilling life. She has isolated herself and it has a harmful effect on her condition. To build a socially active life, she needs to join Turkish support group and Turkish community and regularly pay the visit to church (Meetup.com, 2016, Anglicarevic.org.au, 2016 & Muc.org.au, 2016). She even stops continuing her daily activities that made her happy such as cooking.
For restoring her condition, she needs to learn several exercises that will help her control the problem of urinary incontinence and for controlling her weight. For this, a physiotherapist and an incontinence nurse are required who will help her. The incontinence nurse will teach her pelvic exercise related to muscle coordination that will help in controlling the bladder and while travelling she can use pads for a short time. She can do exercise for controlling weight (Chemmart.com.au, 2016).Townsend et al. (2014) opined that pelvic floor exercises that help in maintaining this condition.
From the case study, it can be concluded that there are certain health determinant factors that have a major effect on the health condition of Gulcin Ozdemir. The factors include social isolation, low level of education and literacy level, health practices and coping ability, health services required, the gender of the doctor, cultural background, biology and genetics endowment. For living and maintaining a healthy lifestyle Gulcin needs to join a community group and support group that will help her extend her social network, she needs to understand the cause, symptoms and effects of type 2 diabetes and urinary incontinence so that she is aware of the negative impacts and can take measures to control the disease. For better result, healthcare services are required that will help her to manage her weight and learn exercise to control her bladder. Gulcin along with the healthcare providers can restore her health condition to an optimal level.
Anglicarevic.org.au, (2016) Broadmeadows Women’s Community HouseRetrieved on September 06, 2016 from:https://www.anglicarevic.org.au/what-we-do/strengthening-communities/broadmeadows-womens-community-house/
Arterburn, D. E., Bogart, A., Sherwood, N. E., Sidney, S., Coleman, K. J., Haneuse, S., & Selby, J. (2013). A multisite study of long-term remission and relapse of type 2 diabetes mellitus following gastric bypass. Obesity surgery, 23(1), 93-102.
Auanet.org, (2016), Guideline For The Surgical Management Of Female Stress Urinary Incontinence: Update (2009), Retrieved on September 16, 2016 from: https://www.auanet.org/education/guidelines/incontinence.cfm
DeFronzo, R. A., Ferrannini, E., Groop, L., Henry, R. R., Herman, W. H., Holst, J. J. & Simonson, D. C. (2014). Type 2 diabetes mellitus. Nature reviews. Disease primers, 1, 15019-15019.
Elaa.org.au, (2016), Melton West Preschool, Retrieved on September 16, 2016 from: https://elaa.org.au/parents/childhood_services/melton_west_preschool
Gore, D., & Kothari, A. (2012). Social determinants of health and safety in Canada: Are healthy living initiatives there yet? A policy analysis. International journal for equity in health, 11(1), 1-8.
Gumtree.com.au, (2016) Gumtree Retrieved on September 06, 2016 from: http://www.gumtree.com.au/s-ad/hillside/childcare-nanny/samantha-s-family-day-care/1116095546
Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., & Matthews, D. R. (2012). Management of hyperglycemia in type 2 diabetes: a patient-centered approach position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes care, 35(6), 1364-1379.