Using The Course Textbook As Your Source, Choose One ✓ Solved

Using the course textbook as your source, choose one of the

Using the course textbook as your source, choose one of the chronic conditions found in Chapters 3 through 10 and answer the prompts below. For this discussion, write your initial post on one of Bronfenbrenner’s ecological systems as assigned in the table:

Bronfenbrenner’s Ecological Model of Human Development

First Initial of Last Name

Micro-system A, D, I, J, O, P, S, V, Y

Meso-system B, E, H, K, N, Q, T, W, Z

Macro-system C, F, G, L, M, R, U, X

Write your response based on your interpretation of what you read and your personal or professional experiences with the chosen health condition. Your post must be a minimum of 250 words in length.

  • Identify the chronic condition.
  • Discuss the biopsychosocial (biological/genetic, psychological, social) factors that influence the patient’s experience with the chronic condition chosen.
  • Explain how your assigned system from Bronfenbrenner’s Ecological Model affects the onset and management of the chronic disease. For example:
    • If assigned micro-system, explain the role immediate family members and coworkers have in the onset of the disease and in managing the disease once diagnosed.
    • If assigned meso-system, explain why the patient may start or stop activities within their greater social circle and community due to the health condition.
    • If assigned macro-system, summarize two laws that support the patient in daily life and one law that needs improvement to better support the patient or family.

Guided responses: Respond to two classmates with at least 100 words each, addressing one additional biopsychosocial issue you would have discussed and include your rationale.

Paper For Above Instructions

Title: Type 2 Diabetes Mellitus — Biopsychosocial Factors and the Micro-system

Assumption: assigned ecological system = micro-system (e.g., last name initial A)

Introduction

Chronic condition identified: Type 2 diabetes mellitus (T2DM). T2DM is a metabolic disorder characterized by insulin resistance and relative insulin deficiency, with progressive hyperglycemia and associated microvascular and macrovascular complications (American Diabetes Association [ADA], 2023). This paper examines biological/genetic, psychological, and social determinants of T2DM and explains how the micro-system (immediate family, household, and coworkers) affects disease onset and ongoing management, drawing on psychosocial and ecological theory (Bronfenbrenner, 1979; Engel, 1977).

Biological and Genetic Factors

Biologically, T2DM risk is driven by genetic predisposition, age-related decline in beta-cell function, obesity-related insulin resistance, and metabolic syndrome components (Mahajan et al., 2018; Lyssenko & Laakso, 2013). Family history multiplies risk: first-degree relatives of people with T2DM have substantially higher odds of developing the disease (DPP Research Group, 2002). Comorbid conditions (hypertension, dyslipidemia) also contribute to disease progression and complication risk (ADA, 2023).

Psychological Factors

Psychological stress, depression, and diabetes distress negatively influence glycemic control and adherence to lifestyle and medication regimens (Gonzalez et al., 2008; Fisher et al., 2010). Depression is both more prevalent among people with diabetes and associated with poorer self-care behaviors, higher A1c, and increased complication rates (Gonzalez et al., 2008). Self-efficacy and health locus of control moderate the patient’s engagement in dietary changes, exercise, and glucose monitoring (Bandura, cited in patient self-management literature).

Social Factors

Social determinants—socioeconomic status, food environment, access to safe spaces for exercise, health literacy, and cultural beliefs—substantially shape onset and management (WHO, 2021; CDC, 2022). Neighborhoods with limited access to fresh foods and higher density of processed-food outlets correlate with higher obesity and T2DM prevalence. Employment conditions (shift work, long hours) also increase metabolic risk and complicate consistent self-care (Hood et al., 2014).

Bronfenbrenner’s Micro-system: Role in Onset and Management

The micro-system comprises immediate relationships and settings—family members, caregivers, partners, and coworkers (Bronfenbrenner, 1979). These proximal influences can both increase risk for and support management of T2DM.

Negative influences on onset

Household norms regarding diet and physical activity shape behaviors from an early age. A family culture of calorie-dense meals, sugar-sweetened beverages, and sedentary leisure increases lifetime obesity risk and insulin resistance (DPP Research Group, 2002). Similarly, coworker norms—frequent fast-food lunches, prolonged sitting, and limited breaks—contribute to weight gain and metabolic risk (Hood et al., 2014).

Positive influences on disease management

Conversely, family support (instrumental and emotional) predicts better diabetes self-care and glycemic outcomes (Fisher et al., 2010). Instrumental support—help with meal planning, shared grocery shopping, reminders for medications—directly improves adherence. Emotional support reduces diabetes distress and depression, improving motivation for self-monitoring and lifestyle change (Fisher et al., 2010; Hood et al., 2014). Coworker support, such as flexible scheduling for medical appointments or workplace wellness initiatives (healthy cafeteria choices, opportunities for movement), facilitates sustained self-management and reduces barriers to exercise and healthy eating (CDC workplace wellness guidance).

Mechanisms and examples

Mechanistically, social modeling and reinforcement shape habits: if family members consistently model healthy eating and physical activity, patients are more likely to adopt those behaviors (social cognitive theory). In contrast, family conflict or criticism about weight results in shame and avoidance of self-care tasks, worsening glycemic control (diabetes distress) (Gonzalez et al., 2008). At work, supervisors who stigmatize chronic disease can impede disclosure and access to accommodations; supportive supervisors enable schedule adjustments for exercise and glucose monitoring (ADA employment guidance).

Implications for Clinical Practice and Interventions

Effective T2DM interventions should integrate the micro-system. Clinicians should assess family dynamics, engage family members in education and goal-setting, and recommend family-based lifestyle changes (DPP-modeled lifestyle programs adapted for households). Behavioral interventions that build self-efficacy and address depression or diabetes distress improve adherence (Gonzalez et al., 2008). Employers can adopt workplace policies that promote healthy food and movement opportunities, and offer flexible scheduling to support medical management (CDC, 2022).

Conclusion

Type 2 diabetes is a multifactorial chronic disease shaped by biological, psychological, and social forces. The micro-system—immediate family and coworkers—plays a central role in both the onset and the day-to-day management of T2DM. Interventions that actively engage the micro-system and address psychosocial barriers (depression, low self-efficacy), while acknowledging genetic risk, are likely to yield better prevention and treatment outcomes (DPP Research Group, 2002; ADA, 2023).

References

  • American Diabetes Association. (2023). Standards of Medical Care in Diabetes—2023. Diabetes Care. https://diabetesjournals.org/care
  • Centers for Disease Control and Prevention (CDC). (2022). National Diabetes Statistics Report. https://www.cdc.gov/diabetes/data/statistics-report/index.html
  • World Health Organization (WHO). (2021). Global Report on Diabetes. https://www.who.int/publications/i/item/9789241565257
  • Bronfenbrenner, U. (1979). The Ecology of Human Development: Experiments by Nature and Design. Harvard University Press.
  • Engel, G. L. (1977). The need for a new medical model: a challenge for biomedicine. Science, 196(4286), 129–136.
  • Diabetes Prevention Program Research Group. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346(6), 393–403.
  • Gonzalez, J. S., Safren, S. A., Cagliero, E., et al. (2008). Depression, self-care, and medication adherence in type 2 diabetes: a meta-analysis. Diabetes Care, 31(12), 2398–2403.
  • Fisher, L., Glasgow, R. E., Mullan, J. (2010). Development of a brief diabetes distress screening instrument. Annals of Family Medicine, 8(4), 290–295.
  • Hood, M., et al. (2014). Social support and diabetes self-management among adults with type 2 diabetes: a systematic review. Patient Education and Counseling, 95(1), 1–12.
  • Mahajan, A., et al. (2018). Genome-wide association study of type 2 diabetes: genetic architecture and biology. Nature Genetics, 50(11), 1505–1513.

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