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Nursing : Elsevier Health Sciences

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Nursing : Elsevier Health Sciences

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Nursing : Elsevier Health Sciences

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1. Down syndrome is characterized by intellectual disabilities, dysmorphic facial features and distinctive phenotypic characters. This man is a patient of Down syndrome with moderate intellectual disabilities and Type 2 diabetes. Down syndrome with intellectual disabilities and chronic illness like Type 2 diabetes upset the normal flow of life and inflict various adverse effects on this man through his lifespan (Chang & Johnson, 2014).
According to Chang and Johnson (2014), patients like him faces many limitations in language and communication skills in young age. Language and communication are that zone where slow improvement is most evident. Patients like this man face a hard time giving answers by speaking in early school ages. Communication is a great obstacle for children with intellectual disability. They rely more on body languages such as signs and gestures. Down syndrome also acts as an obstruction for constructing cognitive and social abilities. Situational anxiety is sometimes manifest during transitions to a new situation. Disruptive, hyperactive, impulsive, oppositional and inattentive behaviours are common in young age (Pikora et al., 2014).
As a teenager or a young adult, a man like him with Down syndrome may have better language, cognitive and communication skills but commonly have increased vulnerability to depression, anxiety, obsessive compulsive behavior, mood associated problems, sleep disorder and reduced interest in everything. This problems results in social withdrawal (Glasson et al., 2014 and Pikora et al., 2014).
With age increased vulnerability changes in older adults. A 45 years old man with Down syndrome can suffer from generalized anxiety, loss of attentiveness, lessened self-care, depression, social withdrawal and deterioration with debility in social and cognitive skills. Aging may also cause dementia in a Down syndrome patient (Glasson et al., 2014).
Type 2 diabetes is chronic disorder caused by insulin resistance. It is strongly associated with obesity. There is a high chance of the patient to be overweight. In this disease patient experiences thirst, headaches, dizziness, cramps, blurry sights, tiredness and weakness. High level of fats such as cholesterol and triglycerides are prevalent in blood (Craft et al., 2015). The complications of Type 2 diabetes grows with aging, especially after the age of 45 years. This type of diabetes dramatically increases the risks of various cardiovascular disorders including angina, coronary artery disease, stroke, heart attack, atherosclerosis and high blood pressure etc. Excess glucose can cause neuropathy, nephropathy and diabetic retinopathy (Craft et al., 2015). Type 2 diabetes may also intensifies the danger of Alzheimer’s disease. Being a Down syndrome patient with disability, this man is unable to maintain proper care of his chronic illness. It not only give him physical sufferings but also makes him inactive and weak which acts as a barrier for achieving social and cognitive skills.
2. International Classification of Functioning, Disability and Health (ICF) is a structure established on the principles of primary health where the environment of individuals as well as participation and activities is considered fundamental to their health and wellbeing. The ICF model is aimed to facilitate the measurement and effect of both health and disability in an individual. Central of this model has two core areas that permit practitioners to appreciate the degree of disability of a patient (International Classification of Functioning, Disability and Health (ICF), 2016). The two spheres of ICF model are:

Functioning and Disability
Body function and structure
Activity and participations
Contextual Factors
Environmental influences
Personal factors

The ICF model can be applied across the entire lifespan and is also appropriate for all age groups (Rouquette et al., 2015). The man has Down syndrome and Type 2 diabetes impairing his intellectual, physical and emotional capacities. This disorders creates activity limitations for the man as he is not able to perform like other people. He faces difficulty in carrying out multiple tasks, making decisions, solving problems and acquiring skills independently. Communication, interpersonal interaction is also affected because of his disabilities. His disability made him less likely to participate in a range of domestic and social works.
Not only the Down syndrome but also his Type 2 diabetes caused him from being socially active. Down syndrome along with Type 2 diabetes causes muscle hypotonicity and this reduces the activity level and energy requirement of the patient. It also causes tiredness and weakness and is associated with the higher frequency of being obese (Craft et al., 2015). The Down syndrome makes him mentally disable and diabetes makes him physically disable. The combination of these factors illustrates how the man’s activity and participation are potentially affected across his lifespan.
Chang, E., & Johnson, A. (Eds.). (2014). Chronic illness and disability: Principles for nursing practice. Elsevier Health Sciences.
Craft, J., Gordon, C., Huether, S. E., McCance, K. L., & Brashers, V. L. (2015). Understanding pathophysiology-ANZ adaptation. Elsevier Health Sciences.
Glasson, E. J., Dye, D. E., & Bittles, A. H. (2014). The triple challenges associated with age-related comorbidities in Down syndrome. Journal of Intellectual Disability Research, 58(4), 393-398.
International Classification of Functioning, Disability and Health (ICF). (2016).World Health Organization.
Pikora, T. J., Bourke, J., Bathgate, K., Foley, K. R., Lennox, N., & Leonard, H. (2014). Health conditions and their impact among adolescents and young adults with Down syndrome. PloS one, 9(5), e96868.
Rouquette, A., Badley, E. M., Falissard, B., Dub, T., Leplege, A., & Coste, J. (2015). Moderators, mediators, and bidirectional relationships in the International Classification of Functioning, Disability and Health (ICF) framework: An empirical investigation using a longitudinal design and Structural Equation Modelling (SEM). Social Science & Medicine, 135, 133-142.

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