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Wondm SA, Zeleke TK, Dagnew SB, Moges TA, Tarekegn GY, Belachew EA, Tamene FB. Association between self-care activities and glycemic control among patients with type 2 diabetes mellitus in Northwest Ethiopia general hospitals : a multicenter cross-sectional study. Sci Rep 2024; 14:23198. [PMID: 39369010 PMCID: PMC11455904 DOI: 10.1038/s41598-024-72981-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Accepted: 09/12/2024] [Indexed: 10/07/2024] Open
Abstract
Diabetes self-care activities are essential for achieving optimal glycemic control. However, little investigation has been conducted in Ethiopia to evaluate the relationship between the rate glycemic controland self-care activities among patients with type 2 diabetes mellitus (T2DM). Therefore, this study was conducted to assess self -care activities and their association with glycemic control among patients with T2DM in Northwest Ethiopia general hospitals. This multicenter cross-sectional study was conducted in Northwest Ethiopia general hospitals diabetic clinics. Diabetes self-care activities were measured using the Amharic version of the Summary of Diabetes Self-Care Activities (SDSCA-Amharic). Glycated hemoglobin (HbA1c) were used to assess the rate of glycemic control. A linear regression model was used to identify predictors of self-care activities and glycemic control. P-value of < 0.05 at 95% confidence interval (CI) was considerd as statistically significant. Of 413 participants included in the final analysis, two-thirds (66.3%) had poor glycemic control, with a mean HbA1c of 7.94% (SD = 1.75). Blood glucose testing was the most important self-care activity domain for predicting better glycemic control [β=-0.36, 95% CI (-0.48, -0.24); P = 0.0001] followed by diet [β=-0.29, 95% CI (-0.39, -0.083); P = 0.0001], foot-care [β=-0.28, 95% CI (-0.3, -0.061); P = 0.003], and physical activity [β=-0.27, 95% CI (-0.29, -0.056); P = 0.004], respectively. Moreover, unable to read and write [β = 0.72, 95% CI (0.57, 3.8); P = 0.037], overweight [β = 0.32, 95% CI (0.011, 0.62); P = 0.042], obesity [β = 0.67, 95% CI (0.39, 0.94); P = 0.0001], and low level of medication adherence [β = 0.7, 95% CI (0.39, 1.1); P = 0.0001] were significant predictors of poor glycemic control. Previous diabetes education [β=-0.88, 95% CI (-1.2, -0.57); P=0.0001] was a significant predictor of good glycemic control. The prevalence of poor glycemic control and poor self-care activities were high among patients with T2DM. Self-care activities were independent predictors of glycemic control among patients with T2DM. Therefore, management interventions for patients with T2DM should focus on improving self-care activities and other predictor variables.
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Affiliation(s)
- Samuel Agegnew Wondm
- Department of Pharmacy, College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia.
| | - Tirsit Ketsela Zeleke
- Department of Pharmacy, College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Samuel Berihun Dagnew
- Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tilaye Arega Moges
- Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | | - Eyayaw Ashete Belachew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fasil Bayafers Tamene
- Department of Pharmacy, College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
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Shahbaz K, Alamgeer, Paudyal V, Zubair M, Safdar MZ, Tahir M, Akram L, Ali S. Prevalence and Impact of Psychological Disorders on Pharmacotherapy of Diabetic Patients in Low Resource Settings: A Prospective Assessment in Primary Healthcare Settings. Patient Prefer Adherence 2024; 18:1939-1948. [PMID: 39315346 PMCID: PMC11416907 DOI: 10.2147/ppa.s463133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 08/03/2024] [Indexed: 09/25/2024] Open
Abstract
Background Prevalence of psychological disorders among individuals with diabetes is significantly higher as compared to the general population. Aim This study aimed to assess the prevalence and impact of psychological disorders on pharmacotherapy of diabetes patients. Methodology This cross-sectional study was conducted at two primary care hospitals in Pakistan from April to June 2023. The nine-item Patient Health Care Questionnaire (PHQ-9) scale was used to assess depression in the study's population, and its effects on pharmacotherapy of diabetes. Chi-square test was used to evaluate relationship between ordinal variables/categorical variables and depression whereas; Student's t-test was used to assess the relationship between numerical variables with depression. Results A total of 320 patients were assessed, comprising 120 (37.5%) males and 200 (62.5%) females, with a mean age of 52.5 (SD±11.8) years. The average duration of diabetes is 7.0 (SD±5.4). The average PHQ-9 score was 8.3 (SD±5.5). Depression was found to be prevalent in 43.7% of the study population. Gender (female) (p-value 0.002), advanced age (p-value 0.002), lower income (p-value 0.001), education levels (p-value 0.001), longer duration of diabetes (p-value 0.001), poor diabetes control according to BSR value (p-value 0.001), usage of injectable insulin (p-value 0.005), and concomitant diseases (p-value 0.001) were found to be independently linked with depression. Significant association was observed between depression and treatment adherence (p-value 0.0025), number of missed doses (p-value 0.045), and difficulty in diabetes management (p-value 0.0015). Conclusion Our study highlights significant prevalence of depression in study population and the prevalent depression negatively impacts on treatment adherence. It also revealed that depression complicates diabetes management resulting in poor medication adherence, poor diabetes control and diabetes related complications, making diabetes control more challenging and difficult.
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Affiliation(s)
- Kiran Shahbaz
- Department of Pharmacology, University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Alamgeer
- Department of Pharmacology, University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Vibhu Paudyal
- Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, UK
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Maryam Zubair
- Faculty of Experimental Medicine, Orebro University, Orebro, Sweden
| | - Maryam Zahra Safdar
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, GC University Faisalabad, Faisalabad, Pakistan
| | - Momina Tahir
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, GC University Faisalabad, Faisalabad, Pakistan
| | - Laraib Akram
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, GC University Faisalabad, Faisalabad, Pakistan
| | - Salamat Ali
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, GC University Faisalabad, Faisalabad, Pakistan
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Majdizadeh G, Beytollahi M, Djazayery A, Movahedi A. Role of Branched and Aromatic Amino Acids, Diet Inflammatory Index, and Anthropometric Indices on Mental Health. Int J Prev Med 2024; 15:23. [PMID: 39170923 PMCID: PMC11338367 DOI: 10.4103/ijpvm.ijpvm_59_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 09/13/2023] [Indexed: 08/23/2024] Open
Abstract
Background Mental health disorders are one of the most important and increasing health problems in the youth of today's societies. Some dietary intake and body mass status are factors that affect mental health. This study aimed to investigate the relationship between the intake of branched-chain amino acids (BCAAs) and aromatic amino acids (AAAs) and anthropometric and dietary inflammatory indices with mental health, including depression, anxiety, and stress. Methods In this case-control study, the data of 138 teenage girls aged 13-18 years were collected. Three-day 24-hour food recall and standard anthropometric methods were used to calculate the dietary inflammation intake score of normal and energy-adjusted diets. Mental health disorders were diagnosed by the DASS-21 questionnaire. Statistical analysis used Student's t-test, correlation, and multiple regression were used to analyze the data based on the study's statistical requirements. Results Based on the findings, 59 (42%) of the girls had mental disorders, and 79 (58%) were healthy. The average weight of stressed people was significantly higher than that of healthy people, and the BMI of anxious people was significantly higher than that of nonanxious people (P < 0.05). A significant positive correlation was found between stress and weight and energy intake. Additionally, there was a significant negative correlation between BCAAs and mental health. The average intake of BCAAs was significantly lower in patients (P = 0.01). The trend analysis showed significantly lower BCAA levels among the 4th quartile of mental disorders. No significant relationship was observed between DII, AAA, and anthropometric indices. After adjustment of the results, no relationship was observed between mental health and the studied factors. Conclusions BCAA might be related to mental health. Further studies in different age and sex groups are highly recommended.
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Affiliation(s)
- Golnaz Majdizadeh
- Department of Nutrition, Science and Research Branch Islamic Azad University, Tehran, Iran
| | - Mina Beytollahi
- Department of Nutrition, Science and Research Branch Islamic Azad University, Tehran, Iran
| | - Abolghasem Djazayery
- Department of Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ariyo Movahedi
- Department of Nutrition, Science and Research Branch Islamic Azad University, Tehran, Iran
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Yoon YJ. Depressive symptom trajectory of older adults with diabetes: exploring the role of physical activities using latent growth modeling. Aging Ment Health 2024; 28:1041-1049. [PMID: 38353514 DOI: 10.1080/13607863.2024.2313722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/25/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVES The literature highlights the role of physical activities in reducing depression, primarily in clinical samples and international longitudinal studies on older adults with diabetes. Based on Andersen's Behavioral Model, this study aims to describe the trajectory of depressive symptoms in this population and examine whether physical activities are associated with this trajectory. METHODS This study used a longitudinal survey design, utilizing three waves of data from the Health and Retirement Study. The respondents were adults aged 50 or older (N = 4,278) with diabetes. After conducting descriptive analyses, latent growth modeling was performed including unconditional and conditional models. RESULTS The overall trajectory of depressive symptoms in adults with diabetes decreased over a 4-year period. Physical activities were significantly associated with the variance in the intercept of the trajectory (p < .05), but not associated with the variance in the slope (p > .05). Additionally, this study identified factors significantly associated with the variance in the intercept (e.g. age, gender, race, marriage, education, income, self-reported health) or the slope (e.g. race, marriage, education, self-reported health) of the depressive symptom trajectory (p < .05). CONCLUSION The findings underscore the importance of implementing targeted interventions to encourage and promote physical activities among older adults with diabetes, recognizing the potential benefits for managing their mental health.
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Affiliation(s)
- Young Ji Yoon
- Department of Social Work, Colorado State University Pueblo, Pueblo, USA
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Al Balushi M, Ahmad A, Al Balushi S, Javaid S, Al-Maskari F, Abdulle A, Ali R. Sociodemographic predictors of the association between self-reported sleep duration and depression. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003255. [PMID: 38865376 PMCID: PMC11168698 DOI: 10.1371/journal.pgph.0003255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 04/19/2024] [Indexed: 06/14/2024]
Abstract
A growing interest has been recently reported in exploring sleep duration within psychology context in particular to its relation to some mental chronic diseases such as depression. The aim of this study is to investigate the association between self-reported sleep hours as an outcome and self-perceived depression among Emirati adults, after adjusting for sociodemographic factors such as age, gender, marital status, and employment status. We performed a cross-sectional analysis using 11,455 participants baseline data of the UAE Healthy Future Study (UAEHFS). Univariate and multivariate logistic regression models were performed with self-reported sleep hours as an outcome. The predictors were the self-reported depression by measuring the PHQ-8 score, sociodemographic factors (age, gender, marital status, and employment status) Odds ratios with 95% confidence intervals (CI) were reported. In a sensitivity analysis, a multivariate imputation by chained equations (MICE) procedure was applied with classification and Regression Trees (CART) to impute missing values. Overall, 11,455 participants were included in the final analysis of this study. Participants' median age was 32.0 years (Interquartile-Range: 24.0, 39.0). There were 6,217 (54.3%) males included in this study. In total, 4,488 (63.6%) of the participants reported sleep duration of more than 7 hours. Statistically significant negative association was observed between the total PHQ-8 score as a measure for depression and binarized self-reported sleep, OR = 0.961 (95% CI: 0.948, 0.974). For one unit increase in age and BMI, the odds ratio of reporting shorter sleep was 0.979 (95% CI: 0.969, 0.990) and 0.987 (95% CI: 0.977, 0.998), respectively. The study findings indicate a correlation between self-reported depression and an increased probability of individuals reporting shorter self-perceived sleep durations especially when considering the sociodemographic factors as predictors. There was a variation in the effect of depression on sleep duration among different study groups. In particular, the association between reported sleep duration and reported depression, students and unemployed individuals have reported longer sleep hours as compared to employed participants. Also, married individuals reported a higher percentage of longer sleep duration as compared to single and unmarried ones when examined reported depression as a predictor to sleep duration. However, there was no gender differences in self-perceived sleep duration when associated with reported depression.
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Affiliation(s)
- Mitha Al Balushi
- Public Health Research Center, New York University-Abu Dhabi, Abu Dhabi, United Arab Emirates
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Alain, United Arab Emirates
| | - Amar Ahmad
- Public Health Research Center, New York University-Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Sara Al Balushi
- Public Health Research Center, New York University-Abu Dhabi, Abu Dhabi, United Arab Emirates
- Lancaster University, Lancaster, United Kingdom
| | - Sayed Javaid
- Department of Psychiatry and Behavioral Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Alain, United Arab Emirates
| | - Fatma Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Alain, United Arab Emirates
| | - Abdishakur Abdulle
- Public Health Research Center, New York University-Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Raghib Ali
- Public Health Research Center, New York University-Abu Dhabi, Abu Dhabi, United Arab Emirates
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
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Okasha T, Mostafa BM, Ibrahim I, Abdelgawad AA, Lloyd CE, Sartorius N, Elkholy H. Comorbidity of depression and type 2 diabetes in Egypt results from the International Prevalence and Treatment of Diabetes and Depression (INTERPRET-DD) study. Int J Soc Psychiatry 2024; 70:730-738. [PMID: 38366940 DOI: 10.1177/00207640241228431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Abstract
BACKGROUND Diabetes mellitus and depression are serious common diseases, and the number of people with both conditions is rising steadily. Depression in people with diabetes mellitus results in poorer prognosis through different mechanisms. On the other hand, the presence of diabetes in individuals with depression increases functional impairment that is associated with depression. AIMS The study aimed to assess the prevalence and factors associated with depression among adults with type 2 diabetes mellitus attending a diabetes clinic in Cairo, Egypt. METHODS A cross-sectional study was conducted among adult patients with diabetes type 2 attending a diabetes clinic in the endocrinology department in Ain Shams University Teaching Hospital, Cairo, Egypt. Data were collected through face-to-face interviews by trained psychiatrists and from patients' records. RESULTS The prevalence of depression among diabetic patients was 21.8% (95% CI [15.6%, 29.1%]). Depression was more common among younger age groups and those with a higher level of education. There was no significant difference between those with lifetime depression compared to those without depression regarding physical health complications. CONCLUSIONS The prevalence of depression among patients with type 2 diabetes is high. Given the impact of co-morbid diabetes and depression, diabetic patients should be routinely screened for the latter condition.
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Affiliation(s)
- Tarek Okasha
- Neurology and Psychiatry Department, Faculty of Medicine, Okasha Institute of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Bassem Murad Mostafa
- Internal Medicine and Endocrinology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Islam Ibrahim
- Neurology and Psychiatry Department, Faculty of Medicine, Okasha Institute of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Ahmed Adel Abdelgawad
- Neurology and Psychiatry Department, Faculty of Medicine, Okasha Institute of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Cathy E Lloyd
- Faculty of Wellbeing Education and Language Studies, The Open University, Milton Keynes, UK
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
| | - Hussien Elkholy
- Neurology and Psychiatry Department, Faculty of Medicine, Okasha Institute of Psychiatry, Ain Shams University, Cairo, Egypt
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Yim SH, Sunwoo JS, Kim D, Chu MK, Yun CH, Yang KI. Fatigue or excessive daytime sleepiness: which is more closely related to depression? Sleep Breath 2024; 28:989-997. [PMID: 38095767 DOI: 10.1007/s11325-023-02964-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 05/31/2024]
Abstract
OBJECTIVE/BACKGROUND This study investigated fatigue and excessive daytime sleepiness to determine which was more closely related to depression in the general population. PATIENTS/METHODS Participants were investigated across 15 South Korean districts. Excessive daytime sleepiness, fatigue, and depression were evaluated using the Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), and Patient Health Questionnaire-9 (PHQ-9), respectively. Depression was defined as PHQ-9 ≥ 10. The authors classified the combination of excessive daytime sleepiness and fatigue as excessive daytime sleepiness with fatigue (E+F+, ESS ≥ 11, FSS ≥ 36), fatigue without excessive daytime sleepiness (E-F+, ESS < 11, FSS ≥ 36), excessive daytime sleepiness without fatigue (E+F-, ESS ≥ 11, FSS < 36), and no fatigue and excessive daytime sleepiness (E-F-, ESS < 11, FSS < 36). RESULTS Among 2,493 participants (1,257 women), mean age was 47.9 ± 0.3 years. The prevalence of depression, fatigue, and excessive daytime sleepiness was 8.4% (n = 210), 30.8% (n = 767), and 15.3% (n = 382), respectively. The frequency of the four categories with depression (vs. controls) was as follows.: E+F+ (n = 67, 31.9% vs. 7.3%) (P < 0.001), E-F+ (n = 71, 33.8% vs. 20.3%) (P < 0.001), E+F-( n = 16, 7.6% vs. 5.8%) (P = 0.294), and E-F- (n = 56, 26.7% vs. 66.6%) (P < 0.001). After adjusting for covariates, depression was associated with E+F+ (odds ratio, OR 8.804, 95% confidence interval (CI) 5.818-13.132), E-F+ (OR 3.942, 95% CI 2.704-5.747), E+F- (OR 2.812, 95% CI 1.542-5.131), and E-F- (reference). Additionally, we performed logistic regression according to two categories. There was no significant difference in the association of depression between E+F- (reference) and E-F+ (OR 1.399, 95% CI 0.760-2.575). CONCLUSION Although fatigue and excessive daytime sleepiness were associated with depression regardless of the presence of each other, we could not clarify which was more closely related to depression.
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Affiliation(s)
- Soo Hwan Yim
- Department of Neurology, Ulsan University, College of Medicine, Gangneung Asan Hospital, Gangneung, Republic of Korea
| | - Jun-Sang Sunwoo
- Department of Neurology, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Daeyoung Kim
- Department of Neurology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Min Kyung Chu
- Department of Neurology, College of Medicine, Severance Hospital, Yonsei University, Seoul, Republic of Korea
| | - Chang-Ho Yun
- Department of Neurology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Kwang Ik Yang
- Sleep Disorders Center, Department of Neurology, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea.
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Assaf EA, Al Sabbah H, Momani A, Al-Amer R, A. Al-Sa’ad G, Ababneh A. Factors influencing gestational diabetes self-care among pregnant women in a Syrian Refugee Camp in Jordan. PLoS One 2024; 19:e0297051. [PMID: 38358984 PMCID: PMC10868830 DOI: 10.1371/journal.pone.0297051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 12/27/2023] [Indexed: 02/17/2024] Open
Abstract
AIM The main objective of this study is to identify the level of self-care practices and the determinants of Gestational Diabetes Mellitus (GDM) among pregnant women residing in one of the refugee camps in Jordan. METHOD A cross-sectional study was conducted on a convenient sample of forty women diagnosed with GDM from the high-risk maternity clinic in one of the Syrian refugee camps in Jordan. The study used the Gestational Diabetes Management Self-Efficacy Scale (GDMSES), Diabetes Knowledge (DMK) assessment, and Diabetes Self-Care Activities Questionnaire (SDSCA) to measure the variables of interest. Descriptive analysis and Multiple logistic regression were used to assess for significant factors. RESULTS Significant associations were found between the subcategories of diet, exercise, and blood sugar control in both the self-efficacy and self-activity scales (p < 0.01, p < 0.01, p < 0.05), respectively. Two factors were associated with higher GDM self-care: diabetes knowledge and higher self-efficacy toward GDM self-care (p < 0.05). CONCLUSION The findings of this study highlight that pregnant women with GDM who have higher levels of self-efficacy and diabetes knowledge are more likely to achieve higher levels of GDM self-care. Beside developing health promotion programs to enhance women's self-efficacy in adhering to GDM care, adequate support and relevant resources to facilitate GDM management among refugee women are recommended. Future research for identifying other potential factors affecting GDM self-care among refugees is highly recommended.
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Affiliation(s)
- Enas A. Assaf
- Faculty of Nursing, Applied Science Private University, Amman, Jordan
| | - Haleama Al Sabbah
- College of Health Sciences, Abu Dhabi University, Khalifa City, United Arab Emirates
| | - Aaliyah Momani
- Faculty of Nursing, Applied Science Private University, Amman, Jordan
| | | | - Ghada A. Al-Sa’ad
- United Nation High Commissioner for Refugees (UNHCR) Jordan Office, Amman, Jordan
| | - Anas Ababneh
- Faculty of Nursing, Yarmouk University, Irbid, Jordan
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Ismail M, Seif MH, Metwally N, Neshnash M, Joudeh AI, Alsaadi M, Al-Abdulla S, Selim N. Prevalence and determinants of depression among patients with Type 2 diabetes mellitus attending family medicine clinics in Qatar. AMERICAN JOURNAL OF MEDICINE OPEN 2023; 9:100014. [PMID: 39035064 PMCID: PMC11256244 DOI: 10.1016/j.ajmo.2022.100014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 04/05/2022] [Accepted: 05/24/2022] [Indexed: 07/23/2024]
Abstract
Aims To assess the prevalence of depression and its associated factors among patients with Type 2 diabetes mellitus attending family medicine clinics in Qatar. Methods A cross-sectional study was conducted from January to April 2021 where 683 adult patients with Type 2 diabetes mellitus were selected by cluster sampling technique using probability-proportionate to size sampling. Diabetes mellitus was defined as having HA1c of greater than or equal to 6.5%, and patients were assessed for depression using the Patient Health Questionnaire-9. The relationship between depression, glycemic control, and background characteristics was analyzed using Chi-square, and binary logistic regression analyses. Adjusted logistic regression models estimated the significant factors that were independently associated with depression. Results 20.1% of the study participants had depression with the vast majority of them having mild depression (70.8%). More than three-quarters had uncontrolled diabetes mellitus (81.5%). Male patients were at higher risk for developing depression (AOR =1.98, 1.25-3.14) when compared to female patients. On the other hand, being Qatari was associated with a lower risk for depression compared to non-Qatari patients (AOR =0.56, 0.34-0.90), and treatment with insulin-containing regimens was associated with a lower risk for depression as compared to treatment with non-insulin- containing regimens (AOR =0.49, 0.30-0.78). Conclusions Prevalence of depression among patients with Type 2 diabetes attending family medicine clinics in Qatar is high. Therefore, utilizing a multidisciplinary health care plan for screening and management of depression in patients with diabetes in a primary health care setting is highly recommended. Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
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Affiliation(s)
- Mansoura Ismail
- Primary Health Care Corporation, Doha-Qatar
- Family Medicine Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | | | | | | | - Anwar I. Joudeh
- Internal Medicine Department, Al-Khor Hospital, Hamad Medical Corporation, Doha-Qatar
- Internal Medicine Department, Faculty of Medicine, University of Jordan, Amman, Jordan
| | | | | | - Nagah Selim
- Primary Health Care Corporation, Doha-Qatar
- Public Health Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Ababneh A, Moosa S, Al Jarrah Q, Alsoufi Y, Abu Qamar MZ, Saleh M, Jarrah S, Younes NA. Factors Associated With Foot Self-Care in Patients With Diabetes-Related High-Risk Feet: A Cross-Sectional Design. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231220135. [PMID: 38140753 DOI: 10.1177/00469580231220135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
Foot self-care has been commonly studied among people with diabetes. Previous research on foot self-care among those with diabetes-related high-risk feet is almost unavailable or very limited. The current study aims to fill this gap and provide a contemporary unprecedented analysis of this area of specialization. To assess the levels of, and factors associated with foot self-care among people with diabetes-related high-risk feet. A multi-center cross-sectional study from Jordan assessed the foot self-care of 107 participants with diabetes-related high-risk feet. Multiple socio-demographic, physiological, and psychosocial factors were collected, and the Arabic version of the diabetes foot self-care behavior scale was used to estimate the foot self-care of the study population. A multiple linear regression model was employed to identify factors associated with foot self-care. The mean score of foot self-care was 25.4 ± 7.1 (35 is the highest) indicating ~73% of adherence to foot self-care. Factors associated with higher foot self-care were being treated at the King Abdullah University Hospital (β = .30, P < .01) and reporting higher scores of patients' interpretations about neuropathy physical causes of foot ulcers (β = ".22," P = .02). People with diabetes-related high-risk feet reported a relatively adequate foot self-care practice. However, clinicians are still required to enhance foot self-care among this population. Health promotion programs may benefit from engaging people in understanding the pathophysiology of diabetes-related foot ulcers to improve foot self-care practices.
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Affiliation(s)
- Anas Ababneh
- Yarmouk University, Irbid, Jordan
- Applied Science Private University, Amman, Jordan
| | - Sameh Moosa
- National Center for Diabetes, Endocrinology, and Genetics, Amman, Jordan
| | | | - Yazan Alsoufi
- Jordan University of Science and Technology, Irbid, Jordan
| | | | | | | | - Nidal A Younes
- National Center for Diabetes, Endocrinology, and Genetics, Amman, Jordan
- University of Jordan, Amman, Jordan
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Li Y, Storch EA, Ferguson S, Li L, Buys N, Sun J. The efficacy of cognitive behavioral therapy-based intervention on patients with diabetes: A meta-analysis. Diabetes Res Clin Pract 2022; 189:109965. [PMID: 35718018 DOI: 10.1016/j.diabres.2022.109965] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/10/2022] [Accepted: 06/13/2022] [Indexed: 11/28/2022]
Abstract
AIMS This meta-analysis aims to update former meta-analyses from randomized controlled trials (RCT) focused on the efficacy of CBT for diabetes. METHODS Five databases were searched for RCTs. Primary outcomes were glycated hemoglobin (HbA1c), fasting blood glucose (FBS), systolic blood pressure (SBP), diastolic blood pressure (DBP), and body mass index (BMI). Secondary outcomes were depression, anxiety and distress symptoms, quality of life, sleep quality. RESULTS 32 RCTs were included. Results revealed that CBT could reduce HbA1c: -0.14% (95% CI: -0.25 to -0.02%, P = 0.020); FBS: -15.48 mg/dl (95% CI: -30.16 to -0.81 mg/dl, P = 0.040); DBP: -2.88 mmHg (95% CI: -4.08 to -1.69 mmHg, P < 0.001); depression symptoms: -0.90 (95% CI: -1.22 to -0.57, P < 0.001); anxiety symptoms: -0.28 (95% CI: -0.50 to -0.07, P = 0.009); improve sleep quality: -0.92 (95% CI: -1.77 to -0.07, P = 0.030). Subgroup analysis indicated that CBT has siginificantly reduced HbA1c when delivered as a group-based and face-to-face method, and psycho-education, behavioral, cognitive, goal-setting, homework assignment strategies were applied as central strategies. CONCLUSION CBT was an effective treatment for diabetes patients, significantly reduced their HbA1c, FBS, DBP, depression and anxiety symptoms, and improved sleep quality.
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Affiliation(s)
- Yanni Li
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland Q422, Australia
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA
| | - Samantha Ferguson
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland Q422, Australia
| | - Li Li
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, Zhejiang Province 315010, China
| | - Nicholas Buys
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland Q422, Australia
| | - Jing Sun
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland Q422, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland Q422, Australia.
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12
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Moshomo T, Rivera YP, Boshe J, Rwegerera GM. The prevalence of depression and its associated factors among patients with diabetes mellitus attending a tertiary clinic in Gaborone, Botswana. S Afr J Psychiatr 2022; 28:1647. [PMID: 35281957 PMCID: PMC8905448 DOI: 10.4102/sajpsychiatry.v28i0.1647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 07/16/2021] [Indexed: 11/16/2022] Open
Abstract
Background Depression is one of the commonest co-existing medical conditions among patients with diabetes mellitus (DM). A bidirectional relationship between depression and DM exists, complicating glycaemic control leading to an increase in diabetic complications. There is a dearth of information regarding the prevalence of depression and associated factors among patients with DM in Botswana. Aim This study aimed to determine the prevalence of depression and associated factors among patients with DM. The study also assessed the association between depression and glycaemic control. Setting A tertiary diabetic referral clinic in Gaborone, Botswana. Method A sample of 260 randomly selected patients with DM was recruited in this cross-sectional study. Socio-demographic and clinical characteristics of the patients were collected using a case report form. Depression was evaluated using the Patient Health Questionnaire (PHQ)-9 scale. Multivariate regression analysis was used to determine factors significantly associated with depression. Results The mean age (standard deviation [s.d.]) of study participants was 58.4 (11.8) years, and the majority, 160/260 (61.5%), were females. The prevalence of depression was 30.4% and significantly associated with female sex (adjusted odds ratio [AOR] = 5.529, p-value = 0.004), three or more diabetes-related hospitalisations (AOR = 3.886, p-value = 0.049) and inversely associated with systolic blood pressure (SBP) ≥ 140 mmHg (AOR = 0.11, p-value = 0.001). Conclusion Depression is a common problem among patients with DM in our setting. Routine screening of depression in diabetic patients to enable early detection and treatment is recommended.
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Affiliation(s)
- Thato Moshomo
- Department of Internal Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | | | - Judith Boshe
- Department of Psychiatry, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Godfrey M Rwegerera
- Department of Internal Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana
- Department of Medicine, Princess Marina Hospital, Gaborone, Botswana
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13
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Almomani MH, AL-Tawalbeh S. Glycemic Control and Its Relationship with Diabetes Self-Care Behaviors Among Patients with Type 2 Diabetes in Northern Jordan: A Cross-Sectional Study. Patient Prefer Adherence 2022; 16:449-465. [PMID: 35221675 PMCID: PMC8865859 DOI: 10.2147/ppa.s343214] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 01/15/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a chronic progressive disease that significantly impacts morbidity and mortality worldwide. Glycemic control is central in diabetes management, yet complex and challenging to achieve; it can be affected by various factors. Diabetes self-care behaviors are vital strategies for effective T2DM management. PURPOSE To evaluate the levels of glycemic control and diabetes self-care behaviors, and the significance of each behavior on glycemic control among patients with T2DM in Jordan. PATIENTS AND METHODS This cross-sectional study was conducted in medical and endocrinology outpatient clinics of three hospitals in northern Jordan. A convenience sample of 520 patients with T2DM participated in the study. Diabetes self-care behaviors, including diet, exercise, blood glucose testing, taking medication, and foot care behaviors, were measured using the Arabic version of the Summary of Diabetes Self-Care Activities (SDSCA-Arabic) questionnaire. Psychological distress was measured using the Arabic version of the 4-items Patient Health Questionnaire (PHQ-4). Glycated hemoglobin (HbA1c) levels were used to assess glycemic control. RESULTS Out of 520 participants, 92.7% (n= 482) had poor glycemic control (HbA1c ≥7%), with a mean of 9.29% (SD=2.06) for HbA1c. The SDSCA overall mean score was 3.25 days (SD=0.88), indicating an unsatisfactory level, with 79.2% of participants having performed self-care activities 4-days/week. Greater adherence to diabetes self-care behaviors was associated with better glycemic control. Exercise was the most important predictor of HbA1c (p<0.001), followed by general diet (p<0.001), specific diet (p<0.001), and blood sugar testing (p<0.001). Moreover, the Body Mass Index (p<0.001), treatment type (p<0.001), and income (p=0.03) were significant predictors. CONCLUSION The proportions of poor glycemic control and unsatisfactory self-care behaviors were high among T2DM patients. To enhance patients' self-care behaviors and lifestyles changes, the patients need tailored diabetes self-care management educational and supportive programs, conducted by qualified diabetes educators using culturally sensitive strategies.
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Affiliation(s)
- Maysa H Almomani
- Department of Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
- Correspondence: Maysa H Almomani, Tel +962 2 7201000 Ext 26176, Fax +962 2 7201065, Email
| | - Shahinaz AL-Tawalbeh
- Department of Community and Mental Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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14
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AlOtaibi AA, Almesned M, Alahaideb TM, Almasari SM, Alsuwayt SS. Assessment of diabetes-related distress among type 2 diabetic patients, Riyadh, Saudi Arabia. J Family Med Prim Care 2021; 10:3481-3489. [PMID: 34760777 PMCID: PMC8565154 DOI: 10.4103/jfmpc.jfmpc_488_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/07/2021] [Accepted: 07/12/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To assess the prevalence of diabetes-related distress (DRD) among Type 2 diabetics in the diabetic center of King Salman Hospital, Riyadh, Saudi Arabia. METHODS This was an observational descriptive study conducted between December 2019 and January 2020 among T2DM patients followed up at the diabetic clinics of the Diabetic Center of King Salman Hospital in Riyadh, Saudi Arabia. We used the 17-items Diabetes Distress Scale (DDS17) to measure DRD. RESULTS A total of 399 T2DM patients were included in the study, 58.4% were males. High distress was seen in 40 patients. Multivariate analysis showed that longer duration of diabetes (>15 years), female gender, longer intervals in-between visits (>6 months), and experience of episodes of severe hypoglycemia as the most significant factors related to higher levels of distress. The patients who were diabetics longer than 15 years had an increased risk for high distress by 3.6 times, infrequent clinic visits (longer than 6 months) increased the risk for high distress by 5.3 times×, and patients who experienced severe hypoglycemia had an increased risk for high distress by 5.8 times. CONCLUSION This study showed a high (35.6%) prevalence of moderate to severe DRD. Long-standing diabetes, a longer interval of a clinic visit, and severe hypoglycemia increase the risk for DRD by 3.6, 5.3, and 5.8 folds. Health care providers should focus on reducing DRD and devise ways to increase self-care practices and coping skills.
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Affiliation(s)
- Abdullah Aedh AlOtaibi
- Family Medicine Physicians, Academy of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | - Mohammed Almesned
- Head Department of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | - Turki Mohammed Alahaideb
- Family Medicine Physicians, Academy of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | - Saad Mohammed Almasari
- Family Medicine Physicians, Academy of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | - Saleh Saad Alsuwayt
- Family Medicine Physicians, Academy of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
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15
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Khassawneh AH, Alzoubi A, Khasawneh AG, Abdo N, Abu-Naser D, Al-Mistarehi AH, Albattah MF, Kheirallah KA. The relationship between depression and metabolic control parameters in type 2 diabetic patients: A cross-sectional and feasibility interventional study. Int J Clin Pract 2021; 75:e13777. [PMID: 33098211 DOI: 10.1111/ijcp.13777] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/13/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Substantial evidence supports a bidirectional relationship between diabetes and clinical depression. However, little is known about the effect of treating one condition on the control of the other. Thus, this study aimed to determine the prevalence of depression among Type II diabetes mellitus (T2DM) patients and to assess the efficacy and feasibility of escitalopram treatment of depression on their metabolic control parameters. METHODS T2DM patients attending primary care clinics in the North of Jordan were enrolled in a cross-sectional study during the period from February to December 2019 (n = 157). Depressive symptoms were screened utilising the patient health questionnaire-9 (PHQ-9) tool. Metabolic control was assessed by measurement of glycated haemoglobin (HbA1c), triglycerides, cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Patients with moderate to severe depressive symptoms by PHQ-9 (n = 58) were interviewed by a psychiatrist to confirm a clinical diagnosis of depression. Eligible depressed patients were administered escitalopram 10 mg orally once daily for 3 months (n = 12). Thereafter, depressive symptoms and metabolic control measures were reassessed. RESULTS The prevalence of moderate to severe depressive symptoms among T2DM patients, according to PHQ-9, was 36.94%, while the prevalence of clinical depression based on interview was 7.64%. Baseline PHQ-9 scores correlated significantly with baseline levels of HbA1c, HDL, cholesterol and triglycerides. Escitalopram treatment intervention resulted in significant improvement of PHQ-9 scores without significantly improving any of the metabolic control measures. CONCLUSION The relationship between depression and T2DM in the context of metabolic syndrome is plausible. However, our results show that escitalopram treatment may not be associated with significant improvement in metabolic control parameters among these patients. Our study has laid the groundwork for future randomised clinical trials with larger sample size and longer follow-up.
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Affiliation(s)
- Adi H Khassawneh
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdallah Alzoubi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- College of Medicine, Ajman University, Ajman, United Arab Emirates
| | - Aws G Khasawneh
- Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Nour Abdo
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Dania Abu-Naser
- Department of Applied Sciences, Irbid University College, Al-Balqa' Applied University, Irbid, Jordan
| | - Abdel-Hameed Al-Mistarehi
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Malak F Albattah
- Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid A Kheirallah
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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16
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Malak MZ, Tawalbeh LI, Al-Amer RM. Depressive Symptoms among Older Jordanian Patients with Cancer Undergoing Treatment. Clin Gerontol 2021; 44:133-142. [PMID: 32924883 DOI: 10.1080/07317115.2020.1818660] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To date, predictive and risk factors for depression among older patients with cancer have not been adequately studied in the Middle Eastern countries including Jordan. Therefore, this study aimed to assess the levels of depressive symptoms, anxiety, and hope among older Jordanian patients with cancer aged 60 years and over who are currently undergoing treatment, and to identify the relationship between selected factors (socio-demographic, treatment, and psychological) and depressive symptoms. METHODS A cross-sectional design was conducted on a convenience sample consisting of 150 patients with cancer from one of the biggest governmental hospitals in Jordan. RESULTS The findings revealed that almost 34% and 27% of the patients experienced anxiety and depression and had a moderate level of hope. Correlating factors with depression were age, duration of treatment, hope, anxiety, educational level, and health insurance. However, low duration of treatment, high anxiety, and low hope were the significant predictors of high depression. CONCLUSION Understanding the risk factors correlated with depression could help develop early interventions to enhance the psychological consequences for patients with cancer at risk for depression. CLINICAL IMPLICATIONS Health-care providers need to develop psychological care for older patients with cancer and interventions directed at minimizing depression. Also, nurses should focus on providing holistic care including physical, social, psychological, and spiritual dimensions. Depression care should be an important part of the comprehensive treatment care plan for older patients undergoing cancer treatment.
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Affiliation(s)
- Malakeh Z Malak
- Community Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan , Amman, Jordan
| | - Loai I Tawalbeh
- Adult Health Nursing, Faculty of Nursing, Al-AlBayt University , Al-Mafraq, Jordan
| | - Rasmieh M Al-Amer
- Psychiatric Health Nursing, Faculty of Nursing, Isra' University , Amman, Jordan.,School of Nursing and Midwifery, Western Sydney University , Sydney, Australia
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17
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Depression and Anxiety among Patients with Type II Diabetes Mellitus in Chitwan Medical College Teaching Hospital, Nepal. Nurs Res Pract 2021; 2021:8846915. [PMID: 33520315 PMCID: PMC7817292 DOI: 10.1155/2021/8846915] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 12/09/2020] [Accepted: 12/18/2020] [Indexed: 11/23/2022] Open
Abstract
The prevalence of depression and anxiety disorders is common among people with diabetes mellitus. Coexistence of diabetes and depression/anxiety increases the risk of diabetes complications and reduces the overall quality of life. Hence, this study aimed to assess the depression and anxiety among patients with type 2 diabetes mellitus in Chitwan. Descriptive survey was carried out among 296 purposively selected clinically diagnosed type 2 diabetes patients admitted in the Chitwan Medical College Teaching Hospital from 15th June 2018 to 17th September 2019. Patients were interviewed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorders-7 (GAD-7). Data were analyzed using descriptive and inferential statistics. Of 296 diabetic patients, 48.6% were 60 years and above, 59.5% female and 61.5% literate; their common occupation was agriculture (38.2%) followed by household work (26.4%). Nearly two-thirds (62.8%) of diabetes patients had other chronic comorbid conditions. Depression and anxiety were observed among 57.8% and 49.7% of diabetes patients, respectively. While observing the severity, 27.4%, 19.6%, 8.4%, and 2.4% of patients had mild, moderate, moderately severe, and severe depression, respectively. Likewise, 24.7%, 20.3%, and 4.7% of patients had mild, moderate, and severe anxiety, respectively. Current living status, educational status, medicine adherence, satisfaction toward current treatment, and history of mental illness in the family were found to be significant factors associated with the anxiety of patients with diabetes. Further, educational status, smoking habit, satisfaction towards current treatment, and history of diabetes in family were the factors associated with depression. Prevalence of depression and anxiety is high among admitted patients with diabetes mellitus, and many factors are associated with it. Hence, regular screening services are essential along with diabetes management plan for timely identification and treatment of the vulnerable groups in the healthcare centers.
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18
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Al Toobi MM, Al Subhi LK, Bose S, Al-Adawi S. Nutrition quality of life associated with affective functioning among Omani patients with type 2 diabetes from primary health care. J Nutr Sci 2021; 10:e6. [PMID: 33889389 PMCID: PMC8057477 DOI: 10.1017/jns.2020.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/15/2020] [Indexed: 11/08/2022] Open
Abstract
Diabetes requires challenging lifelong dietary management, affects quality of life and heightens the impact of affective functioning. The aim of this study was to investigate the relationship between Nutrition Quality of Life (NQOL) and affective functioning in a sample of Omani patients with type 2 diabetes. A sample of 149 adults with type 2 diabetes was conveniently recruited from seven Primary Health Centers (PHCs) during follow-up visits. Data were gathered via face-to-face interviews. Pearson correlation and χ2 test of independence were applied to examine associations at P < 0⋅05. Most patients had poor glycemic control (71⋅1 %), BMI ≥ 25 kg/m2 (85⋅2 %) and central obesity (75⋅8 %), and moderate (54⋅4 %) and poor (32⋅9 %) level of NQOL. Based on the Hospital Anxiety and Depression Scale (HADS), 16⋅1 and 23⋅5 % of the sample endorsed the presence of anxiety and depression, respectively. A significant negative correlation was found between NQOL and HADS (r -0⋅590, P = 0⋅000), anxiety (r -0⋅597, P = 0⋅000) and depression (r -0⋅435, P = 0⋅000). There was a significant association between NQOL and HADS, χ2 (2) = 38⋅21, P < 0⋅01 that was large, Cramer's V = 0⋅51. Also, there were significant associations (P < 0⋅01) between NQOL and HADS when controlling for HbA1c, BMI, waist circumference and HMNT that were moderately to largely strong, Cramer's V = 0⋅43-0⋅55. There is an evident association between NQOL and affective functioning in adults with type 2 diabetes. Further research is recommended to confirm these relationships and to guide intervention programmes at PHCs to help improve the general quality of life of such patients.
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Affiliation(s)
- Masooma M. Al Toobi
- Department of Food Science and Nutrition, College of Agricultural and Marine Sciences, Sultan Qaboos University, P. O. Box 34, Al Khoud123, Oman
| | - Lyutha K. Al Subhi
- Department of Food Science and Nutrition, College of Agricultural and Marine Sciences, Sultan Qaboos University, P. O. Box 34, Al Khoud123, Oman
| | - Shekar Bose
- Department of Natural Resource Economics, College of Agricultural and Marine Sciences, Sultan Qaboos University, P. O. Box 34, Al Khoud123, Oman
| | - Samir Al-Adawi
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos Muscat, P. O. Box 35, Al Khoud123, Oman
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19
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Nouri Saeidlou S, Kiani A, Ayremlou P. Association between Dietary Patterns and Major Depression in Adult Females: A Case-Control Study. J Res Health Sci 2021; 21:e00506. [PMID: 34024764 PMCID: PMC8957692 DOI: 10.34172/jrhs.2021.37] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 01/04/2021] [Indexed: 11/09/2022] Open
Abstract
Background: Depression is one of the most common mental disorders. This study aimed to determine the association between dietary patterns and major depression in adult females.
Study design: A case-control study.
Methods: This study was conducted on adult females suffering from major depression within the age range from 19 to 65 years. The total participants of this study included 170 cases and 340 controls. Dietary intakes were collected using a 168-item validated semi-quantitative food-frequency questionnaire. Household food security was measured using a locally adapted Household Food Insecurity Access Scale. Moreover, the depression status of the adult females was assessed through a validated "Beck" questionnaire. Logistic regression was utilized to assess the association between dietary pattern scores and depression.
Results: The mean ±SD ages of the participants were 36.97 ±11.28 and 36.07 ±10.58 years in the case and control groups, respectively (P=0.374), and five major dietary patterns were extracted in this study. The odds ratio (OR) in the last adjusted model was (OR: 0.61; 95% CI: 0.46, 0.81); therefore, the "Healthy pattern" was significantly inversely associated with the odds of depression. Adherence to the "Western pattern" significantly increased depression by 29% (OR: 1.29; 95% CI: 1.06, 1.59). Furthermore, the "Traditional pattern" was positively associated with depression (OR: 1.16; 95% CI: 0.94, 1.43). There was no significant association between "Sugar and fast food" and "red meat and oils" dietary pattern and depression.
Conclusions: Healthy dietary pattern reduces the risk of depression in adult females; however, the western and traditional dietary patterns increases this risk.
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Affiliation(s)
- Sakineh Nouri Saeidlou
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Arezou Kiani
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran.
| | - Parvin Ayremlou
- Clinical Research Development Unit of Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran
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Ebrahim M, Tamiru D, Hawulte B, Misgana T. Prevalence and associated factors of depression among diabetic outpatients attending diabetic clinic at public hospitals in Eastern Ethiopia: A cross-sectional study. SAGE Open Med 2021; 9:20503121211066244. [PMID: 34992781 PMCID: PMC8725011 DOI: 10.1177/20503121211066244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 11/24/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: Depression is one of the most common comorbid psychiatric disorders among diabetic patients. Depression among diabetic people has led to poor treatment adherence, defective treatment outcomes, and consequently worsened quality of life. However, there is a limited study conducted to assess the magnitude and factors associated with depression among diabetic patients in Ethiopia including this study area. Objective: This study aimed to assess the prevalence and factors associated with depression among adult diabetic outpatients attending diabetic clinic in Eastern Ethiopia. Methods: An institution-based cross-sectional study was conducted among 407 adult diabetic outpatients on treatment in Ethiopia in 2020. Patient Health Questionnaire-9 was used to assess depression among randomly selected samples. Bivariate and multivariate logistic regression was fitted to identify factors associated with depression among diabetic outpatients. A p value less than 0.05 with a 95% confidence interval was considered statistically significant. Results: The overall prevalence of depression among diabetic outpatients was found to be 48.9% (95% confidence interval: 44.2%, 53.4%). Being female (adjusted odds ratio = 1.50, 95% confidence interval: 1.39, 2.73), Khat chewing (adjusted odds ratio = 1.88, 95% confidence interval: 1.22, 2.93), having poor and moderate social support (adjusted odds ratio = 1.79, 95% confidence interval: 1.07, 2.98 and adjusted odds ratio = 1.90, 95% confidence interval: 1.14, 3.17, respectively), taking both oral hypoglycemic agents and insulin medication (adjusted odds ratio = 1.33, 95% confidence interval: 1.13, 2.80) and duration of diabetes mellitus for more than 6 years (adjusted odds ratio = 5.40, 95% confidence interval: 3.42, 8.14) were significantly associated with depression. Conclusion: This study revealed a relatively high prevalence of depression in diabetic outpatients. A lesser level of social support, taking oral and insulin treatment regimes, longer duration of illness, using Khat, and being female were associated with depression among diabetic outpatients. Therefore, early screening and identification of such factors could help ameliorate some of the deleterious effects of depression in diabetic outpatients.
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Affiliation(s)
| | - Dawit Tamiru
- Department of Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Behailu Hawulte
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tadesse Misgana
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Powell TM, Shin OJ, Li SJ, Hsiao Y. Post-traumatic stress, social, and physical health: A mediation and moderation analysis of Syrian refugees and Jordanians in a border community. PLoS One 2020; 15:e0241036. [PMID: 33095832 PMCID: PMC7584168 DOI: 10.1371/journal.pone.0241036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 10/07/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES This study examined the mediating or moderating relationship of social health on physical health and post-traumatic stress symptoms among displaced Syrians and Jordanians at high risk for physical and mental health ailments. Frequency of mental health symptoms stratified by demographic factors was also explored. We hypothesized social health would mediate and/or moderate the relationship between physical and post-traumatic stress symptoms (PTSS). METHODS This cross-sectional study includes 598 adults between 18 and 75 years old recruited from three health centers in the city of Irbid, Jordan, 20 km away from the Syrian border. Post-traumatic stress symptoms (PTSS) were measured through the primary care post-traumatic stress disorder checklist. Physical and social health were assessed through the Duke Health Profile. One-way ANOVA and independent samples T-tests examined mean scores of social health, PTSS, physical health stratified by age, gender, nationality, education level, and trauma exposure. Bivariate correlations explored the relationship between social health, PTSS, and physical health. PROCESS macro tested social health as a moderator and mediator on the association of the physical health and PTSS. RESULTS Social health moderated and mediated the relationship between physical health and PTSS. Males reported (t = 2.53, p < .05) better physical health scores than females. Those who had less than a high school education reported lower social health (F = 13.83, p < .001); higher PTSS (F = 5.83, p < .001); and lower physical health (F = 5.76, p < .01) than more educated individuals. Syrians reported significantly higher PTSS (F = 4.13, p < .05) than Jordanians, however, there was no significant differences between nationality for physical or social health. Social health was positively associated with better physical health (r = 0.10, p < .01) and negatively with PTSS (r = -.293, p < .01). CONCLUSIONS Our results support our primary hypothesis suggesting social health mediates and moderates PTSS and physical health. Secondary findings illustrate gender, educational, and income differences in physical health and PTSS. CLINICAL TRIALS REGISTRY NCT03721848.
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Affiliation(s)
- Tara M. Powell
- School of Social Work, University of Illinois Urbana-Champaign, Urbana, Illinois, United States of America
- * E-mail:
| | - Oe Jin Shin
- School of Social Work, University of Illinois Urbana-Champaign, Urbana, Illinois, United States of America
| | - Shang-Ju Li
- Evaluation Department, Americares, Stamford, Connecticut, United States of America
| | - Yuan Hsiao
- Department of Sociology, University of Washington, Seattle, Washington, United States of America
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Prevalence of Depression among Type-II Diabetic Patients Attending the Diabetic Clinic at Arar National Guard Primary Health Care Center, Saudi Arabia. PSYCHIATRY JOURNAL 2020; 2020:9174818. [PMID: 32637427 PMCID: PMC7322613 DOI: 10.1155/2020/9174818] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 05/22/2020] [Indexed: 12/30/2022]
Abstract
Background Depression is a common comorbidity in type-II diabetic patients, which if undiagnosed leads to poor clinical outcomes. Objectives To determine the prevalence and risk factors of depression among type-II diabetic patients attending the National Guard Diabetic Clinic in Arar city. Subjects and methods. This cross-sectional study included every third type-II diabetic patient attending the National Guard Primary Health Care Center between the 1st of January and 31st of March 2019. Participants were interviewed using the Patient Health Questionnaire 9 (PHQ-9). Patients who scored ≥5 were considered to have depression. Chi-square test (χ2) was used to compare differences between categorical variables. P ≤ 0.05 was considered statistically significant. Results Of the total 422 diabetic patients approached for this study, 397 provided complete responses (94% response rate). Of these, 37% had depression: 23% mild, 9% moderate, and 5% severe. Diabetic patients with low education, poor income, and long duration of diabetes mellitus were found to be at higher risk of depression. Poor compliance with physical activities, diet regimen, family history of DM, and the presence of complications was also significantly associated with depression. On logistic regression analysis, low family income, duration of DM, poor compliance to physical activity, and presence of complications as neuropathy or libido were the main predictors of depression in diabetic patients. Conclusion More than one-third of type-II diabetic patients had depression. Regular screening of type-II diabetic patients for depression is a necessity, as it can affect the clinical outcome.
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Pati S, Swain S, Knottnerus JA, Metsemakers JFM, van den Akker M. Magnitude and determinants of multimorbidity and health care utilization among patients attending public versus private primary care: a cross-sectional study from Odisha, India. Int J Equity Health 2020; 19:57. [PMID: 32349770 PMCID: PMC7191801 DOI: 10.1186/s12939-020-01170-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 04/07/2020] [Indexed: 12/21/2022] Open
Abstract
Background Multimorbidity in primary care is a challenge not only for developing countries but also for low and medium income countries (LMIC). Health services in LMIC countries are being provided by both public and private health care providers. However, a critical knowledge gap exists on understanding the true extent of multimorbidity in both types of primary care settings. Methods We undertook a study to identify multimorbidity prevalence and healthcare utilization among both public and private primary care attendees in Odisha state of India. A total of 1649 patients attending 40 primary care facilities were interviewed using a structured multimorbidity assessment questionnaire collecting information on 22 chronic diseases, medication use, number of hospitalization and number of outpatient visits. Result The overall prevalence of multimorbidity was 28.3% and nearly one third of patients of public facilities and one fourth from private facilities had multimorbidity. Leading diseases among patients visiting public facilities included acid peptic diseases, arthritis and chronic back pain. No significant difference in reporting of hypertension and diabetes across the facilities was seen. Besides age, predictors of multimorbidity among patients attending public facilities were, females [AOR: 1.6; 95% CI 1.1–1.3] and non-aboriginal groups [AOR: 1.6; 95%CI 1.1–2.3] whereas, in private females [AOR: 1.6; 95%CI 1.1–2.4], better socioeconomic conditions [AOR 1.4; 95% CI 1.0–2.1] and higher educational status [primary school completed [AOR 2.6; 95%CI 1.6–4.2] and secondary schooling and above [AOR 2.0; 95%CI 1.1–3.6] with reference to no education were seen to be the determinants of multimorbidity. Increased number of hospital visits to public facilities were higher among lower educational status patients [IRR: 1.57; 95% CI 1.13–2.18] whereas, among private patients, the mean number of hospital visits was 1.70 times more in higher educational status [IRR: 1.70; 95%CI 1.01–3.69]. The mean number of medicines taken per day was higher among patients attending private hospitals. Conclusion Our findings suggest that, multimorbidity is being more reported in public primary care facilities. The pattern and health care utilization in both types of settings are different. A comprehensive care approach must be designed for private care providers.
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Affiliation(s)
- Sanghamitra Pati
- Indian Council of Medical Research, Department of Health Research, ICMR Regional Medical Research Centre, Bhubaneswar, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India.
| | - Subhashisa Swain
- School of Medicine, Clinical Sciences Building, City Hospital, University of Nottingham, Nottingham, NG5 1PB, UK
| | - J André Knottnerus
- Department of Family Medicine, School Caphri, Maastricht University, Maastricht, The Netherlands
| | - Job F M Metsemakers
- Department of Family Medicine, School Caphri, Maastricht University, Maastricht, The Netherlands
| | - Marjan van den Akker
- Department of Family Medicine, School Caphri, Maastricht University, Maastricht, The Netherlands.,Academic Centre of General Practice / Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
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Mukeshimana M, Chironda G. Depression and Associated Factors Among the Patients with Type 2 Diabetes in Rwanda. Ethiop J Health Sci 2020; 29:709-718. [PMID: 31741641 PMCID: PMC6842718 DOI: 10.4314/ejhs.v29i6.7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Various studies have found a greater prevalence of depression among patients having one or more chronic non communicable disease like diabetes mellitus than in the general population. This co-morbidity is linked with serious health consequences such as high mortality and morbidity, debility, low quality of life and increased health costs. The aim was to determine the prevalence of depression among patients with diabetes attending three selected district hospitals in Rwanda. Sociodemographic factors associated with depression were also explored. Methods It was a descriptive cross sectional study. A sample of 385 was selected randomly to participate in the study and 339 complete the questionnaires making a response rate of 88%. The Patient Health Questionnaire-9 (PHQ-9) was used to screen depression. Descriptive and inferential analysis were done. Results The majority of respondents 83.8% (n=284) had depression. Among them 17.9% (n=61) had moderately severe to severe depression while 81.9% (n=223) had minimal to moderate depression. A statistically significant association was found between age and depression (p=0.01) also between gender and depression (p=0.02). Significance was determined at P<0.05. Conclusion we found a high prevalence of depression among patients with diabetes. The regular screening of depression among these patients is recommended.
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Affiliation(s)
| | - Geldine Chironda
- Senior Lecturer, Human Resource for Health, University of Rwanda, College of Medicine and Health Sciences
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Al-Rawashdeh BM, Saleh MYN, Mustafa RB, Alkhoujah MF, Elkhatib AH, Alsghaireen H, Hubaishy LZ. Prevalence of depression and anxiety among otolaryngology outpatients at Jordan University Hospital. Perspect Psychiatr Care 2019; 55:383-395. [PMID: 30171688 DOI: 10.1111/ppc.12320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 07/02/2018] [Accepted: 07/14/2018] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To determine the prevalence of depression and anxiety among otolaryngology outpatients at Jordan University Hospital. METHODS A cross-sectional observational study was conducted between January 2017 and February 2018. The sample included 1328 otolaryngology adult outpatients, who completed (PHQ-9) and (GAD-7) questionnaires for depression and anxiety. Sociodemographic and clinical data were recorded. RESULTS Depression and anxiety prevalence rates were 36.1% and 22.9%. The significant risk factors found for them were: age range 30 to 50 years, female sex, divorced status, smoking, alcohol drinking, asthma, family history of psychiatric illness, chronic illnesses, negative life events, secondary education, unemployment, low income, globus pharyngeus, tinnitus, and dizziness. PRACTICE IMPLICATIONS Healthcare providers should have the vigilance to suspect and treat these disorders to improve patients' symptoms and quality of life.
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Affiliation(s)
| | - Mohammad Y N Saleh
- Department of Clinical Nursing, Nursing Faculty, University of Jordan, Amman, Jordan
| | | | | | - Ahmad H Elkhatib
- Department of Otolaryngology-Head & Neck Surgery, Jordan University Hospital, Amman, Jordan
| | - Hadil Alsghaireen
- 5th Year Student, School of Medicine, University of Jordan, Amman, Jordan
| | - Lana Z Hubaishy
- 5th Year Student, School of Medicine, University of Jordan, Amman, Jordan
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Sunny AK, Khanal VK, Sah RB, Ghimire A. Depression among people living with type 2 diabetes in an urbanizing community of Nepal. PLoS One 2019; 14:e0218119. [PMID: 31181109 PMCID: PMC6557519 DOI: 10.1371/journal.pone.0218119] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/27/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Diabetes mellitus is a major public health problem which accounts for serious medical and economic consequences. Depression is an important associated condition that upsets the management and complications of diabetes. This study aimed to measure the prevalence of depression among people living with Type 2 Diabetes and to examine the factors linked with it. METHODS This community based, cross-sectional study was conducted among 278 people living with type 2 diabetes in Duhabi-Bhaluwa municipality, Nepal. A face to face interview was conducted using a pre-tested semi-structured questionnaire to gain information on socio-demographic characteristics and clinical profile of the participants. Depression was assessed using the Beck Depression Inventory (BDI-II) scale. Variables were categorical and were thus, compared with Pearson's chi-square tests and binary logistic regression models. RESULTS The prevalence of depression in this study was 22.7%. Most people indicative of having depression were of older age, females, below secondary level education, with a smaller family size, with low family income, using insulin, without a family history of diabetes and/or having an additional illness. However, multivariate analysis showed that the only significant factors for depression were older age, education below secondary level, homemaker, smaller family size, using insulin and having an additional illness. CONCLUSION The prevalence of depression in this study is consistent with that reported by other communities. Factors like older age, lower education level, being a homemaker, living in a small size family, insulin use and additional illness could increase the likelihood of developing Major Depressive disorder among people with type 2 diabetes, hence, psychosocial assessment is necessary along with diabetes management plan in a primary health care setting.
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Affiliation(s)
- Avinash K. Sunny
- School of Public Health and Community Medicine, B.P Koirala Institute of Health Sciences, Dharan, Nepal
| | - Vijay K. Khanal
- School of Public Health and Community Medicine, B.P Koirala Institute of Health Sciences, Dharan, Nepal
| | - Ram B. Sah
- School of Public Health and Community Medicine, B.P Koirala Institute of Health Sciences, Dharan, Nepal
| | - Anup Ghimire
- School of Public Health and Community Medicine, B.P Koirala Institute of Health Sciences, Dharan, Nepal
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Khaledi M, Haghighatdoost F, Feizi A, Aminorroaya A. The prevalence of comorbid depression in patients with type 2 diabetes: an updated systematic review and meta-analysis on huge number of observational studies. Acta Diabetol 2019; 56:631-650. [PMID: 30903433 DOI: 10.1007/s00592-019-01295-9] [Citation(s) in RCA: 167] [Impact Index Per Article: 33.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 02/02/2019] [Indexed: 02/06/2023]
Abstract
AIMS Depression is a common co-morbidity in patients with type 2 diabetes mellitus (T2DM). Untreated depression in these patients adversely affects self-care activities and other diabetes complications. The aim of this study is to estimate the prevalence of depression among patients with T2DM by conducting a meta-analysis of observational studies. METHODS MEDLINE, Web of Science, Science Direct, and Google Scholar databases were searched for all observational studies that assessed depression in T2DM. Relevant articles were searched using the combination of Medical Subject Heading (MeSH) terms of "depression", "depressive disorder", and "diabetes mellitus" published between January 2007 and July 2018. Random effects model was used to estimate the weighted prevalence rates and 95% CI using "metaprop program in STATA 11". RESULTS In total, the 248 included studies (with 273 reported prevalence) identified 83,020,812 participants; of them, 23,245,827 (28%; 95% CI 27, 29) suffered from different severity levels of depressive disorders. The prevalence of depression was separately reported in 137,372 males and 134,332 females. Of them, 31,396 males (23%, 95% CI: 20, 26) and 45,673 females (34%, 95% CI: 31, 38) were depressed. Compared with global estimate, depression prevalence was lower in Europe (24%) and Africa (27%), but higher in Australia (29%) and Asia (32%). The prevalence in America was equal to the estimated prevalence in the world (28%). Depression was more common in subjects younger than 65 compared with elderlies (31% vs. 21%). CONCLUSION Our findings demonstrated that almost one in four adults with T2DM experienced depression. Given the high prevalence of depressive disorders in diabetic patients, screening these patients for co-morbid depression and its relevant risk factors is highly recommended.
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Affiliation(s)
- Mohammad Khaledi
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Biostatistics and Epidemiology Department, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Aminorroaya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Al-Sahouri A, Merrell J, Snelgrove S. Barriers to good glycemic control levels and adherence to diabetes management plan in adults with Type-2 diabetes in Jordan: a literature review. Patient Prefer Adherence 2019; 13:675-693. [PMID: 31118591 PMCID: PMC6507072 DOI: 10.2147/ppa.s198828] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 04/03/2019] [Indexed: 12/17/2022] Open
Abstract
Poorly controlled Type-2 diabetes is considered a significant public health problem and associated with adverse outcomes in Jordan. This review focuses on barriers to good glycemic control levels and adherence to diabetes management plan in adults with Type-2 diabetes in Jordan. The aim was to identify the extent of Type-2 diabetes and the influence of knowledge, perceptions and sociocultural factors on adherence to the diabetes management plan. Thirty-two studies were included in the literature review. The high prevalence rate of poorly controlled Type-2 diabetes is associated with many negative consequences among patients in Jordan. Despite the publication of research findings that have shown the importance of adherence to diet, physical activity, medications, monitoring blood glucose and foot care, the level of adherence is still unsatisfactory among patients in Jordan. This review also identified that social, cultural and religious factors influence diabetes management. These factors highlighted the overwhelming influence of socio-cultural factors and lifestyles as determinants of patients' health and health behaviors. For example, the influence of family, friends and culture on herbal use and food preferences that patients make on a daily basis and during social gatherings. A holistic approach incorporating patient-centered care could usefully be incorporated into educational programs to improve the understanding of patients' health and information needs. The importance of factors beyond the individual level in terms of social, cultural, organizational and policy influences such as food habits, religious beliefs and lack of continuity of care were identified as key factors which influence adherence to the diabetes management plan. Recognition of multiple determinants of patients' health among health care professionals may expand the scope of interventions to seek to modify social norms and values and improve patient outcomes.
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Affiliation(s)
- Amer Al-Sahouri
- Department of Public Health, Policy and Social Sciences, Swansea University, Swansea, UK
| | - Joy Merrell
- Department of Public Health, Policy and Social Sciences, Swansea University, Swansea, UK
| | - Sherrill Snelgrove
- Department of Public Health, Policy and Social Sciences, Swansea University, Swansea, UK
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Daré LO, Bruand PE, Gérard D, Marin B, Lameyre V, Boumédiène F, Preux PM. Co-morbidities of mental disorders and chronic physical diseases in developing and emerging countries: a meta-analysis. BMC Public Health 2019; 19:304. [PMID: 30866883 PMCID: PMC6417021 DOI: 10.1186/s12889-019-6623-6] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 03/05/2019] [Indexed: 12/12/2022] Open
Abstract
Background As the data on the association of mental disorders and chronic physical diseases in developing and emerging countries is heterogeneous, this study aims to produce the first meta-analysis of these comorbidities. Methodology The meta-analysis protocol was registered in PROSPERO (N°CRD42017056521) and was performed in accordance with PRISMA guidelines. Initially, an article search was conducted on Medline, Embase, Lilacs and the Institut d’Epidémiologie et de Neurologie Tropicale database [Institute of Epidemiology and Tropical Neurology], as well as manually, with no restriction on language or date focusing on mental disorders, chronic diseases and neurotropic diseases. Two independent investigators assessed the quality of the studies which met the inclusion criteria using the Downs and Black assessment grid. The pooled estimates were calculated out using a random-effects method with CMA software Version 3.0. A meta-regression was then performed, and the significance level was set at 0.05. Results Of the 2604 articles identified, 40 articles involving 21,747 subjects met the inclusion criteria for co-morbidities between mental disorders and chronic physical diseases. Thirty-one articles were included in the meta-analysis of prevalence studies and 9 articles in that of the analytical studies. The pooled prevalence of mental disorders in patients with chronic physical diseases was 36.6% (95% CI, 31.4–42.1) and the pooled odds ratio was 3.1 (95% CI, 1.7–5.2). There was heterogeneity in all the estimates and in some cases, this was explained by the quality of the studies. Conclusion Some estimates regarding the prevalence of mental disorders in people with chronic physical diseases living in developing and emerging countries were similar to those in developed countries. Mental disorders are a burden in these countries. In order to respond effectively and efficiently to the morbidity and mortality associated with them, mental health care could be integrated with physical care. Electronic supplementary material The online version of this article (10.1186/s12889-019-6623-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Labanté Outcha Daré
- INSERM, Univ. Limoges, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, F-87000, Limoges, France.
| | - Pierre-Emile Bruand
- Access to Medicines, SANOFI, SAG / CSVB, 82 AV Raspail, 94250, Gentilly, France
| | - Daniel Gérard
- Access to Medicines, SANOFI, SAG / CSVB, 82 AV Raspail, 94250, Gentilly, France
| | - Benoît Marin
- INSERM, Univ. Limoges, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, F-87000, Limoges, France
| | - Valerie Lameyre
- Access to Medicines, SANOFI, SAG / CSVB, 82 AV Raspail, 94250, Gentilly, France
| | - Farid Boumédiène
- INSERM, Univ. Limoges, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, F-87000, Limoges, France
| | - Pierre-Marie Preux
- INSERM, Univ. Limoges, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, F-87000, Limoges, France
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Prevalence of Depression among Patients with Type 2 Diabetes Mellitus and its associated Clinical Factors. J ASEAN Fed Endocr Soc 2019; 34:197-203. [PMID: 33442156 PMCID: PMC7784119 DOI: 10.15605/jafes.034.02.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 08/02/2019] [Indexed: 12/05/2022] Open
Abstract
Introduction Type 2 diabetes mellitus has been linked to depression. However, this has been largely unrecognized and untreated. There are no current data available in the Philippine setting of the prevalence of the disease. Objective The objective of the study was to determine the prevalence of depression among adult Filipino patients with type 2 diabetes mellitus and investigate the different clinical factors associated with it. Methodology This is a single-center, analytic cross-sectional study conducted at a tertiary hospital, with 476 patients aged above 18 years old diagnosed with type 2 Diabetes Mellitus included. The Physicians Health Questionnaire 9 (PHQ-9) with a score of >5 was used to make a diagnosis of depression. Results Prevalence of depression among patients with type 2 diabetes mellitus was 19.9%. Factors associated with increased odds of depression were having a post-graduate degree (p-value=0.012), presence of retinopathy (p-value=0.018), and higher MMA Score (lower adherence) (p-value=0.000). Conclusion Depression is prevalent among Filipino patients with type 2 diabetes mellitus. An integrated approach by the attending physicians and psychiatrists is required for the effective management of these patients.
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Udedi M, Pence B, Kauye F, Muula AS. The effect of depression management on diabetes and hypertension outcomes in low- and middle-income countries: a systematic review protocol. Syst Rev 2018; 7:223. [PMID: 30518434 PMCID: PMC6280497 DOI: 10.1186/s13643-018-0896-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 11/23/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Depression and non-communicable diseases (NCDs) account for a growing burden on health systems in low- and middle-income countries (LMICs). Depression is generally associated with the outcomes of NCDs and is an important barrier to consistent NCD care management. There is great need to understand the efficacy of interventions to treat depression for people with NCDs, but there is a paucity of evidence of the efficacy of the interventions in LMICs. Therefore, the broad objective of this review is to systematically review the literature on the effectiveness of depression management among patients with diabetes and hypertension to improve outcomes. METHODS This is a systematic review to assess the evidence of the effect of depression management in diabetic and hypertensive patients on diabetes and hypertension outcomes in LMICs. Two independent reviewers will search articles on PubMed, EMBASE, PsycINFO, and Global Index Medicus. Two reviewers will then screen the articles independently based on predefined criteria. We will use standard methods as recommended by the Cochrane Collaboration of assessing quality of evidence and publish our report using the PRISMA guidelines. DISCUSSION The findings from this review will provide evidence to be used in guiding practice and policy on how to integrate depression management in diabetes and hypertension clinics. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017068257.
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Affiliation(s)
- Michael Udedi
- College of Medicine, University of Malawi, P/Bag 360, Chichiri, Blantyre, 3 Malawi
| | - Brian Pence
- Department of Epidemiology, University of North Carolina-Chapel Hill, McGavran-Greenberg, 2103C Campus Box 7435, UNC-Chapel Hill, Chapel Hill, NC 27599-7435 USA
| | - Felix Kauye
- College of Medicine, University of Malawi, P/Bag 360, Chichiri, Blantyre, 3 Malawi
| | - Adamson S. Muula
- College of Medicine, University of Malawi, P/Bag 360, Chichiri, Blantyre, 3 Malawi
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Bai X, Liu Z, Li Z, Yan D. The association between insulin therapy and depression in patients with type 2 diabetes mellitus: a meta-analysis. BMJ Open 2018; 8:e020062. [PMID: 30498035 PMCID: PMC6278799 DOI: 10.1136/bmjopen-2017-020062] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 09/12/2018] [Accepted: 09/25/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Several patients with type 2 diabetes mellitus (T2DM) have depressive disorders. Whether insulin treatment was associated with increased risk of depression remains controversial. We performed a meta-analysis to evaluate the association of insulin therapy and depression. DESIGN A meta-analysis. METHODS We conducted a systematic search of PubMed, PsycINFO, Embase and the Cochrane Library from their inception to April 2016. Epidemiological studies comparing the prevalence of depression between insulin users and non-insulin users were included. A random-effects model was used for meta-analysis. The adjusted and crude data were analysed. RESULTS Twenty-eight studies were included. Of these, 12 studies presented with adjusted ORs. Insulin therapy was significantly associated with increased risk of depression (OR=1.41, 95% CI 1.13 to 1.76, p=0.003). Twenty-four studies provided crude data. Insulin therapy was also associated with an odds for developing depression (OR=1.59, 95% CI 1.41 to 1.80, p<0.001). When comparing insulin therapy with oral antidiabetic drugs, significant association was observed for adjusted (OR=1.42, 95% CI 1.08 to 1.86, p=0.008) and crude (OR=1.61, 95% CI 1.35 to 1.93, p<0.001) data. CONCLUSIONS Our meta-analysis confirmed that patients on insulin therapy were significantly associated with the risk of depressive symptoms.
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Affiliation(s)
- Xiaosu Bai
- Department of Endocrinology, People’s Hospital of Longhua, Shenzhen, China
| | - Zhiming Liu
- Department of Endocrinology, People’s Hospital of Longhua, Shenzhen, China
| | - Zhisen Li
- Department of Endocrinology, People’s Hospital of Longhua, Shenzhen, China
| | - Dewen Yan
- Department of Endocrinology, The Second People’s Hospital of Shenzhen, Shenzhen, China
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Sopjani I, Vehapi S, Gorani D, Imeri M, Vitoja S, Tahiri S. The Relation Between Depressive Symptoms and Self-Care in Patients with Diabetes Mellitus Type 2 in Kosovo. Med Arch 2018; 70:425-428. [PMID: 28210013 PMCID: PMC5292218 DOI: 10.5455/medarh.2016.70.425-428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: The depression is a significant problem in patients with diabetes. This research is the first of it’s kind conducted in the Republic of Kosovo to determine the prevalence of depression diagnosed in people with diabetes mellitus type 2 (DMT2) and interrelation between depressive symptoms and behavior of diabetes self-care (glucose monitoring, exercise, diet, and self- health care). Methods: Research was conducted in the University Clinical Center of Kosovo (UCCK), in Pristine. The sample consisted of 200 individuals. Data collection was done through structured questionnaires. HANDS (Harvard Department of Psychiatry / National Depression Screening Day Scale) questionnaire was used to assess depressive symptoms and DSMQ (The Diabetes Self-Management Questionnaire) was used to assess self-care behavior. Data analysis was run through SSPS program, version 21. Results: The results showed that the prevalence of depression in diabetic patients was 66.5% in Kosovo. Being a woman, a resident of rural areas or with low level of education, there were significant predictors and were associated with increased chance of developing the symptoms of major depression. Significant relations were found between major depression and physical activity (p<0.05). While between major depression and management of blood glucose level, dietary control and self health care, no significant correlation was found. Conclusion: This paper concluded the involvement of psychological aspect in health care plan for diabetics, in order to reduce the number of individuals affected by depression, to diagnose and to treat these individuals for a better quality of life.
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Affiliation(s)
| | | | - Daut Gorani
- Nursing Faculty, AAB College, Pristine, Kosovo
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Strauss SM, Rosedale MT, Rindskopf DM. Predictors of Depression Among Adult Women With Diabetes in the United States: An Analysis Using National Health and Nutrition Examination Survey Data From 2007 to 2012. DIABETES EDUCATOR 2017; 42:728-738. [PMID: 27831524 DOI: 10.1177/0145721716672339] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE The purpose of the study was to identify the sex-specific characteristics that predict depression among adult women with diabetes. METHODS Data from the 2007-2012 National Health and Nutrition Examination Survey in the United States were used to identify the predictors of depression in a large sample of women ages 20 years and older with diabetes (n = 946). RESULTS When extrapolated to almost 9 million women in the United States ≥ 20 years of age with diabetes, 19.0% had depression. Female-specific significant predictors of depression included younger age (< 65 years old), less than high school graduation, self-rated fair or poor health, inactivity due to poor health, and pain that interferes with usual activities. Marital status and diabetes-related factors (years living with diabetes, use of insulin, parent or sibling with diabetes) were not significant predictors of depression in adult women with diabetes. CONCLUSION When educating and counseling women with diabetes, diabetes educators should be aware that some of the predictors of depression in women with diabetes differ from those of populations that include both sexes. Depression screening, although important for all women with diabetes, should especially be performed among women with female-specific depression predictors.
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Affiliation(s)
- Shiela M Strauss
- New York University, Rory Meyers College of Nursing, New York, New York (Dr Strauss, Dr Rosedale)
| | - Mary T Rosedale
- New York University, Rory Meyers College of Nursing, New York, New York (Dr Strauss, Dr Rosedale)
| | - David M Rindskopf
- City University of New York, Graduate School and University Center, New York, New York (Dr Rindskopf)
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Darawad MW, Hammad S, Samarkandi OA, Hamdan-Mansour AM, Khalil AA. Evaluating the Psychometric Properties of the Arabic Version of the Diabetes Distress Scale. J Psychosoc Nurs Ment Health Serv 2017; 55:43-51. [PMID: 28850650 DOI: 10.3928/02793695-20170818-12] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 05/31/2017] [Indexed: 11/20/2022]
Abstract
The current study evaluated the psychometric properties of the Arabic version of the Diabetes Distress Scale (DDS-A) among Arab patients with diabetes mellitus (DM) using a descriptive cross-sectional design. Participants' DDS-A total scores significantly correlated with depressive symptoms (r = 0.288, p = 0.000) as well as two subscales, emotional burden (r = 0.276, p = 0.000) and regimen distress (r = 0.265, p = 0.000). Participants' DDS-A scores had significant negative correlations with income, DM self-management, and knowledge (r = -0.184, p = 0.008; r = -0.310, p = 0.000; r = -0.174, p = 0.003, respectively) and a positive correlation with HbA1c level (r = 0.153, p = 0.018). Factor analysis revealed a four-factor solution that retained all items and explained a variance of 65.59%. Cronbach's alpha was 0.822 for the total scale and 0.778 to 0.881 for the subscales, indicating a high internal consistency. The DDS-A was found to be a psychometrically sound measure to evaluate DM-related distress among Arab patients. [Journal of Psychosocial Nursing and Mental Health Services, 55(9), 43-51.].
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Hall KK, Tambekou J, Penn L, Camara A, Balde NM, Sobngwi E. Association between depression, glycaemic control and the prevalence of diabetic retinopathy in a diabetic population in Cameroon. S Afr J Psychiatr 2017; 23:983. [PMID: 30263178 PMCID: PMC6138139 DOI: 10.4102/sajpsychiatry.v23i0.983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 03/30/2017] [Indexed: 12/03/2022] Open
Abstract
Purpose The prevalence of diabetes mellitus is increasing especially in low- and middle-income countries in which 75% of the world’s diabetic population reside. The macro- and microvascular complications of diabetes such as diabetic retinopathy are also set to increase in these populations. The relationship between depression and glycaemic control has been established in high-income countries, but evidence from low- and middle-income countries is scarce. This research aimed to determine an association between depression and glycaemic control and record the prevalence of diabetic retinopathy in a diabetic population in Cameroon. Methods Analysis of cross-sectional data from the ‘Improving access to HbA1c measurements in sub-Saharan Africa’ study was used. Primary data were collected from six diabetic care facilities in Yaoundé, Cameroon. Participants were aged ≥ 18 years with at least a 6-month history of diabetes. Depression was assessed using the Centre for Epidemiological Studies Depression Scale (CES-D). A CES-D score ≥ 16 was used to identify the presence of clinically significant depressive symptoms. Data on glycaemic control were measured using HbA1c measurements at baseline. The presence of diabetic retinopathy was established through ophthalmoscopy and angiography using the Early Treatment Diabetic Retinopathy Study classification. Results A total of 261 participants were included in the study, and information on depressive symptoms at baseline (CES-D score) were available for 240 participants. The results of the data analysis found that 60% of the study participants had clinically significant depressive symptoms (CES-D > 16). A weak non-significant positive correlation was found between CES-D score and HbA1c level (p = 0.46, r = 0.05) using the Pearson’s correlation co-efficient. Gender and attendance to a patient support group were significantly associated with the presence of clinically significant depressive symptoms. Poor glycaemic control (HbA1c > 7%) was found in 72.8% of the population. Educational level and insulin use were significantly associated with glycaemic control. The prevalence of diabetic retinopathy was 27.2% (23.4% non-proliferative, 2.5% pre-proliferative and 3.2% proliferative), and the prevalence of diabetic maculopathy was 10.0%. Conclusion The study found that a large proportion of diabetic patients may be experiencing depressive symptoms for which they are currently not receiving treatment or support. We also found a large proportion to have poor glycaemic control that is known to worsen the vascular complications of diabetes. In light of the increasing epidemic of type 2 diabetes in sub-Saharan Africa, it is important that the recognition of depressive symptoms becomes integrated into future healthcare policies in the nations of sub-Saharan Africa. This research suggests that individuals experiencing depressive symptoms may be more likely to engage in patient support groups. These groups can be beneficial in providing patients with diabetes valuable information, which could lead to better glycaemic control.
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Affiliation(s)
- Kirsty K Hall
- Institute of Health and Society, Newcastle University, United Kingdom
| | | | - Linda Penn
- Institute of Health and Society, Newcastle University, United Kingdom
| | - Alioune Camara
- Department of Endocrinology, University Hospital, Guinea
| | - Naby M Balde
- Department of Endocrinology, University Hospital, Guinea
| | - Eugene Sobngwi
- Institute of Health and Society, Newcastle University, United Kingdom
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Naskar S, Victor R, Nath K. Depression in diabetes mellitus-A comprehensive systematic review of literature from an Indian perspective. Asian J Psychiatr 2017; 27:85-100. [PMID: 28558904 DOI: 10.1016/j.ajp.2017.02.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 02/18/2017] [Accepted: 02/18/2017] [Indexed: 12/18/2022]
Abstract
UNLABELLED Diabetes and depression are rapidly growing chronic health conditions that have significant negative impact upon the physical, psychological, social and occupational functioning, quality of life and often leads to socio-economic burden. Presence of both these comorbid diseases results in various short term and long term complications and increases the mortality as compared to those with depression or diabetes alone. OBJECTIVES Systematic review of the epidemiological data, risk factors and relationship between depression and glycaemic control among the Indian studies. METHODS We searched Pubmed, Pubmed Central, Google Scholar and Directory of Open Access Journal (DOAJ) databases to identify relevant Indian studies. RESULTS Substantial variation in the prevalence of depression in people with diabetes was found across the 41 selected studies; according to this review the range is 2% to 84% (T1DM - 2-7%; T2DM - 8%-84%). Correlates of depression in diabetic patients are advancing age, female gender, low literacy rate, burden of being from a lower socioeconomic status, rural domicile, marriage and duration of diabetes of >2years, diabetes related complications and poor glycaemic control. Sedentary life without adequate physical activities, lack of self-care are often the factors that precipitates depression in a T2DM patient and vice versa. CONCLUSION According to this review, among Indian population there is a significant association between depression and diabetes.
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Affiliation(s)
- Subrata Naskar
- Department of Neuropsychiatry, Institute of Neurosciences, Kolkata, West Bengal, India.
| | - Robin Victor
- Department of Psychiatry, Silchar Medical College and Hospital, Silchar, Assam, India
| | - Kamal Nath
- Department of Psychiatry, Silchar Medical College and Hospital, Silchar, Assam, India
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AlBekairy A, AbuRuz S, Alsabani B, Alshehri A, Aldebasi T, Alkatheri A, Almodaimegh H. Exploring Factors Associated with Depression and Anxiety among Hospitalized Patients with Type 2 Diabetes Mellitus. Med Princ Pract 2017; 26:547-553. [PMID: 29131123 PMCID: PMC5848470 DOI: 10.1159/000484929] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 11/02/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The aims of the current study were to determine the prevalence and severity of anxiety and depression, and to explore associated factors among hospitalized patients with type 2 diabetes mellitus. SUBJECTS AND METHODS All patients with type 2 diabetes (160 patients) who were admitted to the Internal Medicine Wards of the King Abdulaziz Medical City, Riyadh, Saudi Arabia, from January to August 2015 were asked to participate, and 158 patients agreed to do so. A self-administered questionnaire consisting of 2 parts was used. The first part was on sociodemographic information, and the second part was a validated screening tool for assessing depression and anxiety. The severity of anxiety and depression was classified as normal, mild, moderate, and severe. Logistic regression was carried out to identify variables that were independently associated with anxiety and depression. RESULTS Using the screening tool, 85 (53.8%) and 80 (50.6%) study patients were identified as patients who suffered from depression and anxiety, respectively. The severity of distress was moderate/severe in 36 (42.4%) patients with depression and 41 (51.3%) patients with anxiety. The factors independently associated with the risk for anxiety in hospitalized patients with diabetes were physical inactivity and staying 8 days or longer in the hospital. On the other hand, factors that were independently associated with the risk for depression were older age, low income, and nephropathy. CONCLUSION The majority of hospitalized patients with diabetes developed moderate/severe anxiety or depression, or both, during hospitalization. Hence, screening for anxiety and depression in high-risk hospitalized diabetic patients is recommended during hospitalization.
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Affiliation(s)
- Abdulkareem AlBekairy
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- Pharmaceutical Care Services, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Salah AbuRuz
- College of Pharmacy, Al Ain University of Science and Technology, Al Ain, United Arab Emirates
- College of Pharmacy, University of Jordan, Amman, Jordan
- *Salah AbuRuz, College of Pharmacy, Al Ain University of Science and Technology, Albaladya Street, 124th Street, PO Box 64141, Al Ain (United Arab Emirates), E-Mail
| | - Bandar Alsabani
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Abdulmajeed Alshehri
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Tariq Aldebasi
- Division of Ophthalmology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Abdulmalik Alkatheri
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- Pharmaceutical Care Services, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Hind Almodaimegh
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- Pharmaceutical Care Services, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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Self-Efficacy, Depression, and Self-Care Activities in Adult Jordanians with Type 2 Diabetes: The Role of Illness Perception. Issues Ment Health Nurs 2016; 37:744-755. [PMID: 27484761 DOI: 10.1080/01612840.2016.1208692] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Diabetes mellitus is reaching epidemic levels worldwide. In a developing country like Jordan, type 2 diabetes mellitus (T2DM) has reached a prevalence rate of 17.1%. This cross-sectional study examined the relationship between self-care activities and: illness perception, depression, social support, religiosity and spiritual coping, and self-efficacy among patients with T2DM. A random sample of 220 patients with T2DM, who attended Jordan University Hospital in Jordan were enrolled. The data were collected through a structured interview and the medical files. The instruments consisted of a sociodemographic and clinical standardised questionnaires: Brief Illness Perception Questionnaire, Patients' Health Questionnaire-9; ENRICH Social Support Instrument; Religious and Spiritual Coping Subscale; Diabetes Management Self-Efficacy Scale; and Summary of Diabetes Self-Care Activities. Bivariate analysis investigated the relationship between variables. Structure Equation Modelling (SEM) was performed to test the proposed conceptual model. The study found that approximately 70% of the respondents suffered some form of depressive symptoms. The SEM showed a direct relationship between self-efficacy and self-care activities (β = 0.40; p < 0.001). Depression was indirectly related to self-care activities through self-efficacy (β = -0.20; p = 0.003); nevertheless, it was directly related to perception of: treatment control, consequences, and emotional representations. Overall, the sequence between illness perception and self-efficacy was mediated by depression. Strategies to promote self-efficacy and illness perception are vital in customising a diabetes health plan to meet Arabic cultural expectations.
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Yu S, Yang H, Guo X, Zheng L, Sun Y. Prevalence of Depression among Rural Residents with Diabetes Mellitus: A Cross-Sectional Study from Northeast China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13060542. [PMID: 27240394 PMCID: PMC4923999 DOI: 10.3390/ijerph13060542] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 05/05/2016] [Accepted: 05/10/2016] [Indexed: 11/16/2022]
Abstract
Recent economic development in China has resulted in large increases in psychogenic and metabolic diseases. However, few studies have focused on the mental status of rural residents with diabetes. We aimed to investigate the prevalence of depressive symptoms among patients with diabetes to establish the association between depressive symptoms and socio-demographic and clinical factors. We conducted a cross-sectional analysis of 1187 patients with diabetes aged ≥35 years from rural Northeast China. Metabolic and anthropometric indicators were measured according to standard methods. Depressive symptoms were defined using the Patient Health Questionnaire-9 (PHQ-9). Five hundred and twenty-six residents (44.3%) of the total sample were male and 931 (78.4%) were <65 years old. One hundred and eight residents (8.76%) score ≥10 on the PHQ-9 scale. A statistically significant relationship was found between depressive symptoms and female gender, older age (≥65 years), high school or above education level, moderate physical activity, high family income, multiple additional illnesses, current alcohol consumption, and 7-8 h/d sleep duration. Multivariate analysis showed that female gender [odds ratio (OR) = 1.984, p = 0.028], high family income (OR = 0.483 for 5000-20,000 CNY/year, p = 0.011; OR = 0.356 for >2000 CNY/year, p = 0.003), 7-8 h/d sleep duration (OR = 0.453, p = 0.020), and having multiple additional illness (OR = 3.080, p < 0.001) were significantly associated with depressive symptoms. Prevalence of depressive symptoms in our study was high. Female gender and multiple illnesses were risk factors for depression, while long sleep duration and high family income seem to protect against depression among rural residents with diabetes in China.
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Affiliation(s)
- Shasha Yu
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China.
| | - Hongmei Yang
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China.
| | - Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China.
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Shenjing Hospital of China Medical University, Shenyang 110001, China.
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China.
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Al-Eitan LN, Nassar AM, Saadeh NA, Almomani BA. Evaluation of Glycemic Control, Lifestyle and Clinical Characteristics in Patients with Type 2 Diabetes Treated at King Abdullah University Hospital in Jordan. Can J Diabetes 2016; 40:496-502. [PMID: 27212046 DOI: 10.1016/j.jcjd.2016.04.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 04/08/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The study aimed to assess glycemic control in a Jordanian population with type 2 diabetes and to explore the sociodemographic, clinical and medication-related factors as well as the anthropometric indexes and laboratory values associated with and possibly contributing to unsatisfactory glycemic control. METHODS We included 237 patients previously diagnosed as having type 2 diabetes. Data were collected through direct interviews. Sociodemographic and clinical details were collected using a questionnaire designed for the purpose of the study, anthropometric measurements were obtained at the time of the interviews, and laboratory data were extracted from the medical records of King Abdullah University Hospital. RESULTS Of the participants, 60.8% were found to have unsatisfactory glycemic control (glycated hemoglobin levels ≥7%). Unsatisfactory glycemic control was associated with younger ages at diabetes diagnosis, higher mean weights and higher prevalences of diabetic neuropathy. No relationships were found among glycemic control and body mass index, waist circumference or central obesity. Patients with adequate control were more likely to have health insurance and to have hypothyroidism as a comorbidity. Insulin use and medication plans containing insulin were associated with unsatisfactory control. Patients with unsatisfactory control had higher mean levels of low-density lipoproteins and triglycerides and lower mean levels of high-density lipoproteins. Moreover, elevated triglycerides (≥150 mg/dL) and dyslipidemia were associated with unsatisfactory glycemic control. CONCLUSIONS More than half of the participants had unsatisfactory glycemic control, highlighting the need for a change in the approach and strategies used for patients with diabetes in Jordan. Factors associated with glycemic control that were found in this study should be further studied and used in the prevention and management of diabetes.
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Affiliation(s)
- Laith N Al-Eitan
- Department of Applied Biological Sciences, Jordan University of Science and Technology, Irbid, Jordan; Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, Irbid, Jordan.
| | | | - Nesreen A Saadeh
- Department of Internal Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Basima A Almomani
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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Darawad MW, Mosleh S, Khalil AA, Maharmeh M, Hamdan-Mansour AM, Samarkandi OA. Investigating Physical Exercise among Jordanians with Diabetes Mellitus. Health (London) 2016. [DOI: 10.4236/health.2016.82021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hawamdeh S, Dator WLT, Abunab HY. Prevalence of Depression among Arab Women with Type 2 Diabetes: A Systematic Review and Meta-Analysis. Health (London) 2016. [DOI: 10.4236/health.2016.87068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Albikawi ZF, Petro-Nustas W, Abuadas M. Self-care Management Intervention to Improve Psychological Wellbeing for Jordanian Patients with Type Two Diabetes Mellitus. Issues Ment Health Nurs 2016; 37:190-201. [PMID: 26962749 DOI: 10.3109/01612840.2015.1122118] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of the study is to evaluate the effectiveness of self-care management intervention on psychological wellbeing for Jordanian patients with type two diabetes mellitus. A quasi-experimental design was used. The study was conducted in a diabetes clinic of a specialized diabetes center in Amman. One hundred and forty-nine participants completed the three-month post-treatment assessments (76 in the intervention group and 73 in the control group). Both the control and intervention groups received a standard diabetic educational program. The intervention group received the following additional interventions: (1) Diabetes Self-care Management booklet, (2)DVD viewing, (3) counseling rehearsal session, and (4) a telephone follow-up. The main study instrument was an Arabic version 20 of the depression anxiety stress scales: To assess the group differences of dependent variable changes, repeated measure ANOVA was used. It was found that psychological wellbeing was not significant at 2-week post-intervention and significant change was observed at 3-month post-intervention. The findings from this study can guide the health providers to be trained to provide relevant diabetic interventions into their nursing interventions, education, and research.
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Affiliation(s)
- Zainab Fatehi Albikawi
- a Al-Gad International Colleges for Applied Medical Sciences, Nursing Faculty , Tabuk , Kingdom of Saudia Arabia
| | | | - Mohammad Abuadas
- a Al-Gad International Colleges for Applied Medical Sciences, Nursing Faculty , Tabuk , Kingdom of Saudia Arabia
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Crispín-Trebejo B, Robles-Cuadros MC, Bernabé-Ortiz A. Association between depression and glycemic control among type 2 diabetes patients in Lima, Peru. Asia Pac Psychiatry 2015; 7:419-26. [PMID: 26037488 PMCID: PMC4979668 DOI: 10.1111/appy.12190] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 04/22/2015] [Indexed: 12/21/2022]
Abstract
INTRODUCTION There is limited and controversial information regarding the potential impact of depression on glycemic control. This study aims to evaluate the association between depression and poor glycemic control. In addition, the prevalence of depression and rates of poor glycemic control were determined. METHODS Cross-sectional study performed in the endocrinology unit of two hospitals of ESSALUD in Peru. The outcome of interest was poor glycemic control, evaluated by glycated hemoglobin (HbA1c: <7% versus ≥7%), whereas the exposure of interest was depression defined as 15 or more points in the Patient Health Questionnaire-9 tool. The association of interest was evaluated using Poisson regression models with robust standard errors reporting prevalence ratios (PR) and 95% confidence intervals (95% CI) adjusting for potential confounders. RESULTS A total of 277 participants, 184 (66.4%) males, mean age 59.0 (SD: 4.8), and 7.1 (SD: 6.8) years of disease were analyzed. Only 31 participants (11.2%; 95% CI: 7.5%-14.9%) had moderately severe or severe depression, whereas 70 (25.3%; 95% CI 20.3%-30.8%) had good glycemic control. Depression increased the probability of having poor glycemic control (PR=1.32; 95% CI 1.15-1.51) after adjusting for several potential confounders. CONCLUSIONS There is an association between depression and poor glycemic control among type 2 diabetes patients. Our results suggest that early detection of depression might be important to facilitate appropriate glycemic control and avoid further metabolic complications.
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Affiliation(s)
| | | | - Antonio Bernabé-Ortiz
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú,CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Perú
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Kim TH, Choi JY, Lee HH, Park Y. Associations between Dietary Pattern and Depression in Korean Adolescent Girls. J Pediatr Adolesc Gynecol 2015; 28:533-7. [PMID: 26324576 DOI: 10.1016/j.jpag.2015.04.005] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 04/05/2015] [Accepted: 04/07/2015] [Indexed: 12/21/2022]
Abstract
STUDY OBJECTIVE Dietary patterns are important for the physical and psychological development of adolescent girls. The purpose of the present study was to evaluate the relationship between dietary patterns and depression in this population. DESIGN, SETTING, AND POPULATION We conducted a case-control study in a tertiary university hospital of 849 girls aged 12 to 18 years. METHODS The study was conducted from April 2011 to December 2012. Participants were identified as having depression if they had scores greater than 16 on the Korean version of the Beck Depression Inventory. Data were obtained using validated Korean-language questionnaires. MAIN OUTCOME MEASURES The subjects' usual dietary patterns during the past 12 months were assessed using the Food Frequency Questionnaire published by the Korean Health and Nutrition Examination Survey. RESULTS Among the 849 enrolled volunteers, 116 were identified as having depressive symptoms. The mean age of the participants was 15.0 ± 1.5 years. The prevalence of girls diagnosed with depression was 13.6%. Multivariate adjusted regression analysis demonstrated that the risk of depression was significantly positively associated with the consumption of instant and processed foods and negatively associated with the intake of green vegetables and 1 to 3 servings/day of fruits, after adjusting for energy intake and menstrual regularity. Additionally, depression was negatively associated with intake of fiber, β-carotene, vitamin B6, vitamin E, vitamin C, potassium, zinc, folate, iron, and copper after adjusting for confounding variables. CONCLUSION Consumption of fast foods including ramen noodles, hamburger, pizza, fried food, and other processed foods was associated with increased risk of depression in adolescent girls. Thus, caution is required regarding dietary choices in this population.
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Affiliation(s)
- Tae-Hee Kim
- Department of Obstetrics and Gynecology, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - Ji-young Choi
- Department of Food and Nutrition, Hanyang University College of Human Ecology, Seoul, Republic of Korea
| | - Hae-Hyeog Lee
- Department of Obstetrics and Gynecology, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea.
| | - Yongsoon Park
- Department of Food and Nutrition, Hanyang University College of Human Ecology, Seoul, Republic of Korea
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Park CY, Kim SY, Gil JW, Park MH, Park JH, Kim Y. Depression among Korean Adults with Type 2 Diabetes Mellitus: Ansan-Community-Based Epidemiological Study. Osong Public Health Res Perspect 2015; 6:224-32. [PMID: 26473089 PMCID: PMC4588455 DOI: 10.1016/j.phrp.2015.05.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 04/20/2015] [Accepted: 05/20/2015] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES There are an increasing number of studies being carried out on depression in patients with diabetes. Individuals with diabetes have been reported as having a higher prevalence of depression compared to those without diabetes. However, only a few studies involving Korean patients have been conducted. The aims of this study were to examine the prevalence of depression and to find various risk factors according to the degree of depression among Korean patients with Type 2 diabetes mellitus (T2DM). METHODS An Ansan-community-based epidemiological study was conducted from 2005 to 2012. The total number of participants in this study was 3,540, from which patients with diabetes (n = 753) have been selected. The presence of depression was evaluated using the Beck Depression Inventory total score. RESULTS The prevalence of depression was 28.8%. The mean age of participants was 55.5 ± 8.2 years. We divided the participants into three groups (without-depression, moderate-depression, and severe-depression groups) to examine the depression prevalence among Korean T2DM patients. The unemployed participants had 2.40 [95% confidence interval (CI) 1.21-4.76], the low-income participants had 2.57 (95% CI 1.52-4.35), the participants using an oral diabetes medicine or insulin had 2.03 (95% CI 1.25-3.32), the participants who are currently smoking had 2.03 (95% CI 1.10-3.73), and those without regular exercise had 1.91 (95% CI 1.17-3.14) times higher odds of depression in the severe-depression group, compared with the without-depression group. CONCLUSION There was a significant association between depression prevalence and diabetes, and we found various risk factors according to the degree of depression in Korean patients with T2DM.
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Affiliation(s)
- Chan Young Park
- Course of convergence in Health and Biomedicine Program in Health Policy, College of Medicine, Chungbuk National University, Cheongju, Korea ; Division of Genome and Epidemiology, Center for Genome Science, Korea National Institute of Health, Cheongju, Korea
| | - So Young Kim
- Course of convergence in Health and Biomedicine Program in Health Policy, College of Medicine, Chungbuk National University, Cheongju, Korea ; Regional Cardiocerebrovascular Center, Chungbuk National University Hospital, Cheongju, Korea
| | - Jong Won Gil
- Course of convergence in Health and Biomedicine Program in Health Policy, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Min Hee Park
- Department of Medicine Graduate School, Chungbuk National University, Cheongju, Korea
| | - Jong-Hyock Park
- Course of convergence in Health and Biomedicine Program in Health Policy, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Yeonjung Kim
- Regional Cardiocerebrovascular Center, Chungbuk National University Hospital, Cheongju, Korea
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Al-Amer R, Ramjan L, Glew P, Salamonson Y. Diagnosis of Type 2 Diabetes: The Experience of Jordanian Patients with Co-existing Depression. Issues Ment Health Nurs 2015; 36:231-8. [PMID: 25897571 DOI: 10.3109/01612840.2014.960627] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In Jordan, Type 2 diabetes mellitus (T2DM) is becoming a significant health problem, and a high concomitant rate of depression among this population complicates the situation. This qualitative study explored and described the emotional reactions of Jordanian patients with co-existing depression, on diagnosis of T2DM. Data were collected using semi-structured qualitative interviews from 15 patients with T2DM and depression in 2013. Interviews were audiotaped, translated and then analysed using thematic analysis. A major theme-'Initial reactions to the diagnosis'-emerged with four accompanying sub-themes (Devastation, Mixed Emotions, Denial and Acceptance). Although the majority of participants expressed negative emotional reactions on first diagnosis, a strong religious conviction allowed for acceptance of the diagnosis. Overall, the study findings support that in Arabic countries, spirituality and faith played a key role in promoting acceptance of concomitant comorbidities, and will often be useful in enhancing positive coping strategies among patients with T2DM and depression.
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Affiliation(s)
- Rasmieh Al-Amer
- School of Nursing and Midwifery, University of Western Sydney , Penrith, NSW , Australia
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49
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Shivashankar R, Kirk K, Kim WC, Rouse C, Tandon N, Narayan KMV, Ali MK. Quality of diabetes care in low- and middle-income Asian and Middle Eastern countries (1993-2012): 20-year systematic review. Diabetes Res Clin Pract 2015; 107:203-23. [PMID: 25529849 DOI: 10.1016/j.diabres.2014.11.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 10/07/2014] [Accepted: 11/23/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To assess the extent to which people with diabetes in low- and middle-income countries (LMIC) of Asia and the Middle East met evidence-based care recommendations through a systematic review of published literature. METHODS Electronic searches of Medline and Embase were carried out for studies assessing quality of care among people with diabetes in Asia and the Middle East between 1993 and 2012. Benchmarking against American Diabetes Association guidelines, we reported level and proportions meeting recommended risk factor control (glycated hemoglobin [HbA1c], blood pressure, and low density lipoprotein-cholesterol [LDL]) and preventive care processes across different settings. RESULTS One hundred and fifteen publications met eligibility for inclusion (91 reported risk factor control, 7 reported preventive processes, and 17 reported both). Only China, Thailand, Malaysia and Philippines had nationally representative data. Mean HbA1c (6.5-11% or 48-97 mmol/mol), SBP (120-152 mm Hg), and LDL (2.4-3.8 mmol/l) varied greatly. Despite variation in availability of data, studies consistently showed that recommended care goals were not being achieved. CONCLUSIONS The practice of auditing and benchmarking against evidence-based guidelines appears to be uncommon in Asia and the Middle East and there was heterogeneity of reporting across studies, populations, and methods used. The available data showed inadequate care.
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Affiliation(s)
- Roopa Shivashankar
- Centre for Chronic Disease Control, New Delhi, India; Public Health Foundation of India, New Delhi, India.
| | - Katy Kirk
- Brody School of Medicine at East Carolina University, Greenville, NC, USA
| | - Woon Cho Kim
- Emory University School of Medicine, Atlanta, GA, USA
| | - Chaturia Rouse
- Center for Disease Control and Prevention, Atlanta, GA, USA
| | - Nikhil Tandon
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Mahammed K Ali
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
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50
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Joshi S, Dhungana RR, Subba UK. Illness Perception and Depressive Symptoms among Persons with Type 2 Diabetes Mellitus: An Analytical Cross-Sectional Study in Clinical Settings in Nepal. J Diabetes Res 2015; 2015:908374. [PMID: 26236749 PMCID: PMC4508465 DOI: 10.1155/2015/908374] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 05/25/2015] [Accepted: 06/21/2015] [Indexed: 01/04/2023] Open
Abstract
Background. This study aimed to assess the relationship between illness perception and depressive symptoms among persons with diabetes. Method. This was an analytical cross-sectional study conducted among 379 type 2 diabetic patients from three major clinical settings of Kathmandu, Nepal. Results. The prevalence of depressive symptoms was 44.1% (95% CI: 39.1, 49.1). Females (p < 0.01), homemakers (p < 0.01), 61-70 age group (p = 0.01), those without formal education (p < 0.01), and people with lower social status (p < 0.01) had significantly higher proportion of depressive symptoms than the others. Multivariable analysis identified age (β = 0.036, p = 0.016), mode of treatment (β = 0.9, p = 0.047), no formal educational level (β = 1.959, p = 0.01), emotional representation (β = 0.214, p < 0.001), identity (β = 0.196, p < 0.001), illness coherence (β = -0.109, p = 0.007), and consequences (β = 0.093, p = 0.049) as significant predictors of depressive symptoms. Conclusion. Our study demonstrated a strong relationship between illness perception and depressive symptoms among diabetic patients. Study finding indicated that persons living with diabetes in Nepal need comprehensive diabetes education program for changing poor illness perception, which ultimately helps to prevent development of depressive symptoms.
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Affiliation(s)
- Suira Joshi
- Ministry of Health and Population, Nepal
- *Suira Joshi:
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