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Jafari A, Moshki M, Naddafi F, Ghelichi-Ghojogh M, Armanmehr V, Kazemi K, Nejatian M. Depression literacy, mental health literacy, and their relationship with psychological status and quality of life in patients with type 2 diabetes mellitus. Front Public Health 2024; 12:1421053. [PMID: 39056082 PMCID: PMC11269263 DOI: 10.3389/fpubh.2024.1421053] [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: 04/21/2024] [Accepted: 06/24/2024] [Indexed: 07/28/2024] Open
Abstract
Background This study was conducted to measure depression literacy (D-Lit) and mental health literacy (MHL) and to investigate their relationship with psychological status and quality of life among Iranian patients with type 2 diabetes mellitus (T2DM). Methods This cross-sectional study was conducted in 2021 among 400 patients with T2DM in Iran. Samples were selected using proportional stratified sampling. Data collection tools comprised a demographic questionnaire, measures of MHL and D-Lit, the diabetes quality of life (DQOL) scale, and the DASS-21. After confirming the normality of the data using the Kolmogorov-Smirnov test, parametric statistical tests (such as one-way ANOVA, independent samples t-test, and Chi-Square) were used to investigate the relationship between the variables using SPSS v22 software. The results of continuous quantitative data are reported in the form of means and standard deviations, and qualitative data are reported in the form of absolute and relative frequencies. Results In this study, 10.25% of the participants (n = 41) had severe depression, while 36.75% (n = 147) experienced severe anxiety. The mean (standard deviation) of MHL was 80.92 (9.16) from 130 points. Of the participants, only 1.7% (n = 7) did not answer any questions correctly on the D-lit scale, and only 5.8% (n = 23) were able to answer 15 questions or more correctly on the D-lit. MHL had a significant negative correlation with depression (r = -0.236), anxiety (r = -0.243), and stress (r = -0.155) (P < 0.001). There was a positive and significant correlation between MHL and D-Lit (r = 0.186) (P < 0.001). D-Lit had a significant negative correlation with depression (r = -0.192), anxiety (r = -0.238), and stress (r = -0.156) (P < 0.001). There was a positive and significant correlation between the ability to recognize disorders (r = 0.163), knowledge of self-treatment (r = 0.154), and DQOL (P < 0.001). Depression (r = -0.251), anxiety (r = -0.257), and stress (r = -0.203) had a significant negative correlation with DQOL (P < 0.001). Conclusion MHL and D-Lit levels were found to be inadequate in patients with T2DM. These low levels of MHL and D-Lit among patients with T2DM were associated with higher levels of anxiety, depression, and stress, as well as a lower quality of life. Therefore, designing and implementing preventive programs to improve the mental health of patients with T2DM can help prevent mental disorders and ultimately improve their quality of life.
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Affiliation(s)
- Alireza Jafari
- Department of Health Education and Health Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mahdi Moshki
- Department of Health Education and Health Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Fatemehzahra Naddafi
- Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mousa Ghelichi-Ghojogh
- Neonatal and Children's Research Center, Department of Biostatistics and Epidemiology, School of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Vajihe Armanmehr
- Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Kimia Kazemi
- Department of Clinical Psychology, Islamic Azad University, Birjand, Iran
| | - Mahbobeh Nejatian
- Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
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Lekha PPS, Azeez EPA. Psychosocial Facilitators and Barriers to Type 2 Diabetes Management in Adults: A Meta-Synthesis. Curr Diabetes Rev 2024; 20:110-123. [PMID: 38310483 DOI: 10.2174/0115733998283436231207093250] [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: 10/04/2023] [Revised: 11/10/2023] [Accepted: 11/29/2023] [Indexed: 02/05/2024]
Abstract
BACKGROUND Globally, the cases of type 2 diabetes are increasing, and this is largely attributed to lifestyle changes. Though diabetes is primarily a metabolic disease determined by biological factors, psychosocial aspects play a crucial role in its progression and management. However, the literature on psychosocial dimensions of diabetes management is minuscule and scattered. OBJECTIVE This synthesis sought to understand the psychosocial facilitators and barriers to type 2 diabetes management and coping among adults. METHODS We have adopted a meta-synthesis to review available qualitative studies using Pub- Med and Scopus databases. Based on inclusion criteria, we have chosen 24 studies published between 2010 and 2023. We have considered studies across countries, among which 63% of the studies included were from Western countries, and most have employed qualitative descriptive design. The selected studies were analyzed thematically using a deductive framework. RESULTS Six themes emerged as the psychosocial barriers and facilitators of managing and coping with type 2 diabetes: 1) cognitive-emotional factors, 2) faith, 3) constraints to behavioural change, 4) social constraints and support, 5) healthcare provider-patient relationship, and 6) awareness. Further, a conceptual framework was developed from the synthesis. CONCLUSION The patients' experiences evident from this synthesis signify the crucial role of psychosocial factors in diabetes management and coping. This evidence emphasizes the need for integrated care so that psychosocial aspects are addressed by healthcare providers and behavioural health professionals, which may lead to the promotion of facilitators and the minimization of barriers.
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Affiliation(s)
- P Padma Sri Lekha
- School of Social Sciences and Languages, Vellore Institute of Technology, Vellore, India
| | - E P Abdul Azeez
- School of Social Sciences and Languages, Vellore Institute of Technology, Vellore, India
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Cengiz D, Korkmaz F. Effectiveness of a nurse-led personalized patient engagement program to promote type 2 diabetes self-management: A randomized controlled trial. Nurs Health Sci 2023; 25:571-584. [PMID: 37670722 DOI: 10.1111/nhs.13048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 07/29/2023] [Accepted: 08/19/2023] [Indexed: 09/07/2023]
Abstract
PHEinAction® is a theory-based nurse-led patient engagement intervention developed among an Italian older adult population with various chronic diseases to facilitate cognitive, emotional, and behavioral processes in promoting individuals' active roles. This study aims to adapt and evaluate the effectiveness of PHEinAction® on diabetes self-management (DSM) among Turkish type 2 diabetes mellitus patients. First, the generic content of the intervention was customized for diabetes management and adapted for the Turkish population, including back-forward translation and expert panel evaluation; then, a randomized controlled trial was conducted with 51 adult diabetes patients randomly assigned to intervention or the control group receiving the usual care. The intervention consisted of two in-person sessions of 4-week intervals, a telephone consultation, and home-based written exercises, which involved personalized care activities addressing individuals' engagement levels and covering the cognitive, emotional, and behavioral aspects. The scores for treatment adherence, self-efficacy, and patient engagement had significantly improved with a large size effect in the intervention group at the fourth-week follow-up compared with the control group. Findings suggest that the nurse-led personalized patient engagement program could effectively promote DSM.
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Affiliation(s)
- Dilara Cengiz
- Department of Fundamentals of Nursing, Hacettepe University Faculty of Nursing, Ankara, Turkey
| | - Fatoş Korkmaz
- Department of Fundamentals of Nursing, Hacettepe University Faculty of Nursing, Ankara, Turkey
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Yorikawa F, Ishikawa J, Tamura Y, Murao Y, Toba A, Harada K, Araki A. Determinants of depressive symptoms in older outpatients with cardiometabolic diseases in a Japanese frailty clinic: Importance of bidirectional association between depression and frailty. PLoS One 2023; 18:e0281465. [PMID: 36780484 PMCID: PMC9925076 DOI: 10.1371/journal.pone.0281465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 01/24/2023] [Indexed: 02/15/2023] Open
Abstract
INTRODUCTION Frailty and depression may play important roles in the management of older patients with cardiometabolic diseases. We explored the determinants of depressive symptoms and their association with frailty among patients with cardiometabolic diseases (hypertension, diabetes, and atrial fibrillation) in a cross-sectional study. METHODS A total of 633 outpatients aged 65 years or older with cardiometabolic disease and suspected symptoms of frailty participated in this study. Depressive symptoms, physical activity, and social network were assessed using the Geriatric Depression Scale (GDS)-15, International Physical Activity Questionnaire, and Lubben Social Network Scale-6 (LSNS-6), respectively. Frailty was evaluated using the Kihon Checklist (KCL) based on the Comprehensive Geriatric Assessment (CGA), the modified Cardiovascular Health Study (mCHS), and the Clinical Frailty Scale (CFS). Binomial logistic regression analysis was used to examine the determinants of depressive symptoms and their association with frailty. RESULTS Depressive symptoms with GDS-15 scores ≥ 5 were present in 43.6% of the patients. In logistic regression, after adjusting for covariates, the determinants of depressive symptoms in all patients were lack of social network, low years of education, and frailty. In contrast, in logistic regression with frailty as the dependent variable, depressive symptoms were independently associated KCL-defined frailty (OR = 6.28, 95% CI: 4.13-9.55) and mCHS-defined frailty (OR = 2.66, 95% CI: 1.70-4.17), but not with CFS. Similarly, significant associations between depression and frailty were observed in patients with hypertension, diabetes, or atrial fibrillation. CONCLUSIONS Lack of social networks, low education, and frailty based on the KCL and mCHS were important determinants of depressive symptoms in all patients. The relatively strong associations between depressive symptoms and frailty based on CGA in patients with hypertension, diabetes, or atrial fibrillation suggest that the assessment of depressive symptoms is of great importance in clinical practice in those patients at high risk of frailty.
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Affiliation(s)
- Fumino Yorikawa
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Center for Comprehensive Care and Research for Prefrailty, Tokyo, Japan
| | - Joji Ishikawa
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Center for Comprehensive Care and Research for Prefrailty, Tokyo, Japan
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
- * E-mail:
| | - Yoshiaki Tamura
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Center for Comprehensive Care and Research for Prefrailty, Tokyo, Japan
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Yuji Murao
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Center for Comprehensive Care and Research for Prefrailty, Tokyo, Japan
| | - Ayumi Toba
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Kazumasa Harada
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Atsushi Araki
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Center for Comprehensive Care and Research for Prefrailty, Tokyo, Japan
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
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Nguyen VB, Thi KHP, Nguyen TX, Pham NTL, Nguyen VVH, Van Le C. Diabetes self-management and its associated factors among patients with diabetes in central Vietnam: A cross-sectional study. PLoS One 2022; 17:e0270901. [PMID: 35802719 PMCID: PMC9269929 DOI: 10.1371/journal.pone.0270901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/19/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Diabetes self-management (DSM) enables maintenance of optimal individualized glycemic control for patients with diabetes through comprehensive lifestyle, medication adherence, and self-monitoring glucose level. This study aimed to evaluate DSM and to find associated factors among Vietnamese diabetes patients by using the Vietnamese version of Diabetes Self-Management Instrument (DSMI). Methods A cross-sectional study was conducted at a single hospital in the central Vietnam. DSM was assessed using the DSMI. The participant’s socio-demographic and clinical features were obtained through face-to-face interviews and medical records. Multivariate linear regression was used to determine independent factors associated with total DSMI. Results The mean total DSM score based on DSMI self-administered questionnaire scores was 88.4 ± 22.1, with a range of 47 to 140. The mean self-integration, self-regulation, interaction with health professionals, self-monitoring blood glucose, and adherence to the prescribed regime were 24.8, 22.3, 21.6, 10.2, and 9.5, respectively. 48.1% of DM patients had good HbA1c control. Sex, educational status, BMI, waist circumference, medical nutrition therapy, and sufficient physical activities were factors independently predictive of DSMI total score. Conclusion This study emphasizes that the DSM situation is seen to be average among DM patients with mean DSMI score 88.4 ± 22.1 and sex, educational status, BMI, waist circumference, medical nutrition therapy, and sufficient physical activities were independently predictive factors of DSMI total score. This evidence suggests that there is a need to enhance the effectiveness of DSM education programs among diabetic patients.
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Affiliation(s)
- Van Bang Nguyen
- Center of Endocrinology and Diabetes, Family Hospital, Da Nang, Vietnam
| | | | - Thi Xuan Nguyen
- Center of Endocrinology and Diabetes, Family Hospital, Da Nang, Vietnam
| | | | - Van Vy Hau Nguyen
- Center of Endocrinology and Diabetes, Family Hospital, Da Nang, Vietnam
| | - Chi Van Le
- Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
- * E-mail:
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Abstract
Background Self-management is one of the vital elements in diabetes management for adults with Type 2 diabetes mellitus (T2DM). Although the number of people with T2DM in Indonesia has risen, clinical understanding of the problems related to practicing diabetes self-management (DSM) is limited because of the lack of a valid measurement instrument. The 35-item Diabetes Self-Management Instrument (DSMI-35) is one instrument widely used in research to assess DSM-related behavior among patients with diabetes. Purpose This study was designed to translate the psychometric properties of the Indonesian version of the DSMI-35 and evaluate the efficacy of this instrument in a sample of Indonesian adults with T2DM. Methods Forward and backward translation processes were used to translate the DSMI-35 into Indonesian (IDN-DSMI). Then, the translation equivalence, content validity, face validity, construct validity, and internal consistency were assessed using a sample of 222 Indonesian adults with T2DM from eight public health centers. Confirmatory factor analysis was used to test the data. Results The confirmatory factor analysis confirmed that the 35 items all had acceptable goodness of fit. Although the analysis supported removing several of the items, removal of these items was not theoretically justified. The average variance extracted was acceptable, and composite reliability was satisfied. The Cronbach's alpha was .96 for the IDN-DSMI and .84–.93 for the subscales. The significant interitem correlations between some items were consistent with the findings of other previous studies. Conclusions/Implications for Practice The IDN-DSMI is a valid and reliable instrument that may be used to measure DSM behavior in Indonesian patients with T2DM in primary healthcare settings.
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