Type 2 diabetes: perceptions of quality of life and attitudes towards diabetes from a gender perspective

Vitality, mental health and role-physical mediate the influence of coping on depressive symptoms and self-efficacy in patients with non-alcoholic fatty liver disease: A cross-sectional study

OBJECTIVE

Our aim was to determine whether the association between active coping and depressive symptoms in patients with non-alcoholic fatty liver disease (NAFLD) was mediated by vitality, and whether diabetes and obesity could impact on this relationship. We also wanted to find out whether mental health and role-physical modulated the relationship between passive/avoidance coping and self-efficacy, and the role of liver fibrosis.

METHODS

Depressive symptoms (BDI-II), self-efficacy (GSE), coping (COPE-28) and quality of life (SF-12) were evaluated in 509 biopsy-proven NAFLD patients in this cross-sectional study. Mediation and moderated mediation models were conducted using the SPSS PROCESS v3.5 macro.

RESULTS

Vitality mediated the relationship between active coping and depressive symptoms (-2.254, CI = -2.792 to -1.765), with diabetes (-0.043, p = 0.017) and body mass index (BMI) (-0.005, p = 0.009) moderating the association. In addition, mental health (-6.435, CI = -8.399 to -4.542) and role-physical (-1.137, CI = -2.141 to -0.315) mediated the relationship between passive/avoidance coping and self-efficacy, with fibrosis stage (0.367, p < 0.001) moderating this association. Specifically, the presence of diabetes and significant fibrosis, and a higher BMI, were associated with greater negative impact on participant depressive symptoms or self-efficacy.

CONCLUSION

A maladaptive coping style was associated with poorer vitality, mental health and role-physical in NAFLD patients, which along with the presence of metabolic comorbidity (diabetes and obesity) and significant fibrosis predicted more depressive symptoms or poorer self-efficacy in these patients. These results suggested incorporating emotional and cognitive evaluation and treatment in patients with NAFLD.

International feasibility study for the Women's Wellness with Type 2 Diabetes Programme (WWDP): An eHealth enabled 12-week intervention programme for midlife women with type 2 diabetes

AIMS

The current study aimed to examine feasibility of participant recruitment and retention rates for the Women's Wellness with Type 2 Diabetes program (WWDP), and to assess initial efficacy of the program in improving wellbeing outcomes.

METHODS

70 midlife women with type 2 diabetes mellitus (T2DM) participated in a 12-week wellness-focused intervention, the WWDP. The WWDP involved a structured book (with participatory activities), an interactive website and nurse consultations. This study had an Australian and a UK arm. Analyses were conducted using chi-square, McNemar, paired t-test, and Wilcoxon signed-ranks tests.

RESULTS

The attrition rate for the sample was 22.2%. Overall, significant improvement was observed in diabetes distress (DD), diabetes self-efficacy, weight, BMI, menopausal symptoms and sleep symptoms from baseline to program completion at 12 weeks. Australian participants were also more likely to meet fruit recommendation guidelines and had significant waist- and hip-circumference reductions.

CONCLUSIONS

Good retention rates and initial efficacy findings indicated feasibility of the WWDP as a promising 12-week health and wellness program for women with T2DM. They also suggest incorporating a focus on self-efficacy and gendered information may be important in improving wellness and health outcomes related to distress and menopause.

Life satisfaction and other determinants of eating behaviours among women aged 40-65 years with type 2 diabetes from the Krakow population

Introduction

A rational dietary model is one of the key aspects in the treatment of type 2 diabetes.

Aim of the study

The study aimed to analyse the frequency of consuming selected groups of food products among women aged 40-65 years with type 2 diabetes, depending on age, BMI, duration of disease, and level of life satisfaction.

Material and methods

The study was carried out among 276 women using the author’s specially designed questionnaire (metric data, duration of diabetes) and the Satisfaction with Life Scale (SWLS). We assessed BMI values on the basis of measurements of somatic indicators (body mass and height). Statistical analysis was performed using Pearson’s r and Spearman’s R correlation coefficients via the SPSS programme (significance level of α = 0.05).

Results

Among the women with type 2 diabetes we observed nutritional deficiencies, in particular a low frequency of consuming the recommended product groups (vegetables, fruit, legume seeds, whole-grain cereals, dairy products with reduced fat content, and nuts). The scale of rational dietary choices among women increased along with age and perceived life satisfaction. As the time from diagnosis passed, this scale decreased. A decrease was also noted along with the increase in BMI.

Conclusions

The frequency of consuming some product groups shows a significant relationship with age, BMI, duration of disease, and the level of life satisfaction among women aged 40-65 years with type 2 diabetes.

General health status in Iranian diabetic patients assessed by short-form-36 questionnaire: a systematic review and meta-analysis

BACKGROUND

Diabetes mellitus is one of the most prevalent diseases worldwide. Diabetes is a chronic disease associated with micro- and macro-vascular complications and deterioration in general health status. Therefore, the aim of this study was to estimate general health status among Iranian diabetic patients through a systematic review and meta-analysis of study utilizing the Short-Form-36 questionnaire.

METHODS

Searching the EMBASE, PubMed, ISI/Web of Sciences (WOS), MEDLINE via Ovid, PsycoINFO, as well as Iranian databases (MagIran, Iranmedex, and SID) from January 2000 to December 2017. The methodological quality of the studies was evaluated using the "A Cochrane Risk of Bias Assessment Tool: for Non-Randomized Studies of Interventions" (ACROBAT-NRSI). Random-effect model was used and the means were reported with their 95% confidence interval (CI). To evaluate the heterogeneity between studies, I² test was used. Egger's regression test was used to assess the publication bias.

RESULTS

Fourteen studies were retained in the final analysis. The mean general health status using SF-36 in diabetic patients of Iran was 51.9 (95% CI: 48.64 to 53.54). The mean physical component summary was 52.92 [95% CI: 49.46-56.38], while the mean mental component summary was 51.02 [95% CI: 46.87-55.16].

CONCLUSION

The findings of this study showed that general health status in Iranian diabetic patients is low. Health policymakers should work to improve the health status in these patients and take appropriate interventions.

Sex-related illness perception and self-management of a Thai type 2 diabetes population: a cross-sectional descriptive design

BACKGROUND

Increased knowledge concerning the differences in the illness perception and self-management among sexes is needed for planning proper support programs for patients with diabetes. The aim of this study was to investigate the illness perception and self-management among Thai women and Thai men with type 2 diabetes and to investigate the psychometric properties of the translated instruments used.

METHODS

In a suburban province of Thailand, 220 women and men with type 2 diabetes participated in a cross-sectional descriptive study. The participants were selected using a multistage sampling method. Data were collected through structured interviews and were analyzed using group comparisons, and psychometric properties were tested.

RESULTS

Women and men with type 2 diabetes demonstrated very similar experiences regarding their illness perception and no differences in self-management. Women perceived more negative consequences of the disease and more fluctuation in the symptoms than men, whereas men felt more confident about the treatment effectiveness than women. Furthermore, the translated instruments used in this study showed acceptable validity and reliability.

CONCLUSIONS

The Thai sociocultural context may influence people's perceptions and affect the self-care activities of Thai individuals, both women and men, with type 2 diabetes, causing differences from those found in the Western environment. Intervention programs that aim to improve the effectiveness of the self-management of Thai people with diabetes might consider a holistic and sex-related approach as well as incorporating Buddhist beliefs.

The Effect of Yoga and Peer Support Interventions on the Quality of Life of Women with Diabetes: Results of a Randomized Controlled Trial

OBJECTIVE

This was an interventional study to understand the effect of two low-cost interventions; yoga and peer support on the quality of life (QOL) of women with type 2 diabetes.

METHODOLOGY

An open label parallel three-armed randomized control trial was conducted among 124 recruited women with diabetes for 3 months. Block randomization with a block length of six was carried out. In the yoga arm, sessions by an instructor, consisting of a group of postures coordinated with breathing were conducted for an hour, 2 days a week. In the peer support arm, each peer mentor after training visited 13-14 women with diabetes every week followed by a phone call. The meeting was about applying disease management plans in daily life. At the beginning and end of the study, QOL was assessed by the translated, validated World Health Organization QOL-BREF in four domains physical, psychological, social, and environmental domains.

RESULTS

The majority (96%) of the study participants perceived the peer support and yoga intervention to be beneficial. Paired t-test revealed significant increases in the social and environmental domain in the peer group and in the environmental domain in the yoga group, though this disappeared in the between-group comparison perhaps due to poor glycemic control (hemoglobin A1c varied from 9.4 to 9.6) and the short duration of 3 months of the study.

CONCLUSION

Peer support and yoga improved perceptions of QOL though its impact on scores was not significant due to a short period of study among women with poor glycemic control.

Health Related Quality of Life among Omani Men and Women with Type 2 Diabetes

The aim of this study was to explore predictors of health related quality of life (HRQoL) among men and women with type 2 diabetes. This cross-sectional descriptive study consisted of a random sample of 300 adults with type 2 diabetes in a selected public hospital. Euro-QoL and Revised Summary of Diabetes Self-Care Activities scales were used to collect data between January and June 2010. Schooling and ability to manage positively were highly significant predictors of quality of life (QoL) among women as compared to men. Age, prevention of activities of daily living and knowledge/management of diabetes were significant predictors of Health state among women as compared to men. Findings demonstrate that 30.6% (versus 35.7%) of the variance in the total QoL and 14% (versus 23%) of the variance in health state could be explained by personal and clinical characteristics among women and men, respectively. The study underlines the importance for nurse educators to assess HRQoL among men and women and to develop effective self-care management strategies based on personal and clinical characteristics.

Gender-Specific Factors Influencing Diabetes Self-Care Behaviors and Health-Related Quality of Life Among Older Adults With Type 2 Diabetes in South Korea

The purpose of the current study was to identify gender-specific factors influencing diabetes self-care behaviors and health-related quality of life among older adults with type 2 diabetes in South Korea. This is a secondary analysis using data from 278 older adults (77 women, 201 men) with type 2 diabetes. An independent t test and hierarchical multiple regression analyses were used to analyze the data. No significant mean differences in diabetes self-care behaviors and health-related quality of life were observed according to gender. Regarding predictors by gender, the number of diabetes-related complications was a unique predictor of diabetes self-care behaviors in older men, whereas duration of diabetes and barriers were unique predictors in older women. Depression was a significant common predictor of health-related quality of life in older men and women. Nurses should be aware of and consider gender specificity when developing intervention programs for promoting self-care behaviors and health-related quality of life.

Health needs of older Aboriginal people in Taiwan: a community-based assessment using a multidimensional instrument

AIMS AND OBJECTIVES

To explore the health needs of older Aboriginal people, using a multidimensional instrument. The gender differences related to their health needs were also addressed.

BACKGROUND

Health status and life expectancy between Aborigines and non-Aborigines have been shown to differ. The investigation of the health needs of Aboriginal people is however scarce, particularly among the older adult population. There is a need to address unmet health needs and improve information on the health needs assessment of the older Aboriginal population.

DESIGN

A cross-sectional design was used.

METHODS

Aboriginal people aged 65 and over were randomly sampled to take part in the present study. A multidimensional instrument consisting of eight domains and three cross-domain categories was used to assess their health needs.

RESULTS

A group of older Aboriginal people was recruited (n = 90, mean age = 73·5). The top three identified needs were 'mental health and well-being', 'staying healthy' and 'social participation'. The female participants had statistically significant higher scores for the 'mental health and well-being', 'getting around' domains and in the 'risk of falls' than the male ones. A regression model demonstrated that the health need of 'looking after oneself' was associated with all cross-domain categories of health need, which are 'independence', 'risk of breakdown in care' and 'risk of falls'.

CONCLUSIONS

The present study has revealed major health needs among older Aboriginal people and found that older female Aborigines have more health needs than older male Aborigines. Further study to identify effective approaches to address these needs among this group is warranted.

RELEVANCE TO CLINICAL PRACTICE

The findings can be used to identify effective approaches to addressing health needs among older Aboriginal people with a consideration of gender. Only then can resources be allocated and prioritised in a culturally sensitive and gender-specific manner nationally and globally.

Psychological well-being of gynecologic and obstetric patients: a validation of the 12-item Well-Being Questionnaire (W-BQ12)

BACKGROUND

Gynecology and obstetrics are areas of medicine associated with emotionally loaded concerns. Both positive and negative aspects of psychological well-being can be assessed with the 12-item Well-Being Questionnaire (W-BQ12). Our study aimed to evaluate the psychometric properties of the W-BQ12 in gynecologic and obstetric patients.

METHODS

A cohort of 228 gynecologic patients, consisting of endocrinologic (n = 102) and obstetric (n = 126) subgroups, responded to a structured interview or to a questionnaire about sociodemographic and medical data, and to a set of psychometric tests: the W-BQ12, the Hospital Anxiety and Depression Scale (HADS), the Beck Depression Inventory (BDI), and the Hamilton Depression Scale (HAMD). Except for the current health problem, all probable confounding factors (psychiatric, oncologic, or other somatic morbidity, postmenopausal status) were excluded.

RESULTS

The W-BQ12 scores correlated significantly and adequately (r = 0.35-0.80) with reference instruments (HADS, BDI, and HAMD). The internal consistency, measured by Cronbach's alpha, was very good for the whole questionnaire (0.86) as well as for the subscales (0.76-0.79). The principal component analysis indicated a clear three-factor structure with eigenvalues >1. Factors 1 ("negative well-being"), 2 ("positive well-being"), and 3 ("energy") explained 22, 21, and 19 % of the variance, respectively.

CONCLUSIONS

The W-BQ12 is suitable for the global assessment of psychological well-being, as well as for differentiation between negative and positive well-being aspects in gynecologic patients.

Effects of mobile Internet use on college student pedestrian injury risk

BACKGROUND

College-age individuals have the highest incidence of pedestrian injuries of any age cohort. One factor that might contribute to elevated pedestrian injuries among this age group is injuries incurred while crossing streets distracted by mobile devices.

OBJECTIVES

Examine whether young adult pedestrian safety is compromised while crossing a virtual pedestrian street while distracted using the Internet on a mobile "smartphone."

METHOD

A within-subjects design was implemented with 92 young adults. Participants crossed a virtual pedestrian street 20 times, half the time while undistracted and half while completing an email-driven "scavenger hunt" to answer mundane questions using mobile Internet on their cell phones. Six measures of pedestrian behavior were assessed during crossings. Participants also reported typical patterns of street crossing and mobile Internet use.

RESULTS

Participants reported using mobile Internet with great frequency in daily life, including while walking across streets. In the virtual street environment, pedestrian behavior was greatly altered and generally more risky when participants were distracted by Internet use. While distracted, participants waited longer to cross the street (F=42.37), missed more safe opportunities to cross (F=42.63), took longer to initiate crossing when a safe gap was available (F=53.03), looked left and right less often (F=124.68), spent more time looking away from the road (F=1959.78), and were more likely to be hit or almost hit by an oncoming vehicle (F=29.54; all ps<0.01). Results were retained after controlling for randomized order; participant gender, age, and ethnicity; and both pedestrian habits and mobile Internet experience.

CONCLUSION

Pedestrian behavior was influenced, and generally considerably riskier, when participants were simultaneously using mobile Internet and crossing the street than when crossing the street with no distraction. This finding reinforces the need for increased awareness concerning the risks of distracted pedestrian behavior.

The current and future roles of community pharmacists: views and experiences of patients with type 2 diabetes

BACKGROUND

The current UK government agenda is for community pharmacists to assume greater responsibility for medication management in patients with chronic conditions. This agenda may require a significant change in the way patients currently interact with their community pharmacist.

OBJECTIVES

To explore the experiences and views of patients with type 2 diabetes regarding the current and proposed future role of community pharmacists.

METHODS

This study used focus groups to collect experiences and views of patients with type 2 diabetes. A National Health Service (NHS) ethics committee approved this study. Pharmacists identified all patients with type 2 diabetes to whom they provided an information sheet and a consent form which included a request to supply basic demographic details. Focus group members were purposively sampled to gain a diverse range of opinions. Two researchers independently coded and thematically analyzed the transcripts. The researchers discussed the emergent themes to ensure all valid themes had been identified.

RESULTS

Twenty-five participants attended one of 4 focus groups. Two broad themes were identified: the place of pharmacy in the wider primary care team and pharmacy as a healthcare destination. Participants who had been living with diabetes for a long time and those who felt they had received a lower level of care from the medical practice were more likely to acknowledge contributions of pharmacists in their care for advice on side effects, drug interactions and supply than participants with a good relationship with their general practitioner (GP) or practice nurse and whose diabetes was well controlled.

CONCLUSIONS

Participants with type 2 diabetes identified a role for pharmacists in their care linked to their perceived expertise on medicines. However, the extent to which they would engage with the pharmacist depended on the quality of relationship with their GP or practice nurse.

Lifestyle changes - a continuous, inner struggle for women with type 2 diabetes: a qualitative study

OBJECTIVE

The objective of this study was to describe how women handle necessary lifestyle changes due to a chronic disease using diabetes as a model.

DESIGN

Interview study.

SETTING

Ten women living in western Sweden were interviewed.

METHOD

In-depth interviews and analysis were performed using the phenomenological ideas of Giorgi.

SUBJECTS

Ten women diagnosed with type 2 diabetes, mean age 65. All were either on disability pension or retired with varying complications ranging from none to stroke.

RESULTS

The findings revealed five themes: the ambiguous feeling of others' involvement, becoming a victim of pressurizing demands, experiencing knowledge deficits, experiencing an urge, and finding reasons to justify not changing. The invariant meaning of a continuous inner struggle illuminates the experience of making lifestyle changes for women with type 2 diabetes.

CONCLUSION

The findings of the present study show that it is vital for health care professionals to treat women diagnosed with type 2 diabetes with great respect and understanding regarding the struggle that they are going through. By being aware of the everyday burden for these women, acknowledging the fact that they want their lives to go on as before, may serve as a "key" to assist women in changing attitudes towards living in accordance with the disease and appreciating the lifestyle changes as a challenge as they become healthier and improve their quality of life.

Health care professionals meeting with individuals with Type 2 diabetes and obesity: Balancing coaching and caution

The burden of diabetes and obesity is increasing worldwide, indicating a need to find the best standard for diabetes care. The aim of this study was to generate a theory grounded in empirical data derived from a deeper understanding of health care professionals' main concerns when they consult with individuals with diabetes and obesity and how they handle these concerns. Tape-recorded interviews were conducted with seven groups and three individual members of a diabetes team in an area of western Sweden. The grounded theory (GT) method was used to analyse the transcribed interviews. A core category, labelled Balancing coaching and caution and three categories (Coaching and supporting, Ambivalence and uncertainty, and Adjusting intentions) emerged. The core category and the three categories formed a substantive theory that explained and illuminated how health care professionals manage their main concern; their ambition to give professional individualised care; and find the right strategy for each individual with diabetes and obesity. The theory generated by this study can improve our understanding of how a lack of workable strategies limits caregivers' abilities to reach their goals. It also helps identify the factors that contribute to the complexity of meetings between caregivers and individuals with diabetes.