1
|
Elyeli K, Esmaeilzadeh S, Bebiş H. Is Web-Based Diabetes Training Effective or Ineffective on the Quality of Life of Individuals with Type 2 Diabetes Mellitus?: A Systematic Review. J Med Syst 2024; 48:92. [PMID: 39322812 DOI: 10.1007/s10916-024-02112-9] [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: 06/08/2024] [Accepted: 09/19/2024] [Indexed: 09/27/2024]
Abstract
Diabetes mellitus is called as the "pandemic of the era" due to its rising prevalence. Since it is a disease that affects all spheres of life, it has an impact on the quality of life of individuals. This systematic review aims to examine the effect of web-based diabetes training programmes prepared for individuals with type 2 diabetes mellitus on their quality of life. The PRISMA-P (Preferred Reporting Items for Systematic Review and Meta Analysis Protocols) flowchart was used in the literature search stage. A comprehensive search was performed through the [MeSH] keywords (Web-based Intervention, Randomised Controlled Trial, HRQOL, Type 2 Diabetes) until May 8, 2024 in databases of PubMed, Web of Science, Science Direct, Medline, CINAHL, EBSCO host, Cochrane Library, and Google Scholar. Zotero software program was used to identify duplications of the obtained studies. Seven randomised controlled studies were included in the review. It was found that, most of the studies that were included in review showed that quality of life did not cause any significant difference in the level of quality of life; whereas, improvement was observed in quality-of-life levels in all of the experimental groups. Also, studies conducted for 1.5 to 3 months showed that web-based training was effective in improving the quality of life. Consequently, it is recommended that web-based trainings be long enough to prevent patients from dropping out of training, with possibility of an online individual interview, and follow-up periods of 1.5 to 3 months in order to achieve effective results. PROSPERO Number: CRD42024530777.
Collapse
Affiliation(s)
- Kemal Elyeli
- Faculty of Nursing / Department of Public Health Nursing, Near East University, Near East Boulevard, ZIP: 99138, Nicosia / TRNC Mersin 10, Turkey.
| | - Samineh Esmaeilzadeh
- Faculty of Nursing / Department of Mental Health and Illness Nursing, Near East University, Near East Boulevard, ZIP: 99138, Nicosia / TRNC Mersin 10, Turkey
| | - Hatice Bebiş
- Faculty of Health Sciences / Department of Public Health Nursing, Eastern Mediterranean University, 99628, Famagusta, / TRNC Mersin 10, Turkey
| |
Collapse
|
2
|
Ghasemi P, Jafari M, Maskouni SJ, Hosseini SA, Amiri R, Hejazi J, Chambari M, Tavasolian R, Rahimlou M. Impact of very low carbohydrate ketogenic diets on cardiovascular risk factors among patients with type 2 diabetes; GRADE-assessed systematic review and meta-analysis of clinical trials. Nutr Metab (Lond) 2024; 21:50. [PMID: 39030553 PMCID: PMC11264514 DOI: 10.1186/s12986-024-00824-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 07/08/2024] [Indexed: 07/21/2024] Open
Abstract
OBJECTIVE This study was designed to evaluate the impact of VLCKD on cardiovascular risk factors in patients with T2DM. METHODS Until March 2024, extensive searches were conducted on PubMed, Scopus, Web of Science, Embase, and other relevant databases. The purpose was to identify clinical trials examining the impact of VLCKD on glycemic control, lipid profile, and blood pressure. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) method was used to assess the evidence's degree of certainty. RESULTS Our initial search found a total of 2568 records and finally 29 trials were included in final analysis. Our results showed that adherence from VLCKD led to significant reduction in fasting blood sugar (WMD= -11.68 mg/dl; 95% CI: -18.79, -4.56; P = 0.001), HbA1c (WMD= -0.29; 95% CI: -0.44, -0.14; P < 0.001), HOMA-IR(WMD= -0.71; 95% CI: -1.14, -0.29; P = 0.001), insulin (WMD= -1.45; 95% CI: -2.54, -0.36; P = 0.009), triglyceride (WMD= -17.95; 95% CI: -26.82, -9.07; P < 0.001), systolic blood pressure (WMD= -2.85, 95% CI: -4.99, -0.71; P = 0.009) and diastolic blood pressure (WMD= -1.40; 95% CI: -2.66, -0.13; P = 0.03). We also found a significant increase in high-density lipoprotein (HDL) level after adherence from VLCKD diet (WMD = 3.93, 95% CI: 2.03, 5.84; P = 0.000). We couldn't find any significant differences between groups in term of LDL and total cholesterol levels. CONCLUSION People following a VLCKD experience a more significant improvement in cardiovascular risk factors when compared to individuals on control diets.
Collapse
Affiliation(s)
- Parisa Ghasemi
- Research Committee, Medical School, Arak University of Medical Sciences, Arak, Iran
| | - Malihe Jafari
- Department of Exercise physiology, Faculty of Physical Education and Sports Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Saber Jafari Maskouni
- Department of nutrition, School of Public health, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Seyed Ahmad Hosseini
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Roksaneh Amiri
- Mofid Childrens Hospital Clinical Research Development Unit, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Jalal Hejazi
- Department of Nutrition, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mahla Chambari
- Department of Food Science and Nutrition, Faculty of Applied Sciences, UCSI University, 56000 Cheras, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Ronia Tavasolian
- Department of Nutrition, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mehran Rahimlou
- Department of Nutrition, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran.
| |
Collapse
|
3
|
Wu D, Shi Z, Wu C, Sun W, Jin G. Sex differences in symptom network structure of depression, anxiety, and self-efficacy among people with diabetes: a network analysis. Front Public Health 2024; 12:1368752. [PMID: 38496386 PMCID: PMC10941846 DOI: 10.3389/fpubh.2024.1368752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/19/2024] [Indexed: 03/19/2024] Open
Abstract
Aims The present study aims to explore the relations between symptoms of depression and anxiety and self-efficacy among people with diabetes. At the same time, we also examined the sex difference between network structures. Methods This study recruited 413 participants with diabetes, and they completed Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire (PHQ-9), and the Self-efficacy for Diabetes (SED). Symptom network analysis and network comparison test were used to construct and compare the depression-anxiety symptom network models of the female and male groups. Finally, we conducted flow diagrams to explore the symptoms directly or indirectly related to self-efficacy. Results The strongest edges in the depression-anxiety symptom networks are the edge between "GAD3" (Excessive worry) and "GAD4" (Trouble relaxing) and the edge between "PHQ1" (Anhedonia) and "PHQ4" (Energy) in the female and male groups, respectively. Most of the symptoms with the highest EI and bridge EI are related to worry and nervousness. Additionally, in the flow diagram of the female group, "PHQ6" (Guilt) has a high negative association with self-efficacy. Conclusion Females with diabetes are more vulnerable to depression and anxiety. Interventions targeting key symptoms in the network may be helpful in relieving the psychological problems among people with diabetes.
Collapse
Affiliation(s)
| | | | | | | | - Guoxi Jin
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Bengbu Medical University, Bengbu, China
| |
Collapse
|
4
|
Gupta SK, Lakshmi P, Chakrapani V, Rastogi A, Kaur M. Understanding the diabetes self-care behaviour in rural areas: Perspective of patients with type 2 diabetes mellitus and healthcare professionals. PLoS One 2024; 19:e0297132. [PMID: 38330094 PMCID: PMC10852243 DOI: 10.1371/journal.pone.0297132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/28/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Diabetes self-care behaviour plays a crucial role in managing the diabetes effectively and preventing complications. Patients with type 2 diabetes mellitus (T2DM) and health care professionals (HCPs) of rural areas often face unique challenges when it comes to diabetes self-care practices (SCPs). Therefore, this study aim to explore the perspectives of patients with T2DM and HCPs on diabetes SCPs. METHODS Eight focus group discussions (FGDs) among individuals with T2DM and In-depth interviews (IDIs) with 15 HCPs were conducted in rural areas of Punjab, North India. Capability, Opportunity, Motivation, and Behaviour model (COM-B) was employed for thematic framework analyses. RESULTS The study participants perceived that a limited understanding of diabetes mellitus (DM), beliefs in alternative therapies, drug side effects, attitudes towards DM (psychological capability), comorbidities (physical capability), family support (social opportunity), financial and time constraints, and weather conditions (physical opportunity) contributed to lack of DM SCPs. Physicians' guidance and support were motivating them to adhere to SCPs, especially when aligned with their sense of self-efficacy (reflective motivation). HCPs constraints in providing patient-centred care are due to training limitations (psychological capability) and a lack of essential resources (physical opportunities). Participants expressed need for comprehensive diabetes care (automatic motivation) through structured diabetes education intervention to improve diabetes SCPs. CONCLUSIONS The study findings indicate that various factors influence diabetes SCPs from the perspectives of both patients with T2DM and HCPs and emphasizes the need for a multi-faceted approach to improve diabetes SCPs in rural areas. Implementing a structured diabetes self-care intervention strategy in rural areas may help for preventing and mitigating the impact of diabetes-related complications in rural areas.
Collapse
Affiliation(s)
- Saurabh Kumar Gupta
- Department of Community Medicine and School of Public Health, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
| | - P.V.M. Lakshmi
- Department of Community Medicine and School of Public Health, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Ashu Rastogi
- Department of Endocrinology, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manmeet Kaur
- Department of Community Medicine and School of Public Health, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
- HEAL Foundation, Chandigarh, India
| |
Collapse
|
5
|
Alam AS, Samiasih A, Mubin MF, Pranata S, Dhamanik R. Types of Nursing Intervention on Improving Quality of Life among Patients with Diabetes Mellitus: A Systematic Review. Curr Diabetes Rev 2024; 20:e290823220467. [PMID: 37644750 PMCID: PMC10909825 DOI: 10.2174/1573399820666230829103016] [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: 09/28/2022] [Revised: 06/29/2023] [Accepted: 07/14/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Long-term treatment of patients with diabetes mellitus (DM) is considered a major factor causing disease complications. DM complications mostly impact the patient's quality of life (QoL). Only a few studies have been conducted summarizing the types of nursing interventions for improving the QoL of DM patients. OBJECTIVE The objective of this study is to explore the types of nursing interventions that can improve the QoL of DM patients. METHODS The online databases, including ScienceDirect, Medline, Google Search, and Pro-Quest, were used to search for the relevant articles. Articles that met the inclusion criteria were analyzed, and their level of evidence was determined and synthesized. RESULTS A total of 30 articles defining the types of nursing intervention on improving the QoL of DM patients were discovered, comprising the five types of nursing interventions, such as health education (15 articles), exercise (8 articles), WhatsApp/short message service (WA/SMS) gateway (3 articles), blood glucose control (3 articles), and black garlic herbal therapy (1 article). CONCLUSION Sequentially, the most common types of nursing interventions to improve the QoL of DM patients was health education, followed by exercise, WA/SMS gateway, and glucose control. A personal approach to health education is a significant point in improving the QoL of DM patients in the future. The findings of this study might not be strongly generalized, so further randomized controlled trial (RCT) studies with larger samples are needed.
Collapse
Affiliation(s)
- Agung Samsu Alam
- Department of Nursing, Faculty of Nursing and Health Sciences, Universitas Muhammadiyah Semarang, Semarang City, Central Java, Indonesia
| | - Amin Samiasih
- Department of Nursing, Faculty of Nursing and Health Sciences, Universitas Muhammadiyah Semarang, Semarang City, Central Java, Indonesia
| | - Mohammad Fatkhul Mubin
- Department of Nursing, Faculty of Nursing and Health Sciences, Universitas Muhammadiyah Semarang, Semarang City, Central Java, Indonesia
| | - Satriya Pranata
- Department of Nursing, Faculty of Nursing and Health Sciences, Universitas Muhammadiyah Semarang, Semarang City, Central Java, Indonesia
| | - Reina Dhamanik
- Department of Nursing, Faculty of Nursing and Health Sciences, Universitas Muhammadiyah Semarang, Semarang City, Central Java, Indonesia
| |
Collapse
|
6
|
Gulbahar Eren M, Celik S, Celik M, Yon B, Can Ozturk F. Spiritual Well-being, Diabetes Burden, Self-management, and Glycemic Control Among Patients with Type 2 Diabetes in Turkey: A Descriptive and Correlational Study. JOURNAL OF RELIGION AND HEALTH 2023; 62:4363-4381. [PMID: 36871283 DOI: 10.1007/s10943-023-01783-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
Spiritual well-being is considered a significant factor in helping to manage chronic diseases and cope with the disease process. This descriptive-correlational study aimed to investigate the relationship between spiritual well-being, diabetes burden, self-management, and among 300 outpatients with type 2 diabetes in Turkey. A significant relationship was found between the diabetes burden and self-management levels and the spiritual well-being of patients with diabetes (p < 0.005). Multiple linear regression analyses found that a high diabetes burden (ß = -0.106) decreased well-being, and high self-management increased well-being (ß = 0.415). Additionally, the results revealed that marital status, household members, performing daily life activities alone, hospitalization due to complications, diabetes burden, self-management, glycemic control, and blood lipid parameters explained 29% of the total variance in the spiritual well-being level. Accordingly, the present study recommended that health professionals should consider spiritual well-being to support disease management with a holistic approach to diabetes patients.
Collapse
Affiliation(s)
- Merve Gulbahar Eren
- Internal Medicine Nursing Department, Faculty of Health Science, Sakarya University, Sakarya, Turkey
| | - Selda Celik
- Hamidiye Faculty of Nursing, University of Health Sciences Turkey, Istanbul, Turkey.
| | - Melike Celik
- Internal Medicine Nursing Department, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Burcu Yon
- Vocational School of Health Services, Düzce University, Düzce, Turkey
| | | |
Collapse
|
7
|
Yuksel M, Bektas H, Ozer ZC. The effect of nurse-led diabetes self-management programmes on glycosylated haemoglobin levels in individuals with type 2 diabetes: A systematic review. Int J Nurs Pract 2023; 29:e13175. [PMID: 37394284 DOI: 10.1111/ijn.13175] [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: 01/04/2023] [Revised: 05/22/2023] [Accepted: 06/05/2023] [Indexed: 07/04/2023]
Abstract
AIMS This review aimed to examine the content, frequency, duration, and outcomes of nurse-led diabetes self-management programmes on glycosylated haemoglobin levels in individuals with type 2 diabetes. BACKGROUND Diabetes self-management programmes improve glycemic control in individuals with type 2 diabetes to acquire specific behavioural changes and develop effective problem-solving skills. DESIGN A systematic review was used in this study. DATA SOURCES PubMed, Science Direct, Cochrane Library, Web of Science, Ovid, CINAHL, Proquest and Scopus databases were searched for studies published in English until February 2022. The risk of bias was assessed using the Cochrane Collaboration tool. REVIEW METHODS This study followed the recommendations of the Cochrane 2022 guidelines and was reported using the Preferred Reporting Items for Systematic Reviews and Meta-analysis. RESULTS Eight studies with 1747 participants met the inclusion criteria. Interventions included telephone coaching, consultation services and individual and group education. The duration of the intervention ranged from 3 to 15 months. The results showed that nurse-led diabetes self-management programmes had positive and clinically significant effects on glycosylated haemoglobin levels in individuals with type 2 diabetes. CONCLUSION These findings highlight the important role of nurses in improving self-management and achieving glycemic control in individuals with type 2 diabetes. The positive outcomes of this review offer suggestions for health care professionals to develop effective self-management programnmes in type 2 diabetes treatment and care.
Collapse
Affiliation(s)
- Merve Yuksel
- Department of Internal Medicine Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
| | - Hicran Bektas
- Department of Internal Medicine Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
| | - Zeynep Canli Ozer
- Department of Internal Medicine Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Numsang P, Oumtanee A, Kurat S, Sananok R, Kraichan S, Sarapoke P. "Failure to control blood sugar" experiences of persons with type 2 diabetes mellitus. Int J Nurs Sci 2023; 10:527-532. [PMID: 38020838 PMCID: PMC10667290 DOI: 10.1016/j.ijnss.2023.09.004] [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: 04/15/2023] [Revised: 08/05/2023] [Accepted: 09/14/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives This study aimed to explore the experiences of persons with type 2 diabetes mellitus having poor glycemic control. Methods A narrative qualitative study was conducted. Eight participants were recruited at a hospital's primary care unit (PCU) in northeastern Thailand from October to December 2021. The data was collected using in-depth interviews, field notes, and non-participatory observation. It was then analyzed based on the thematic analysis guide of Braun & Clarke (2006). Results The results revealed four main themes and eight sub-themes: lifestyle practice (inappropriate eating behaviors, taking diabetes drugs irregularly, exercising irregularly); perception of self-care (misperceptions about self-care practices, diabetes was a genetic disease and therefore had to be accepted); awareness regarding complications (not being aware of glycemic control, issues with social gatherings); stress from socioeconomic issues (feeling stressed in daily life). Conclusions It is the role of healthcare professionals to stress the importance of healthy behaviors to improve glycemic control in terms of diet, exercise, medication use, perception, awareness, culture, and beliefs. The study results could aid healthcare providers in developing innovations in nursing care or interventions to change unhealthy behaviors.
Collapse
Affiliation(s)
- Patcharee Numsang
- Srimahasarakham Nursing College, Faculty of Nursing, Praboromarajchanok Institute, Thailand
| | | | - Suwakon Kurat
- Faculty of Nursing, College of Asian Scholars, Khonkaen, Thailand
| | | | - Sakaorat Kraichan
- Srimahasarakham Nursing College, Faculty of Nursing, Praboromarajchanok Institute, Thailand
| | - Puangkaew Sarapoke
- Srimahasarakham Nursing College, Faculty of Nursing, Praboromarajchanok Institute, Thailand
| |
Collapse
|
10
|
Kiarie JN, Mambo SN, Kamundi GK. A cross-sectional study on the association between varied social support modalities and glycemic levels amongst diabetic patients residing in Machakos County, Kenya. Pan Afr Med J 2023; 45:99. [PMID: 37692985 PMCID: PMC10491716 DOI: 10.11604/pamj.2023.45.99.39472] [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: 02/28/2023] [Accepted: 06/09/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. While there's increasing evidence that social support from caregivers improves health outcomes in chronic illness management, the potential associations of the different types of social support and glycemic control among Type II diabetes clients have largely been ignored in Kenya. This cross-sectional study sought to establish the association between tangible, emotional, and informational social support and glycemic levels among clients diagnosed with Type II diabetes in Machakos County, Kenya. Methods semi-structured interviews were conducted with 726 randomly selected Type II diabetes clients enrolled in diabetes care and treatment programs in government-owned public health facilities in Masinga and Matungulu sub-counties, Machakos, Kenya. Descriptive statistics and multinomial logistic regression were conducted to elucidate any associations. Results seventy-three percent (73%) of the respondents were female, and 27% were male, with the majority (77.9%) being above 50 years and having lived with diabetes for over 3 years (61.5%). Opportunities for social support existed, with 62% of the respondents living with more than 2 persons above 18 in their households. From the Random Blood Glucose test analysis, 38.9% of the clients had high glycemic levels, partly because the majority (66.9%) of the respondents did not practice good diabetes self-management practices at the time of the study. While all three types of social support were reported as provided, only 30.6% reported receiving adequate social support. An association was found between social support and glycemic levels with respondents receiving adequate informational- P<0.05, OR 1.92, emotional -P<0.05, OR 3.7, and tangible support -P<0.05, OR 4.1 more likely to have better glycemic control than those with inadequate support. Conclusion clients receiving adequate informational, emotional, and tangible social support were 2, 4, and 4 times, respectively, likely to have better glycemic control than those with inadequate support. Of the three types of social support, tangible support was most needed. Ultimately, a greater understanding of these interactions through longitudinal studies is required to identify solutions and optimize glycaemic control for diabetes clients in Kenya and beyond.
Collapse
Affiliation(s)
- Jackline Njeri Kiarie
- School of Public Health, Department of Environmental Health and Disease Control, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Susan Njoki Mambo
- School of Public Health Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | | |
Collapse
|
11
|
Afsahi F, Alimehdi M, Sharif-Nia H. The translation and psychometrics Persian version of irrational food belief scale. BMC Psychiatry 2023; 23:435. [PMID: 37322507 PMCID: PMC10268467 DOI: 10.1186/s12888-023-04909-3] [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: 10/20/2022] [Accepted: 05/29/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND This study aimed to translate into the Irrational Food Belief Scale proposed by Osberg into the Persian language and determine the psychometric properties of in Iranian culture. METHODS Osberg's 57-item scale was translated into Persian by using the forward-backward method. The scale's validity was examined using face validity, content validity, and construct validity (exploratory and confirmatory factor analysis). Its reliability was assessed with Cronbach's alpha and McDonald's Omega coefficient. Exploratory factor analysis and confirmatory factor analysis was performed by SPSS 28 (500 subjects) and also by AMOS 26 (500 subjects). The participants completed the demographic questionnaire and the Irrational Food Belief Scale (IFBS) over the Internet. RESULTS After translation into Persian, the validity of the scale was determined by impact score, quantitative and qualitative face validity (modification of 10 items) and qualitative content validity (modification of 8 items), and quantitative content validity (CVR, CVI and Kappa coefficient), which were greater than 0.46, 0.86, and 0.85, respectively. In exploratory factor analysis, 30 items were removed and the remaining 27 items were loaded on five factors, including behavioral and psychological aspects, nutritional attitudes, healthy eating, controlled eating, and diet, which described 30.95% of the total variance. Confirmatory factor analysis showed that the 5-factor model was the best fitting model to explain the data. CONCLUSION Considering the need for a tool about in irrational food beliefs, this tool was unable to explain all these dimensions well. It is recommended to create a new questionnaire for the Iranian culture.
Collapse
Affiliation(s)
- Fatemeh Afsahi
- Department of Psychology, Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran
| | - Mansoor Alimehdi
- Department of Psychology, Faculty of Medicine, Islamic Azad University, Tehran Medical Branch, Tehran, Iran.
- Tehran Islamic Azad University of Medical Sciences, Building Intersection of Karimi St. Shahid Mosivand St. Shariati St., Tehran, 1916893813, Iran.
| | - Hamid Sharif-Nia
- Traditional and Complementary Medicine Research Center, Addiction Institute Mazandaran University of Medical Sciences, Sari, Iran
- Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| |
Collapse
|
12
|
Nunes LB, Santos JCD, Reis IA, Torres HDC. [Evaluation of the behavioral program in type 2 diabetes mellitus: a randomized clinical trial]. CIENCIA & SAUDE COLETIVA 2023; 28:851-862. [PMID: 36888868 DOI: 10.1590/1413-81232023283.10102022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 09/12/2022] [Indexed: 03/08/2023] Open
Abstract
The scope of this article was to evaluate the effect of the behavioral group education program and telephone intervention in modifying psychological attitudes, enhancing empowerment, and self-care practices aimed at improving clinical control in type 2 diabetes mellitus. It involved a randomized cluster clinical trial, carried out with 199 people with diabetes. In order to perform intragroup comparisons (final and initial phases) and between groups with respect to the indices of the psychological attitude, empowerment, self-care and glycated hemoglobin level variables, the Generalizing Estimating Equation (GEE) approach was used. In all analyses, a 5% significance level and 95% confidence interval were used. When compared to the CG, the IG showed a significant reduction in the mean values of glycated hemoglobin (95%CI: -1.49 to -0.45), a statistically significant increase in the change in psychological attitude scores (95%CI: 9.70 to 15.40), on the empowerment scale (95%CI: 0.81 to 2.72) and adherence to self-care practices (95%CI: 1.44 to 2.10) at the end of the study. The behavioral program proved to be capable of modifying psychological attitudes, improving empowerment, self-care practices and clinical control.
Collapse
Affiliation(s)
- Laura Barbosa Nunes
- Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Jéssica Caroline Dos Santos
- Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Ilka Afonso Reis
- Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Heloísa de Carvalho Torres
- Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| |
Collapse
|
13
|
Guo H, Xiao Y, Liao C, Sun J, Xie Y, Zheng Y, Fan G. U-shaped association between online information exchange and app usage frequency: a large-scale survey of China 's online young and middle-aged people with pre diabetes and diabetes. Front Endocrinol (Lausanne) 2023; 14:1141645. [PMID: 37152927 PMCID: PMC10161200 DOI: 10.3389/fendo.2023.1141645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/20/2023] [Indexed: 05/09/2023] Open
Abstract
Background China has the world's largest diabetic population, and the cost of caring for all these people every day is substantial. Online information exchange and app usage frequency have been demonstrated to play a significant influence in the management of blood glucose and enhancement of diabetes-related quality of life. However, the association between online information exchange and app usage frequency among actual online populations remains unclear and deserves additional study. Therefore, we evaluated the factors affecting the frequency of app usage in the online glucose management population, with a particular emphasis on the connection between online information exchange and app use frequency, contributing to the expansion of the research of diabetes management models. Method This cross-sectional study was conducted by disseminating questionnaires in blood glucose management-related forums and WeChat groups and included 1586 online users concerned about blood glucose management. Information exchange and app usage frequency were considered as independent and dependent variables, respectively. We performed stratified and single factor analysis, multiple equation regression analysis, smooth curve fitting, and threshold effect and saturation effect analysis. R (version 4.1.3, http://www.Rproject.org) and EmpowerStats were used for data analysis. Result After adjusting for other covariates, information exchange was independently and positively associated with app use frequency (β = 8.6, 95% CI: 6.5 to 11.2, p < 0.001). Through interaction analysis, the most significant interaction factors influencing the relationship between information exchange and app usage frequency were identified as health insurance status, whether living with parents, glycated hemoglobin status in the previous month, and self-monitoring of blood glucose (SMBG). The association between information exchange and app usage frequency is U-shaped, with information exchange inflection points of 3.0 and 4.2. Information exchange and app usage frequency are negatively correlated when the average information exchange score is less than 3.0, and for every point increase in the average information exchange score, the likelihood of the app high usage frequency group compared to the app low usage frequency group decreases by 70%. The relationship between information exchange and app usage frequency is strongest when it is greater than or equal to 3.0 and less than or equal to 4.2. The probability of the app high usage frequency group occurring compared to the app low usage frequency group rises 17.3 times for every 1 point increase in the average information exchange score. The probability of the app high usage frequency group occurring in comparison to the app low usage frequency group increased by 1.8 times for every 1 point rise in information exchange when the average information exchange score was higher than 4.2. Conclusion Age, body mass index, married, living with parents, hemoglobin level, SMBG, and information exchange were positively connected with app usage frequency in our study of online blood glucose management population. The link between information exchange and app use frequency was significantly U-shaped. The app usage frequency changed the most with the rise in information exchange when the information exchange score was greater than or equal to 3.0 and less than or equal to 4.2. Therefore, we ought to offer effort to concentrate on and increase the health-related behaviors and activities of those in this score interval.
Collapse
|
14
|
Phoosuwan N, Ongarj P, Hjelm K. Knowledge on diabetes and its related factors among the people with type 2 diabetes in Thailand: a cross-sectional study. BMC Public Health 2022; 22:2365. [PMID: 36527016 PMCID: PMC9758850 DOI: 10.1186/s12889-022-14831-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a global public health problem with complications related to knowledge guiding self-care. Limited knowledge might result in poor control of blood glucose, but there is no previous investigation measuring diabetes knowledge in people diagnosed with T2DM in Thailand. This study was aimed to investigate level of diabetes knowledge and related factors among people with T2DM in Thailand. METHOD This cross-sectional study was conducted in a Northeastern province in Thailand among 276 people with T2DM, 195 women and 81 men, using a standardized self-report questionnaire, the Diabetes Knowledge Test. The data were analyzed using Pearson's chi-square test, one-way analysis of variance, and independent samples t-test. RESULTS The majority of respondents had poor diabetes knowledge in all subscales; total knowledge of diabetes (96.7%), general knowledge of diabetes (71.7%), and insulin use knowledge (92.3%). There was no difference found in knowledge scores between males and females. Having finished secondary school education or higher, being employed, or having diabetes-related complications were related to increased total diabetes knowledge and general diabetes knowledge. CONCLUSION The people with T2DM had poor diabetes knowledge, and those using insulin also had poor knowledge about the use of insulin.
Collapse
Affiliation(s)
- Nitikorn Phoosuwan
- grid.9723.f0000 0001 0944 049XDepartment of Community Health, Faculty of Public Health, Kasetsart University, 59/7 M.1 Chiangkrua, Muang, Sakon Nakhon Province Thailand ,grid.8993.b0000 0004 1936 9457Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden
| | - Passakorn Ongarj
- grid.9723.f0000 0001 0944 049XDepartment of Community Health, Faculty of Public Health, Kasetsart University, 59/7 M.1 Chiangkrua, Muang, Sakon Nakhon Province Thailand
| | - Katarina Hjelm
- grid.8993.b0000 0004 1936 9457Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden
| |
Collapse
|
15
|
Rajatanavin N, Witthayapipopsakul W, Vongmongkol V, Saengruang N, Wanwong Y, Marshall AI, Patcharanarumol W, Tangcharoensathien V. Effective coverage of diabetes and hypertension: an analysis of Thailand's national insurance database 2016-2019. BMJ Open 2022; 12:e066289. [PMID: 36456029 PMCID: PMC9716924 DOI: 10.1136/bmjopen-2022-066289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/08/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES This study assesses effective coverage of diabetes and hypertension in Thailand during 2016-2019. DESIGN Mixed method, analysis of National health insurance database 2016-2019 and in-depth interviews. SETTING Beneficiaries of Universal Coverage Scheme residing outside Bangkok. PARTICIPANTS Quantitative analysis was performed by acquiring individual patient data of diabetes and hypertension cases in the Universal Coverage Scheme residing outside bangkok in 2016-2019. Qualitative analysis was conducted by in-depth interview of 85 multi-stakeholder key informants to identify challenges. OUTCOMES Estimate three indicators: detected need (diagnosed/total estimated cases), crude coverage (received health services/total estimated cases) and effective coverage (controlled/total estimated cases) were compared. Controlled diabetes was defined as haemoglobin A1C (HbA1C) below 7% and controlled hypertension as blood pressure below 140/90 mm Hg. RESULTS Estimated cases were 3.1-3.2 million for diabetes and 8.7-9.2 million for hypertension. For diabetes, all indicators have shown slow improvement between 2016 and 2019 (67.4%, 69.9%, 71.9% and 74.7% for detected need; 38.7%, 43.1%, 45.1% and 49.8% for crude coverage and 8.1%, 10.5%, 11.8% and 11.7% for effective coverage). For hypertension, the performance was poorer for detection (48.9%, 50.3%, 51.8% and 53.3%) and crude coverage (22.3%, 24.7%, 26.5% and 29.2%) but was better for effective coverage (11.3%, 13.2%, 15.1% and 15.7%) than diabetes. Results were better for the women and older age groups in both diseases. Complex interplays between supply and demand side were a key challenge. Database challenges also hamper regular assessment of effective coverage. Sensitivity analysis when using at least three annual visits shows slight improvement of effective coverage. CONCLUSION Effective coverage was low for both diseases, though improving in 2016-2019, especially among men and ัyounger populations. The increasing rate of effective coverage was significantly smaller than crude coverage. Health information systems limitation is a major barrier to comprehensive measurement. To maximise effective coverage, long-term actions should address primary prevention of non-communicable disease risk factors, while short-term actions focus on improving Chronic Care Model.
Collapse
Affiliation(s)
| | | | | | - Nithiwat Saengruang
- Health Financing, International Health Policy Program, Muang District, Thailand
| | - Yaowaluk Wanwong
- Health Financing, International Health Policy Program, Muang District, Thailand
| | | | | | | |
Collapse
|
16
|
De Bellis A, McCloud C, Abigail W, Hill P, Giles J, Apolloni M, Gregoric C. Understanding the planning and preparation for diabetes self‐management of grey nomads when travelling in rural and remote Australia: An exploratory survey. Australas J Ageing 2022. [DOI: 10.1111/ajag.13150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/30/2022] [Accepted: 10/13/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Anita De Bellis
- College of Nursing and Health Sciences Flinders University Adelaide South Australia Australia
| | - Christine McCloud
- College of Nursing and Health Sciences Flinders University Adelaide South Australia Australia
| | - Wendy Abigail
- College of Nursing and Health Sciences Flinders University Adelaide South Australia Australia
| | - Pauline Hill
- College of Nursing and Health Sciences Flinders University Adelaide South Australia Australia
| | - Jane Giles
- Diabetes Service, Rural Support Service, South Australia Health Adelaide South Australia Australia
| | - Marc Apolloni
- Pharmacy Guild of Australia Adelaide South Australia Australia
| | - Carolyn Gregoric
- College of Nursing and Health Sciences Flinders University Adelaide South Australia Australia
| |
Collapse
|
17
|
Zhang A, Wang J, Wan X, Zhang J, Guo Z, Miao Y, Zhao S, Bai S, Zhang Z, Yang W. Mediation Effect of Self-Efficacy Between Health Beliefs and Glycated Haemoglobin Levels in Elderly Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study. Patient Prefer Adherence 2022; 16:3015-3026. [PMID: 36387053 PMCID: PMC9645127 DOI: 10.2147/ppa.s388967] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose To explore the mediating effect of self-efficacy in the relationship between glycated haemoglobin (HbA1c) levels and health beliefs in community elderly patients with type 2 diabetes. Patients and Methods From January to March 2022, convenience sampling was adopted to investigate 200 elderly patients with type 2 diabetes in a community in Yangzhou, China. Data were collected using the Health Beliefs Questionnaire, Self-efficacy for Diabetes, and Medication Compliance Questionnaire. Laboratory parameters included HbA1c, fasting blood glucose, postprandial blood glucose, total cholesterol, triglyceride, high-density-lipoprotein cholesterol, and low-density-lipoprotein cholesterol levels. Correlation, linear regression, and mediation analyses were performed using SPSS 27.0. Results HbA1c levels were higher in men (women vs men: 6.80% [6.08%, 7.73%] vs.7.30% [6.30%, 9.18%]) and employed (employed vs not employed vs retired: 7.60% [6.90%, 10.45%] vs 5.85% [5.40%, 6.95%] vs 7.10% [6.20%, 8.20%]) and low self-efficacy (low vs high: 13.1% [6.55%, 13.85%] vs 6.8% [6.10%, 7.70%]). HbA1c levels were negatively associated with health beliefs (r = -0.246) and self-efficacy (r = -0.240; p<0.01). Linear regression showed that perceived susceptibility, severity, benefit, and barriers, cues to action, and self-efficacy explained 50% of the variance in HbA1c levels after adjusting for sex and current work status. The mediation effect of self-efficacy was partial between health beliefs and HbA1c levels and accounted for 24.65% of the total effect (p < 0.001). Conclusion Health beliefs influenced the improvement of self-efficacy in older patients with type 2 diabetes mellitus, which in turn could improve HbA1c control. Self-efficacy plays a partial mediating role between health beliefs and Hba1c levels in elderly patients with type 2 diabetes.
Collapse
Affiliation(s)
- Anqi Zhang
- The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, 225003, People’s Republic of China
- School of Nursing and Public Health, Yangzhou University, Yangzhou, Jiangsu, 225009, People’s Republic of China
| | - Jinsong Wang
- The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, 225003, People’s Republic of China
- School of Nursing and Public Health, Yangzhou University, Yangzhou, Jiangsu, 225009, People’s Republic of China
- Yangzhou Commission of Health, Yangzhou, Jiangsu, 225009, People’s Republic of China
| | - Xiaojuan Wan
- School of Nursing and Public Health, Yangzhou University, Yangzhou, Jiangsu, 225009, People’s Republic of China
| | - Jing Zhang
- Yangzhou Commission of Health, Yangzhou, Jiangsu, 225009, People’s Republic of China
| | - Zihe Guo
- Yangzhou Commission of Health, Yangzhou, Jiangsu, 225009, People’s Republic of China
| | - Yamin Miao
- School of Nursing and Public Health, Yangzhou University, Yangzhou, Jiangsu, 225009, People’s Republic of China
| | - Shuhan Zhao
- School of Nursing and Public Health, Yangzhou University, Yangzhou, Jiangsu, 225009, People’s Republic of China
| | - Shuo Bai
- School of Nursing and Public Health, Yangzhou University, Yangzhou, Jiangsu, 225009, People’s Republic of China
| | - Ziyi Zhang
- School of Nursing and Public Health, Yangzhou University, Yangzhou, Jiangsu, 225009, People’s Republic of China
| | - Weiwei Yang
- Community Health Service Center, Yangzhou, Jiangsu, 225003, People’s Republic of China
| |
Collapse
|
18
|
Rana D, Kumar R, Kant R. Psychological Predictors of Adherence to Self-Care Behaviour amongst Patients with Type 2 Diabetes Mellitus (T2DM) Visiting Public Hospital, North India. Indian J Endocrinol Metab 2022; 26:558-564. [PMID: 39005517 PMCID: PMC11245295 DOI: 10.4103/ijem.ijem_116_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/24/2022] [Accepted: 07/31/2022] [Indexed: 02/05/2023] Open
Abstract
Background and Aims Patients with type 2 diabetes mellitus (T2DM) need a high degree of self-care behavior, treatment adherence, and good psychological health. Psychological health play a vital role in adherence to treatment regimen and self-management of diabetes. This study aims to identify the psychological predictors of self-care behaviors among patients with T2DM. Methods A descriptive cross-sectional survey was conducted at a diabetic clinic at a tertiary care hospital in North India. Structured pre-tested personal and clinical profile and self-efficacy, diabetes distress, depression and anxiety, and complications and fear of developing hypoglycaemia due to diabetes mellitus in the future are measured through standardized questionnaires. Results The mean age of the participants was 53.5 (±3.68) years, and 41.4% were in the overweight (BMI: 25.0-29.9) and obese (16.7%, BMI > 30) category. Self-care behaviours found significant association with self-efficacy (r = 0.34, P < 0.001), anxiety (r = -0.28, P < 0.001), depression (r = -0.28, P < 0.001) and diabetes-related distress (r = -0.30, P < 0.001). Further, self-efficacy (P = 0.001), diabetes distress (P < 0.001) and fear of developing hypoglycaemia (P < 0.001) were reported independent predictors of self-care behaviour in patients with T2DM. Conclusions The current study suggests that self-efficacy, fear of hypoglycaemia and emotional state played an important role in adherence to self-care behaviour in T2DM management. Patients with diabetes mellitus should be routinely screened for psychological factors at diabetes clinics. Thus, developing tailored interventions to raise belief and self-efficacy might be a useful way to increase the involvement of patients in treatment.
Collapse
Affiliation(s)
- Divya Rana
- College of Nursing, Division of Diabetes and Metabolism, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Rajesh Kumar
- College of Nursing, Division of Diabetes and Metabolism, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Ravi Kant
- Internal Medicine, Division of Diabetes and Metabolism, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| |
Collapse
|
19
|
Babak A, Golshiri P, Farasatkish S. Effect of self-efficacy-based training on metabolic control of patients with type 2 diabetes. INTERNATIONAL JOURNAL OF PHYSIOLOGY, PATHOPHYSIOLOGY AND PHARMACOLOGY 2022; 14:281-288. [PMID: 36419674 PMCID: PMC9678751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Type 2 diabetes is a significant problem in today's society. Considering the possible effect of self-efficacy training on diabetes control, we aimed to investigate its impact on type 2 diabetes control. METHODS This randomized controlled clinical trial was performed in 2018 in Isfahan city. Iranian Registry of Clinical Trials (IRCT) code for this study is IRCT20190219042762N1 (https://en.irct.ir/trial/37677). In so doing, 161 patients with diabetes were divided into two groups: intervention and control. The intervention group received six self-efficacy and healthy lifestyle training sessions, and self-efficacy strategies were taught in all sessions. Metabolic indices and the data collected by Diabetes Management Self-Efficacy Scale (DMSES) were analyzed before and three months after training by descriptive and inferential statistics. RESULTS The self-efficacy score of the intervention group was significantly higher after training (175.7±18 vs. 163.7±26, P = 0.001). Also, the cholesterol level, LDL, and systolic blood pressure reduced significantly in this group after the intervention (167±39 vs. 179±43.7 mg/dl, 94.2±31 vs. 102.6±39 mg/dl, 115.6±1.4 vs. 120.1±1.8 mmHg, respectively. P<0.05). CONCLUSION Generally, self-efficacy training effectively improved metabolic control in patients with type 2 diabetes.
Collapse
Affiliation(s)
- Anahita Babak
- Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran
| | - Parastoo Golshiri
- Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran
| | - Shiva Farasatkish
- Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran
| |
Collapse
|
20
|
Nouhjah S, Shahbazian H, Ghodrati N. Changes in self-care behaviors of Iranian patients with type 2 diabetes using insulin pens during COVID-19 pandemic. OBESITY MEDICINE 2022; 33:100418. [PMID: 35664969 PMCID: PMC9142209 DOI: 10.1016/j.obmed.2022.100418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 04/10/2022] [Accepted: 04/26/2022] [Indexed: 11/29/2022]
Abstract
Aims The COVID-19 pandemic as a serious public health concern has been accompanied with changes and restrictions in everyday life. This can affect directly or indirectly health behaviors and disease management, particularly in developing countries with low resources. This study aimed to compare self-care behaviors of patients with type 2 diabetes using insulin pens before and after the COVID-19 pandemic. Methods This was a prospective cohort study involving 300 patients with type 2 diabetes who had been referred to a referral tertiary care diabetes clinic during 2018–2019. The Summary of Diabetes Self-Care Activities Assessment (SDSCA) questionnaire was used for the evaluation of 5 self-care activities. Results The mean total self-care score before and one year after the onset of the COVID-19 crisis was 37.63 (SD, 10.89) and 26.14 (SD, 10.99), respectively. Before the COVID-19 crisis, 27%, 54.3%, and 18.7% of patients had poor, moderate, and good self-care, respectively. One year after the onset of the epidemic, however, these rates were 66.3%, 29%, and 4.7%, respectively. There was a significant difference between the mean score of 5 indices of self-care behaviors before and after the COVID-19 crisis (p < 0.01). Conclusion Our findings suggest the deterioration of self-care behaviors amidst the COVID-19 pandemic in an Iranian population. Continuous follow-up of patients with diabetes and the design of effective educational programs for these patient can prevent or delay the long-term consequences of diabetes, especially in the context of the COVID-19 crisis.
Collapse
|
21
|
El-Radad HM, Sayed Ahmed HA, Eldahshan NA. The relationship between self-care activities, social support, and glycemic control in primary healthcare patients with type 2 diabetes. Diabetol Int 2022; 14:65-75. [PMID: 35966954 PMCID: PMC9362383 DOI: 10.1007/s13340-022-00598-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 07/20/2022] [Indexed: 02/01/2023]
Abstract
Objective Egyptian studies in assessing the relationship between diabetes self-care, social support, and glycemic control in primary healthcare (PHC) are limited. Therefore, this study aimed to assess this relationship, and to evaluate the associated factors of diabetes self-care, social support, and glycemic control in Egyptian PHC patients with type 2 diabetes (T2DM). Methods A cross-sectional study was conducted on 320 T2DM patients at four PHC settings in Port Said city, affiliated with the General Authority of Healthcare. A semi-structured questionnaire was used to collect data, including demographic characteristics, socioeconomic status scale, disease profile, the Arabic versions of the Summary of Diabetes Self-Care Activities, and the received social support scales. Data were collected from January 2020 to June 2020. Results Diabetes self-care activities, and self-monitoring of blood glucose had a very weak negative correlations with glycated hemoglobin (HbA1c) levels (rho = - 0.125, p = 0.025, rho = - 0.112, p = 0.044, respectively). Receiving social support on following a meal correlated positively and very weakly with HbA1c levels (rho = 0.145, p = 0.010). Hardly positive correlation was found between receiving emotional support on feelings about diabetes, and following a specific diet (rho = 0.169, p = 0.002). Diabetes self-care activities were positively associated with higher education levels, and elevated BMI. Received social support was negatively associated with having coronary artery disease, and marital status e.g. divorced and widow. Increased age, and female gender were the predictors of good glycemic control. Conclusion Diabetes self-care activities were linked with reduced HBA1c levels. Further studies are needed to evaluate the buffering effect of social support on glycemic outcomes in PHC patients with T2DM.
Collapse
Affiliation(s)
| | - Hazem A. Sayed Ahmed
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Nahed Amen Eldahshan
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| |
Collapse
|
22
|
Hurst C, Rakkapao N, Malacova E, Mongkolsomlit S, Pongsachareonnont P, Rangsin R, Promsiripaiboon Y, Hartel G. Psychometric properties of the general self-efficacy scale among Thais with type 2 diabetes: a multicenter study. PeerJ 2022; 10:e13398. [PMID: 35646480 PMCID: PMC9135036 DOI: 10.7717/peerj.13398] [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: 10/29/2021] [Accepted: 04/17/2022] [Indexed: 01/14/2023] Open
Abstract
Background Type 2 diabetes (T2D) is one of the most common chronic diseases in the world. In recent decades the prevalence of this disease has increased alarmingly in lower to middle income countries, where their resource-limited health care systems have struggled to meet this increased burden. Improving patient self-care by improving diabetes knowledge and diabetes management self-efficacy represents a feasible way of ameliorating the impact of T2D on the patient, and the health care system. Unfortunately, the relationships between self-efficacy, diabetes self-management, and thereafter, patient outcomes, are still far from well understood. Although a domain-specific measure of diabetes management self-efficacy, the Diabetes Management Self-Efficacy Scale (DMSES), has been validated in the Thai T2D population, more general measures of self-efficacy, such as the General Self-Efficacy scale (GSE) have not been validated in this population. In this paper we translate and examine the psychometric properties of the GSE in Thais living with T2D. Methods In this nation-wide study we examined the psychometric properties of the GSE in 749 Thais diagnosed with T2D within the last five years, and evaluated its relationship with the DMSES along with other patient characteristics. Reliability of GSE was assessed using Cronbach's alpha, and the construct validity was examined using confirmatory factor analysis, along with GSE's convergence and discrimination from DMSES. Results The Thai version of the GSE was shown to have good psychometric properties in Thais living with T2D. Cronbach's alpha was shown to be 0.87 (95% CI [0.86, 0.88]). We also demonstrated the structural validity of the GSE (Tucker-Lewis Index = 0.994, Cumulative Fit Index = 0.995, Adjusted Goodness of Fit Index = 0.998, Root Mean Square Error of Approximations = 0.025, 95% CI [0.06-0.039]), and that this instrument has a similar structure in Thais as in other populations. GSE was also shown to have some overlap with the DMSES with correlations among GSE and the DMSES domains ranging from 0.18 to 0.26, but also the GSE has substantial discrimination from DMSES (Disattenuated correlation coefficient = 0.283, 95% CI [0.214-0.352], p < 0.001). This suggests that while general and diabetes management self-efficacy are somewhat associated, there are aspects of diabetes management self-efficacy not captured by the more stable general self-efficacy. Conclusions We demonstrate that the Thai GSE is a reliable and valid measure. We believe the GSE may represent a useful tool to examine the efficacy of proposed and existing diabetes self-management, and management self-efficacy interventions.
Collapse
Affiliation(s)
- Cameron Hurst
- Biostatistics Group, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Faculty of Public Health, Thammasat University, Rangsit, Prathumthani, Thailand
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Queensland, Australia
| | - Nitchamon Rakkapao
- Faculty of Public Health, Thammasat University, Rangsit, Prathumthani, Thailand
| | - Eva Malacova
- Biostatistics Group, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | | | | | - Ram Rangsin
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Din Daeng, Bangkok, Thailand
| | - Yindee Promsiripaiboon
- Department of Public Health, Surat Thani Rajabhat University, Mueng, Surat Thani, Thailand
| | - Gunter Hartel
- Biostatistics Group, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| |
Collapse
|
23
|
Pitchalard K, Wimolphan P, Singkhorn O, Purkey E, Moonpanane K. Feasibility and Acceptability of the HOME Model to Promote Self-Management Among Ethnic Minority Elderly with Type 2 Diabetes Mellitus in Rural Thailand: A Pilot Study. Health Equity 2022; 6:629-637. [PMID: 36081879 PMCID: PMC9448522 DOI: 10.1089/heq.2021.0161] [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] [Accepted: 07/30/2022] [Indexed: 11/12/2022] Open
Abstract
Introduction: Ethnic minority elderly (EME) people are recognized as a vulnerable group who have higher prevalence of type 2 diabetes mellitus (T2DM) than the majority of the population. The aim of this study was to explore the feasibility, acceptability, and effect of the HOME model (Home intervention; Online monitoring; Multidisciplinary approach; and Equity and education) specifically for enhancing self-management activities, glycemic control, and satisfaction of EME with T2DM in rural areas in Thailand. Methods: In this quasi-experimental study, a single group used a pre-test and post-test, which were conducted as a pilot study to examine the effect of the HOME model. Results: Overall, 23 dyads of EME with T2DM and their family caregivers completed the 12-week intervention. They reported that the HOME model was helpful and motivating, and they reported satisfaction with the service provided. EME with T2DM showed significant reduction of blood glucose level, and significant improvement in self-management activities, happiness, and satisfaction compared with baseline. Family caregivers had also significant improvements in happiness and reported satisfaction with the HOME model. Conclusion: The primary evidence suggested that the HOME model was acceptable and feasible for EME with T2DM and their families in rural Thailand.
Collapse
Affiliation(s)
| | | | | | - Eva Purkey
- School of Medicine, Queen's University, Kingston, Ontario, Canada
| | | |
Collapse
|
24
|
“Life is Bitter and Sweet”: The Lived Experience of Ethnic Minority Elders with Type 2 Diabetes Mellitus in rural, Thailand. Asian Nurs Res (Korean Soc Nurs Sci) 2022; 16:155-161. [DOI: 10.1016/j.anr.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 11/22/2022] Open
|
25
|
Social Support, Self-Care Behaviour and Self-Efficacy in Patients with Type 2 Diabetes during the COVID-19 Pandemic: A Cross-Sectional Study. Healthcare (Basel) 2021; 9:healthcare9111607. [PMID: 34828652 PMCID: PMC8622453 DOI: 10.3390/healthcare9111607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/11/2021] [Accepted: 11/17/2021] [Indexed: 02/01/2023] Open
Abstract
Diabetes mellitus is a major public health issue that considerably impacts mortality, morbidity, and healthcare costs worldwide. The COVID-19 pandemic has created havoc in diabetes management, too, like other spectrums of life. A descriptive, cross-sectional study was adopted to determine the effect of Social Support, Self-Care Behaviour and Self-Efficacy in Type 2 Diabetes Mellitus (T2D) during this COVID-19 pandemic. Two hundred T2D patients who satisfied the inclusion criteria were chosen using a convenient sampling procedure. The tool consists of four sections, including socio-demographic characteristics, Multidimensional Scale of Perceived Social Support (MSPSS), revised Summary of Diabetes Self-Care Activities (SDSCA) Scale and modified Diabetes Management Self-Efficacy Scale (DMS). Descriptive and inferential statistics were used to analyze the obtained data. The mean and SD of diabetic management self-efficacy is 5.74 (1.95) and 4.37 (1.4), respectively, for patients with HbA1c < 6.5% and HbA1c ≥ 6.5%. The self-care activities of the patients who had good glycemic control were 4.31 (2.06) compared to 3.50 (1.73) who did not. The social support received by the patients was 6.13 (2.13) vs. 5.31 (1.67) among patients with glycemic control vs. no control. The results show that social support (p = 0.04), self-efficacy (p =0.01) and self-care activities (p = 0.001) were significantly related to the level of glycemic control of the T2D patients. A significant relationship was also identified between gender (p = 0.036), age (p = 0.001) and education status (p = 0.000) with HbA1c control of the participants. This study demonstrates a significant relationship between social support, self-care behaviours, self-efficacy and glycemic management in T2D patients. During this COVID-19 pandemic, interventions to enhance the self-care activities like exercise and social support to boost their self-efficacy; for better diabetes management, reducing diabetes complications or prolonging their onset are the need of the hour.
Collapse
|
26
|
Effects of diabetes self-management education program on lowering blood glucose level, stress, and quality of life among females with type 2 diabetes mellitus in Thailand. Prim Health Care Res Dev 2021; 22:e46. [PMID: 34521493 PMCID: PMC8444461 DOI: 10.1017/s1463423621000505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aim: The aim of this study is to assess the effect of diabetes self-management education (DSME) on lowering blood glucose level, stress, and quality of life (QoL) among female patients with type 2 diabetes mellitus (T2DM) in Thailand. Background: The burden of noncommunicable diseases has increased globally, and it has negatively affected the QoL of diabetic patients. Methods: A quasi-experimental study was conducted by including 77 T2DM patients selected from 2 public health centers in Thailand. The respondents were randomly selected 38 in control group and 39 in intervention group. Pretested, piloted, and validated tool were used during this study. Knowledge on blood glucose level, stress, and QoL was measured at baseline and then compared to end line after 3 months of the intervention. The effects of intervention were estimated by regression coefficient of intervention on blood glucose level and QoL. The study was ethically approved by the Chulalongkorn University, Thailand. Findings: Baseline characteristics of both the groups were similar before the start of the intervention and there were no significant differences observed in age, education, blood sugar monitoring behavior, medical checkup, knowledge, self-care, stress, and hemoglobin HbA1c (>0.05). However, blood HbA1c, stress level, and QoL among the T2DM patients had significant changes (<0.05) after the intervention. The control group was remained same and there was no statistically significant difference reported (>0.05). Conclusions: The study concluded that the designed intervention of DSME has proved effective in lowering the blood sugar level, HbA1c level, stress level, and improved QoL among T2DM patients during this limited period of time. Hence, policy-makers can replicate this intervention for diabetic patients in a similar context.
Collapse
|