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Namdeo MK, Verma S, Das Gupta R, Islam R, Nazneen S, Rawal LB. Depression and health-related quality of life of patients with type 2 diabetes attending tertiary level hospitals in Dhaka, Bangladesh. Glob Health Res Policy 2023; 8:43. [PMID: 37845742 PMCID: PMC10577997 DOI: 10.1186/s41256-023-00328-9] [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: 09/14/2022] [Accepted: 10/03/2023] [Indexed: 10/18/2023] Open
Abstract
INTRODUCTION Type 2 diabetes mellitus (T2DM) and depression are closely linked. People with T2DM are at increased risk of developing depression and vice versa. T2DM and depression comorbid conditions adversely affect Health-Related Quality of Life (HRQOL) and management of T2DM. In this study, we assessed depression and HRQOL among patients with T2DM in Dhaka, Bangladesh. METHODS A cross-sectional study was conducted in two tertiary-level hospitals in Dhaka, Bangladesh. Data were collected from 318 patients with T2DM. A set of standard tools, PHQ-9 (for assessing depression) and EuroQol-5D-5L (for assessing the HRQOL), were used. Statistical analyses, including Chi-square and Fisher's exact tests, Wilcoxon (Mann-Whitney), and Spearman's correlation coefficient tests, were performed using SPSS (v.20). RESULTS The majority of the patients (58%) were females, with a mean age (standard deviation) of 52 ± 10 years, and 74% of patients lived in urban areas. The prevalence of depression was 62% (PHQ-9 score ≥ 5). Over three-quarters (76%) reported problems in the anxiety/ depression dimension of EQ-5D, followed by pain/discomfort (74%), mobility (40%), self-care (36%), and usual activities (33%). The depression and T2DM comorbid condition were associated with all the five dimensions of EQ-5D (χ2 statistics with df = 1 was 52.33, 51.13, 52.67, 21.61, 7.92 for mobility, self-care, usual activities, pain/discomfort, and anxiety/ depression dimensions respectively, p- < 0.01). The mean EQ-5D index (0.53 vs. 0.75) and the mean EQ-5D VAS (65 vs. 76) both showed lower values in T2DM patients with depression compared to T2DM patients without depression (Wilcoxon test, p- < 0.001). CONCLUSIONS We conclude that the majority of the patients with T2DM had comorbid conditions, and the HRQOL was negatively affected by comorbid depression in T2DM patients. This suggests the importance of timely screening, diagnosis, treatment, and follow-up of comorbid depression in T2DM patients to improve overall health and QOL.
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Affiliation(s)
- Manish K Namdeo
- Independent Scholar and Alumni, JPGSPH, BRAC University, Bangladesh, Chhindwara, India.
| | - Sarita Verma
- Tata Institute of Social Sciences, Mumbai, India
| | | | - Rubana Islam
- International Initiative for Impact Evaluation (3Ie), Columbia, SC, USA
| | | | - Lal B Rawal
- Central Queensland University, Sydney Campus, Sydney, Australia
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Sayed Ahmed HA, Fouad AM, Elotla SF, Joudeh AI, Mostafa M, Shah A, Shah J, Mohamed SF. Prevalence and Associated Factors of Diabetes Distress, Depression and Anxiety Among Primary Care Patients With Type 2 Diabetes During the COVID-19 Pandemic in Egypt: A Cross-Sectional Study. Front Psychiatry 2022; 13:937973. [PMID: 35722556 PMCID: PMC9203894 DOI: 10.3389/fpsyt.2022.937973] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/16/2022] [Indexed: 11/17/2022] Open
Abstract
The prevalence of type 2 diabetes mellitus (T2DM) is growing worldwide. T2DM is often complicated by a range of psychological disorders that interfere with glycemic control and self-care. Previous studies have reported diabetes distress, depression, and anxiety among patients with T2DM; however; little is known about the burden of these comorbid mental disorders in primary care patients with T2DM treated in Egypt during the COVID-19 era. Participants were selected by convenient sampling from eight rural primary healthcare facilities from Ismailia in Egypt. Symptoms of diabetes distress, depression and anxiety were assessed by using the Arabic version of the 20-item Problem Areas in Diabetes (PAID), Patient Health Questionnaire 9, and Generalized Anxiety Disorder Scales, respectively. Multiple hierarchical logistic regression models were used to estimate the significant factors associated with diabetes distress, depression, and anxiety. A total of 403 individuals with T2DM were interviewed. The prevalence of severe diabetes distress was 13.4% (95% CI: 10.1-16.7), while prevalence of depressive and anxiety symptoms was 9.2% (95% CI: 6.4-12.0%), and 4.0% (95% CI: 2.1-5.9), respectively. In a series of hierarchical logistic regression models, significant predictors for diabetes distress were being married, illiterate, not-working, living with insufficient income, and having multi-comorbidities. Likewise, the significant predictors for depression and anxiety were elevated glycated hemoglobin level and the higher PAID total score, while having multi-comorbidities was a significant predictor for anxiety only. Diabetes distress was more prevalent than depressive and anxiety symptoms in this study population. Several sociodemographic and clinical characteristics were identified to be related with psychological problems among patients with T2DM, which necessitate a multidisciplinary team-based approach for optimal screening and management.
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Affiliation(s)
- Hazem A Sayed Ahmed
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Ahmed Mahmoud Fouad
- Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Sally Fawzy Elotla
- Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Anwar I Joudeh
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.,Department of Internal Medicine, Faculty of Medicine, University of Jordan, Amman, Jordan
| | - Mona Mostafa
- Department of Internal Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Asghar Shah
- Division of Biology and Medicine, Brown University, Providence, RI, United States
| | - Jaffer Shah
- Medical Research Center, Kateb University, Kabul, Afghanistan
| | - Samar F Mohamed
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Heikkala E, Mikkola I, Jokelainen J, Timonen M, Hagnäs M. Multimorbidity and achievement of treatment goals among patients with type 2 diabetes: a primary care, real-world study. BMC Health Serv Res 2021; 21:964. [PMID: 34521389 PMCID: PMC8442281 DOI: 10.1186/s12913-021-06989-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/07/2021] [Indexed: 12/15/2022] Open
Abstract
Background Type 2 diabetes (T2D), with its prevalence and disability-causing nature, is a challenge for primary health care. Most patients with T2D are multimorbid, i.e. have one or more long-term diseases in addition to T2D. Multimorbidity may play a role in the achievement of T2D treatment targets, but is still not fully understood. The aims of the present cross-sectional, register-based study were to evaluate the prevalence and the most common patterns of multimorbidity among patients with T2D; and to study the potential associations between multimorbidity and treatment goal achievement, including measurements of glycosylated haemoglobin A1c (HbA1c), low-density lipoprotein (LDL) and systolic blood pressure (sBP). Methods The study population consisted of 4545 primary care patients who received a T2D diagnosis between January 2011 and July 2019 in Rovaniemi Health Centre, Finland. Data on seven long-term concordant (T2D-related) diseases, eight long-term discordant (non-T2D-related) diseases, potential confounders (age, sex, body mass index, prescribed medication), and the outcomes studied were collected from patients’ records. Logistic regression models with odds ratios (ORs) and 95 % confidence intervals (CIs) were assessed to determine the associations between multimorbidity and the achievement of treatment targets. Results Altogether, 93 % of the patients had one or more diseases in addition to T2D, i.e. were considered multimorbid. Furthermore, 21 % had only concordant disease(s) (Concordant subgroup), 8 % had only discordant disease(s) (Discordant subgroup) and 64 % had both (Concordant and discordant subgroup). As either single diseases or in combination with others, hypertension, musculoskeletal (MS) disease and hyperlipidaemia were the most prevalent multimorbidity patterns. Being multimorbid in general (OR 1.32, CI 1.01–1.70) and belonging to the Concordant (OR 1.45, CI 1.08–1.95) and Concordant and discordant (OR 1.31, CI 1.00–1.72) subgroups was associated with achievement of the HbA1c treatment target. Belonging to the Concordant and discordant subgroup was related to meeting the LDL treatment target (OR 1.31, CI 1.00–1.72). Conclusions Multimorbidity, including cardiovascular risk and the musculoskeletal disease burden, was extremely prevalent among the T2D patients who consulted primary health care. Primary care clinicians should survey the possible co-existence of long-term diseases among T2D patients to help maintain adequate treatment of T2D.
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Affiliation(s)
- Eveliina Heikkala
- Rovaniemi Health Center, Koskikatu 25, 96200, Rovaniemi, Finland. .,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014, Oulu, Finland. .,Center for Life Course Health Research, University of Oulu, PO Box 5000, 90015, Oulu, Finland.
| | - Ilona Mikkola
- Rovaniemi Health Center, Koskikatu 25, 96200, Rovaniemi, Finland
| | - Jari Jokelainen
- Center for Life Course Health Research, University of Oulu, PO Box 5000, 90015, Oulu, Finland
| | - Markku Timonen
- Center for Life Course Health Research, University of Oulu, PO Box 5000, 90015, Oulu, Finland
| | - Maria Hagnäs
- Rovaniemi Health Center, Koskikatu 25, 96200, Rovaniemi, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, PO Box 5000, 90015, Oulu, Finland
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Tran NMH, Nguyen QNL, Vo TH, Le TTA, Ngo NH. Depression Among Patients with Type 2 Diabetes Mellitus: Prevalence and Associated Factors in Hue City, Vietnam. Diabetes Metab Syndr Obes 2021; 14:505-513. [PMID: 33568927 PMCID: PMC7869718 DOI: 10.2147/dmso.s289988] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/06/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND AIMS Depression is common in people with type 2 diabetes mellitus. The association of depression and diabetes has negative effects on patients. This study investigated the prevalence of depression in individuals with type 2 diabetes mellitus and examined the social, psychological and clinical factors associated with depression. PATIENTS AND METHODS The study included 216 inpatients with type 2 diabetes mellitus at the Department of Endocrinology and Neurology, Hue Central Hospital and the Department of General Internal Medicine, Hue University Hospital. This descriptive cross-sectional study evaluated depression using the Patient Health Questionnaire-9 (PHQ-9). Data were collected on patients' socio-demographic factors such as sex, age, marital and economic status, level of education and clinical factors including duration of type 2 diabetes mellitus, fasting blood glucose, HbA1C, comorbidities or complications as well as health behavior including alcohol consumption, smoking and physical activities. Logistic regression was used to analyze the factors associated with depression in patients with type 2 diabetes mellitus. RESULTS 23.2% of the patients had depression. The rates of severe, moderate and mild depression were 0.5, 0.9 and 21.8%, respectively. Multivariate logistic regression analysis indicated several factors associated with depression in participants, including age under 60 years, poor economic status, unstable or part-time work, having stress during the past year, without/poor treatment adherence to type 2 diabetes mellitus, and engaging in heavy physical activity or physical activity less than three days per week. CONCLUSION The prevalence of depression among patients with type 2 diabetes mellitus is high. Endocrinologists should be made aware of the increased risk of depression in this patient population and screening individuals for relevant risk factors is highly recommended.
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Affiliation(s)
- Nhu Minh Hang Tran
- Department of Psychiatry, Hue University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, Vietnam
- Correspondence: Nhu Minh Hang Tran Department of Psychiatry, Hue University of Medicine and Pharmacy, Hue University, 346/1 Phan Chu Trinh, Hue, Thua Thien Hue, VietnamTel +84905108019 Email
| | - Quang Ngoc Linh Nguyen
- Department of Psychiatry, Hue University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, Vietnam
| | - Thi Han Vo
- Department of Psychiatry, Hue University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, Vietnam
| | - Tran Tuan Anh Le
- Department of Psychiatry, Hue University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, Vietnam
| | - Ngoc Ha Ngo
- Preventive Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, Vietnam
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Abu-Farha M, Tuomilehto J, Abubaker J. Editorial: Diabetes in the Middle East. Front Endocrinol (Lausanne) 2021; 12:638653. [PMID: 33716990 PMCID: PMC7945692 DOI: 10.3389/fendo.2021.638653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/28/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Mohamed Abu-Farha
- Biochemistry and Molecular Biology Department, Dasman Diabetes Institute, Dasman, Kuwait
- *Correspondence: Mohamed Abu-Farha,
| | - Jaakko Tuomilehto
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jehad Abubaker
- Biochemistry and Molecular Biology Department, Dasman Diabetes Institute, Dasman, Kuwait
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Abdulrahman M, Tabatabaei Z, Maqbool S, Hafidh K, Husain ZS, Al Raeesi FH, Abo Sada NM, Akbar M, Hubaishi NM, Tahlak MAR, Carrick FR. A review of gestational diabetes mellitus management, risk factors, maternal and neonatal outcomes in two major maternity hospitals in the United Arab Emirates: A report from Dubai. J Neonatal Perinatal Med 2020; 13:555-562. [PMID: 32568122 DOI: 10.3233/npm-200410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study was conducted in order to explore and analyze the status of gestational diabetes (GDM) amongst pregnant women in Dubai, United Arab Emirates (UAE); a country with high prevalence of diabetes. We aimed to describe GDM-associated risk factors and clinical outcomes of pregnant women and their neonates. Our objective was to contribute to the broader literature on reproductive health disparities and to inform efforts to improve GDM care at our region. METHODS Chart review of case records were used to collect data on both maternal and neonatal parameters and outcomes during the specified study period from two main maternity hospitals in Dubai. RESULTS UAE national women with GDM were more prone to be obese or overweight compared to non-UAE women (p < 0.0001, and p < 0.0001 respectively). In addition, UAE national women with GDM had higher history of GDM in previous pregnancies (p < 0.0001) and more family history of diabetes (p < 0.0001).The neonate admission into NICU was significantly associated with cesarean section (p < 0.0001), twins (p < 0.0001), preeclampsia (p = 0.02), receiving MgSO4 (p = 0.02), birth weight less than 2500 g (p < 0.0001), low Apgar scores (p < 0.0001), baby with congenital anomaly (p < 0.0001), and neonatal hypoglycemia (p < 0.0001). CONCLUSIONS Our results demonstrate that pregnant women with GDM who are UAE nationals and have higher parity need to be under special attention during their pregnancy in order to improve both maternal and neonatal outcomes.
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Affiliation(s)
- Mahera Abdulrahman
- Health Informatics & Smart Health Department, Dubai, United Arab Emirates
| | | | - Sadia Maqbool
- Latifa Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Khadija Hafidh
- Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Zahra Sm Husain
- Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | | | | | - Madiha Akbar
- Latifa Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | | | | | - Frederick Robert Carrick
- University of Central Florida College of Medicine, Orlando, FL USA.,Adjunct Professor MGH Institute for Health Professions, Boston, MA, USA.,Centre for Mental Health Research in Association with University of Cambridge, Cambridge UK
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Abdulrahman M, Husain ZSM, Abdouli KA, Kazim MN, Sayed Mahdi Ahmad F, Carrick FR. Association between knowledge, awareness, and practice of patients with type 2 diabetes with socio-economic status, adherence to medication and disease complications. Diabetes Res Clin Pract 2020; 163:108124. [PMID: 32259614 DOI: 10.1016/j.diabres.2020.108124] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 02/12/2020] [Accepted: 03/23/2020] [Indexed: 01/29/2023]
Abstract
AIMS Diabetes is a self-managed condition; knowledge, attitudes, and practices about the condition can influence the overall treatment outcomes and complications of the disease. The aim of this study was to assess the knowledge, attitude, and practice toward diabetes among T2DM patients in the UAE, a highly prevalent country with diabetes. METHODS We used the revised Michigan Diabetes Knowledge Scale on T2DM patients. The awareness on diabetes was then assessed based on socio-demographic characteristics, illness perceptions, medication adherence, diabetic self-care, and T2DM complications. RESULTS Overall assessment of T2DM patients on their knowledge, and attitude toward their diabetes were good in the majority of participants (544, 76%; 570, 76% respectively). However, adherence to diabetic self-care practices was fair in the mainstream (437, 57%). The compliance to medication (527, 70%) and eye care practice (475, 63%), were quite high; yet regular checking blood sugar at home 330 (44%) and the foot care practice 336 (45%) were not satisfying. CONCLUSION Our results demonstrate that the intensive education service being given and time the physician spends with the T2DM patients is highly associated with better practice and outcome of the disease. There is a need for the establishment of better DM education programs in PHC clinics and the development of more campaigns and enlightening programs, both for health care providers and public on T2DM self-care, complications, and nature of the disease. We suggest that new policies be established with a focus on increasing community awareness of diabetes and preventive measures in UAE.
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Affiliation(s)
- Mahera Abdulrahman
- Health Regulation Sector, Dubai Health Authority, Dubai, United Arab Emirates.
| | - Zahra S M Husain
- Primary Healthcare Sector, Dubai Health Authority, Dubai, United Arab Emirates
| | | | | | | | - Frederick R Carrick
- Centre for Mental Health Research in association with University of Cambridge, Cambridge, UK; University of Central Florida College of Medicine, Orlando, FL USA; MGH Institute for Health Professions, Boston, MA, USA
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Bąk E, Marcisz-Dyla E, Młynarska A, Sternal D, Kadłubowska M, Marcisz C. Prevalence of Depressive Symptoms in Patients with Type 1 and 2 Diabetes Mellitus. Patient Prefer Adherence 2020; 14:443-454. [PMID: 32184573 PMCID: PMC7060793 DOI: 10.2147/ppa.s237767] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/11/2020] [Indexed: 12/03/2022] Open
Abstract
PURPOSE Patients with diabetes are at increased risk of developing depression. The aim of the study was to determine the occurrence of depressive symptoms in patients with type 1 (T1DM) and type 2 diabetes (T2DM), including the association with different independent sociodemographic and clinical variables. PATIENTS AND METHODS The studies were carried out on 618 people, including 115 patients with T1DM and 215 patients with T2DM and 288 people without diabetes constituting two control groups. Subjects were characterized in terms of sociodemographic, clinical and biochemical aspects, and the occurrence of depressive symptoms using Beck Depression Inventory (BDI) was determined. In the logistic regression analysis, the correlations between BDI score and with independent variables such as sex, age, body mass index, duration of diabetes, HbA1c level, diabetic complications and mean arterial pressure were examined. RESULTS The mean BDI score was significantly higher in women and men with T1DM and T2DM compared to controls. In diabetic patients, depressive symptoms occurred more often in women than in men. Among patients with T1DM, the incidence of depressive symptoms was 17.5% of the women and 8.6% of the men and in patients with T2DM, the incidence of depressive symptoms was revealed in 28.9% of the women and in 19.8% of the men. In patients with T1DM and T2DM, the occurrence of depressive symptoms increases with age, HbA1c level and complications, and the risk of depressive symptoms turned out to be almost three times higher in women than in men with T2DM. CONCLUSION The prevalence of depressive symptoms in diabetic patients is higher than in non-diabetics. Depressive symptoms account for 13% of the patients with T1DM and 24.7% of the patients with T2DM. The risk of depressive symptoms in T1DM and T2DM increases with age, HbA1c level and the presence of complications, and it is gender-related in T2DM only.
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Affiliation(s)
- Ewelina Bąk
- Faculty of Health Sciences, University of Bielsko-Biala, Bielsko-Biala, Poland
- Correspondence: Ewelina Bąk Faculty of Health Sciences, University of Bielsko-Biala, ul. Willowa 2, Bielsko-Biala43-309, PolandTel +48 33 827 9198 Email
| | - Ewa Marcisz-Dyla
- Department of Anxiety Disorders, Hospital of Ministry of Internal Affairs, Katowice, Poland
| | - Agnieszka Młynarska
- Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, Katowice, Poland
| | - Danuta Sternal
- Faculty of Health Sciences, University of Bielsko-Biala, Bielsko-Biala, Poland
| | - Monika Kadłubowska
- Faculty of Health Sciences, University of Bielsko-Biala, Bielsko-Biala, Poland
| | - Czesław Marcisz
- Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, Katowice, Poland
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