Multimodal Therapeutic Approach in Women with High Risk of Metabolic Syndrome-A Single Group One Center Pre-Post Study

Educational intervention on perceived stress among adults with type 2 diabetes and metabolic syndrome: a non-randomized clinical trial

Objective

To assess the effectiveness of an educational intervention on perceived stress and metabolic syndrome parameters among adults with type 2 diabetes mellitus.

Method

Fifty-one adults (aged 48.73±7.84; 86.3% of women) were included in a non-randomized clinical trial performed in a healthcare unit for six months (Brazilian Clinical Trial Registry: RBR-43K52N). All participants were diagnosed with type 2 diabetes mellitus and metabolic syndrome (intervention group, n=26; control group, n=25). The intervention consisted of a nurse-led educational health-promoting program with a multidisciplinary approach organized in seven workshops. The primary outcome was decreased perceived stress, and the secondary outcome was improvement in metabolic syndrome parameters according to perceived stress levels. These outcomes were assessed at two points in time, at the baseline and follow-up.

Results

Participation in the intervention program resulted in a significant decrease in perceived stress (p=0.028). The stressed participants in the intervention group experienced a significant decrease in blood glucose levels (p=0.001) and a significant increase in high-density lipoprotein-cholesterol (p=0.003) concentrations after the six-month intervention.

Conclusion

The nurse-led educational health-promoting program decreased perceived stress among adults with type 2 diabetes mellitus and metabolic syndrome, improving fasting blood glucose and high-density lipoprotein cholesterol among the stressed participants in the intervention group.

Factors Associated with Undertaking Health-Promoting Activities by Older Women at High Risk of Metabolic Syndrome

BACKGROUND

The complexity of health problems concerning women aged ≥60 years makes it necessary to develop effective, low-cost strategies involving biopsychosocial interventions. The aim of this study is to identify the factors associated with undertaking health-promoting activities by older women at high risk of metabolic syndrome (MetS) with or without depressive symptoms.

METHODS

The study group consisted of 70 older women (62-84 years old) undertaking regular physical activity. A self-developed questionnaire (used to determine the living situation, selected lifestyle components and health problems), the Perceived Stress Questionnaire (PSQ) and the Geriatric Depression Scale (GDS) were used.

RESULTS

In the study group undertaking regular physical activity, 40% had increased symptoms of depression (D group), and 60% were classified as non-depressed (ND group). The D group had a higher general stress level (t = -6.18, p = 0.001). Improving and/or maintaining physical fitness was identified as the greatest motivation in both groups. Willingness to spend time with other people significantly differed between the two groups (χ² = 4.148, p = 0.042). The sole factor significantly differentiating between both groups was lack of time (χ² = 8.777, p = 0.003).

CONCLUSIONS

Motivations and barriers to undertaking health-promoting activities and levels of perceived stress were significantly different between the depressed and non-depressed groups. It is important to encourage primary care physicians to perform screening tests for late-life depression and to provide information on where therapeutic interventions are available for patients with symptoms of MetS and coexisting depressive symptoms.

Remote Support of Elderly Women Participating in Mental Health Promotion Programme during the COVID-19 Pandemic: A Single-Group Longitudinal Intervention

The aim of the study was to evaluate the longitudinal changes in mental well-being during the switch of the intervention from a personal contact to a remotely delivered Mental Health Prevention and Promotion Programme in elderly women at high risk of developing depression. The study included 70 women aged over 60 with a mean age of 72.28 years. In order to determine mental well-being, the Geriatric Depression Scale (GDS) was used at four time points: January, April, September and December 2020. A self-developed questionnaire was used to determine predictors of mental well-being. Two-way ANOVA demonstrated a lack of significant differences between the means in the GDS scores at the four data collection time points (p = 0.21). Frequent use of green areas reduced the GDS score on average by 1.52 points (p = 0.01), while owning a garden by 1.51 points (p = 0.04). The illness of a family member increased the GDS score by an average of 1.7 points (p = 0.02). No significant mood deterioration was found between January 2020 and December 2020 in the studied group of elderly women at a high risk of developing depression, which suggests that the remote support provided in the mental health promotion programme was effective.