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Chew BH, Lai PSM, Sivaratnam DA, Basri NI, Appannah G, Mohd Yusof BN, Thambiah SC, Nor Hanipah Z, Wong PF, Chang LC. Efficient and Effective Diabetes Care in the Era of Digitalization and Hypercompetitive Research Culture: A Focused Review in the Western Pacific Region with Malaysia as a Case Study. Health Syst Reform 2025; 11:2417788. [PMID: 39761168 DOI: 10.1080/23288604.2024.2417788] [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: 06/05/2024] [Revised: 08/28/2024] [Accepted: 10/14/2024] [Indexed: 01/11/2025] Open
Abstract
There are approximately 220 million (about 12% regional prevalence) adults living with diabetes mellitus (DM) with its related complications, and morbidity knowingly or unconsciously in the Western Pacific Region (WP). The estimated healthcare cost in the WP and Malaysia was 240 billion USD and 1.0 billion USD in 2021 and 2017, respectively, with unmeasurable suffering and loss of health quality and economic productivity. This urgently calls for nothing less than concerted and preventive efforts from all stakeholders to invest in transforming healthcare professionals and reforming the healthcare system that prioritizes primary medical care setting, empowering allied health professionals, improvising health organization for the healthcare providers, improving health facilities and non-medical support for the people with DM. This article alludes to challenges in optimal diabetes care and proposes evidence-based initiatives over a 5-year period in a detailed roadmap to bring about dynamic and efficient healthcare services that are effective in managing people with DM using Malaysia as a case study for reference of other countries with similar backgrounds and issues. This includes a scanning on the landscape of clinical research in DM, dimensions and spectrum of research misconducts, possible common biases along the whole research process, key preventive strategies, implementation and limitations toward high-quality research. Lastly, digital medicine and how artificial intelligence could contribute to diabetes care and open science practices in research are also discussed.
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Affiliation(s)
- Boon-How Chew
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Family Medicine Specialist Clinic, Hospital Sultan Abdul Aziz Shah (HSAAS Teaching Hospital), Persiaran MARDI - UPM, Serdang, Selangor, Malaysia
| | - Pauline Siew Mei Lai
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, School of Medical and Life Sciences, Sunway University, Kuala Lumpur, Selangor, Malaysia
| | - Dhashani A/P Sivaratnam
- Department of Opthalmology, Faculty of .Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Nurul Iftida Basri
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Geeta Appannah
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Barakatun Nisak Mohd Yusof
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Subashini C Thambiah
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Zubaidah Nor Hanipah
- Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | | | - Li-Cheng Chang
- Kuang Health Clinic, Pekan Kuang, Gombak, Selangor, Malaysia
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Abdul-Samed AB, Jahan Y, Reichenberger V, Peprah EB, Agyekum MP, Lawson H, Balabanova D, Mirzoev T, Agyepong IA. Barriers and facilitators of primary care management of type II diabetes mellitus in the West African sub-region: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2025; 5:e0003733. [PMID: 40324001 PMCID: PMC12052127 DOI: 10.1371/journal.pgph.0003733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2024] [Accepted: 02/28/2025] [Indexed: 05/07/2025]
Abstract
The prevalence of diabetes is rising rapidly across West Africa, posing a significant public health challenge. Effective diabetes management through accessible and quality primary healthcare is crucial, yet multiple barriers persist. This review aimed to synthesise the available evidence on factors influencing access, utilisation, and quality of diabetes primary care in West Africa. Following Arksey and O'Malley's framework and PRISMA-ScR guidelines, we searched four electronic databases (PubMed, Scopus, Google Scholar, CAIRN Info) and grey literature sources. Eligibility criteria included: peer-reviewed studies published between 2000-2023 in English or French; primary research focusing on adult type II diabetes care in West African countries; and studies reporting on factors affecting access, utilisation, or quality of primary healthcare. Data were extracted using a standardised form and analysed through framework synthesis integrating the WHO Primary Health Care Framework, Social Determinants of Health model, and Innovative Care for Chronic Conditions model. Twelve studies were included from Nigeria (n=7), Ghana (n=4), and Senegal (n=1). Key barriers to access, utilisation, and quality were identified as health system deficiencies, including inadequate infrastructure, workforce shortages, supply gaps, fragmented coordination of care, absence of standardised guidelines, high costs of care, and inefficient leadership/governance for chronic disease management. Broader determinants of health, such as poverty, gender, cultural beliefs, reliance on traditional medicine, and health policy gaps, significantly influenced access to and utilisation of care. Individual-level barriers like psychological distress and delays in care-seeking were also significant. Family/social support systems emerged as potential facilitators of accessing and utilising PHC services. Our review identified that to improve diabetes care, West Africa needs context-specific models that align indigenous healing practices with PHC, strengthen health systems, and address sociocultural determinants. Future research should focus on developing and evaluating culturally resonant interventions that can navigate both biomedical and sociocultural factors shaping diabetes management in resource-constrained settings.
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Affiliation(s)
| | - Yasmin Jahan
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | | | - Henry Lawson
- Ghana College of Physicians and Surgeons, Accra, Ghana
| | - Dina Balabanova
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Tolib Mirzoev
- London School of Hygiene & Tropical Medicine, London, United Kingdom
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Huang YC, Zuñiga JA, Kuo HJ, Bang SH, García AA. The Effect of Acculturation on Diabetes Knowledge Among Chinese Americans With Type 2 Diabetes. Sci Diabetes Self Manag Care 2025:26350106251326503. [PMID: 40165456 DOI: 10.1177/26350106251326503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/02/2025]
Abstract
PurposeThe purpose of the study was to examine the level of diabetes knowledge among Chinese Americans with type 2 diabetes (T2DM) and the influence of acculturation levels on diabetes knowledge. T2DM is a significant health issue for Chinese Americans because of the unique challenges they face that reflect a complex interplay of culture, language, insufficient numbers of culturally congruent health care providers, and socioeconomic factors. Diabetes knowledge is an essential foundation for effective diabetes self-management behaviors. However, few studies have assessed Chinese Americans' level of diabetes knowledge and its relationship to acculturation.MethodsA secondary analysis of cross-sectional survey data from 110 Chinese Americans with T2DM was conducted. Descriptive analyses summarized specific knowledge deficits, and a hierarchical regression model was used to test the contribution of acculturation to the level of knowledge after controlling for demographics, diabetes duration, treatment, number of comorbidities, and diabetes numeracy.ResultThe average percentage of correct responses on the Diabetes Knowledge Questionnaire-Revised was approximately 77%. Items that were answered incorrectly the most frequently pertained to low or high blood glucose symptoms, desired A1C level, and glucose levels' relation to emotions. Diabetes numeracy and acculturation significantly predicted diabetes knowledge after controlling for demographic and health indicators.ConclusionChinese American patients may have significant gaps in knowledge regarding diabetes and its management that correspond to lower numeracy and acculturation levels. Health care providers should reinforce diabetes education for Chinese American patients who have lower acculturation levels.
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Affiliation(s)
- Ya-Ching Huang
- College of Nursing, Texas A&M University, College Station, Texas
- St. David's School of Nursing, Texas State University, San Marcos, Texas
| | - Julie A Zuñiga
- School of Nursing, The University of Texas at Austin, Austin, Texas
| | - Hsuan-Ju Kuo
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - So Hyeon Bang
- School of Nursing, The University of Texas at Austin, Austin, Texas
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Gomez Aguilar PIDS, Thomas JJ, Yam Sosa AV, Rosado Alcocer LM, Santoyo Fuentes SP. Type 2 Diabetes Self-Care in Oxcutzcab, Yucatan, Mexico: The Role of Mental Health. J Transcult Nurs 2025:10436596251323579. [PMID: 40099900 DOI: 10.1177/10436596251323579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2025] Open
Abstract
INTRODUCTION Understanding mental health in the context of type 2 diabetes self-care behaviors may lead to improvements in disease prognosis, overall well-being, and delivery of services. The purpose of this study was to understand differences in adherence to type 2 diabetes treatment among individuals who report anxiety, anger, and depression. METHODS Questionnaires were administered to 111 individuals with type 2 diabetes in Oxcutzcab, Yucatan, Mexico. Participants completed the State-Trait Anxiety Inventory, State-Trait Anger Expression Inventory-2, the Beck Depression Inventory, and the Scale of Adherence to Diabetes Mellitus Type 2 Treatment. RESULTS Independent-samples t-test was used to determine mean differences in mental health variables for adherence to treatment variables. Overall, reported levels of anxiety, anger, and depression differed for certain adherence-related behaviors and experiences. DISCUSSION Our results indicate the importance of mental health assessment and support as part of the type 2 diabetes disease management process in Yucatan.
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Park JH, Sherman LD, Smith ML, Patterson MS, Prochnow T. The Association Between Health Belief Model Components and Self-Care Practices Among Black/African American Men with Type 2 Diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2025; 22:414. [PMID: 40238475 PMCID: PMC11941972 DOI: 10.3390/ijerph22030414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2024] [Revised: 02/19/2025] [Accepted: 03/11/2025] [Indexed: 04/18/2025]
Abstract
This study investigates the impact of the Health Belief Model (HBM) constructs on self-care behaviors among Black/African American men with Type 2 Diabetes (T2D). A cross-sectional survey was conducted from February to June 2024, involving 1225 Black/African American men aged 21 years or older who self-reported a T2D diagnosis. The survey included HBM constructs, and self-care behaviors measured using established scales. Statistical analyses, including multiple linear regression, were performed to assess the relationships between HBM components and self-care practices, adjusted by demographic factors such as age, education, and income. The study found that self-efficacy was the strongest predictor of self-care behaviors across all domains (β = 0.055, p < 0.001). Perceived susceptibility was positively associated with healthful eating (β = 0.042, p = 0.038), glucose monitoring (β = 0.117, p < 0.001), and foot care (β = 0.140, p < 0.001). Perceived severity was positively linked to diet adherence (β = 0.015, p < 0.001) and glucose monitoring (β = 0.028, p < 0.001). Perceived barriers were negatively associated with self-care practices, including glucose monitoring (β = -0.047, p < 0.001). However, perceived benefits did not significantly impact overall self-care behaviors (β = 0.001, p = 0.893). Self-efficacy, perceived susceptibility, and perceived severity were significant predictors of self-care behaviors among Black/African American men with T2D. In particular, interventions aimed at enhancing self-efficacy, addressing barriers, and promoting awareness of diabetes risks may improve diabetes management and self-care behaviors in this population.
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Affiliation(s)
- Jeong-Hui Park
- Department of Health Behavior, School of Public Health, Texas A&M Health Science Center, 212 Adriance Lab Rd., College Station, TX 77843, USA; (J.-H.P.); (L.D.S.); (M.L.S.); (M.S.P.)
- Center for Health Equity and Evaluation Research, Texas A&M University, College Station, TX 77843, USA
- Center for Community Health and Aging, Texas A&M University, College Station, TX 77843, USA
| | - Ledric D. Sherman
- Department of Health Behavior, School of Public Health, Texas A&M Health Science Center, 212 Adriance Lab Rd., College Station, TX 77843, USA; (J.-H.P.); (L.D.S.); (M.L.S.); (M.S.P.)
- Center for Health Equity and Evaluation Research, Texas A&M University, College Station, TX 77843, USA
| | - Matthew Lee Smith
- Department of Health Behavior, School of Public Health, Texas A&M Health Science Center, 212 Adriance Lab Rd., College Station, TX 77843, USA; (J.-H.P.); (L.D.S.); (M.L.S.); (M.S.P.)
- Center for Health Equity and Evaluation Research, Texas A&M University, College Station, TX 77843, USA
- Center for Community Health and Aging, Texas A&M University, College Station, TX 77843, USA
| | - Megan S. Patterson
- Department of Health Behavior, School of Public Health, Texas A&M Health Science Center, 212 Adriance Lab Rd., College Station, TX 77843, USA; (J.-H.P.); (L.D.S.); (M.L.S.); (M.S.P.)
| | - Tyler Prochnow
- Department of Health Behavior, School of Public Health, Texas A&M Health Science Center, 212 Adriance Lab Rd., College Station, TX 77843, USA; (J.-H.P.); (L.D.S.); (M.L.S.); (M.S.P.)
- Center for Health Equity and Evaluation Research, Texas A&M University, College Station, TX 77843, USA
- Center for Community Health and Aging, Texas A&M University, College Station, TX 77843, USA
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Vlahovic B, Jha V, Stojanovic V, Vojinovic T, Dutta A, Dutta P, Medenica S. Enhancing patient-centered care: Evaluating quality of life in type 2 diabetes management. PLoS One 2025; 20:e0319369. [PMID: 40067804 PMCID: PMC11896040 DOI: 10.1371/journal.pone.0319369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2024] [Accepted: 01/31/2025] [Indexed: 03/15/2025] Open
Abstract
AIMS To evaluate quality of life (QoL) in patients with type 2 diabetes mellitus (T2DM). METHODS A cross-sectional study included 151 T2DM patients at the Clinical Centre of Montenegro. The Ferrans and Powers Quality of Life Index (QLI), validated for the Montenegrin population, assessed QoL across five domains. Participants rated items on a Likert scale from 1 (very dissatisfied) to 5 (very satisfied). Data were analysed using SPSS version 22. RESULTS The cohort included 51% women, with a mean age of 60.05 ± 11.63 years. Of the patients, 42% had diabetes for over a decade, and 64% had no additional health conditions. Overall, patients reported satisfactory QoL, especially in self-care and glucose management, though dissatisfaction was high regarding sexual life. Emotional support from family, housing, and friendships significantly contributed to life satisfaction, while financial concerns and job dissatisfaction were common. QoL showed no significant gender differences but declined with age and was notably lower in patients with comorbidities. CONCLUSION Patients with T2DM report generally satisfactory QoL, with notable concerns in socio-economic and health-related areas. Routine QoL assessments in clinical practice can improve communication, aid in early complication detection, and enable timely interventions to enhance patient outcomes.
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Affiliation(s)
- Branka Vlahovic
- Metabolic Intensive Care Unit, Internal Medicine Clinic, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Vivek Jha
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, Punjab, India
| | - Vukasin Stojanovic
- Emergency Medicine Center of Montenegro, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
| | - Tanja Vojinovic
- Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
| | | | - Pinaki Dutta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, Punjab, India
| | - Sanja Medenica
- Department of Endocrinology, Internal Medicine Clinic, Clinical Center of Montenegro, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
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Chia AWY, Teo WLL, Acharyya S, Munro YL, Dalan R. Patient-physician communication of health and risk information in the management of cardiovascular diseases and diabetes: a systematic scoping review. BMC Med 2025; 23:96. [PMID: 39984943 PMCID: PMC11846366 DOI: 10.1186/s12916-025-03873-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2024] [Accepted: 01/14/2025] [Indexed: 02/23/2025] Open
Abstract
BACKGROUND The communication of health and risk information is an integral part of patient-physician interaction. Effective communication of risk information for cardiovascular diseases and diabetes has been shown to improve medication adherence, increase physical activity levels, and improve dietary control. Patients who understand their risk profile are better able to work towards modifying their lifestyle behaviours as part of a shared decision-making process with physicians. This scoping review examines the evidence on patient-physician risk communication strategies, approaches and interventions for CVDs and diabetes management in primary care and secondary outpatient settings. METHODS A comprehensive database search for quantitative and qualitative studies was conducted in PubMed, Embase, Web of Science, Scopus, CINAHL, PsycINFO, and Cochrane Library from 1st January 2000 to 3rd October 2023. Two reviewers independently performed the screening of articles. Studies that report on patient-physician risk communication processes were included. Data were extracted and analysed using descriptive summaries and narrative synthesis. Results are reported in accordance with PRISMA-ScR guidelines. Included articles were appraised for quality following JBI critical appraisal and MMAT tools. RESULTS A total of 8378 articles published between 1st Jan 2000 to 3rd October 2023 were screened. After a full-text review of 88 articles, a total of 30 articles, consisting of 15 qualitative, 14 quantitative and 1 mixed method studies were included. Common areas of inquiry among articles include: (1) understanding and recalling risk information, (2) strategies and approaches used by physicians to communicate risk, and (3) interventions to improve the communication of risk. Studies reveal how physicians use a range of strategies, approaches and interventions to discuss risk with patients. We present and discuss each theme narratively in detail. CONCLUSIONS There is a critical need for further research into risk communication strategies for cardiovascular diseases (CVDs) and diabetes, with a focus on developing targeted approaches that enhance patients' understanding of their risk profiles. Evidence-based guidelines should assist healthcare professionals improve risk communication within clinical settings, with the goal of facilitating patient comprehension of health risks that can sustain lifestyle changes. Misalignment in communication may lead to dissatisfaction and confusion, which may impede the effective management of chronic conditions.
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Affiliation(s)
- Aloysius Wei-Yan Chia
- Department of Endocrinology, Tan Tock Seng Hospital, National Healthcare Group, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
| | - Winnie Li-Lian Teo
- Group Education, National Healthcare Group, Annex@National Skin Centre, Level 3, 1 Mandalay Road, Singapore, 308205, Singapore
| | - Sanchalika Acharyya
- Clinical Research and Innovation Office, Tan Tock Seng Hospital, Ng Teng Fong Centre for Healthcare Innovation (CHI), Level 2, 18 Jalan Tan Tock Seng, Singapore, 308443, Singapore
| | - Yasmin Lynda Munro
- Medical Library, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308232, Singapore
| | - Rinkoo Dalan
- Department of Endocrinology, Tan Tock Seng Hospital, National Healthcare Group, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308232, Singapore
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Ting Z, Huicai W, Kudelati Z, Yongkang G, Alimu A, Xiaotian Z, Xingge Q, Tong L. Exploring the dynamics of self-efficacy, resilience, and self-management on quality of life in type 2 diabetes patients: A moderated mediation approach from a positive psychology perspective. PLoS One 2025; 20:e0317753. [PMID: 39854536 PMCID: PMC11759368 DOI: 10.1371/journal.pone.0317753] [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: 08/15/2024] [Accepted: 01/04/2025] [Indexed: 01/26/2025] Open
Abstract
OBJECTIVES Type 2 diabetes mellitus (T2DM) significantly deteriorates patients' quality of life (QOL). This study examined the dynamic interplay of factors that influence QOL in patients with T2DM, utilizing concepts from positive psychology and intrinsic mechanisms, to lay the groundwork for improving patient outcomes. Improving self-management behaviors is essential for effective disease management. METHODS Using a cross-sectional design, this study incorporated 408 patients with T2DM from the endocrinology department of a public hospital in Urumqi, who were selected through convenience sampling from December 29, 2023 to June 30, 2024. Data collection tools included the General Data Questionnaire, Summary of Diabetes Self-Care Activities, Self-Efficacy for Diabetes Questionnaire, Connor-Davidson Resilience Scale, and Diabetes-Specific Quality of Life Scale. Structural equation modeling and Model 15 of Hayes' SPSS-Process program facilitated the moderated mediation analysis. RESULTS The findings demonstrated that self-efficacy significantly enhanced the QOL (β = -0.8557, p < 0.01), with resilience serving as a partial mediator, accounting for 43.1% of this effect. Interactions between self-efficacy and self-management, and resilience and self-management, were also significant predictors of QOL (β = -0.0751, p < 0.01 and β = -0.0073, p < 0.05, respectively). CONCLUSION These findings introduce a novel theoretical framework for T2DM from the perspective of positive psychology, which will be beneficial for intervention development. This study underscores the importance of promoting diabetes self-management as an effective strategy to enhance QOL. Additionally, healthcare providers must focus on fostering patients' positive psychological traits and reliable self-management behaviors.
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Affiliation(s)
- Zheng Ting
- Nursing School, Xinjiang Medical University, Urumqi, China
| | - Wang Huicai
- Department of Undergraduate Educational Management, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Zakeer Kudelati
- College of Health Management, Xinjiang Medical University, Urumqi, China
| | - Ge Yongkang
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Ayimire Alimu
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Zhang Xiaotian
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Qu Xingge
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Li Tong
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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Yun JY, Jung JY, Keam B, Lee NR, Kang JH, Kim YJ, Shim HJ, Jung KH, Koh SJ, Ryu H, Yoo SH, Kang E, Yun YH. Depression, performance status, and discontinued treatment mediate an association of curability belief with prognosis in advanced cancer patients. Sci Rep 2024; 14:29098. [PMID: 39582048 PMCID: PMC11586441 DOI: 10.1038/s41598-024-80687-6] [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: 04/17/2024] [Accepted: 11/21/2024] [Indexed: 11/26/2024] Open
Abstract
Individuals diagnosed with advanced cancer often experience stress and depression, factors linked to worse survival. Curability belief-defined as the hope and expectation of cure through treatment, based on affective forecasting-may differ from the patient's actual life expectancy (i.e., likelihood estimation) and has shown variable associations with cancer survival. In this study, multivariate Cox regression analyses were used to examine the effect of curability belief and depression on 1-year survival after adjustment for physical factors. Additionally, regularized partial correlations among physical and psychological factors were assessed using mixed graphical models to elucidate their roles in mediating the relationship between curability belief and 1-year survival. This multi-center cohort study, conducted across 13 tertiary hospitals (including four ranked among the 'World's Best Specialized Hospitals 2025' in oncology), involved 382 adults with stage IV advanced cancer and an oncologist-estimated survival of more than 6 months. Baseline data included demographics, primary tumor site, number of metastatic sites, symptom burdens (EORTC QLQ-C15-PAL), performance status (ECOG-PS), depression levels (PHQ-9), anti-cancer treatment type, patient's life expectancy estimation, and curability belief. Follow-up data included 1-year survival and end-of-life care (place of death) for deceased patients. Multivariate Cox proportional hazards models were used to assess adjusted hazard ratios (aHRs) for curability belief, depression, and their interaction on 1-year survival, adjusting for significant demographic and clinical factors from univariate Cox regressions. The Kaplan-Meier method was used to plot survival probability by curability belief and depression interaction. Mixed graphical models estimated regularized partial correlations among 1-year survival, curability belief, patient's life expectancy, depression, primary tumor site, anti-cancer treatment type, performance status, and symptom burden. In terms of healthcare utilization, patients with curability belief were more likely to receive standard or advanced anti-cancer therapy, while those without curability belief tended to suspend or discontinue therapy (P < 0.001). Among patients who did not survive the 1-year follow-up (N = 161), end-of-life care settings differed significantly between those with curability belief (predominantly nursing homes and home settings) and those without (primarily hospice and tertiary/secondary hospitals; P = 0.036). In multivariate Cox regression, curability belief (P = 0.003), depression (PHQ-9 score ≥ 10; P = 0.003), and their interaction (P = 0.040) were significantly associated with 1-year survival, after adjusting for sex, residential area, primary tumor site, performance status, anti-cancer treatment type, and symptom burdens (fatigue and appetite loss). The relationship between curability belief and 1-year survival was significant only in patients without depression [PHQ-9 score < 10; aHR (95% CI) = 2.20 (1.31-3.70); P = 0.003]. In the mixed graphical model, node predictability values for curability belief, depression, and 1-year survival were 0.68, 0.50, and 0.70, respectively, with curability belief showing partial correlations with depression (r = 0.30) and patients' life expectancy (r = 0.20); depression correlated with fatigue (r = 0.53), anorexia (r = 0.16), life expectancy (r = 0.24), performance status (r = 0.23), and curability belief; and 1-year survival correlated with suspended/stopped anti-cancer treatment (r = 0.45), primary tumor site (r = 0.24), and performance status (r = 0.15). Partial correlations of performance status with depression and discontinued treatment mediated the association between curability belief and 1-year survival. Curability belief among stage IV advanced cancer patients with an oncologist-estimated survival of over 6 months was associated with depression levels and patients' perceived life expectancy estimations. Performance status, depression, and anti-cancer treatment status mediate the relationship between curability belief and improved 1-year survival in patients without depression. Further research using longitudinal modeling of depression, performance status, and healthcare utilization, with curability belief and primary tumor site as covariates, is warranted.Trial registration: Clinical Trial Number (ClinicalTrials.gov): NCT03222258; Study Registration Dates (First submitted: 2017-06-05; First submitted following the QC criteria: 2017-07-16; First posted: 2017-07-19).
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Affiliation(s)
- Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ju Youn Jung
- Department of Biomedical Science, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Bhumsuk Keam
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Na-Ri Lee
- Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Jung Hun Kang
- Department of Internal Medicine, Gyeongsang National University, Jinju, Republic of Korea
| | - Yu Jung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Hyun-Jeong Shim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Kyung Hae Jung
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Su-Jin Koh
- Department of Hematology and Oncology, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Republic of Korea
| | - Hyewon Ryu
- Internal Medicine, Chungnam National University College of Medicine, Chungnam, Republic of Korea
| | - Shin Hyu Yoo
- Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul, Republic of Korea
| | - EunKyo Kang
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
- Department of Family Medicine, National Cancer Center, Goyang, Republic of Korea
| | - Young Ho Yun
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
- Department of Human System Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Weston SJ, Hill PL, Mroczek DK. Associations for Sense of Purpose with Smoking and Health Outcomes Among Adults with Diabetes. Int J Behav Med 2024; 31:538-548. [PMID: 37415036 PMCID: PMC11269333 DOI: 10.1007/s12529-023-10191-0] [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] [Accepted: 06/03/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Health complications from diabetes place major strain on individuals, financially and emotionally. The onset and severity of these complications are largely driven by patients' behaviors, making psychosocial factors that influence behaviors key targets for interventions. One promising factor is sense of purpose or the degree to which a person believes their life has direction. METHOD The current study investigated whether sense of purpose predicts self-rated health, cardiovascular disease, and smoking status among adults with diabetes concurrently and prospectively. Moreover, it tested whether these associations held across multiple samples and cultures. Coordinated analysis using 12 datasets cross-sectionally and eight longitudinally (total N = 7277) estimated the degree to which sense of purpose is associated with subjective health, smoking status, and cardiovascular disease among adults with diabetes. Coordinated analysis allows for greater generalizability of results across cultures, time periods, and measurement instruments. Datasets were included if they concurrently included a measure of sense of purpose and diabetes status and at least one health measure: self-rated health, current smoking status, or heart condition status. RESULTS Sense of purpose was associated with higher self-rated health, smoking status, and cardiovascular disease cross-sectionally and self-rated health prospectively. Purpose was unassociated with changes in health over time. CONCLUSION These results highlight the relationship of a key individual difference, sense of purpose, to the behaviors and outcomes of adults with diabetes. While more research is needed to determine the boundaries of this relationship, it seems sense of purpose may be considered in the future as a potential target for intervention.
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Affiliation(s)
- Sara J Weston
- Department of Psychology, University of Oregon, 1451 Onyx St, Eugene, OR, 97403, USA.
| | - Patrick L Hill
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, USA
| | - Daniel K Mroczek
- Department of Medical Social Sciences, Northwestern University, Chicago, USA
- Department of Psychology, Northwestern University, Evanston, USA
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11
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Mangoulia P, Milionis C, Vlachou E, Ilias I. The Interrelationship between Diabetes Mellitus and Emotional Well-Being: Current Concepts and Future Prospects. Healthcare (Basel) 2024; 12:1457. [PMID: 39057600 PMCID: PMC11276337 DOI: 10.3390/healthcare12141457] [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: 06/11/2024] [Revised: 07/19/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024] Open
Abstract
Diabetes mellitus is a lifelong metabolic disorder that impacts people's well-being and biopsychosocial status. Psychiatric problems and diabetes mellitus have a complex, reciprocal interaction in which one condition affects the other. In this narrative review, we provide an overview of the literature on the psychological effects of diabetes, expound on the evaluation of emotional disorders in the setting of diabetes, and suggest interventions aimed at enhancing both mental and physical health. Diabetes can make daily life complicated and stressful. Frequent blood glucose testing, taking medications on a regular basis, adhering to a tight diet plan, and exercising are some examples of the suggested daily routine of subjects with diabetes. Furthermore, comorbid diseases and typical diabetic complications can have a detrimental impact on quality of life. When mental health conditions coexist with diabetes mellitus, there is a greater likelihood of medication noncompliance, a decreased commitment to diabetes-related self-care, increased functional impairment, inadequate glycemic control, a higher risk of complications, and overall higher healthcare expenses. Thus, evaluation of the mental health status of patients with diabetes is crucial. When treating psychological issues and psychiatric disorders, a comprehensive biopsychosocial approach should be taken, and where appropriate, psychopharmacological therapies or psychotherapy should be applied. The goal of continuous education and assistance for self-care is to give individuals with the disease the information and abilities they need to control their condition over time.
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Affiliation(s)
- Polyxeni Mangoulia
- Faculty of Nursing, National and Kapodistrian University of Athens, GR-11527 Athens, Greece;
| | - Charalampos Milionis
- Department of Endocrinology, Diabetes, and Metabolism, Elena Venizelou General Hospital, GR-11521 Athens, Greece;
| | - Eugenia Vlachou
- Department of Nursing, University of West Attica, GR-12243 Athens, Greece;
| | - Ioannis Ilias
- Department of Endocrinology, Hippokration General Hospital, GR-11527 Athens, Greece
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12
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Habenicht A, Ahern E, Cody D, McDarby V, Houghton S. 'It's life threatening, it's not life limiting but it's life threatening' - Dyadic framework analysis of adolescent and parent adjustment to a type 1 diabetes diagnosis. J Health Psychol 2024; 29:905-917. [PMID: 38158848 PMCID: PMC11264551 DOI: 10.1177/13591053231216700] [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] [Indexed: 01/03/2024] Open
Abstract
Type 1 diabetes-management can be considered an adolescent-parent collaboration. Given particular adolescent adherence challenges, it is integral that adolescent-parent dyadic relationships are investigated. Therefore, this study aimed to explore dyads' adjustment to type 1 diabetes, while examining the congruence/dissimilarity within these dyads. Semi-structured interviews were conducted with 10 dyads (20 individuals) separately. Interviews were transcribed verbatim and analysed with thematic analysis using a dyadic framework method. Findings suggested complex experiences of adjustment among parents and adolescents which reflect two main themes - Never-Ending Abyss of Management and Diabetes Integration, with three subthemes - A Life of Food Restrictions, Evolving Familial Bonds and Technology as easing the burden of Diabetes. Dyadic analyses revealed dyadic congruence across most themes. This study adds to the adjustment literature by providing a systemic perspective rarely presented in prior paediatric research.
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Affiliation(s)
| | | | - Declan Cody
- Children’s Health Ireland at Crumlin, Ireland
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13
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Muellers KA, Soukas C, Zeidman R, Pantaleon K, Harris YT, Wisnivesky JP, Lin JJ. Cancer beliefs and diet self-management among cancer survivors with comorbid diabetes. J Cancer Surviv 2024; 18:900-906. [PMID: 36715835 DOI: 10.1007/s11764-023-01340-1] [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: 09/13/2022] [Accepted: 01/19/2023] [Indexed: 01/31/2023]
Abstract
PURPOSE Illness beliefs impact disease self-management; however, little is known about the impact of patients' beliefs about one illness on the management of another illness. We sought to understand how cancer beliefs impact diet self-management for cancer survivors with diabetes and whether a change in beliefs leads to a change in dietary adherence. METHODS Seventy-eight participants with diabetes and recently diagnosed early-stage breast, prostate, lung, or colon cancer were recruited. Participants were surveyed at enrollment and after 12 months about their cancer and diabetes illness beliefs and dietary adherence. Associations between beliefs about cancer and diabetes to diet adherence at baseline and at 12 months were assessed. Change in diet adherence was examined in relation to beliefs about each illness. RESULTS The mean age was 62 years, and 23 (32%) identified as black non-Hispanic, 22 (31%) as white non-Hispanic, and 14 (19%) as Hispanic. Participants with more threatening beliefs about both cancer and diabetes at baseline had worse adherence to a diabetes diet than those with less threatening beliefs. However, at 12 months, those with more threatening cancer beliefs had better dietary adherence than participants with less threatening beliefs. Diabetes beliefs were not associated with diet adherence at 12 months. CONCLUSIONS While threatening illness beliefs may initially result in worse diet adherence, over time these beliefs may result in increased activation for better self-care and improved diet adherence. IMPLICATIONS FOR CANCER SURVIVORS Understanding how cancer beliefs impact diet self-management for diabetes may provide coping strategies to improve cancer survivors' management of comorbidities.
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Affiliation(s)
- Kimberly A Muellers
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Psychology, Pace University, 52 Broadway, 4th Floor, New York, NY, 10004, USA.
| | - Chloe Soukas
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, USA
| | - Rebecca Zeidman
- Midwestern University Chicago College of Osteopathic Medicine, Chicago, IL, USA
| | - Karisma Pantaleon
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yael T Harris
- Division of Endocrinology, Northwell Health, Great Neck, NY, USA
| | - Juan P Wisnivesky
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Pulmonary and Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jenny J Lin
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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14
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Endomba FT, Guillaume M, Lemogne C, Chauvet-Gélinier JC. Mise au point sur les liens entre diabète et dépression. MÉDECINE DES MALADIES MÉTABOLIQUES 2024; 18:204-213. [DOI: 10.1016/j.mmm.2024.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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15
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Hayashino Y, Okamura S, Tsujii S, Ishii H. Diabetes Distress Is Associated With Future Risk of Progression of Diabetic Nephropathy in Adults With Type 2 Diabetes: A Prospective Cohort Study (Diabetes Distress and Care Registry at Tenri [DDCRT23]). Can J Diabetes 2023; 47:519-524. [PMID: 37164214 DOI: 10.1016/j.jcjd.2023.04.018] [Citation(s) in RCA: 2] [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: 08/01/2022] [Revised: 04/20/2023] [Accepted: 04/29/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVES Our aim in this study was to investigate the prospective association between diabetes distress assessed with Problem Areas in Diabetes (PAID) survey scores at baseline and the subsequent risk of development or progression of diabetic nephropathy in people with type 2 diabetes. METHODS Longitudinal data were acquired from 2,845 individuals with type 2 diabetes registered in a Japanese diabetes registry. A Cox proportional hazards model was used to adjust for possible confounders to examine the prospective association between baseline diabetes distress (PAID score ≥40) and the development or progression of albuminuria. RESULTS Mean patient age, body mass index, and glycated hemoglobin level were 64.8 years, 24.5 kg/m2, and 57.4 mmol/mol (7.5%), respectively. We did not observe a significant association between diabetes distress and the subsequent risk of diabetic nephropathy development from normoalbuminuria to microalbuminuria/macroalbuminuria (multivariable-adjusted hazard ratio [HR]=0.95 over 4.2 years, 95% confidence interval [CI] 0.77 to 1.17, p=0.640); however, we identified a significant association for progression from microalbuminuria to macroalbuminuria (multivariable-adjusted HR=1.34 over 7.0 years, 95% CI 1.01 to 1.80, p=0.045). Stratification by sex revealed a significant association between diabetes distress and the subsequent risk of progressing diabetic nephropathy (HR=1.45, 95% CI 1.06 to 1.98, p=0.019) in males, but not females (HR=1.42, 95% CI 0.95 to 2.14, p=0.087). CONCLUSIONS Diabetes distress at baseline, assessed using the PAID survey, was associated with a subsequent risk of progressing diabetic nephropathy independent of possible confounders in males, but not females, with type 2 diabetes.
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Affiliation(s)
- Yasuaki Hayashino
- Department of Endocrinology, Tenri Hospital, Tenri City, Nara, Japan.
| | - Shintato Okamura
- Department of Endocrinology, Tenri Hospital, Tenri City, Nara, Japan
| | - Satoru Tsujii
- Department of Endocrinology, Tenri Hospital, Tenri City, Nara, Japan
| | - Hitoshi Ishii
- Department of Doctor-Patient Relationships, Nara Medical University, Kashihara, Nara, Japan
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16
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Korsah KA, Agyeman-Yeboah J. Narratives of type 2 diabetes mellitus patients regarding the influence of social issues on diabetes self-management: Implications for patient care. Nurs Open 2023. [PMID: 37246481 DOI: 10.1002/nop2.1825] [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: 02/22/2022] [Revised: 03/10/2023] [Accepted: 05/05/2023] [Indexed: 05/30/2023] Open
Abstract
AIM To explore the perspectives of individuals living with type 2 diabetes mellitus on the influence of social factors on diabetes self-management in Ghanaian context. DESIGN Hermeneutic phenomenological approach to qualitative research was used. METHOD A semi-structured interview guide was used to collect data from 27 participants who were newly diagnosed with type 2 diabetes. Analysis of data was carried out by using content analysis approach. One main theme with five subthemes emerged. RESULTS Participants experienced social stigma due to the changes in their physical appearance. Mandatory isolation was created by participants in order to manage the diabetes. The financial status of the participants was affected by the diabetes self-management. Differing from the social issues, the overall participants' responses to experiences living with type 2 diabetes mellitus culminated with psychological or emotional hassles, and therefore, patients resorting to alcohol consumption to deal with diabetes related stress, fears, anxiety, apprehension and pain among others.
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Affiliation(s)
| | - Joana Agyeman-Yeboah
- International Maritime Hospital, Tema, Ghana
- Knutsford University College, Accra, Ghana
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17
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Dong N, Wang X, Yang L. The short- and long-term effects of cognitive behavioral therapy on the glycemic control of diabetic patients: a systematic review and meta-analysis. Biopsychosoc Med 2023; 17:18. [PMID: 37150826 PMCID: PMC10165773 DOI: 10.1186/s13030-023-00274-5] [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: 12/15/2022] [Accepted: 04/18/2023] [Indexed: 05/09/2023] Open
Abstract
BACKGROUND Glycemic control is an important issue in the treatment of diabetic patients. However, traditional methods, such as medication (the usual treatment), have limitations. Cognitive behavioral therapy (CBT) might be a useful option to help control the glycemic condition. The effects can be revealed by systemic review or meta-analysis of randomized clinical trials (RCT). METHODS A systematic search and a meta-analysis for the RCT were done of the short- and long-term effects of CBT on the glycemic control of diabetic patients in a comparison with the usual treatment. Nineteen RCT studies and 3,885 diabetic patients were enrolled in this meta-analysis. Subgroup analyses of types 1 and 2 diabetes and individual and group CBT were also performed. RESULTS Patients treated with CBT showed no significant difference in HbA1c when compared to the usual treatment within six months. However, CBT was more effective in reducing HbA1c when compared to usual treatment with at least six months of treatment duration [standardized mean difference: -0.44 (95% confidence interval (CI): -0.63 ~ -0.25), Z = 4.49]. Subgroup analysis of type 1 and 2 diabetic patients supported a long-term effect of CBT on glycemic control [standardized mean difference: -0.85 (95% CI: -1.19 ~ -0.10), Z = 2.23, standardized mean difference: -0.33 (95% CI:-0.47 ~ -0.19), Z = 4.52, respectively]. CONCLUSIONS CBT would be a useful option for improving the glycemic control of diabetic patients undergoing long-term treatment. The advantages of the long-term effects of CBT should be considered by clinicians and staff.
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Affiliation(s)
- Na Dong
- The Affiliated Nanhua Hospital, Department of Endocrinology, Hengyang Medical School, University of South China, Hengyang, Hunan, 421002, China
| | - Xiaowei Wang
- Department of Endocrinology, People's Hospital of Xinchang County, Zhejiang Province, Xinchang, 312500, China
| | - Liu Yang
- Department of Internal Medicine, Wuhan University Hospital, Wuhan, 430072, Hubei, China.
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18
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Ferreira PL, Morais C, Pimenta R, Ribeiro I, Amorim I, Alves SM. Empowerment and Knowledge as Determinants for Quality of Life: A Contribution to a Better Type 2 Diabetes Self-Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4544. [PMID: 36901554 PMCID: PMC10001584 DOI: 10.3390/ijerph20054544] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/22/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
The purpose of this study was to assess how knowledge and empowerment impact the quality of life (QoL) of a person with type 2 diabetes, leading to better communication and disease management. We conducted a descriptive and observational study of individuals with type 2 diabetes. The Diabetes Empowerment Scale-Short Form (DES-SF), Diabetes Knowledge Test (DKT), and EQ-5D-5L were used, in addition to sociodemographic and clinical characteristics. Evaluating the variability in the DES-SF and DKT in relation to the EQ-5D-5L and identifying possible sociodemographic and clinical determinants were conducted using univariate analyses followed by a multiple linear regression model to test whether the factors significantly predicted QoL. A total of 763 individuals were included in the final sample. Patients aged 65 years or older had lower QoL scores, as well as patients who lived alone, had less than 12 years of education, and experienced complications. The insulin-treated group showed higher scores in DKT than the non-insulin-treated group. It was also found that being male, being under 65 years of age, having no complications present, and having higher levels of knowledge and empowerment predicted higher QoL. Our results show that DKT and DES are still determinants of QoL, even after adjusting for sociodemographic and clinical characteristics. Therefore, literacy and empowerment are important for the improvement of the QoL of people with diabetes, by enabling them to manage their health conditions. New clinical practices focused on education, increasing patients' knowledge, and empowerment may contribute to better health outcomes.
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Affiliation(s)
- Pedro L. Ferreira
- Centre for Health Studies and Research, University of Coimbra, 3004-512 Coimbra, Portugal
- Faculty of Economics, University of Coimbra, 3004-512 Coimbra, Portugal
| | - Carminda Morais
- Centre for Health Studies and Research, University of Coimbra, 3004-512 Coimbra, Portugal
- Superior School of Health, Polytechnic of Viana do Castelo, 4900-314 Viana do Castelo, Portugal
| | - Rui Pimenta
- Centre for Health Studies and Research, University of Coimbra, 3004-512 Coimbra, Portugal
- School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
| | - Inês Ribeiro
- Centre for Health Studies and Research, University of Coimbra, 3004-512 Coimbra, Portugal
| | - Isabel Amorim
- Centre for Health Studies and Research, University of Coimbra, 3004-512 Coimbra, Portugal
- Superior School of Health, Polytechnic of Viana do Castelo, 4900-314 Viana do Castelo, Portugal
| | - Sandra Maria Alves
- Centre for Health Studies and Research, University of Coimbra, 3004-512 Coimbra, Portugal
- School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
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19
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Tan KR, Seng JJB, Kwan YH, Chen YJ, Zainudin SB, Loh DHF, Liu N, Low LL. Evaluation of Machine Learning Methods Developed for Prediction of Diabetes Complications: A Systematic Review. J Diabetes Sci Technol 2023; 17:474-489. [PMID: 34727783 PMCID: PMC10012374 DOI: 10.1177/19322968211056917] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND With the rising prevalence of diabetes, machine learning (ML) models have been increasingly used for prediction of diabetes and its complications, due to their ability to handle large complex data sets. This study aims to evaluate the quality and performance of ML models developed to predict microvascular and macrovascular diabetes complications in an adult Type 2 diabetes population. METHODS A systematic review was conducted in MEDLINE®, Embase®, the Cochrane® Library, Web of Science®, and DBLP Computer Science Bibliography databases according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist. Studies that developed or validated ML prediction models for microvascular or macrovascular complications in people with Type 2 diabetes were included. Prediction performance was evaluated using area under the receiver operating characteristic curve (AUC). An AUC >0.75 indicates clearly useful discrimination performance, while a positive mean relative AUC difference indicates better comparative model performance. RESULTS Of 13 606 articles screened, 32 studies comprising 87 ML models were included. Neural networks (n = 15) were the most frequently utilized. Age, duration of diabetes, and body mass index were common predictors in ML models. Across predicted outcomes, 36% of the models demonstrated clearly useful discrimination. Most ML models reported positive mean relative AUC compared with non-ML methods, with random forest showing the best overall performance for microvascular and macrovascular outcomes. Majority (n = 31) of studies had high risk of bias. CONCLUSIONS Random forest was found to have the overall best prediction performance. Current ML prediction models remain largely exploratory, and external validation studies are required before their clinical implementation. PROTOCOL REGISTRATION Open Science Framework (registration number: 10.17605/OSF.IO/UP49X).
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Affiliation(s)
| | | | - Yu Heng Kwan
- MOH Holdings Private Ltd.,
Singapore
- Health Services & Systems Research,
Duke-NUS Medical School, Singapore
- Department of Pharmacy, Faculty of
Science, National University of Singapore, Singapore
| | | | | | | | - Nan Liu
- Health Services & Systems Research,
Duke-NUS Medical School, Singapore
- Health Services Research Centre,
Singapore Health Services, Singapore
- Institute of Data Science, National
University of Singapore, Singapore
| | - Lian Leng Low
- SingHealth Regional Health System,
Singapore Health Services, Singapore
- Department of Family Medicine and
Continuing Care, Singapore General Hospital, Singapore
- SingHealth Duke-NUS Family Medicine
Academic Clinical Program, SingHealth Duke-NUS Academic Medical Centre,
Singapore
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20
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Velázquez-Jurado H, Flores-Torres A, Pérez-Peralta L, Salinas-Rivera E, Valle-Nava MD, Arcila-Martinez D, Hernández-Jiménez S, for the CAIPaDi Study Group. Cognitive behavioral treatment to improve psychological adjustment in people recently diagnosed with type 2 diabetes: Psychological treatment in type 2 diabetes. Health Psychol Behav Med 2023; 11:2179058. [PMID: 36846199 PMCID: PMC9946322 DOI: 10.1080/21642850.2023.2179058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a chronic disease that affects a person's general well-being. Current evidence sets an association between psychological well-being and controlled metabolic parameters. People newly diagnosed with T2DM show higher prevalence of depression and anxiety symptoms. Cognitive behavioral therapy (CBT) has effectively improved psychological adjustment, but most studies do not specifically address recently diagnosed people nor usually include long-term follow-up measures. Objective We sought to assess changes in psychological variables in people with newly diagnosed diabetes who received a cognitive-behavioral intervention, within a comprehensive care program. Method 1208 adults with T2DM (≤5 years) who attended a national health institute in Mexico received a cognitive-behavioral intervention aimed at improving quality of life and reducing emotional distress that often interferes with diabetes control, as well as evaluating cognitive and emotional resources and social support. Measures of quality of life, diabetes-related distress, anxiety and depression questionnaires were compared at pre-test, post-test and follow up using Friedman's ANOVAs. Multiple logistic regression models evaluated glycosylated hemoglobin (HbA1c) and triglycerides control at post-test and follow up. Results Questionnaire measures and metabolic variables significantly decreased symptomatology at post-test and these changes maintained at follow-up. Significant associations were found between quality-of-life scores and HbA1c and triglycerides levels in post-test and follow-up. Diabetes-related distress scores increased the odds of having adequate HbA1c control at post-test. Conclusion This study contributes to the evidence on the importance of considering psychological factors as part of comprehensive diabetes care to improve quality of life and emotional burden and facilitate the achievement of metabolic goals.
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Affiliation(s)
- Héctor Velázquez-Jurado
- Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico,Postgraduate Studies Division, National Autonomous University of Mexico (UNAM), Mexico City, Mexico, Héctor Velázquez-Jurado Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico; National Autonomous University of Mexico, Mexico City, Mexico; Av. Vasco de Quiroga #15, Col. Belisario Dominguez, Sección XVI, Alc. Tlalpan, C.P. 14080, Ciudad de Mexico
| | - Athena Flores-Torres
- Postgraduate Studies Division, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Liliana Pérez-Peralta
- Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Edgar Salinas-Rivera
- Department of Educational Psychology, National Pedagogic University (UPN), Mexico City, Mexico
| | - Marianne Daniela Valle-Nava
- Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico,Postgraduate Studies Division, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Denise Arcila-Martinez
- Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Sergio Hernández-Jiménez
- Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - for the CAIPaDi Study Group
- Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
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21
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Chew BH, Mohd-Yusof BN, Lai PSM, Khunti K. Overcoming Therapeutic Inertia as the Achilles' Heel for Improving Suboptimal Diabetes Care: An Integrative Review. Endocrinol Metab (Seoul) 2023; 38:34-42. [PMID: 36792353 PMCID: PMC10008655 DOI: 10.3803/enm.2022.1649] [Citation(s) in RCA: 2] [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: 12/23/2022] [Revised: 01/28/2023] [Accepted: 02/06/2023] [Indexed: 02/17/2023] Open
Abstract
The ultimate purpose of diabetes care is achieving the outcomes that patients regard as important throughout the life course. Despite advances in pharmaceuticals, nutraceuticals, psychoeducational programs, information technologies, and digital health, the levels of treatment target achievement in people with diabetes mellitus (DM) have remained suboptimal. This clinical care of people with DM is highly challenging, complex, costly, and confounded for patients, physicians, and healthcare systems. One key underlying problem is clinical inertia in general and therapeutic inertia (TI) in particular. TI refers to healthcare providers' failure to modify therapy appropriately when treatment goals are not met. TI therefore relates to the prescribing decisions made by healthcare professionals, such as doctors, nurses, and pharmacists. The known causes of TI include factors at the level of the physician (50%), patient (30%), and health system (20%). Although TI is often multifactorial, the literature suggests that 28% of strategies are targeted at multiple levels of causes, 38% at the patient level, 26% at the healthcare professional level, and only 8% at the healthcare system level. The most effective interventions against TI are shorter intervals until revisit appointments and empowering nurses, diabetes educators, and pharmacists to review treatments and modify prescriptions.
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Affiliation(s)
- Boon-How Chew
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia
- Clinical Research Unit, Hospital Pengajar Universiti Putra Malaysia (HPUPM Teaching Hospital), Persiaran MARDI-UPM, Malaysia
| | - Barakatun-Nisak Mohd-Yusof
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Pauline Siew Mei Lai
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kamlesh Khunti
- National Institute for Health Research Applied Research Collaboration East Midlands, Leicester Diabetes Centre, UK
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
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22
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PERMA Dimensions of Well-Being Among Diabetic and Non-Diabetic Adults: Evidence from Two Diabetic Care Hospitals in Odisha. PSYCHOLOGICAL STUDIES 2022. [DOI: 10.1007/s12646-022-00677-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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Gupta SK, Rastogi A, Kaur M, Lakshmi PVM. Diabetes-related distress and its impact on self-care of diabetes among people with type 2 diabetes mellitus living in a resource-limited setting: A community-based cross-sectional study. Diabetes Res Clin Pract 2022; 191:110070. [PMID: 36067916 DOI: 10.1016/j.diabres.2022.110070] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/26/2022] [Accepted: 08/31/2022] [Indexed: 11/18/2022]
Abstract
AIM To assess the a) prevalence, b) factors associated, and c) effect on self-care practices (SCP) of diabetes related distress (DRD) among patients with Type 2 Diabetes Mellitus (T2DM) in rural Punjab, India. METHODS Amongst the cohort of 700 patients, the Diabetes Distress Scale-17 (DDS-17) was used to assess DRD and the Summary of Diabetes Self Care Activities scale (SDSCA) for diabetes SCP. Multivariable logistic regression identified the factors associated with DRD. RESULTS DRD was universal [severe or moderate in 391 (56%) and 309 (44%) patients, respectively]. Hypertension increased the odds of severe DRD [aOR 3.47; 95% CI:2.48-4.87, p-<0.01] whereas living in a joint family reduced the odds of severe DRD [aOR 0.68; 95% CI: 0.47-0.97, p- 0.03]. Patients with severe DRD were less likely to perform DM SCPs [aOR 0.53; 95% CI:0.32-0.85, p-0.01]. CONCLUSIONS The burden of DRD was alarmingly high. There is an urgent need to screen, prevent and treat DRD to improve selfcare in T2DM.
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Affiliation(s)
- Saurabh Kumar Gupta
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Ashu Rastogi
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Manmeet Kaur
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - P V M Lakshmi
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
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Kusnanto K, Arifin H, Pradipta RO, Gusmaniarti G, Kuswanto H, Setiawan A, Lee BO. Resilience-based Islamic program as a promising intervention on diabetes fatigue and health-related quality of life. PLoS One 2022; 17:e0273675. [PMID: 36048792 PMCID: PMC9436096 DOI: 10.1371/journal.pone.0273675] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/11/2022] [Indexed: 12/08/2022] Open
Abstract
Psychological problems commonly experienced by patients with type 2 diabetes mellitus (T2DM) cause diabetes fatigue conditions that can further worsen the treatment prognosis. We conducted this investigation to determine the effectiveness of a resilience-based Islamic program on diabetes fatigue and health-related quality of life (HRQoL) by measuring the biochemical indicators of T2DM. This was a quasi-experimental study performed from May to August 2021, in which 80 respondents aged 18–64 years diagnosed with T2DM were included through purposive sampling at a male:female sex ratio of 1:1 in the control group and 17:23 in the treatment group. A resilience-based Islamic program (a combination of stress management, mindfulness, prayer, and dhikr (the ritual formula of Sufi brotherhood recited devotionally in praise of Allah and as a means of attaining ecstatic experience)) was implemented in the treatment group for six sessions by blended online and offline interventions. Multidimensional Fatigue Inventory-20 and World Health Organization Quality of Life, Brief Form were used to evaluate diabetes fatigue and HRQoL. Blood tests were performed to measure HbA1c, total antioxidant serum, insulin, cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c) levels from baseline to 3 months. Statistical analyses were conducted using paired t test, Wilcoxon signed-rank test, independent t test, and Mann–Whitney U test. The resilience-based Islamic program had a beneficial impact on the levels of HbA1c (p < 0.001), lipid profile (triglyceride) (p = 0.011), HDL-c (p = 0.01), LDL-c (p < 0.001), total antioxidant serum (p = 0.001), insulin (p < 0.001), diabetes fatigue (p < 0.05), and HRQoL (p < 0.05) in patients of the treatment group. The results of biochemical tests related to T2DM also indicated a reduction in diabetes fatigue and an increase in HRQoL due to the resilience-based Islamic program. Considering that a patient’s resilience to diabetes is an important factor in the management of diabetes fatigue, the resilience-based Islamic program can be applied at public health centers and community levels to increase T2DM resilience.
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Affiliation(s)
- Kusnanto Kusnanto
- Department of Fundamental Nursing Care, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Hidayat Arifin
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
- Doctoral Program in School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Rifky Octavia Pradipta
- Department of Fundamental Nursing Care, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
- * E-mail:
| | - Gusmaniarti Gusmaniarti
- Early Childhood Teacher Education Study Program, Faculty of Teacher Training and Education, Universitas Muhammadiyah Surabaya, Surabaya, Indonesia
| | - Heri Kuswanto
- Department of Statistics, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia
| | - Agus Setiawan
- Department of Community Health Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Bih-O Lee
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
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Silva HCDDAE, Acioli S, Fuly PDSC, Nóbrega MMLD, Lins SMDSB, Menezes HFD. Construction and validation of nursing diagnoses for people with diabetic foot ulcers. Rev Esc Enferm USP 2022; 56:e20220022. [PMID: 35510834 PMCID: PMC10116869 DOI: 10.1590/1980-220x-reeusp-2022-0022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/24/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To construct and validate nursing diagnoses statements of the International Classification for Nursing Practice (ICNP®) for the person with diabetic foot ulcer being followed up in primary health care. METHOD This is a methodological study structured in four stages: identification of terms; cross-mapping of identified terms with ICNP terms®, version 2019/2020; construction of nursing diagnoses statements and organization with Orem's Theory of Self-care; and content validation by expert nurses working in primary care, with those with Content Validity Index (CVI) ≥ 0.80 being considered valid. RESULTS Eighty-one diagnostic statements were constructed, five of which were positive, 67 negative, and nine risky. Of these, 58 were included in ICNP® and 23 were not, 51% of which were categorized as self-care requirements related to health changes. CONCLUSION ICNP® subsidized the construction of a technical product, which can be consulted and used by nurses and will allow the strengthening of the standardization of a specific language in the context of care for people with diabetic foot ulcers in primary health care.
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Affiliation(s)
| | - Sonia Acioli
- Universidade do Estado do Rio de Janeiro, Faculdade de Enfermagem, Departamento de Enfermagem em Saúde Pública, Rio de Janeiro, RJ, Brazil
| | - Patricia Dos Santos Claro Fuly
- Universidade Federal Fluminense, Escola de Enfermagem Aurora de Afonso Costa, Departamento de Enfermagem Médico Cirúrgico, Niterói, RJ, Brazil
| | - Maria Miriam Lima da Nóbrega
- Universidade Federal da Paraíba, Departamento de Enfermagem de Saúde Pública e Psiquiatria, João Pessoa, PB, Brazil
| | - Silvia Maria de Sá Basílio Lins
- Universidade do Estado do Rio de Janeiro, Faculdade de Enfermagem, Departamento de Fundamentos de Enfermagem, Rio de Janeiro, RJ, Brazil
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Agastiya IMC, Kurianto E, Akalili H, Wicaksana AL. The impact of telehealth on self-management of patients with type 2 diabetes: A systematic review on interventional studies. Diabetes Metab Syndr 2022; 16:102485. [PMID: 35512521 DOI: 10.1016/j.dsx.2022.102485] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/29/2022] [Accepted: 04/10/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND AIMS Self-management is critical to manage the glycemic and metabolic outcomes for patients with diabetes. Telehealth applications are recognized as a potential approach to promote self-management of people with type 2 diabetes. This study aimed to investigate the impact of telehealth on self-management among patients with type 2 diabetes. METHODS A systematic review was conducted on several databases, including PubMed, EbscoHost Medline, and Science Direct, with the keywords: Diabetes Mellitus AND Mobile-phone based OR Telemedicine OR Telehealth OR Web-based OR Telenursing AND Self-management. Inclusion criteria were articles with type 2 diabetic respondents, published between 2015 and 2020, open-access articles, and had self-management as outcomes. Hence, qualitative, protocol, or review articles, commentaries, letters to editors, and case study/reports were excluded. The Joanna Briggs Institute critical appraisal tools and Cochrane collaboration's tools were used for assessing risk of bias. RESULTS The total of six studies were included in the qualitative synthesis, with five randomized control trials and one cross-sectional study. Telehealth applications were formed as an online or app-based platform with the key features of educational programs, text or voice messages, consultations and counseling, and active participation of the subjects. Besides improving the self-management outcomes, the telehealth also indicated improvements in positive behaviors, attitudes, and the intention of self-management. CONCLUSION The study concluded that implementation of telehealth provided positive self-management results among patients with type 2 diabetes. The users need to consider an intensive training, peer or family support, and provision of full support for the patients during the implementation of telehealth.
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Affiliation(s)
| | - Endar Kurianto
- Master Program in Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Hanifati Akalili
- Master Program in Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Anggi Lukman Wicaksana
- Department of Medical Surgical Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; The Sleman Health and Demographic Surveillance System, Universitas Gadjah Mada, Yogyakarta, Indonesia; School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC.
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Silva HCDDAE, Acioli S, Fuly PDSC, Nóbrega MMLD, Lins SMDSB, Menezes HFD. Construção e validação de diagnósticos de enfermagem para a pessoa com úlcera do pé diabético. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2022-0022pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo: Construir e validar enunciados de diagnósticos de enfermagem da Classificação Internacional para a Prática de Enfermagem (CIPE®) para a pessoa com úlcera de pé diabético em acompanhamento na atenção primária à saúde. Método: Estudo metodológico, estruturado em quatro etapas: identificação de termos; mapeamento cruzado dos termos identificados com os termos da CIPE®, versão 2019/2020; construção dos enunciados de diagnósticos de enfermagem e organização com a Teoria do Autocuidado de Orem; e validação de conteúdo por enfermeiros peritos atuantes na atenção primária, sendo considerados válidos aqueles com Índice de Validade de Conteúdo (IVC) ≥ 0.80. Resultados: Foram construídos 81 enunciados de diagnósticos, sendo cinco positivos, 67 negativos e nove de risco. Desses, 58 eram constantes na CIPE® e 23 não constantes, sendo 51% categorizados como requisitos de autocuidado relativos às alterações de saúde. Conclusão: A CIPE® subsidiou a construção de um produto técnico, passível de consulta e utilização pelos enfermeiros, o qual permitirá o fortalecimento da padronização de uma linguagem própria no contexto do cuidado à pessoa com úlcera do pé diabético na atenção primária à saúde.
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Affiliation(s)
| | - Sonia Acioli
- Universidade do Estado do Rio de Janeiro, Brazil
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Vidyulatha J, Pramodkumar T, Pradeepa R, Deepa M, Poongothai S, Venkatesan U, Aarthi G, Thenmozhi S, Anjana R, Mohan V. Prevalence and impact of stress among individuals with type 2 diabetes attending a tertiary diabetes center in South India. JOURNAL OF DIABETOLOGY 2022. [DOI: 10.4103/jod.jod_12_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Emery KA, Robins J, Salyer J, Thurby-Hay L, Djira G. Type 2 Diabetes Self-Management Variables and Predictors. Clin Nurs Res 2021; 31:1250-1262. [PMID: 34961341 DOI: 10.1177/10547738211067322] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Guided by the Self and Family-Management framework, relationships between diabetes distress, self-efficacy, resilience and outcomes of A1c, quality of life and health status were explored. A cross sectional descriptive design was used. 78 individuals were enrolled from US clinics. Data were analyzed to test for associations, main effects and interactions and predictors of self-management. Results indicated low diabetes distress (M = 20.53), high self-efficacy (M = 7.32), moderate resilience (M = 80.27), and mean A1c 7.35%/56.88 mmol/mol. 76% scored above the mental health norm, 46% scored above the physical health norm. Average weighted quality of life = -1.74. Diabetes distress was negatively associated with self-efficacy, resilience, physical health, mental health, and quality of life. Self-efficacy was positively associated with resilience, physical health and quality of life. Resilience was positively associated with physical health, mental health and quality of life. Positive associations were found between quality of life, physical and mental health. No associations were found between A1c and variables in the study. Multiple significant interactions were found with A1c, mental health and quality of life outcomes. Terms in the model included treatment regimen, years since diagnosis, provider collaboration and history of diabetes self-management education. Distress was a significant predictor of health status and quality of life. The results confirm self-management facilitators self-efficacy and resilience and barrier diabetes distress and their relationships with outcomes in the framework. This study contributes to the understanding of the emotional aspect of diabetes. Continuing this work will allow researchers to better understand self-management, support self-management efforts and better outcomes.
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Affiliation(s)
| | - Jo Robins
- Virginia Commonwealth University, Richmond, VA, USA
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BILONDI SINASABETI, NOGHABI ALIDELSHAD, AALAMI HOSEIN. The relationship between illness perception and medication adherence in patients with diabetes mellitus type II: illness perception and medication adherence. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E966-E971. [PMID: 35603233 PMCID: PMC9104663 DOI: 10.15167/2421-4248/jpmh2021.62.4.2277] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 10/25/2021] [Indexed: 11/25/2022]
Abstract
Introduction One of the most well-known chronic diseases in the world is diabetes. Disease perception is the patient's organized cognitive representation of his or her illness and can affect treatment adherence. The aim of this study was to investigate the relationship between illness perception and adherence to the medical regimen in patients with type II diabetes mellitus (T2DM). Methods This cross-sectional study was performed among 260 patients with type II diabetes referred to Gonabad Diabetes Clinic by systematic random sampling in 2019. Data collection tools were demographic questionnaire, Morisky medication Adherence Scale (MMAS-8), and Brief illness Perception Questionnaire (BIPQ). Data were analyzed by SPSS 20 software. And using descriptive statistics, Pearson correlation coefficient. P < 0.05 was considered significant. Results The results showed that the mean score of illness perception of type II diabetes was 46.39 ± 9.45 (range 0-70) and the mean score of medication Adherence was 2.93 ± 1.9 (range 0-8). The results of Pearson correlation test showed a significant relationship between illness perception and medication Adherence (P < 0.001, r = 0.199). Also, the regression model showed that the dimensions of disease comprehension and personal control from illness perception were significantly related to medication Adherence of type II diabetic patients (P < 0.001). Conclusion Based on the results of this study on the relationship between illness perception and medical adherence in diabetic patients, it is suggested that in order to understand the increase in adherence to therapy, the perception of the disease should be increased through education to patients. Patients' illness beliefs are candidates for a psycho-educational intervention that should be targeted at improved disease management practices and better adherence to recommended healthy behaviors.
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Affiliation(s)
- SINA SABETI BILONDI
- Department of Nursing, Islamic Azad University, Gonabad Branch, Gonabad, Iran
- Clinical Reasearch Development Unit, Allameh Bohlool Gonabadi hospital, Gonabad University of Medical Sciences, Gonabad, Iran
| | - ALI DELSHAD NOGHABI
- Clinical Reasearch Development Unit, Allameh Bohlool Gonabadi hospital, Gonabad University of Medical Sciences, Gonabad, Iran
- Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - HOSEIN AALAMI
- Clinical Reasearch Development Unit, Allameh Bohlool Gonabadi hospital, Gonabad University of Medical Sciences, Gonabad, Iran
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Yunita Sari R, Muhith A, Rohmawati R, Soleha U, Faizah I, Afiyah RK, Suryadi Rahman F. Spiritual Emotional Freedom Technique against Anxiety and Psychological Well-being of Type 2 DM Patients during the COVID-19 Pandemic. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The COVID-19 pandemic makes patients with type 2 diabetes mellitus experience an increase in anxiety, considering that diabetes mellitus is one of the dangerous comorbidities for people infected with the COVID-19 virus so that it affects their psychological well-being. Low psychological well-being will have an impact on decreasing self-care, thereby increasing the occurrence of complications.
AIM: The purpose of this study was to analyze the effect of the spiritual emotional freedom technique (SEFT) on anxiety and the psychological well-being of patients with type 2 DM during the COVID-19 pandemic.
METHODS: The research design employed is a quasi-experimental research with the untreated control group design with dependent pre-test and post-test samples. The sampling technique used is probability sampling which is a random sampling to meet the inclusion and exclusion criteria with a total sample of 110 respondents with the distribution of the intervention group consisting of 55 respondents and the control group consisting of 55 respondents. The instrument used to measure the level of anxiety is the Hamilton Rating Scale for Anxiety and psychological well-being of Ryff’s psychological well-being. The statistical tests used are Paired Sample t-Test and Independent t-test with significant p < 0.05.
RESULTS: The results showed that the mean level of anxiety in the intervention group before the implementation of the intervention was 21.89 (moderate), while after the intervention was 10.98 (mild) and the psychological well-being before the intervention was 147.49 (low), while after the intervention was 170.91 (moderate). Furthermore, in the case of the control group, the mean level of anxiety before the intervention was 19.16 and after the intervention was 19.11 and psychological well-being before the intervention was 146.67 while after the intervention was 146.45. Furthermore, the data analysis obtained that the SEFT affected the level of anxiety and psychological well-being of patients with type 2 diabetes during the COVID-19 pandemic with p = 0.00.
CONCLUSION: The SEFT that is routinely implemented can reduce the level of anxiety so that it can improve the psychological well-being of patients with type 2 DM during the COVID-19 pandemic.
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Schuman-Olivier Z, Trombka M, Lovas DA, Brewer JA, Vago DR, Gawande R, Dunne JP, Lazar SW, Loucks EB, Fulwiler C. Mindfulness and Behavior Change. Harv Rev Psychiatry 2021; 28:371-394. [PMID: 33156156 PMCID: PMC7647439 DOI: 10.1097/hrp.0000000000000277] [Citation(s) in RCA: 131] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/22/2020] [Accepted: 07/21/2020] [Indexed: 02/07/2023]
Abstract
Initiating and maintaining behavior change is key to the prevention and treatment of most preventable chronic medical and psychiatric illnesses. The cultivation of mindfulness, involving acceptance and nonjudgment of present-moment experience, often results in transformative health behavior change. Neural systems involved in motivation and learning have an important role to play. A theoretical model of mindfulness that integrates these mechanisms with the cognitive, emotional, and self-related processes commonly described, while applying an integrated model to health behavior change, is needed. This integrative review (1) defines mindfulness and describes the mindfulness-based intervention movement, (2) synthesizes the neuroscience of mindfulness and integrates motivation and learning mechanisms within a mindful self-regulation model for understanding the complex effects of mindfulness on behavior change, and (3) synthesizes current clinical research evaluating the effects of mindfulness-based interventions targeting health behaviors relevant to psychiatric care. The review provides insight into the limitations of current research and proposes potential mechanisms to be tested in future research and targeted in clinical practice to enhance the impact of mindfulness on behavior change.
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Extreme Glycemic Fluctuations Debilitate NRG1, ErbB Receptors and Olig1 Function: Association with Regeneration, Cognition and Mood Alterations During Diabetes. Mol Neurobiol 2021; 58:4727-4744. [PMID: 34165684 DOI: 10.1007/s12035-021-02455-1] [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] [Received: 04/15/2021] [Accepted: 06/16/2021] [Indexed: 12/28/2022]
Abstract
Neuronal regeneration is crucial for maintaining intact neural interactions for perpetuation of cognitive and emotional functioning. The NRG1-ErbB receptor signaling is a key pathway for regeneration in adult brain and also associated with learning and mood stabilization by modulating synaptic transmission. Extreme glycemic stress is known to affect NRG1-ErbB-mediated regeneration in brain; yet, it remains unclear how the ErbB receptor subtypes are differentially affected due to such metabolic variations. Here, we assessed the alterations in NRG1, ErbB receptor subtypes to study the regenerative potential, both in rodents as well as in neuronal and glial cell models of hyperglycemia and hypoglycemic insults during hyperglycemia. The pro-oxidant and anti-oxidant status leading to degenerative changes in brain regions were determined. The spatial memory and anxiogenic behaviour of experimental rodents were tested using 'T' maze and Elevated Plus Maze. Our data revealed that the extreme glycemic discrepancies during diabetes and recurrent hypoglycemia lead to altered expression of NRG1, ErbB receptor subtypes, Syntaxin1 and Olig1 that shows association with impaired regeneration, synaptic dysfunction, demyelination, cognitive deficits and anxiety.
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Orange peel flavored unripe plantain noodles with low glycemic index improved antioxidant status and reduced blood glucose levels in diabetic rats. JOURNAL OF FOOD MEASUREMENT AND CHARACTERIZATION 2021. [DOI: 10.1007/s11694-021-00953-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Lica MM, Papai A, Salcudean A, Crainic M, Covaciu CG, Mihai A. Assessment of Psychopathology in Adolescents with Insulin-Dependent Diabetes (IDD) and the Impact on Treatment Management. CHILDREN (BASEL, SWITZERLAND) 2021; 8:414. [PMID: 34069480 PMCID: PMC8159087 DOI: 10.3390/children8050414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/26/2021] [Accepted: 05/17/2021] [Indexed: 11/17/2022]
Abstract
Assessing mental health in children and adolescents with insulin-dependent diabetes (IDD) is an issue that is underperformed in clinical practice and outpatient clinics. The evaluation of their thoughts, emotions and behaviors has an important role in understanding the interaction between the individual and the disease, the factors that can influence this interaction, as well as the effective methods of intervention. The aim of this study is to identify psychopathology in adolescents with diabetes and the impact on treatment management. A total of 54 adolescents with IDD and 52 adolescents without diabetes, aged 12-18 years, completed APS-SF (Adolescent Psychopathology Scale-Short Form) for the evaluation of psychopathology and adjustment problems. There were no significant differences between adolescents with diabetes and control group regarding psychopathology. Between adolescents with good treatment adherence (HbA1c < 7.6) and those with low treatment adherence (HbA1c > 7.6), significant differences were found. In addition, results showed higher scores in girls compared with boys with IDD with regard to anxiety (GAD), Major Depression (DEP), Post-Traumatic Stress Disorder (PTSD), Eating Disturbance (EAT), Suicide (SUI) and Interpersonal Problems (IPP). No significant differences were found regarding the duration of the disease. Strategies such as maladaptive coping, passivity, distorted conception of the self and the surrounding world and using the negative problem-solving strategies of non-involvement and abandonment had positive correlation with poor glycemic control (bad management of the disease). The study highlighted the importance of promoting mental health in insulin-dependent diabetes management.
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Affiliation(s)
- Maria Melania Lica
- Department of Psychiatry, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Tirgu Mures, 540139 Targu Mures, Romania; (M.M.L.); (A.P.); (A.S.); (M.C.)
| | - Annamaria Papai
- Department of Psychiatry, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Tirgu Mures, 540139 Targu Mures, Romania; (M.M.L.); (A.P.); (A.S.); (M.C.)
| | - Andreea Salcudean
- Department of Psychiatry, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Tirgu Mures, 540139 Targu Mures, Romania; (M.M.L.); (A.P.); (A.S.); (M.C.)
| | - Maria Crainic
- Department of Psychiatry, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Tirgu Mures, 540139 Targu Mures, Romania; (M.M.L.); (A.P.); (A.S.); (M.C.)
| | - Cristina Georgeta Covaciu
- Clinical Emergency Hospital for Children‒Child and Adolescent Psychiatry, 400000 Cluj Napoca, Romania;
| | - Adriana Mihai
- Department of Psychiatry, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Tirgu Mures, 540139 Targu Mures, Romania; (M.M.L.); (A.P.); (A.S.); (M.C.)
- IPPD Institute of Psychotherapy and Personal Development, 540044 Tirgu Mures, Romania
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Onyishi CN, Ilechukwu LC, Victor-Aigbodion V, Eseadi C. Impact of spiritual beliefs and faith-based interventions on diabetes management. World J Diabetes 2021; 12:630-641. [PMID: 33995850 PMCID: PMC8107980 DOI: 10.4239/wjd.v12.i5.630] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/23/2021] [Accepted: 03/25/2021] [Indexed: 02/06/2023] Open
Abstract
Management of diabetes constitutes significant social and economic burdens worldwide. There is a shortage of empirical studies on the management of diabetes and the associated mental health issues through spiritual beliefs and faith-based interventions (FBIs). It is not also clear how spiritual beliefs and FBIs account for the effective management of diabetic conditions. This article discusses the impact of spiritual beliefs and FBIs in the management of diabetes, from relationship and efficacy studies that report outcomes from experimental procedures of related interventions. The majority of the relationship studies showed positive relationships, while efficacy studies showed a high efficacy of interventions in faith-based approaches. However, none of the studies clearly reported the mechanisms of change or modality of operation in a FBI that can serve as a model across culture and context. Possible mechanisms of change were discussed for further development of a standard faith-based model, and finally, suggestions for future research were also highlighted by the authors.
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Affiliation(s)
- Charity Neejide Onyishi
- Department of Educational Psychology, University of Johannesburg, Gauteng, 2006, South Africa
- Department of Educational Foundations, University of Nigeria, Nsukka, Enugu 410001, Nigeria
| | | | - Vera Victor-Aigbodion
- Department of Educational Psychology, University of Johannesburg, Gauteng, 2006, South Africa
- Department of Educational Foundations, University of Nigeria, Nsukka, Enugu 410001, Nigeria
| | - Chiedu Eseadi
- Department of Educational Foundations, University of Nigeria, Nsukka, Enugu 410001, Nigeria
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Hardy S. Recognising and treating psychological issues in people with diabetes mellitus. Nurs Stand 2021; 36:77-82. [PMID: 33969646 DOI: 10.7748/ns.2021.e11682] [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] [Accepted: 02/08/2021] [Indexed: 12/15/2022]
Abstract
Diabetes mellitus is a long-term condition that can lead to complications such as diabetic ketoacidosis, retinopathy and cardiovascular disease as a result of uncontrolled high blood glucose levels. In addition to these physical health complications, people with diabetes are more likely to experience psychological issues such as guilt, distress and depression compared with the general population. These issues can negatively affect an individual's ability to effectively monitor and self-manage their condition; however, they are often an overlooked aspect of diabetes care. This article explains how nurses can prevent, recognise and treat some of the psychological issues that people with diabetes commonly experience.
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Affiliation(s)
- Sheila Hardy
- Charlie Waller Trust, Thatcham, England, and post-doctoral researcher, University of Hull, Hull, England
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Mikhael EM, Hassali MA, Hussain SA, Shawky N. The Development and Validation of Quality of Life Scale for Iraqi Patients with Type 2 Diabetes Mellitus. J Pharm Bioallied Sci 2020; 12:262-268. [PMID: 33100785 PMCID: PMC7574754 DOI: 10.4103/jpbs.jpbs_190_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 01/24/2020] [Accepted: 03/08/2020] [Indexed: 11/30/2022] Open
Abstract
Background and Aim: The current trend for determining the effectiveness of new treatment or services provided for diabetes mellitus (DM) patients is based on assessing the improvement in both glycemic control and the patient quality of life. Many scales have been developed to assess quality of life among DM patients, but unfortunately, no one can be considered as gold standard. Therefore, this study aimed to develop and validate a brief and specific scale to assess quality of life among Iraqi type 2 DM patients. Methods: An extensive literature review was done using Google-Scholar and PubMed to find out scales that utilized to assess quality of life among DM patients. Four relevant scales, three diabetes specific and one general, were selected. The selected scales were carefully evaluated to find out domains that are commonly used to assess quality of life and then the items within the selected domains were reviewed to choose relevant and comprehensive items for Iraqi type 2 DM patients. Ten items were selected to formulate the quality of life scale for Iraqi DM patients (QOLSID). The content validity of QOLSID was established via an expert panel. For concurrent validity QOLSID was compared to glycosylated hemoglobin (HbA1C). For psychometric evaluation, a cross sectional study for 103 type 2 DM patients was conducted at the National Diabetes Center, Iraq. Test-retest reliability was measured by re-administering QOLSID to 20 patients 2-4 weeks later. Results: The internal consistency of the QOLSID was 0.727. All items had a corrected total-item correlation above 0.2. There was a negative significant correlation between QOLSID score and the HbA1C level (-0.518, P = 0.000). A significant positive correlation was obtained after re-testing (0.967, P = 0.000). Conclusion: The QOLSID is a reliable and valid instrument that can be used for assessing quality of life among Iraqi type 2 DM patients.
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Affiliation(s)
- Ehab M Mikhael
- Department of social and administrative Pharmacy, College of Pharmacy, Universiti Sains Malaysia, Penang, Malaysia.,Department of clinical pharmacy, College of Pharmacy, University of Baghdad, Baghdad-Iraq
| | - Mohamed A Hassali
- Department of clinical pharmacy, College of Pharmacy, University of Baghdad, Baghdad-Iraq
| | - Saad A Hussain
- Faculty of Pharmacy, Al-Rafidain University College, Baghdad, Iraq
| | - Nizar Shawky
- The National Diabetes Center, Al-Mustansiriyah University, Baghdad, Iraq
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Suglo JN, Evans C. Factors influencing self-management in relation to type 2 diabetes in Africa: A qualitative systematic review. PLoS One 2020; 15:e0240938. [PMID: 33091039 PMCID: PMC7580976 DOI: 10.1371/journal.pone.0240938] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 10/05/2020] [Indexed: 12/30/2022] Open
Abstract
AIM Effective control of type 2 diabetes is predicated upon the ability of a person with diabetes to adhere to self-management activities. In order to develop and implement services that are locally relevant and culturally acceptable, it is critical to understand people's experiences of living with the disease. We synthesized qualitative research evidence describing the views and experiences of persons with type 2 diabetes in Africa regarding diabetes self-management. METHODS Five data bases (MEDLINE, EMBASE, PsychINFO, SCOPUS and CINAHL) were searched for qualitative studies published between the year 2000 and December 2019. After study selection, the included papers were critically appraised using an established tool. The data were extracted, and findings were coded and analysed to identify descriptive and analytical themes using a thematic synthesis approach. This review was registered in the international prospective register of systematic reviews (PROSPERO) with registration number CRD42018102255. RESULTS Sixteen studies were included in this review, representing a total of 426 participants across seven countries. Synthesis of findings produced six analytical themes. The diagnosis of diabetes triggered a range of emotions and revealed culturally specific understandings of the condition that negatively affected self-management practices. People with diabetes seeking health care at hospitals encountered several challenges including long waiting times and costly diabetes treatment. Family support and a state of acceptance of the condition were identified as facilitators to diabetes self-management. CONCLUSION Effective self-management of type 2 diabetes is a challenge for most persons with diabetes in Africa. There is an urgent need for culturally appropriate education strategies and restructuring of the health system to facilitate self-management of diabetes.
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Affiliation(s)
| | - Catrin Evans
- School of Health Sciences, The University of Nottingham, Nottingham, United Kingdom
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Mousavizadeh SN, Banazadeh Z. Loss of Time in the Treatment Adherence Process: A Qualitative Study in a Sample of Iranian People with Diabetes. J Med Life 2020; 13:293-299. [PMID: 33072199 PMCID: PMC7550146 DOI: 10.25122/jml-2019-0110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Diabetes is a significant public health problem and one of the causes of death and disability globally. One of the main problems with diabetes control is the lack of adherence to therapeutic regimens in people with diabetes. This study investigates the experiences and views of the Iranian people with diabetes to identify the challenges of the process of adherence to treatment. A grounded theory research design was used, incorporating in-depth interviews to collect the data. Using purposeful sampling, 28 people with type 2 diabetes (9 men, 19 women) from different places were included in the study. Constant comparative analysis was undertaken to identify key categories. The main challenge in this process is losing the golden time of preventing the complications of the disease that occurs for the following reasons: cultural habits and values, religious beliefs (believing diabetes was God’s will), resistance to change due to age, job conditions, lack of harmony in the family, and non-shared decision-making in the health system. People with diabetes go through trial and error in order to achieve awareness and insight, and consequently, adherence to treatment. Therefore, they need help and support to achieve insight and adherence to treatment faster and without complications. In fact, if the care plan is designed to encourage active patient participation by the treatment team in the shortest possible time, the time to achieve compliance will be shorter and will have the least side effects for these people.
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Affiliation(s)
- Seyedeh Narjes Mousavizadeh
- Department of Psychiatric Nursing, Nursing and Midwifery School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Mostafavi-Darani F, Zamani-Alavijeh F, Mahaki B, Salahshouri A. Exploring the barriers of adherence to dietary recommendations among patients with type 2 diabetes: A qualitative study in Iran. Nurs Open 2020; 7:1735-1745. [PMID: 33072357 PMCID: PMC7544840 DOI: 10.1002/nop2.558] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 05/17/2020] [Accepted: 06/16/2020] [Indexed: 11/09/2022] Open
Abstract
Aims Type 2 diabetes is a major global health concern, and its prevalence is rapidly increasing throughout the world. The present study was conducted to explore the experiences of patients and healthcare providers to identify the social barriers to patients' adherence to their recommended diet and thus help the design of future interventions. Design This study was conducted as a qualitative study with content analysis approach. Methods The present qualitative study was conducted from November 2016–July 2017. Data were collected through 38 unstructured in‐depth interviews with 33 T2D patients and their treatment supervisors and field notes. The interview transcripts were coded using the MAXQDA 10 software. To extract categories and themes, the thematic analysis approach was used. We followed the COREQ Checklist to ensure rigour in our study. Results The analysis of the study revealed the emergence of five categories of perceived barriers including social priorities and rivalries, family's food habits, poor social support, social impasses and dominant food patterns.
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Affiliation(s)
- Firoozeh Mostafavi-Darani
- Department of Health Education and Promotion School of Health Isfahan University of Medical Sciences Isfahan Iran
| | - Fereshteh Zamani-Alavijeh
- Department of Health Education and Promotion School of Health Isfahan University of Medical Sciences Isfahan Iran
| | - Behzad Mahaki
- Department of Biostatistics School of Health Kermanshah University of Medical Sciences Kermanshah Iran
| | - Arash Salahshouri
- Department of Health Education and Promotion School of Public Health Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran
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Relationship between Resilience and Quality of Life in Patients with Fear of Hypoglycemia: The Mediating Effects of Anxiety and Depression. SUSTAINABILITY 2020. [DOI: 10.3390/su12208512] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background: Fear of hypoglycemia is an important problem in individuals with diabetes and could produce a negative impact on blood glucose control and quality of life in individuals with type 1 diabetes. Aim: To analyze (1) the associations among resilience, diabetes-related quality of life, and anxiety and depression in patients with type 1 diabetes with fear of hypoglycemia and (2) whether anxiety and depression mediate the relationship between resilience and quality of life. Design: A non-experimental, descriptive correlational design was used. Methods: Participants were 30 patients with type 1 diabetes with fear of hypoglycemia. Data were collected using several questionnaires administered between September 2019 and March 2020. Results: Resilience played a significant role in the anxiety and depression that accompanies diabetes. Mediation analysis was performed to assess whether the association between resilience and quality of life was mediated by anxiety and depression in series. The results show that the effect of resilience was mainly mediated by anxiety but not by depression. Conclusions: This study provides further evidence that high resilience could be a protective factor against the development of psychological symptomatology, which has a high prevalence in chronic conditions such as diabetes and can improve quality of life. Impact: Our study addresses the relationship between the positive psychological characteristic of resilience and anxiety, depression, and quality of life and the association between these variables. The results indicate that resilience has a positive impact on quality of life in people with type 1 diabetes who experience fear of hypoglycemia. Moreover, health professionals who provide care to these individuals should consider implementing programs to build resilience.
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Haroun M. In Silico Design, Synthesis and Evaluation of Novel Series of Benzothiazole- Based Pyrazolidinediones as Potent Hypoglycemic Agents. Med Chem 2020; 16:812-825. [DOI: 10.2174/1573406416666191227113716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 09/26/2019] [Accepted: 10/29/2019] [Indexed: 12/30/2022]
Abstract
Background:
The discovery of novel ligand binding domain (LBD) of peroxisome proliferator-
activated receptor γ (PPARγ) has recently attracted attention to few research groups in order
to develop more potent and safer antidiabetic agents.
Objective:
This study is focused on docking-based design and synthesis of novel compounds combining
benzothiazole and pyrazolidinedione scaffold as potential antidiabetic agents.
Methods:
Several benzothiazole-pyrazolidinedione hybrids were synthesized and tested for their in
vivo anti-hyperglycemic activity. Interactions profile of title compounds against PPARγ was examined
through molecular modelling approach.
Results:
All tested compounds exhibited anti-hyperglycemic activity similar or superior to the reference
drug Rosiglitazone. Introducing chlorine atom and alkyl group at position-6 and -5 respectively
on benzothiazole core resulted in enhancing the anti-hyperglycemic effect. Docking study
revealed that such groups demonstrated favorable hydrophobic interactions with novel LBD Ω-
pocket of PPARγ protein.
Conclusion:
Among the tested compounds, N-(6-chloro-5-methylbenzo[d]thiazol-2-yl-4-(4((3,5-
dioxopyrazolidin-4-ylidene)methyl)phenoxy)butanamide 5b was found to be the most potent compound
and provided valuable insights to further develop novel hybrids as anti-hyperglycemic
agents.
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Affiliation(s)
- Michelyne Haroun
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
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44
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The predictors of perceived stress in patients with type 2 diabetes in Turkey: styles of coping with stress and metabolic variables. Int J Diabetes Dev Ctries 2020. [DOI: 10.1007/s13410-020-00842-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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45
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A Resilience Intervention for Adults with Type 2 Diabetes: Proof-of-Concept in Community Health Centers. Int J Behav Med 2020; 27:565-575. [DOI: 10.1007/s12529-020-09894-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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46
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Devienne C, Delpech G, Untas A. La photo-expression : un outil pour accompagner le patient en éducation thérapeutique et pour évaluer son évolution. PRAT PSYCHOL 2020. [DOI: 10.1016/j.prps.2019.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Oral health status and impact on the oral health-related quality of life of Egyptian children and early adolescents with type-1 diabetes: a case-control study. Clin Oral Investig 2020; 24:4033-4042. [PMID: 32468484 DOI: 10.1007/s00784-020-03273-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 04/04/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The purpose of the present study is to (1) evaluate the oral health-related quality of life (OHRQoL) among a group of Egyptian children and early adolescents with type-1 diabetes mellitus (T1DM) aged from 8 to 14 years and the impact of individual, environmental, oral health care and biological independent predictors (2) assess oral health status (OHS) in terms of oral hygiene, caries experience, untreated carious cavities and gingival condition. MATERIALS AND METHODS A case-control investigation conducted on eligible 444 participants who have been assigned into four groups (two case groups included 125 children and 97 early adolescents with T1DM and two matched control groups). The OHRQoL was measured using a validated structured CPQ8-10 for children and CPQ11-14 short-form questionnaires for early adolescents. The questionnaire comprised of four parts that represented the study independent variables. Descriptive data were analysed using Mann-Whitney U test for the non-parametric data. Pearson's correlations have been calculated to inspect the interrelation between metabolic disease control and study of different OHS representatives. Log-linear Poisson model regression analyses performed to determine associations between the OHRQoL and independent predictors. RESULTS The prevalence of dental caries (DT ≥ 1) in children with diabetes was 49.6% (75.3%). The worse GI mean and median scores were recorded among early adolescents with T1DM [mean (SD) = 2.24 ± 0.61; median (IQR) = 2.3(1)]. The social well-being of CPQ domains was a prominent concern that negatively affected children and early adolescents' life aspects. A strong correlation between OHRQoL and the level of HbA1c in the two diabetic groups (r = 0.69 for children's group and 0.74 for the early adolescent group) was observed. The final model of log-linear Poisson regression analysis demonstrated that the odds ratio (OR) of poor OHRQoL among children and early adolescents with poor metabolic control was 1.30 [95% CI 1.18-1.47] and 1.22 [95% CI 1.11-1.38] times more than those with good metabolic control do. CONCLUSIONS The overall self-reported OHRQL appears to be adversely affected by T1DM especially among children and early adolescents with poor metabolic control. Socioeconomic status and oral health care demonstrate a significant impact on the OHRQoL; however, the effect was obvious in the diabetic and non-diabetic groups. CLINICAL RELEVANCE 1. In Egypt, the number of new cases rises progressively in a retrospective survey to figure out the prevalence of T1DM among children and adolescents. The available data is limited regarding the incidence and prevalence of dental caries and gingival condition among Egyptian children and early adolescents. 2. The present study is a premier study that assesses the OHRQoL and studies the impact of the individual, environmental, biological and oral health care variables. 3. This study highlights the urgent need for improving the oral health status of diabetic children and adolescents and the necessity for qualified oral health education programs for children and parents. There is an intense need to reinforce the role of preventive oral hygiene measures.
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Lee KW, Ching SM, Devaraj NK, Chong SC, Lim SY, Loh HC, Abdul Hamid H. Diabetes in Pregnancy and Risk of Antepartum Depression: A Systematic Review and Meta-Analysis of Cohort Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113767. [PMID: 32466479 PMCID: PMC7311953 DOI: 10.3390/ijerph17113767] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/18/2020] [Accepted: 05/22/2020] [Indexed: 12/18/2022]
Abstract
Previous literature has reported that patients with diabetes in pregnancy (DIP) are at risk of developing antepartum depression but the results have been inconsistent in cohort studies. We conducted a systematic review and performed a meta-analysis to quantify the association between DIP and risk of antepartum depression in cohort studies. Medline, Cinahl, and PubMed databases were searched for studies investigating DIP involving pregnant women with pre-existing diabetes and gestational diabetes mellitus and their risk of antepartum depression that were published in journals from inception to 27 December 2019. We derived the summary estimates using a random-effects model and reported the findings as pooled relative risks (RR) and confidence interval (CI). Publication bias was assessed using a funnel plot and was quantified by Egger and Begg’s tests. Ten studies, involving 71,036 pregnant women were included in this meta-analysis. The pooled RR to develop antepartum depression was (RR = 1.430, 95% CI: 1.251–1.636) among women with gestational diabetes mellitus. Combining pregnant women with pre-existing diabetes mellitus and gestational diabetes mellitus, they had a significant increased risk of developing antepartum depression (RR = 1.431, 95% CI: 1.205–1.699) compared with those without it. In comparison, we found no association between pre-existing diabetes mellitus in pregnancy (RR = 1.300, 95% CI: 0.736–2.297) and the risk of developing antepartum depression. This study has a few limitations: first, different questionnaire and cut-off points were used in evaluation of depression across the studies. Second, there was a lack of data on history of depression prior to pregnancy, which lead to confounding bias that could not be solved by this meta-analysis. Third, data were dominated by studies in Western countries; this is due to the studies from Eastern countries failing to meet our inclusion criteria for statistical analysis. Women with gestational diabetes mellitus have an increased risk of developing antepartum depression compared to those without the disease. Therefore, more attention on the mental health status should be given on pregnant women diagnosed with pre-existing diabetes mellitus and gestational diabetes mellitus.
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Affiliation(s)
- Kai Wei Lee
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; (K.W.L.); (N.K.D.)
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; (K.W.L.); (N.K.D.)
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia
- Correspondence:
| | - Navin Kumar Devaraj
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; (K.W.L.); (N.K.D.)
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia
| | - Seng Choi Chong
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia;
| | - Sook Yee Lim
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia;
| | - Hong Chuan Loh
- Clinical Research Centre, Hospital Seberang Jaya, Ministry of Health Malaysia, Perai 13700, Pulau Pinang, Malaysia;
| | - Habibah Abdul Hamid
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia;
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Devienne C, Delpech G, Untas A. WITHDRAWN: La photo-expression : un outil pour accompagner le patient en éducation thérapeutique et pour évaluer son évolution. PRAT PSYCHOL 2020. [DOI: 10.1016/j.prps.2019.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lum ZK, Khoo ZR, Toh WYS, Kamaldeen SAK, Shakoor A, Tsou KYK, Chew DEK, Dalan R, Kwek SC, Othman N, Lian JX, Bte Sunari RN, Lee JYC. Efficacy and Safety of Use of the Fasting Algorithm for Singaporeans With Type 2 Diabetes (FAST) During Ramadan: A Prospective, Multicenter, Randomized Controlled Trial. Ann Fam Med 2020; 18:139-147. [PMID: 32152018 PMCID: PMC7062498 DOI: 10.1370/afm.2500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 10/15/2019] [Accepted: 10/21/2019] [Indexed: 02/06/2023] Open
Abstract
PURPOSE We aimed to evaluate the efficacy and safety of use of the Fasting Algorithm for Singaporeans with Type 2 Diabetes (FAST) during Ramadan. METHODS We performed a prospective, multicenter, randomized controlled trial. The inclusion criteria were age ≥21 years, baseline glycated hemoglobin (HbA1c) level ≤9.5%, and intention to fast for ≥10 days during Ramadan. Exclusion criteria included baseline estimated glomerular filtration rate <30 mL/min, diabetes-related hospitalization, and short-term corticosteroid therapy. Participants were randomized to intervention (use of FAST) or control (usual care without FAST) groups. Efficacy outcomes were HbA1c level and fasting blood glucose and postprandial glucose changes, and the safety outcome was incidence of major or minor hypoglycemia during the Ramadan period. Glycemic variability and diabetes distress were also investigated. Linear mixed models were constructed to assess changes. RESULTS A total of 97 participants were randomized (intervention: n = 46, control: n = 51). The HbA1c improvement during Ramadan was 4 times greater in the intervention group (-0.4%) than in the control group (-0.1%) (P = .049). The mean fasting blood glucose level decreased in the intervention group (-3.6 mg/dL) and increased in the control group (+20.9 mg/dL) (P = .034). The mean postprandial glucose level showed greater improvement in the intervention group (-16.4 mg/dL) compared to the control group (-2.3 mg/dL). There were more minor hypoglycemic events based on self-monitered blood glucose readings in the control group (intervention: 4, control: 6; P = .744). Glycemic variability was not significantly different between the 2 groups (P = .284). No between-group differences in diabetes distress were observed (P = .479). CONCLUSIONS Our findings emphasize the importance of efficacious, safe, and culturally tailored epistemic tools for diabetes management.
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Affiliation(s)
- Zheng Kang Lum
- Department of Pharmacy, Faculty of Science, National University of Singapore
| | - Zi Rui Khoo
- Department of Pharmacy, Faculty of Science, National University of Singapore
| | | | | | - Abdul Shakoor
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore
| | - Keith Yu Kei Tsou
- Department of Family Medicine, National University Polyclinics, Singapore
| | | | - Rinkoo Dalan
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore
| | - Sing Cheer Kwek
- Department of Family Medicine, National University Polyclinics, Singapore
| | - Noorani Othman
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore
| | - Joyce Xia Lian
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore
| | | | - Joyce Yu-Chia Lee
- Department of Pharmacy, Faculty of Science, National University of Singapore .,Department of Pharmacy, Tan Tock Seng Hospital, Singapore
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