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World J Diabetes. Dec 15, 2014; 5(6): 796-808
Published online Dec 15, 2014. doi: 10.4239/wjd.v5.i6.796
Psychological aspects of diabetes care: Effecting behavioral change in patients
Boon-How Chew, Sazlina Shariff-Ghazali, Aaron Fernandez
Boon-How Chew, Sazlina Shariff-Ghazali, Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
Aaron Fernandez, Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
Author contributions: Chew BH, Shariff-Ghazali S and Fernandez A contributed to this paper.
Correspondence to: Boon-How Chew, MD, Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia.
Telephone: +60-3-89472520 Fax: +60-3-89472328
Received: August 27, 2014
Revised: November 5, 2014
Accepted: November 17, 2014
Published online: December 15, 2014

Patients with diabetes mellitus (DM) need psychological support throughout their life span from the time of diagnosis. The psychological make-up of the patients with DM play a central role in self-management behaviors. Without patient’s adherence to the effective therapies, there would be persistent sub-optimal control of diseases, increase diabetes-related complications, causing deterioration in quality of life, resulting in increased healthcare utilization and burden on healthcare systems. However, provision of psychosocial support is generally inadequate due to its challenging nature of needs and demands on the healthcare systems. This review article examines patient’s psychological aspects in general, elaborates in particular about emotion effects on health, and emotion in relation to other psychological domains such as cognition, self-regulation, self-efficacy and behavior. Some descriptions are also provided on willpower, resilience, illness perception and proactive coping in relating execution of new behaviors, coping with future-oriented thinking and influences of illness perception on health-related behaviors. These psychological aspects are further discussed in relation to DM and interventions for patients with DM. Equipped with the understanding of the pertinent nature of psychology in patients with DM; and knowing the links between the psychological disorders, inflammation and cardiovascular outcomes would hopefully encourages healthcare professionals in giving due attention to the psychological needs of patients with DM.

Keywords: Psychology, Psychosocial aspects, Emotions, Cognition, Distress, Depression, Psychological resilience, Self-care, Coping behaviors, Quality of life, Diabetes mellitus

Core tip: Positive psychological health may sustain long-term coping efforts and protect patients from the negative consequences of prolonged emotional disorders, illness perception and thus facilitating diabetes self-management behaviors and better physical health. Having patients acquire valued personal beliefs and achievable standards of performance could strengthen self-regulation and self-efficacy leading to more positive experience and healthy behaviors. Furthermore, improved personal resources such as resilience would lead to better functioning of cognition and stronger will power, quality of life and disease control in patients with diabetes mellitus.