The Effects of Group Self-Care Training on Quality of Life and Psychological Wellbeing in Patients With Type 2 Diabetes

Diabetes is a prevalent metabolic disorder associated with hyperglycemia, insufficient secretion, or impaired insulin function. A component affected by diabetes is the Quality of Life (QoL) of patients. The QoL indicates the viewpoint of individuals about their health status and the extent to which they are satisfied with it. Psychological wellbeing reflects optimal psychological performance and experience. Psychological wellbeing is defined as the growth of each individualchr('39')s true talents. One of the most effective pieces of training for patients with diabetes is needs–based self–care education. Self–care is a progressing process concerning increasing awareness through learning that leads to the continuation of onechr('39')s life along with the complex nature of diabetes. The present study aimed to determine the effects of group self–care training on QoL and psychological wellbeing in patients with type 2 diabetes.

This was a quasi–experimental study with a pretest–posttest–follow–up and a control group design. The statistical population of the study included patients with type 2 diabetes referring to the medical centers of Kish Island, Iran, in 2019. The sample consisted of 40 patients with type 2 diabetes. The study subjects were selected by convenience sampling approach; using a simple randomization method, they were assigned into two groups of education based on self–care needs and control (n=20/group). The inclusion criteria were being diagnosed with diabetes for ≥1 year, a hemoglobin A1C level of >7%, having a minimum age of 30 years, having a minimum of ninth–grade education, not receiving psychological treatment since the diagnosis of disease, the lack of acute or chronic psychical or mental diseases, the lack of skeletal diseases, the lack of heart and respiratory failures, etc. causing problems in blood sampling and attending long sessions, not taking psychotropic drugs, and no substance abuse. Furthermore, severe complications of diabetes leading to hospitalization, absence from >2 treatment sessions, and major stresses caused by unconceused accidents were also considered as the exclusion criteria. HbA1C test was performed three months after the end of the training. The required data were achieved using the World Health Organization Quality of Life Questionnaire (WHOQOL–BREF; WHO, 1996) and the Psychological Wellbeing Scale (Ryff, 1989). At the end of the sessions, both study groups re–completed the research questionnaires and the HbA1C test was performed to follow up and evaluate the stability of the effect of the presented training. Self–care education was performed in five 90–minute weekly sessions for two months based on Firooz et al.’s (2015) training package. Repeated–measures Analysis of Variance (ANOVA) was used in SPSS at the significance level of 0.05 to analyze the obtained data.

ANOVA data were significant for intra–group factor (time) (p<0.001) and inter–group factor (p=0.008). Additionally, the time*group interaction was significant (p<0.001) with an effect size of 0.78. Respecting psychological wellbeing, the ANOVA result was significant for intra–group factor (time) (p<0.001). Besides, the group*time interaction was significant (p<0.001) with an effect size of 0.76. There was also a significant difference in psychological wellbeing and QoL between pretest with posttest and follow–up scores (p<0.001). Furthermore, the effectiveness of the presented program in the follow–up phase was lasting for psychological wellbeing (p=0.197) and QoL (p=0.170).

Based on the current study findings, the provided group self–care training was effective on QoL and psychological wellbeing in patients with type 2 diabetes.