فصلنامه پرستاری دیابت
سال نهم شماره 4 (پاییز 1400)

Type II diabetes is one of the most common metabolic diseases that its incidence is increasing among adolescents. Self-care training with a focus on reducing perceived stress leads to a decrease in the complications of diabetes and its better control. This study was conducted to assess the effect of self-care education on perceived stress among type II diabetes patients.

This quasi-experimental study was conducted based on control and intervention groups design. The statistical population consisted of diabetic patients referring to the diabetes clinic, among which 88 samples were selected by availability sampling method and divided into the case and control groups (n=44 in each) using the toss of a coin method. At first, the demographic form and the Perceived Stress Scale were completed by both groups. Subsequently, the intervention group participated in four 60-minute sessions of diabetes self-care training and received the routine training of the center, while the control group only received the routine training of the diabetes clinic. The Perceived Stress Scale was completed once more by both groups 4 weeks after the intervention. Data collection tools included the demographic form and Perceived Stress Scale. The gathered data were analyzed in SPSS version 23 using independent and dependent t-tests.

The results indicated that there was no significant difference in perceived stress between case and control groups before the intervention; however, a significant difference was observed in this regard after the intervention (P<0.05). It was revealed that self-care training significantly reduced perceived stress among diabetes patients (P<0.0001).

Based on the findings, self-care training had a positive effect on perceived stress reduction. Therefore, the use of self-care training programs along with pharmacological treatment is necessary for people with type II diabetes.

Diabetes is a non-communicable disease that affects the physical, mental, and emotional aspects of life. The present study aimed to assess the mediating role of health-promoting behaviors and self-management behaviors in the relationship between stressful life events and health-related quality of life in diabetic patients.

The present study was conducted based on a descriptive-correlational design. The statistical population of the study consisted of all diabetic patients aged 25-75 years who were referred to the Diabetes Clinic of Zabol from January to March 2016 (n=550). The sample consisted of 400 patients who were selected via the convenience sampling method. They completed the life stressful events questionnaire, health-promoting lifestyle profile, diabetes self-management questionnaire, and diabetic patient’s health-related quality of life questionnaire. Data were analyzed in SPSS (version 22) and LISREL 8.8 statistical software using structural equation modeling.

Based on the results, the direct path of stressful events to health-promoting behaviors and self-management behaviors was negative and significant (P<0.01); moreover, it was negative and non-significant to the health-related quality of life (P<0.01). The direct path of health-promoting behaviors and self-management behaviors to health-related quality of life was positive and significant (P<0.01). In addition, it was found that the indirect relationship between stressful events and health-related quality of life was mediated by health-promoting behaviors and self-management behaviors (P<0.01).

These findings indicate that health-promoting behaviors and self-management behaviors can play a significant indirect role in reducing the negative effects of stressful events on health-related quality of life. Strengthening positive psychological characteristics and reducing risky constructs, such as stress and its perception, as well as the development of intervention programs and their application, can help improve the health-related quality of life among diabetic patients.

Type II diabetic patients experience various physical and mental problems, such as stress, anxiety, depression, and sleep quality disorders, that require necessary interventions. So far, few studies have evaluated the effectiveness of nature sounds on mood and sleep disorders in patients. Therefore, this study was conducted to determine the effect of nature sounds on stress, anxiety, depression, and sleep quality among type II diabetic patients.

In this study, 40 patients with type II diabetes were evaluated in the intervention and control groups (n=20 each). The required data were collected using the Anxiety, Stress, and Depression Scale-21 and Pittsburgh Sleep Quality Index at the baseline and 1 week after the nature sounds intervention. The participants in the intervention group listened to an audio file containing the sounds of nature twice a day, once in the morning and once at night before going to bed, for 20 min at each stage. The control group received the usual nursing care program. The gathered data were analyzed using descriptive and inferential statistics.

The independent t-test did not show a significant difference between the mean scores of stress (11.70±3.14 vs 9.60±3.57), anxiety (9.05±3.32 vs 8.05±3.31), depression (9.25±3.77) vs 9.30±4.07), and sleep quality (9.22±3.61 vs 9.44±4/06) of diabetic patients in the intervention and control groups. However, the ANCOVA with Bonferroni post hoc test by controlling pre-test scores significantly reduced the difference between the mean scores of stress in the intervention and control groups, accounting for 9.58 (95% confidence interval [CI] 8.10, 11.07) and 11.71 (95% CI 10.22, 13.20), respectively.

The sound of nature reduced stress in diabetic patients; nevertheless, it did not have a significant effect on their anxiety, depression, and sleep quality.

Diabetic patients are exposed to a number of psychological and social problems that can adversely affect their quality of life. Therefore, this study aimed to investigate the effect of lifestyle training on the quality of diabetic patients’ life.

This quasi-experimental and interventional study was conducted on 74 patients who were randomly assigned to the intervention and control groups (37 cases per group). The intervention was an educational program in the form of training sessions to teach diabetic patients about their lifestyle, including nutrition, exercise, diet, stress and anxiety control, as well as the prohibition of smoking. The data were collected through administering the demographic characteristics and WHOQOL-BREF questionnaires. The independent t-test was then used to compare the intervention and control groups in terms of demographic characteristics, and the chi-square test was utilized for normal quantitative and qualitative variables. Additionally, the independent t-test and a paired t-test were run to evaluate the mean scores of quality of life before and after the intervention between the two groups and within each group, respectively. In all tests, a P-value of less than 0.05 was considered significant. After data collection, the data were analyzed using SPSS statistical software (version 16).

The mean age of the subjects was determined at 48.9±10.8, and the majority (75.6%) of the cases were female. The duration lengths of diabetes were 16.89±5.40 and 19.00±4.60 years in the control and intervention groups, respectively. The results revealed a statistically significant difference (P<0.001) between the intervention and control groups in terms of the mean±SD of the total score of quality of life, as well as its four dimensions before and after the intervention.

Lifestyle education can improve the quality of diabetic patients’ life.

Diabetes mellitus is a chronic disease affecting both the quality of life and mental health of patients. This study aimed to evaluate personality characteristics and cognitive emotion regulation strategies in individuals with diabetes and pre-diabetes compared to the healthy people.

This cross-sectional study was conducted on 207 participants (54 males and 153 females), including 70 diabetic, 68 pre-diabetic, and 69 healthy people. To collect data, the Persian version of the NEO Personality Inventory test and Cognitive Emotion Regulation Questionnaire were used. Data were analyzed in SPSS software version 20 and the variables were compared in three groups using multivariate analysis of covariance with a significance level of α = 0.05.

The three groups did not differ in terms of gender distribution; however, their mean age was significantly different (diabetic group: 51.14±10.35, pre-diabetic: 44.79±10.60, healthy: 40.88±10.54 years; P<0.001). There was no significant difference between the three groups in terms of personality characteristics (P>0.05). In cognitive emotion regulation strategies, the mean scores of self-blame and rumination were significantly higher in the diabetic group than in the pre-diabetic and healthy groups (P=0.02 and P=0.009, respectively). The result was the opposite regarding a refocus on planning. Moreover, the mean scores of catastrophizing were significantly higher in the diabetic (12.80±3.17) and pre-diabetic groups (12.49±3.33) than in the healthy group (11.17±3.11; P=0.02).

Using negative cognitive emotion regulation strategies may reduce the mental health of both diabetic patients and pre-diabetes individuals. The findings of the present study confirmed the necessity for psychological counseling as a part of treatment protocols in both diabetic and pre-diabetic patients.

During the COVID-19 pandemic, diabetic patients need psychological support, in addition to physical care. In this regard, the present study aimed to assess the quality of life and psychological distress of diabetic patients during the COVID-19 pandemic.

In this systematic review, a query on Google Scholar, PubMed, Scopus, and Science Direct was carried out for the titles and abstracts of articles published between 2020 (February) and 2021 (July) using the following keywords: Coronavirus 2019, Quality of Life, Diabetes, Depression, Stress, Anxiety, Mental Health, Pandemic, and Psychology. The abstracts of the published articles were reviewed, and in several stages, duplicate and unrelated items were removed from the study. Finally, 23 articles were selected for comprehensive review and data extraction. In this study, the PRISMA Systematic Review Study Guide was used.

Studies have demonstrated that during the COVID-19 pandemic, patients with diabetes experienced poor quality of life due to insufficient access to insulin and physicians, social isolation, distance from friends, loneliness, and lack of physical activity. Moreover, a weak immune system and fear of developing COVID-19 caused many diabetic patients to suffer from stress, depression, anxiety, and poor sleep quality. Furthermore, such factors as female gender, low income and education, loneliness, history of mental disorder, physical inactivity, smoking, fear of COVID-19, and lack of social support led to the aggravation of psychological distress and reduced quality of life in diabetic patients.

It is acknowledged that during the Covid-19 pandemic, diabetic patients are among the high-risk groups and their mental health plays a crucial role in the severity of disease and their blood sugar levels. Therefore, virtual and remote psychological care is required during this period to increase the quality of life and mental health of diabetic patients.