فصلنامه پرستاری دیابت
سال یازدهم شماره 1 (زمستان 1401)

Diabetes is an important concern for health in the world, which in case of coexisting with anxiety, depression, stress, and an unhealthy lifestyle; it will increase the extent of its severity and complications. Modification of the lifestyle of people with diabetes can improve the psychological distress of the patients, and consequently, the prognosis of the disease. Therefore, the present study aimed to compare the effect of lifestyle education based on the BASNEF model and the World Health Organization model on psychological distress in patients with type II diabetes. 

This extended semi-experimental multi-group study was conducted based on pretest-posttest design with a follow-up, as well as one control and two experimental groups. Three months after the post-test, all three groups were followed up. The statistical population included all patients with type II diabetes referred to the Endocrinology Department of Imam Khomeini Hospital in 2021. From a list of 100 people with diabetes, 60 cases were identified, and then, 45 subjects were randomly selected and allocated into one control and two experimental groups. DASS-21 was used to collect the required data, and the obtained data were analyzed in SPSS software (version 26) through mixed repeated measures ANOVA.

The results indicated the effect of both models on anxiety (P=0.001), depression (P=0.001), and stress (P=0.001), as well as the stability of this effect at the follow-up. Lifestyle education based on the BASNEF model reduced the amount of depression more (P=0.025), compared to the model by the WHO; however, the difference between the two groups was not significant regarding anxiety and stress.

The results indicated the effectiveness of both educational models and the superiority of the BASENF educational model in psychological distress among patients with type II diabetes. Therefore, lifestyle education as an adjunctive treatment in people with type II diabetes seems necessary.

Type II diabetes is one of the chronic diseases, and diabetes distress is one of the psychological factors affecting its management. Therefore, this study was performed to compare the effectiveness of self-healing with mindfulness-integrated cognitive behavior therapy on diabetes distress and control of glycemic in type II diabetic patients

This semi-experimental research was conducted on 60 people with type II diabetes who were selected purposefully. People were randomly divided into two intervention groups and one control group. The intervention groups received twelve 90-minute sessions (one session per week) of mindfulness-integrated cognitive behavior therapy and self-healing. The research tools were Polonsky et al.'s Diabetes Distress Scale (2005), which has content validity and reliability with a Cronbach's alpha of 0.87, and laboratory equipment to measure hemoglobin glycoside. The data were analyzed using variance analysis with repeated measurements and post hoc tests in SPSS-24 software.

Between the two methods of intervention, only self-healing could effectively reduce glycosidic hemoglobin (P≤0.01). Moreover, both methods of intervention reduced diabetes distress; however, the effect of self-healing remained stable over time (P≤0.01).

The results indicated that self-healing was able to reduce hemoglobin glycoside in addition to diabetes distress and its effect remained constant over time. It is suggested to investigate the effect of self-healing in other areas related to diabetes.

Diabetes increases the risk of hospitalization and mortality from COVID-19 due to comorbidities. The purpose of this study was to determine the possible effects of complications related to diabetes and demographic characteristics on mortality and the duration of hospitalization of patients with COVID-19 in the hospital.

The retrospective study was conducted based on a descriptive approach. The statistical population of the study (n=130) consisted of diabetic patients hospitalized with a definite diagnosis of COVID-19 at Amirul Moeminin Ali Hospital in Zabol. The survey period was from 21 March 2021 to 21 March 2022 (one year). Data collection was done by reviewing patients' records by the researcher as well as using questionnaires and checklists.

The average hospitalization time due to infection with COVID-19 was 6.5 days (7.3 days for women and 5.3 days for men). The average age of the examined people was estimated at 59.4 years (women 58.4 years and men 60.8 years). The average BMI of patients was obtained at 30.3 kg/m2 (women 30.9 kg/m2 and men 29.3 kg/m2). Out of 130 examined patients, 4 (3.1%) cases died, whose average age was 74 years. Complications of the cardiovascular system were the most common among patients. The most clinical symptoms were cough and the least was vomiting.

As the results of this study showed, diabetic patients who were infected with COVID-19 were exposed to a higher risk of hospitalization and more complications from this disease. Therefore, the planners of the Ministry of Health as well as nurses and personnel working in the inpatient wards of COVID-19 patients should pay more attention to these patients.

Diabetes is one of the most common diseases in the elderly. Mental health problems, including depression and anxiety disorders, are common in the elderly with diabetes while they are usually not diagnosed. Patients with co-occurrence of diabetes and psychiatric disorders have a worse prognosis. This study aimed to investigate the prevalence of generalized anxiety disorder and depression in patients over 60 years old with type II diabetes.

This cross-sectional and descriptive study included 300 elderly patients with type 2 diabetes referred to the diabetes clinic of Golestan Hospital, Ahvaz, Iran, in 2021. The existence of anxiety and depression was measured using Beck Anxiety and Depression Inventories, Geriatric Depression Scale-Short Form (GDS-SF), Geriatric Anxiety Inventory-Short form-Persian version (GAI-SF-PV), and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). 

Most of the patients were female (56.7%), married (95%), with a diploma or less (86.6%), Arab (57.7%), with average economic status (69%), and living with family (97%). Controlled diabetes was reported in most people using medicines and insulin (94.3%). The rates of generalized anxiety and depression based on the mentioned inventories and the DSM-V were 33.8% and 40.7%, respectively.

The findings of our study showed a high prevalence of depression and anxiety in diabetic patients over 60 years of age. Low level of education, poor economic status, uncontrolled blood sugar, and gender are independent risk factors affecting anxiety and depression. Moreover, life without a family was an independent risk factor for generalized anxiety disorder in diabetic patients over 60 years of age.

Diabetes is the most common disease caused by metabolic disorders. Diabetes disrupts the regular flow of life and affects individuals’ Quality of Life in various dimensions. Some interventions based on cognitive behavioral therapy  have been used to improve the QoL of patients with diabetes. This study aimed to systematically review the effect of cognitive behavioral therapy (CBT) in terms of improving the QoL of diabetic patients in Iran.

External (Google Scholar, PubMed, Scopus, Web of Science) and internal (SID, Magiran) databases were searched from the inception to February 2023. Cognitive behavioral interventions were compared with pre-test and post-test design and usual care control group or other psychosocial interventions. The standardized mean difference effect was calculated using a random effects model with 95% confidence. The risk of bias was assessed according to Cochrane(Rob). Data was analyzed using RewMan-5 software.

A total of 14 studies involving 444 diabetes patients were included in this study. At the first stage of the search, 504 articles were obtained. After reviewing the title and abstract of the articles, 465 articles were excluded due to being irrelevant and repetitive and 39 articles remained. Finally, 14 studies were selected by reviewing the abstracts of the articles and considering the inclusion criteria. Compared to the control group, the standardized mean difference for the effect of CBT on QoL in posttest was high (SMD = 1.06, 95% CI = [0.63, 1.48]) was obtained; The standard mean difference for the effect of CBT on quality of life in the follow-up phase was also moderate and equal to(SMD = 0.66, 95% CI = [0.34, 0.98]). The heterogeneity between the results of the studies was high (76%). Most of the studies had an unclear risk of bias. Despite publication bias, only one study had a high error and less accuracy than the rest of the studies.

This study shows promising results regarding the effects of psychological interventions on QoL, especially on CBT-based interventions. Screening patients with diabetes for mental health comorbidities and referring to a mental health specialist in the context of a multidisciplinary approach should be a priority.