فصلنامه پرستاری دیابت
سال یازدهم شماره 2 (بهار 1402)

Diabetes is a common disease that causes eye complications and leads to vision loss and blindness. Diabetic retinopathy is one of the main causes of blindness in the world and the most common cause of new cases of blindness. Predicting the occurrence time of this complication in diabetic people is one of the health priorities of society. The purpose of this study was to determine the cumulative probability of the occurrence of type II diabetes retinopathy using survival analysis in Zahedan City, Iran.

This was a historical cohort study using the survival analysis method, which was carried out descriptively and analytically on 410 patients in 2019. Data were calculated using SPSS22 software and descriptive tests, followed by the Kaplan-Meier method and the Cox proportional hazards model of survival.

The results of this study showed that 103 (25.13%) patients had retinopathy. The median survival time (months) of the occurrence of cardiac complications was related to marital status, fasting blood sugar, smoking, hemoglobin A1c, and blood lipids (P<0.05). The variables of fasting blood sugar, A1c, and two-hour blood glucose remained in the final model of the multiple Cox regression.

The findings of the current research showed that the prevalence of retinopathy in the studied population was relatively high and had a significant effect on reducing survival time. Therefore, it is necessary to make interventions in lifestyle changes, and regular control of blood pressure, cholesterol, and blood sugar to prevent the disease and reduce complications related to diabetes

Diabetes is a metabolic disease whose prevalence is increasing globally. This study aimed to investigate laboratory diagnostic markers in type I, type II, and gestational diabetes.

This was an analytical cross-sectional study, and the necessary data were collected by referring to the medical records department of the educational hospitals of Abadan University of Medical Sciences. Accordingly, the demographic and laboratory information of patients with type I, type II, and gestational diabetes admitted from March 21, 2019, to March 19, 2020, that was available in the hospital information system, was gathered. The samples were selected randomly and by considering their diagnosis. Data analysis was performed in SPSS16 software, and P < 0.05 was considered statistically significant.

In the current study, the mean values of hematocrit in type I, type II, and gestational diabetes were lower than normal. The mean scores of hemoglobin in type II diabetes and gestational diabetes were lower than normal. The mean blood urea nitrogen, creatinine, international normalized ratio, and prothrombin time in type 2 diabetes were higher than the normal range. In addition, the amount of BUN and creatinine in men was higher than normal and in women. In type I diabetes, the mean creatinine and BUN were higher than normal in the age group above 60. The mean laboratory factors studied in gestational diabetes showed a significant difference compared to type I diabetes and type II diabetes.

The results of this study showed that type 1 and type 2 diabetes were more common in women than in men. It was also found that diabetes was associated with numerous complications and risks for sufferers, including anemia, kidney complications, and coagulation problems that resulted from increased blood sugar in these people, and these complications were more severe in old age. Screening, investigation, and timely diagnosis can help reduce and treat these complications in people with diabetes.

Diabetes is a complex and chronic disease that affects and changes the quality of life of patients. The purpose of this study is to investigate the combination of pattern design and dimensions affecting the quality of life of diabetic patients.

The working method in the present qualitative research is of met composite type, which library method was used to collect data. This method has seven steps, according to which it evaluates the results of the findings of past studies. Based on this, past research results from domestic and foreign sources have been collected and analyzed during 2018-2019. From the initial 30 articles, 18 articles were selected for the final analysis. After examining each of the articles, its main themes were extracted and the final interpretation was made on them. Also, the validity and reliability of this research is 0.88 and the Kappa coefficient is at an excellent level.

The findings of the research led to 38 concepts according to the review of the extracted articles, and then by reviewing the initial findings and by reviewing the existing sub-fields, 5 main factors were obtained, and these dimensions and factors include physical dimensions, social dimensions, economic dimensions, It is psychological and has individual and mental dimensions. Each of these dimensions consists of components, and based on that, the final integrated model is presented and surveyed.

The results of the current research show that each of the dimensions somehow affects the quality of life of diabetic patients and all the dimensions and components of the research are consistent with previous studies. Also, with proper control of blood sugar and other methods, a higher quality of life is achieved for diabetic patients.

Diabetes mellitus, like any other chronic and debilitating disease, leads to problems that affect all aspects of the affected person's daily life. The aim of this study was to compare the effectiveness of emotion-focused therapy and acceptance and commitment therapy on emotional self-regulation and diabetes management self- efficacy in women with type II diabetes.

This semi-experimental study was conducted using a pretest-posttest design with control group. The statistical population of this study was all women with type II diabetes in the city of Tehran in the summer and autumn of 1401. In the first phase, 75 subjects were selected by convenience sampling method and then randomly divided into 2 experimental groups (each group 25 subjects) and one control group (25 subjects), and the experimental groups participated in emotion-focused therapy and acceptance and commitment therapy. The Gross and John (2003) emotion regulation questionnaire and the Bijl and et al (1999) diabetes management self-efficacy scale were used to collect data were analyzed by repeated measures using SPSS version 24.

The results showed that both interventions had a significant effect on improving emotional self-regulation and self-efficacy (P<0.05).  In addition, the results of the Bonferroni post hoc test showed that emotion-focused therapy was more effective in emotional self-regulation and acceptance and commitment therapy was more effective in self-efficacy (P<0.05).

Emotion -focused therapy and acceptance and commitment therapy were therefore found to be effective interventions for emotional self-regulation and self-efficacy in women with type II diabetes.  It is therefore recommended that endocrinologists and diabetes associations include psychological interventions, including emotion-focused therapy and acceptance and commitment therapy, in the care program for women with type II diabetes.

Abstract

The relatively high prevalence of diabetes, the substantial costs associated with its treatment, and the increased recognition of psychological issues necessitate research in the field of diabetes. This study aimed to investigate the mediating role of diabetes self-compassion in the relationship between stressful life events and the health-related quality of life in diabetic patients.

This study is of a descriptive correlational nature. The study population consisted of all patients with diabetes aged from March to July 2021, who were referred to the Diabetes Clinic of Zabol  (N = 795). The sample consisted of 400 patients selected through convenience sampling. They completed the Life Stressful Events Questionnaire, the Diabetes Self-Compassion Scale, and the health-Related Quality of Life Questionnaire for diabetic patients. Data were analyzed using structural equation modeling and statistical software, including SPSS 22 and LISREL 8.8.

The results revealed that the direct relationship between stressful events and diabetes self-compassion was negative and significant (p < 0.01), whereas the direct relationship between stressful events and health-related quality of life was positive but non-significant (p < 0.01). Furthermore, the direct relationship between diabetes self-compassion and health-related quality of life was positive and significant (p < 0.01). Importantly, the findings also showed that the indirect relationship between stressful events and health-related quality of life is mediated by diabetes self-compassion (p < 0.01).

These findings underscore the mediating role of diabetes self-compassion in the relationship between stressful events and health-related quality of life. Based on the results of this study, educational and intervention programs grounded in self-compassion, in conjunction with medical and pharmacological treatments, can prove beneficial for the health outcomes of diabetic patients.

Adolescence is a sensitive and critical stage of human development marked by numerous physical, sexual, and mental changes. Chronic diseases can significantly impact the identity formation process during adolescence due to its unique developmental characteristics. Diabetes, as one such chronic disease, has long-term effects on adolescents, including low sleep quality. Spirituality, particularly in children and adolescents, alongside routine care, can influence how individuals cope with stress, pain intensity, interpersonal relationships, and their overall quality of life, ultimately enhancing the lives of children with chronic diseases.

This experimental study aimed to investigate the impact of spiritual self-care training on the sleep quality of adolescents aged 12 to 20 with diabetes. The study was conducted in Qaemshahr city, with participants recruited from comprehensive urban and rural health service centers, using a simple random allocation method. A pre-test and post-test design was employed, with a total of 66 diabetic teenagers (33 in the test group, 33 in the control group) who provided written consent. Data were collected using the Petersburg Sleep Quality Questionnaire. The test group received training in White's spiritual self-care during six sessions lasting 30 to 45 minutes each. The collected data were analyzed using descriptive statistics and inferential statistics.

Prior to the intervention, the average sleep quality was 15.06±3.4 in the test group and 13.84±3.38 in the control group. After the intervention, the control group's sleep quality improved to 14.26±3.31, while the test group's sleep quality improved significantly to 12.47±3.49 (P < 0.01, Eta = 0.12). Notably, 12% of the improvements in sleep quality were attributed to the spiritual self-care of diabetic adolescents. Significant differences were observed in the components of mental quality of sleep, sleep duration, and daily dysfunction (p < 0.01).

The study highlights the significant role of spiritual self-care training in enhancing the sleep quality of diabetic adolescents, emphasizing the potential for nurses and healthcare workers to provide this training to patients. It is recommended that this research be expanded to include complementary self-care methods in various communities, especially in larger cities. Additionally, longitudinal studies are encouraged to assess the long-term effects of this intervention.