Journal of Diabetes Nursing
Year:2016 | Volume:4 | Issue:2|Papers Count:9

Introduction: Type II diabetes, as a chronic disease with various side-effects, can challenge the psychosocial adaptation of patients. This study was conducted with the aim of investigating the effect of an educational program based on Roy’s adaptation model on the psychosocial adaptation of type II diabetic patients in Birjand, Iran in 2013.Methodology: In this quasi-experimental study, 60 patients with type II diabetes, aged 30-70 years, were selected via convenience sampling among patients referred to a diabetes clinic in Birjand. The subjects were assigned to the intervention and control groups via block randomization. First, the demographic form and psychosocial adjustment to illness scale (PAIS) were completed by the two groups. In addition, Roy’s assessment form was completed by the intervention group. The maladaptive behaviors of patients were determined and the program curriculum was designed. Group training was carried out in eight sessions, while face-to-face training was performed in two sessions. The patients were followed-up for one month via phone calls. For data analysis, independent t-test, paired t-test, and covariance analysis were performed, using SPSS version 15.Results: Following the intervention, there was a significant decline in the mean scores of all domains of psychosocial adaptation, i.e., disease perception, vocational environment, domestic environment, family relations, social environment, and psychological distress (P<0.05), with the exception of sexual relationship (P=0.66). In the control group, only the mean score of domestic environment significantly increased after the study, compared to the baseline (P=0.002).Conclusion: The present results indicated the major positive impact of training based on Roy’s adaptation model on type II diabetic patients. In fact, given the changing condition of diabetes, improvement of different aspects of psychosocial adaptation can result in the management of maladaptive behaviors and improvement of patient adaptation. Regarding the cost-effective and non-invasive design of Roy’s adaptation model, it can be incorporated as an effective tool for the analysis of type II diabetic patients.

Introduction: Fatty liver disease is recognized as the most common chronic liver disease in industrialized Western countries. Evidence suggests a relationship between diabetes and the risk factors for fatty liver disease. The present study was performed to determine the relationship between fatty liver disease and diabetes in patients referred to hospitals affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran.Methodology: This descriptive, correlational study was performed on 180 patients, admitted to hospitals affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran. The data collection tools included the demographic and clinical form, consisting of information on the liver index and serum cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride, and hemoglobin levels. For data analysis, t-test and Chi-square test were performed using SPSS.Results: According to the ANOVA test results, LDL, triglyceride, cholesterol, and alanine aminotransferase (ALT) levels were correlated. In fact, an increase in triglyceride level resulted in a rise in hemoglobin A1c (HbA1c) level (P<0.05). On the other hand, a decline in HDL level caused an increase in HbA1c. In addition, triglyceride and alkaline phosphatase (ALP) level were significantly correlated. In fact, an increase in triglyceride and ALP level resulted in a rise in fasting blood sugar (P<0.05).Conclusion: The present results indicated the major positive impact of training based on Roy’s adaptation model on type II diabetic patients. In fact, given the changing condition of diabetes, improvement of different aspects of psychosocial adaptation can result in the management of maladaptive behaviors and improvement of patient adaptation. Regarding the cost-effective and non-invasive design of Roy’s adaptation model, it can be incorporated as an effective tool for the analysis of type II diabetic patients.

Introduction: Diabetes is one of the major stressors in life and lack of control led to inappropriate social behaviors such as aggression. Having mental health and reduce stress in healthier patients can communicate person in the community and thus receive better health care help, Therefore, this study aimed to investigate the relationship between perceived stress and aggression in patients with diabetes type II..Methodology: This study is a descriptive correlational study.150 patients were randomly chosen, Perceived Stress Scale (PSQ) and and Aggression Questionnaire of Buss & perry were applied to obtain data. To analyze the data, in addition to descriptive statistics, inferential statistical analyses including Pearson correlation coefficient and ttest were performed using SPSS.Results: The results showed a significant positive correlation between perceived stress and aggression of diabetic patients (P=0.001, r=0.66). That will enhance the perceived stress score, score increases aggression.Conclusion: short-term and long-term programs in order to identify stressors and strengthen coping skills, can patients for the prevention and control aggression and ultimately receive better health care, be considered as a target.

Introduction: Diabetes has become a serious disease in the 21st century, affecting a large number of people around the world. Considering the chronic nature and long-term effects of diabetes, problems such as changes in disease perception and sleep quality may occur. As a result, diabetic patients are exposed to a higher risk of depression, compared to non-diabetic cases. The aim of this study was to evaluate a prediction model of depression based on disease perception and sleep quality, mediated by pain catastrophizing.Methodology: In this correlational study, the population consisted of all diabetic patients, referred to the diabetes clinic of Ayatollah Taleghani Hospital in Kermanshah, Iran. A total of 150 patients were selected via convenience sampling. The data collection tools included Beck Depression Inventory, brief illness perception questionnaire (IPQ), Pittsburgh sleep quality index, and pain catastrophizing scale. For statistical analysis, path analysis was performed using AMOS software. Also, stepwise regression analysis was carried out using SPSS.Results: The results showed that disease perception and sleep quality could significantly and directly predict pain catastrophizing and depression. Finally, based on the proposed model, disease perception and sleep quality, mediated by pain catastrophizing, could significantly predict depression.Conclusion: Based on the present results, use of appropriate treatments, such as cognitive behavioral therapy, acceptance and commitment therapy, and interventions for sleep quality improvement, pain relief, and mediation of catastrophic thoughts could prevent depression in diabetic patients.

Introduction: Psychological burden of diabetes, social and economical families and caregivers imports. The primary caregiver for a family member over other family members involved in the disease, treatment and supportive care of patients and of all the responsibilities, ill health and emotional act. This study aimed to determine the burden of caring caregivers of patients with type II diabetes.Methodology: This was a analytic descriptive study, about 70 caregivers of patients with type II diabetes instrument for gathering data were two questionnaires consisted of demographic information data for both patient and caregivers and the second questionnaire was care burden zarit included. The questionnaire contains 22 questions that each question separately mesured the whole 5-point Likert scale (from never to always) with grades ranging between 0 and 88. To analyze the data, descriptive and inferential statistics were used and software spss 16.Results: Results showed that the average age of caregivers were 46.76±12.06 years.caregivers of most of patients (70%) were the wife of their caregivers 28% of them were suffering from chronic diseases. The lowest score of the burden of caring 6 and the highest score of 77 with an average of 38.58±11.91 85.38 respectively, Represents a moderate burden of care.Conclusion: The findings of this study represents the burden of care of Caregivers was moderat that can affect quality of life. Therefore, it is suggested Appropriate programs to support caregivers and reduce the burden of caring caregivers were also taken into account.

Introduction: Mental health of adolescents with type II diabetes is affected by several factors including personality characteristics and religious attitudes. The present study was performed to evaluate the relationship between personality characteristics, religious attitudes, and mental health among adolescents with type II diabetes in order to propose nursing care strategies.Methodology: In this descriptive, analytical, correlational study, all adolescents with type II diabetes, referring to a healthcare center in Gharchak, Iran were recruited in 2015. A total of 120 patients were selected via simple random sampling. The participants completed the personality characteristics questionnaire (PCQ), religiosity attitude questionnaire (RAQ), and general health questionnaire (GHQ). For data analysis, Pearson’s correlation test and multivariate stepwise regression analysis were performed, using SPSS version 19.Results: The findings showed a negative and significant relationship between neuroticism, external religiosity, and mental health in adolescents with type II diabetes. Also, a positive and significant relationship was found between mental health and extroversion, compatibility, conscientiousness, and internal religiosity in adolescents with type II diabetes. In the prediction model, variables such as conscientiousness, extroversion, and internal religiosity predicted 28.1% of the variance in mental health among adolescents with type II diabetes (P≤0.01).Conclusion: Based on the present results, counselors and therapists should take these factors into account and design appropriate programs for the improvement of mental health in adolescents with type II diabetes.

Introduction: Gestational diabetes is a common complication during pregnancy, affecting maternal and fetal outcomes. Considering the increasing prevalence of gestational diabetes around the world, in the present study, we aimed to assess fetal and maternal outcomes in pregnant diabetic women.Methodology: In this cross-sectional study, 85 women with gestational diabetes (gestational age>28 weeks), admitted to the maternity ward, were enrolled, along with 160 women with a normal pregnancy, who met the inclusion criteria (i.e., no history of diabetes, chronic diseases, endocrine disorders, or steroid use). By using a questionnaire, the required information, i.e., demographic data, medical information, gestational age, Apgar score, and adverse pregnancy outcomes such as preeclampsia, premature rupture of membranes, postpartum hemorrhage, macrosomia, stillbirth, and hypoglycemia, was recorded. The gathered data were analyzed using SPSS.Results: The mean age of diabetic and healthy mothers was reported to be 30.4±5.01 and 27.2±4.03 years, respectively; a statistically significant difference was found between the two groups (P<0.02). Also, the meansystolic and diastolic pressure, body mass index, and cesarean section were more prevalent in diabetic mothers (P=0.01); the two groups were significantly different in this regard. Furthermore, fetal complications such as macrosomia, stillbirth, and hypoglycemia were more common among diabetic subjects, compared to their healthy counterparts (P<0.01).Conclusion: Among maternal and fetal complications, gestational hypertension and cesarean section were more common in diabetic cases. Also, fetal complications such asmacrosomia, stillbirth, and hypoglycemia were more prevalent in newborns of diabetic women. Therefore, implementation of educational programs, screening of diabetic mothers, and attention to the associated complications seem essential. Overall, all these complications highlight the importance of gestational diabetes prevention.

Introduction: Diabetic foot ulcer is one of the serious complications of diabetes. Even in some cases, this condition can lead to lower limb amputation. Generally, education can help prevent the complications of diabetes including diabetic foot ulcer. Therefore, evaluation of the main domains of education (cognitive, functional, and emotional domains) can be a good strategy for proper educational planning in hospitalization units.Methodology: This descriptive, analytical, one-stage study was performed on 60 patients (30 males and 30 females) with diabetic foot ulcers in Noor and Ali Asghar hospitals of Isfahan, Iran. Information was collected using a questionnaire on cognitive, functional, and emotional domains of education. For data analysis, descriptive statistics were calculated and analysis of variance was performed using SPSS version 20.Results: The present study showed that both sexes had similar educational needs in functional and cognitive domains (P>0.05). However, in the emotional domain, anxiety and disappointment about the future of the disease were more prevalent in women.Conclusion: The present study, which aimed to determine the learning needs of patients in three major educational domains, showed that more attention needs to be paid to all these domains, especially the emotional aspect in order to propose an appropriate educational program.

Introduction: Lower extremity conditions including peripheral artery disease, peripheral neuropathy, foot ulcer, and amputation are more common in diabetic patients, compared to non-diabetic cases. These conditions affect 30% of individuals, aged above 40 years. Foot ulcers are among the most common, serious, and costly complications associated with diabetes, causing a two- to four-fold increase in the risk of mortality; therefore, identification of risk factors can help prevent the irreparable side-effects. In the present study, we aimed to determine the foot condition in diabetic patients.Methodology: In this descriptive, cross-sectional study, foot condition was analyzed in 355 diabetic patients, referred to Razi Educational-Therapeutic Center in Rasht, Iran in 2013. The subjects were selected via convenience sampling and were evaluated by a trained nurse. Data were collected through interviews and a researcher-made questionnaire. For statistical analysis, descriptive and inferential statistics, Chi-square, and logistic regression analysis were calculated and performed, using SPSS version 16. P-value less than 0.05 was considered statistically significant.Results: Based on the Chi-square test results, there was a significant relationship between foot ulcer and dry skin (without sweat) (P=0.01), fissure (P=0.004), impaired growth of toenails (P=0.02), blister (P=0.008), hammer toe (P=0.05), claw toe (P=0.001), Charcot arthropathy (P=0.02), superficial pain (induced by a pin), vibrational sense (induced by a tuning fork) (P=0.001), pulse of dorsalis pedis artery and right/left posterior tibia (P<0.001), ulcer scar (P=0.001), cause of hospitalization, and history of hospitalization due to foot problems (P=0.001). Based on the logistic regression analysis, variables associated with diabetic foot condition included blister, claw toe, and cause of hospitalization due to diabetes.Conclusion: Since blister, claw toe, and cause of hospitalization seem to be associated with foot ulcer, nurses can play an important role in the prevention and timely treatment of foot ulcers through identifying the risk factors.