scholarly journals Feasibility and acceptance of a virtual multidisciplinary care programme for patients with type 2 diabetes during the COVID-19 pandemic

2021 ◽  
Vol 12 ◽  
pp. 204201882110598
Author(s):  
Sergio Hernández-Jiménez ◽  
Ana Cristina García-Ulloa ◽  
María Teresa Alcántara-Garcés ◽  
Luz Elena Urbina-Arronte ◽  
Carolina Lara-Sánchez ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Self Care ◽  
Comprehensive Care ◽  
Metabolic Parameters ◽  
Diabetes Distress ◽  
Foot Care ◽  
Care Programme ◽  
Face To Face ◽  
Emotional Factors

Background and aims: Type 2 diabetes mellitus is one of the major public health concerns. The current lifestyle and advances in technology resulted in the development of a virtual mode of professional healthcare, which is an effective alternative method of management of patients. This study aimed to assess the feasibility of implementation of a virtual comprehensive care programme during the COVID-19 pandemic, patients’ acceptance and the changes in self-care behaviours, metabolic parameters and emotional factors. Methods: The programme employed in this study included nine health interventions in 1 day. Due to the COVID-19 pandemic, the mode of interventions, including questionnaires, patient evaluations and a satisfaction survey, was modified to the virtual form in 2020. This study assessed the changes in self-care behaviours, metabolic parameters and emotional factors and compared the data pertaining to patients who received virtual healthcare in 2020 with those who received face-to-face modality of medical care in 2019. Results: During June to November 2020, 130 patients received healthcare by means of the virtual modality. The change in modality of healthcare was feasible and 75% of the patients displayed good acceptance of the same. The evaluation of self-care behaviours included self-monitoring blood glucose (SMBG) levels, foot care and regular exercise. The duration of exercise decreased from 120 to 0 min/week ( p < 0.001). However, there was no change in metabolic parameters. Regarding the mental health parameters, we observed an increase in the proportion of patients with anxiety (21.5% versus 11.1%), depressive symptoms (10.8% versus 4.3%), diabetes distress (18.5% versus 11.1%) and prescription of psychotropic drugs (32.8% versus 18.2%) ( p < 0.05) in virtual versus face-to-face, respectively. Conclusion: The virtual comprehensive care programme for the management of patients with diabetes is a feasible approach that allows healthcare professionals to provide an adequate care during the COVID-19 pandemic.

scholarly journals Self-care adherence and affective disorders in Barbadian adults with type 2 diabetes

2021 ◽  
Vol 9 (1) ◽  
pp. 62-72
Author(s):  
Allison DaSantos ◽  
◽  
Carlisle Goddard ◽  
Dalip Ragoobirsingh ◽  
◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Management ◽  
Behavioral Problem ◽  
Self Care ◽  
Self Report ◽  
Diabetes Distress ◽  
Glucose Testing ◽  
Blood Glucose Testing ◽  
Distress Scale

<abstract><sec> <title>Purpose</title> <p>Diabetes management requires adherence to complicated self-care behaviors. Therefore, the emotional state of the individual living with diabetes, is likely to affect their ability to comply with recommendations. This study explored the relationship of self-care adherence to diabetes distress and depression in Barbadian adults with type 2 diabetes.</p> </sec><sec> <title>Methods</title> <p>Adults aged 20 to 80 years, with type 2 diabetes, completed self-report questionnaires comprised of a profile section consisting of demographic and clinical characteristics; and standardized questionnaires comprising, The Diabetes Distress Scale (DDS), The Patient Health Questionnaire (PQH-9), and the Summary of Diabetes Self-care Activities Scale (SDSCA). Additionally biological measures (BP and HbA1c) were collected.</p> </sec><sec> <title>Results</title> <p>For the 509 participants there were no differences in adherence for males (30.8%) and females (69.2%), high diabetes distress and depression were associated with low adherence. General diet was negatively associated with BP and HbA1c; while HbA1c was positively correlated with blood glucose testing.</p> </sec><sec> <title>Conclusion</title> <p>Self-care non-adherence is more than a behavioral problem; it is a multidimensional phenomenon inclusive of demographic factors, condition or disease factors, psychological and social factors.</p> </sec></abstract>

scholarly journals KNOWLEDGE AND SELFCARE PRACTICES AMONG DIABETICS

2017 ◽  
Vol 10 (12) ◽  
pp. 234
Author(s):  
Sheeba S ◽  
Sneha Ak ◽  
Veena Biju
Keyword(s):  
Type 2 Diabetes ◽  
Survey Design ◽  
Medical Science ◽  
Self Care ◽  
Sampling Technique ◽  
Ideal Body Weight ◽  
Care Practice ◽  
Foot Care ◽  
Care Practices

Objective: The objectives of the study were to assess the knowledge and self-care practices among patients with type 2 diabetes mellitus.Methods: Quantitative approach with descriptive survey design and convenience sampling technique was used. The study was conducted among 100 patients with type 2 diabetes mellitus, from the Inpatient and Outpatient Department of Amrita Institute of Medical Science, Kochi. A structured knowledge questionnaire and structured practice assessment questionnaire were used to assess the knowledge and self-care practices of the subjects.Result: Result shows that 77% subjects had good knowledge regarding diabetes and majorityof the subjects had good level of self-care practices. 63% of subjects regularly monitoring blood glucose level, 72% following proper diet, 88% of subjects taking regular medication, 84% of subjects follow proper eye care, 79% of subjects follow proper foot care, 57% of subjects maintaining ideal body weight, and only 46% of subjects doing regular exercise. There was a positive relationship (r=0.09) between level of knowledge and self-care practice of the subjects and no significant association between knowledge level and selected sociodemographic variables.Conclusion: It is important that the patient should have adequate knowledge regarding diabetes and they should follow proper self-care practices to prevent further complications.

scholarly journals Spousal Influence on Diabetes Self-care: Moderating Effects of Distress and Relationship Quality on Glycemic Control

2020 ◽  
Author(s):  
Emily C Soriano ◽  
James M Lenhard ◽  
Jeffrey S Gonzalez ◽  
Howard Tennen ◽  
Sy-Miin Chow ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Relationship Quality ◽  
Self Care ◽  
Glucose Variability ◽  
Diabetes Distress ◽  
Sample Mean ◽  
Spousal Influence ◽  
High Distress

Abstract Background Spouses often attempt to influence patients' diabetes self-care. Spousal influence has been linked to beneficial health outcomes in some studies, but to negative outcomes in others. Purpose We aimed to clarify the conditions under which spousal influence impedes glycemic control in patients with type 2 diabetes. Spousal influence was hypothesized to associate with poorer glycemic control among patients with high diabetes distress and low relationship quality. Methods Patients with type 2 diabetes and their spouses (N = 63 couples) completed self-report measures before patients initiated a 7-day period of continuous glucose monitoring. Mean glucose level and coefficient of variation (CV) were regressed on spousal influence, diabetes distress, relationship quality, and their two- and three-way interactions. Results The three-way interaction significantly predicted glucose variability, but not mean level. Results revealed a cross-over interaction between spousal influence and diabetes distress at high (but not low) levels of relationship quality, such that spousal influence was associated with less variability among patients with low distress, but more among those with high distress. Among patients with high distress and low relationship quality, a 1 SD increase in spousal influence predicted a difference roughly equivalent to the difference between the sample mean CV and a CV in the unstable glycemia range. Conclusions This was the first study to examine moderators of the link between spousal influence and glycemic control in diabetes. A large effect was found for glucose variability, but not mean levels. These novel results highlight the importance of intimate relationships in diabetes management.

scholarly journals Effects of Face-to-Face and Telephone-Based Family-Oriented Education on Self-Care Behavior and Patient Outcomes in Type 2 Diabetes: A Randomized Controlled Trial

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Masumeh Hemmati Maslakpak ◽  
Somaieh Razmara ◽  
Zahra Niazkhani
Keyword(s):  
Type 2 Diabetes ◽  
Patient Outcomes ◽  
Controlled Trial ◽  
Self Care ◽  
Control Group ◽  
Face To Face ◽  
Randomized Controlled ◽  
Education Group ◽  
Care Behavior

Background. Education of patients and their families is the cornerstone of effective diabetes care. The present study aimed to compare the effects of a face-to-face and telephone-based family-oriented educational program on self-care behavior and patient outcomes in type 2 diabetes patients. Methods. In the present randomized controlled trial, 90 type 2 diabetes patients were randomly divided into three groups of 30 participants: a face-to-face education group, a telephone-based education group, and a control group. The educational program lasted for 3 months. Outcomes evaluated included self-care, fasting blood sugar, hemoglobin A1c, cholesterol, and triglyceride. Results. The overall self-care scores in the intervention groups were significantly higher than that in the control group (P=0.0001). In addition, lipid profiles significantly improved in the interventions compared to the control (P<0.05). Comparing the two interventions showed better results for the face-to-face group regarding dietary adherence and physical activity, but the latter group had comparable results in blood glucose monitoring, foot care, and cholesterol level. Conclusions. This study shows the beneficiary effects of a family-oriented education on self-care and patient outcomes. It also shows the potential value of low-cost telephone technology in delivering effective diabetes care.

scholarly journals Effectiveness of Patient-centered Care for Diabetes Self-management to Improve Glycemic Control and Self-care Behaviors in Adults With Type 2 Diabetes: a Systematic Review

2021 ◽  
Author(s):  
Kainat Asmat ◽  
Khairunnisa Dhamani ◽  
Raisa Gul ◽  
Erika Sivarajan Froelicher
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Self Care ◽  
Self Management ◽  
Foot Care ◽  
Patient Centered ◽  
Management Interventions ◽  
Centered Care ◽  
Care Outcomes

Abstract Background: Patient-centered care in diabetes self-management might be a significant factor in improving self-care outcomes yet the supporting evidence is inadequate. This review is aimed to assess the effectiveness of patient-centered self-management care interventions on self-care outcomes such as glycemic control (HbA1c) and self-care behaviors in adults with type-2 diabetes compared with usual care. Methods: CINAHL, PubMed, Cochrane Library, Google Scholar and the HEC Pakistan digital library were searched for English language studies that assessed patient-centered self-management educational and/or behavioral interventions in adults aged 18 years or above with type 2 diabetes from 1991 to 2020. Interventional studies comprising randomized controlled trials (RCT) and quasi experimental studies (QES) with at least three months follow up and reporting on self-care outcomes with glycemic control (HbA1c) as primary outcome and self-care behaviors including diet control, physical activity, medication adherence and foot care as secondary outcomes were included. Results: Of the 168 identified records, 25 were found eligible comprising 21 RCTs and 4 QESs with total 4,443 participants. The meta-analysis involved 23 studies that provided enough information for a pooled estimate of HbA1c. Compared with the control group, patient-centered self-management interventions significantly lowered HbA1c −0.53 (95% CI −0.73, −0.32). Stratified analysis for HbA1c with respect to various aspects of intervention showed larger effects in interventions employing both educational and behavioral components −0.59 (95% CI −0.86, −0.32), spanned over shorter (<03 months) duration −0.56 (95% CI −0.86, −0.27), administered by nurses −0.80 (95% CI −1.44, −0.16) and delivered in community setting −0.65 (95% CI −1.00, −0.29). Moreover, patient-centered self-management interventions were found effective in improving diet control, physical activity and foot care. Conclusion: This systematic review provided the evidence supporting the effectiveness of patient-centered self-management care interventions in improving glycemic control and self-care behaviors in adults with type 2 diabetes and identified key features of intervention contributing towards success.

scholarly journals Guided self-determination intervention versus attention control for people with type 2 diabetes in outpatient clinics: a protocol for a randomised clinical trial

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e047037
Author(s):  
Anne Sophie Mathiesen ◽  
Vibeke Zoffmann ◽  
Tine Bruhn Skytte ◽  
Janus C Jakobsen ◽  
Christian Gluud ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Attention Control ◽  
Self Determination ◽  
Outpatient Clinics ◽  
Diabetes Distress ◽  
Haemoglobin A1c ◽  
Trial Protocol ◽  
Serious Adverse Events ◽  
Face To Face

IntroductionIn the management of type 2 diabetes, autonomy-supporting interventions may be a prerequisite to achieving more long-term improvement. Preliminary evidence has shown that the guided self-determination (GSD) method might have an effect on haemoglobin A1c and diabetes distress in people with type 1 diabetes. Previous trials were at risk of uncertainty. Thus, the objective is to investigate the benefits and harms of a GSD intervention versus an attention control group intervention in adults with type 2 diabetes.Methods and analysisThis trial protocol is guided by the The Standard Protocol Items: Recommendations for International Trials Statement. We describe the protocol for a pragmatic randomised, dual-centre, parallel-group, superiority clinical trial testing a GSD intervention versus an attention control for people with type 2 diabetes in outpatient clinics. The participants (n=224) will be recruited from two diverse regions of Denmark. The experimental stepped-care intervention will consist of three to five GSD sessions lasting up to 1 hour with a trained GSD facilitator. The sessions will be conducted face to face, by video conference or over the telephone. The attention controls will receive three to five sessions lasting up to an hour with a communication-trained healthcare professional provided face to-face, by video conference, or over the telephone. Participants will be included if they have type 2 diabetes,>18 years old, are not pregnant. Participants will be assessed before randomisation, at 5-month, and 12-month follow-up, the latter being the primary. The primary outcome is diabetes distress. Secondary outcomes are quality of life, depressive symptoms and non-serious adverse events. Exploratory outcomes are haemoglobin A1c, motivation and serious adverse events. Data will be collected using REDCap and analysed using Stata V.16.Ethics and disseminationThe trial will be conducted in compliance with the protocol, the Helsinki Declaration in its latest form, International Harmonisation of Good Clinical Practice guidelines and the applicable regulatory requirement(s). The trial has been approved by the Danish Data Protection Agency (P-2020-864). The Ethics Committee of the Capital Region of Denmark reviewed the trial protocol, but exempted the trial protocol from full review (H-20003638). The results of the trial will be presented at the outpatient clinics treating people with type 2 diabetes, at national and international conferences as well as to associations for people with diabetes and their relatives.Trial registration numberClinicalTrials.gov identifier: NCT04601311.

Empowerment and Social Support as Predictors of Self-Care Behaviors and Glycemic Control in Individuals With Type 2 Diabetes

2017 ◽  
Vol 27 (4) ◽  
pp. 395-413 ◽  
Author(s):  
Hamdiye Arda Sürücü ◽  
Dilek Büyükkaya Besen ◽  
Elif Yeter Erbil
Keyword(s):  
Social Support ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Linear Regression Analysis ◽  
Glucose Monitoring ◽  
Self Care ◽  
Blood Glucose Monitoring ◽  
Foot Care

This study investigated empowerment, social support, and diabetes-related characteristics as predictors of self-care behaviors and glycemic control in individuals with type 2 diabetes in Turkey. Descriptive cross-sectional and relational research designs were used in this study. The study was carried out with a cohort of 220 individuals with type 2 diabetes. Linear regression analysis revealed that patient empowerment was a statistically significant predictor of diet (β = .30; p < .001), exercise (β = .19; p = .003), blood glucose monitoring (β = .27; p < .001), foot care (β = .27; p < .001), and A1c (β = −.19; p = .004). Social support was a statistically significant predictor of diet (β = .24; p < .001), exercise (β = .26; p < .001), blood glucose monitoring (β = .16; p = .011), and foot care (β = .19; p = .003). These results indicate that social support and empowerment are important for nurses to consider when planning interventions that increase the self-care behavior of individuals with type 2 diabetes and for improving glycemic control.

The Relationships Between Diabetes Self-Care, Diabetes Time Management, and Diabetes Distress in Women With Type 2 Diabetes Mellitus

2021 ◽  
pp. 263501062110144
Author(s):  
Lisa Summers-Gibson
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Effect Size ◽  
Time Management ◽  
Self Care ◽  
Diabetes Distress ◽  
Natural Setting ◽  
Distress Scale

Purpose The purpose of this study was to examine the relationships between and among diabetes self-care, diabetes time management, and diabetes distress in women with type 2 diabetes mellitus (T2DM). Methods A descriptive correlational design with a total of 188 participants completed 3 valid and reliable instruments to measure the main study variables, the Diabetes Self-Management Questionnaire, the Diabetes Time Management Questionnaire, and the Diabetes Distress Scale, in an uncontrolled, natural setting using mix-mode surveys (electronic and paper). Survey responses were analyzed using several descriptive, bivariate, and multivariate analyses. Results Diabetes time management was the strongest, statistically significant, unique contributor to explaining self-care. The regression model showed that diabetes time management demonstrated a large effect size and that diabetes distress demonstrated a small effect size. Conclusions The 2 predictor variables among diabetes self-care in women showed diabetes time management had a stronger effect size compared to diabetes distress. This is the first known study to measure the influence of diabetes time management on diabetes self-care and to examine the relationship between and among diabetes time management and diabetes distress. Diabetes time management, an understudied variable in individuals with T2DM, has the potential to be a contributor to improve patient outcomes.

scholarly journals Predictors of Adherence Toward Specific Domains of Diabetic Self-Care Among Type-2 Diabetes Patients

2020 ◽  
Vol 13 ◽  
pp. 117955142098190
Author(s):  
Girma Degefa ◽  
Kindie Wubshet ◽  
Sisay Tesfaye ◽  
Agete Tadewos Hirigo
Keyword(s):  
Type 2 Diabetes ◽  
Physical Exercise ◽  
Diabetic Foot ◽  
Self Care ◽  
Healthy Diet ◽  
Care Practice ◽  
Foot Care ◽  
Male Sex ◽  
Care Practices

Background: Adequate knowledge, awareness, and adherence to diabetic self-care practices are vital tools to protect patients from risks of disease complications, developing comorbidity and mortality. Therefore, this study aimed to assess specific domains of diabetic self-care practice and associated factors among patients with type-2diabetes in Hawassa University Comprehensive Specialized Hospital, Sidama regional state. Materials and methods: A hospital-based cross-sectional study design was conducted on 217 patients with type 2 diabetes from January 01 to April 30, 2020. A structured questionnaire and the Summary of Diabetes Self-Care Activities (SDSCA) tool were used to collect relevant data through interviewer administration. Statistical analysis was done using SPSS version 23. Results: A total of 207 patients with type-2 diabetes were participated in the study with a 95% response rate. Overall 47.8% (95%CI: 41.2-55) of patients adhered to diabetic self-care practice. Concerning the specific domain of self-care practice, 54.6%, 39.1%, 28%, and 65.2% of patients adhered to a healthy diet, physical exercise, self-monitoring blood glucose (SMBG), and diabetic foot care practices, respectively. Besides, all patients received at least 80% of the prescribed doses and frequency of anti-diabetic agents and 60.4% had good glycemic control. Receipt of advice from treating physicians and having no familial history of diabetes were significantly associated with adherence toward eating a healthy diet, diabetic foot care, and SMBG. While male sex was associated with adherence toward healthy diet management. Moreover, having glucometer, age, male sex, diabetes duration ⩾ 5 years, and anti-diabetic treatment modality were associated with adherence toward SMBG. Conclusion: This study indicates 52.2%, 72%, and 60.1% of diabetes patients did not adhere to diabetic self-care, SMBG, and physical exercise, respectively. Improving awareness and regular diabetic education is imperative to scale up patients’ adherence toward diabetic self-care practice.

scholarly journals Diabetes Distress, Depressive Symptoms and Type 2 Diabetes Management and Glycemic Control: The Mediating Role of Self-Efficacy

2020 ◽  
Author(s):  
Yuexia Gao ◽  
Yarong Han ◽  
Xin Zou ◽  
Judy Xu ◽  
Dean Getrude Mawen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Depressive Symptoms ◽  
Glycemic Control ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Self Care ◽  
Diabetes Distress ◽  
Psychological Variables ◽  
Diabetes Outcomes

Abstract BackgroundDiabetes distress has been distinguished from depressive symptoms in the linkages to type 2 diabetes management and glycemic control. There are few evidences in rural China untangled the underlying pathways among them. The aim of our study was to examine whether self-efficacy reduced the detrimental effects of psychological variables on diabetes outcomes such as self-care behaviors, glycemic control and health-related quality of life (HRQoL).Methods1574 adults diagnosed with type 2 diabetes from 31 rural clinics in China were assessed for psychological variables, self-management and HRQoL. Hemoglobin A1c (HbA1c) data at 6 months after the survey were extracted from electronic medical records. Hierarchical regression model examined independent effects of psychological variables, self-efficacy on diabetes outcomes. KHB method and bootstrapping confidence intervals were employed to test the mediating effect of self-efficacy.ResultsHierarchical regression analysis showed both diabetes distress and depressive symptoms were significantly related to diet and HRQoL, but not related to glycemic control and medication adherence. Depressive symptoms, but not diabetes distress, was directly associated with physical activity. Mediation analysis demonstrated self-efficacy mediated the relationships of both diabetes distress and depressive symptoms on self-care behaviors, glycemic control and HRQoL.ConclusionsSelf-efficacy may contribute to better diabetes outcome by ameliorating the effects of diabetes distress and depressive symptoms. Patients with psychological conditions may need tailored intervention that enhance self-efficacy to improve diabetes management.

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