scholarly journals Effectiveness of self-care training on physical and mental health of patients with diabetic type 2

2017 ◽  
Vol 25 (2) ◽  
pp. 54-60
Author(s):  
Shams Al-din Shams ◽  
Yaser Moradi ◽  
Mohammad Reza Zaker
2018 ◽  
Vol 24 (4) ◽  
pp. 621-639 ◽  
Author(s):  
Ashleigh Coser ◽  
Kelley J. Sittner ◽  
Melissa L. Walls ◽  
Tina Handeland

American Indian (AI) communities experience a disproportionate rate of Type 2 diabetes (T2D) and cumulative exposure to stress. Although this link is well researched among various populations, it has not been examined among AI communities. Path analysis was used to examine a multiple-mediator model to explain how caregiver stress influences self-reported mental and physical health among 100 AI participants with T2D. Caregiver stress was negatively associated with physical and mental health. Physical health was positively associated with family/community connectedness and mental health was positively associated with both family support and connectedness. The relationship between caregiver stress and mental health was partially mediated by family/community connectedness; caregiver stress had no indirect effects on physical health via either hypothesized mediator. Findings demonstrate the importance of integrating individuals’ connection to family and community and its influence on caregiver stress and mental health in intervention programs targeting diabetes management and care among AI communities.


BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e033866
Author(s):  
Salwa S Zghebi ◽  
Douglas T Steinke ◽  
Martin K Rutter ◽  
Darren M Ashcroft

ObjectivesTo compare the patterns of 18 physical and mental health comorbidities between people with recently diagnosed type 2 diabetes (T2D) and people without diabetes and how these change by age, gender and deprivation over time between 2004 and 2014. Also, to develop a metric to identify most prevalent comorbidities in people with T2D.DesignPopulation-based cohort study.SettingPrimary and secondary care, England, UK.Participants108 588 people with T2D and 528 667 comparators registered in 391 English general practices. Each patient with T2D aged ≥16 years between January 2004 and December 2014 registered in Clinical Practice Research Datalink GOLD practices was matched to up to five comparators without diabetes on age, gender and general practice.Primary and secondary outcome measuresPrevalence of 18 physical and mental health comorbidities in people with T2D and comparators categorised by age, gender and deprivation. Odds for association between T2D diagnosis and comorbidities versus comparators. A metric for comorbidities with prevalence of ≥5% and/or odds ≥2 in patients with T2D.ResultsOverall, 77% of patients with T2D had ≥1 comorbidity and all comorbidities were more prevalent in patients with T2D than in comparators. Across both groups, prevalence rates were higher in older people, women and those most socially deprived. Conditional logistic regression models fitted to estimate (OR, 95% CI) for association between T2D diagnosis and comorbidities showed that T2D diagnosis was significantly associated with higher odds for all conditions including myocardial infarction (OR 2.13, 95% CI 1.85 to 2.46); heart failure (OR 2.12, 1.84 to 2.43); depression (OR 1.75, 1.62 to 1.89), but non-significant for cancer (OR 1.12, 0.98 to 1.28). In addition to cardiovascular disease, the metric identified osteoarthritis, hypothyroidism, anxiety, schizophrenia and respiratory conditions as highly prevalent comorbidities in people with T2D.ConclusionsT2D diagnosis is associated with higher likelihood of experiencing other physical and mental illnesses. People with T2D are twice as likely to have cardiovascular disease as the general population. The findings highlight highly prevalent and under-reported comorbidities in people with T2D. These findings can inform future research and clinical guidelines and can have important implications on healthcare resource allocation and highlight the need for more holistic clinical care for people with recently diagnosed T2D.


2016 ◽  
Vol 43 (6) ◽  
pp. 716-725 ◽  
Author(s):  
Jane McCusker ◽  
Sylvie D. Lambert ◽  
Martin G. Cole ◽  
Antonio Ciampi ◽  
Erin Strumpf ◽  
...  

Objectives. In a sample of primary care participants with chronic physical conditions and comorbid depressive symptoms: to describe the cross-sectional and longitudinal associations of activation and self-efficacy with demographic, physical and mental health status, health behaviors, depression self-care, health care utilization, and use of self-care tools; and to examine the effects of a depression self-care coaching intervention on these two outcomes. Design/Study Setting. A secondary analysis of activation and self-efficacy data collected as part of a randomized trial to compare the effects of a telephone-based coached depression self-care intervention with a noncoached intervention. Activation (Patient Activation Measure) was measured at baseline and 6 months. Depression self-care self-efficacy was assessed at baseline, at 3 months, and at 6 months. Principal Findings. In multivariable cross-sectional analyses ( n = 215), activation and/or self-efficacy were associated with language, birthplace, better physical and mental health, individual exercise, specialist visits, and antidepressant nonuse. In longitudinal analyses ( n = 158), an increase in activation was associated with increased medication adherence; an increase in self-efficacy was associated with use of cognitive self-care strategies and increases in social and solitary activities. There were significant improvements from baseline to 6 months in activation and self-efficacy scores both among coached and noncoached groups. The self-care coaching intervention did not affect 6-month activation or self-efficacy but was associated with quicker improvement in self-efficacy. Conclusions. Overall, the results for activation and self-efficacy were similar, although self-efficacy correlated more consistently than activation with depression-specific behaviors and was responsive to a depression self-care coaching intervention.


2016 ◽  
Author(s):  
Vincent Deary ◽  
Saskia P Hagenaars ◽  
Sarah E Harris ◽  
W David Hill ◽  
Gail Davies ◽  
...  

Self-reported tiredness and low energy, often called fatigue, is associated with poorer physical and mental health. Twin studies have indicated that this has a heritability between 6% and 50%. In the UK Biobank sample (N = 108 976) we carried out a genome-wide association study of responses to the question, ″Over the last two weeks, how often have you felt tired or had little energy?″ Univariate GCTA-GREML found that the proportion of variance explained by all common SNPs for this tiredness question was 8.4% (SE = 0.6%). GWAS identified one genome-wide significant hit (Affymetrix id 1:64178756_C_T; p = 1.36 x 10-11). LD score regression and polygenic profile analysis were used to test for pleiotropy between tiredness and up to 28 physical and mental health traits from GWAS consortia. Significant genetic correlations were identified between tiredness and BMI, HDL cholesterol, forced expiratory volume, grip strength, HbA1c, longevity, obesity, self-rated health, smoking status, triglycerides, type 2 diabetes, waist-hip ratio, ADHD, bipolar disorder, major depressive disorder, neuroticism, schizophrenia, and verbal-numerical reasoning (absolute rg effect sizes between 0.11 and 0.78). Significant associations were identified between tiredness phenotypic scores and polygenic profile scores for BMI, HDL cholesterol, LDL cholesterol, coronary artery disease, HbA1c, height, obesity, smoking status, triglycerides, type 2 diabetes, and waist-hip ratio, childhood cognitive ability, neuroticism, bipolar disorder, major depressive disorder, and schizophrenia (standardised β′s between -0.016 and 0.03). These results suggest that tiredness is a partly-heritable, heterogeneous and complex phenomenon that is phenotypically and genetically associated with affective, cognitive, personality, and physiological processes.


JMIR Aging ◽  
10.2196/13513 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e13513
Author(s):  
Marcia Johansson ◽  
Ponrathi Athilingam

Background Presently, 6.5 million Americans are living with heart failure (HF). These patients are expected to follow a complex self-management regimen at home. Several demographic and psychosocial factors limit patients with HF in following the prescribed self-management recommendations at home. Poor self-care is associated with increased hospital re-admissions. Under the Affordable Care Act, there are financial implications related to hospital re-admissions for hospitals and programs such as the Program of All-Inclusive Care for the Elderly (PACE) in Pinellas County, Florida. Previous studies and systematic reviews demonstrated improvement in self-management and quality of life (QoL) in patients with HF with structured telephone support (STS) and short message service text messaging (SMS). Objective This study aimed to evaluate the effects of STS and SMS on self-care, knowledge, medication adherence, and QoL of patients with HF. Methods A prospective quality improvement project using a pre-post design was implemented. Data were collected at baseline, 30 days, and 3 months from 51 patients with HF who were enrolled in PACE in Pinellas County, Florida. All participants received STS and SMS for 30 days. The feasibility and sustained benefit of using STS and SMS was assessed at a 3-month follow-up. Results A paired t test was used to compare the mean difference in HF outcomes at the baseline and 30-day follow-up, which demonstrated improved HF self-care maintenance (t49=0.66; P=.01), HF knowledge (t49=0.71; P=.01), medication adherence (t49=0.92; P=.01), and physical and mental health measured using Short-Form-12 (SF-12; t49=0.81; P=.01). The results also demonstrated the sustained benefit with improved HF self-care maintenance, self-care management, self-care confidence, knowledge, medication adherence, and physical and mental health (SF-12) at 3 months with P<.05 for all outcomes. Living status and social support had a strong correlation with HF outcomes. Younger participants (aged less than 65 years) performed extremely well compared with older adults. Conclusions STS and SMS were feasible to use among PACE participants with sustained benefits at 3 months. Implementing STS and SMS may serve as viable options to improve HF outcomes. Improving outcomes with HF affects hospital systems and the agencies that monitor and provide care for outpatients and those in independent or assisted-living facilities. Investigating viable options and support for implementation will improve outcomes.


2021 ◽  
Vol 24 (1) ◽  
pp. 150-167
Author(s):  
Zahra Zarimoghadam ◽  
◽  
Hosein Davoodi ◽  
Khalil Ghafari ◽  
Hamidreza Jamilian ◽  
...  

Background and Aim: The development of any society depends on the educational system of that society. The educational system can be efficient and successful when considering the academic performance of learners in different courses. This study aimed to investigate the effects of mental self-care education on students’ mental health and academic motivation. Methods & Materials: This was a quasi-experimental study with unequal control and experimental groups. The statistical population of this study was students referring to school counseling centers; 40 of them (n=20/group) were selected by random sampling method. The Depression, Anxiety, and Stress Scale - 21 Items (DASS-21), and Academic Performance Rating Scale were used to collect the necessary data. Psychological self-care training was presented to the experimental group in ten 2-hour sessions. Then, a posttest was conducted on the study groups. Data analysis was performed using Multivariate Analysis of Covariance (MANCOVA). Ethical Considerations: This article was approved by the Ethics Committee of the Islamic Azad University, Khomeini Branch (Code: IR.IAU.ARAK.REC.1399.001). Results: The obtained findings indicated that mental self-care education was effective on students’ mental health (P<0.05). Furthermore, psychological self-care education was ineffective on students’ academic motivation. Conclusion: Mental self-care education was used to improve mental health; however, this training did not affect academic motivation in the examined subjects.


2020 ◽  
Author(s):  
Martin Martin ◽  
Jonathan Patterson ◽  
Matt Allison ◽  
Blakely B O’Connor ◽  
Dhiren Patel

BACKGROUND Digital health coaching is an increasingly common diabetes self-management support strategy for individuals with type 2 diabetes and has been linked to positive mental and physical health outcomes. However, the relationship between baseline risk and outcomes has yet to be evaluated in a real-world setting. OBJECTIVE The purpose of this real-world study was to evaluate trends in digital health coaching outcomes by baseline A1c to better understand which populations may experience the greatest clinical and psychosocial benefit. METHODS Participants were referred to a 12-week digital health coaching program, administered by Pack Health, through their healthcare provider, payer or employer. The program included patient-centered lifestyle counseling and psychosocial support delivered via telephone, text and/or email. Self-reported A1c and weight were collected at baseline and completion. Physical and mental health were assessed using the PROMIS Global Health short form and the Diabetes Distress Scale-2. A retrospective cohort study design was used to evaluate program effect in a convenience sample of participants. Changes in Alc, weight, BMI, physical and mental health were analyzed within three participant cohorts stratified by baseline A1c level. RESULTS Participants with complete A1c datasets (n = 226) were included in the analysis. Participants were 71.68% female, with 61.50% identifying as white and 34.07% as black. Most participants (81.41%) reported a baseline A1c ≥ 7%, and 20.35% were classified as high-risk (A1c > 9%). Across A1c cohorts, the average baseline BMI was 35.83 (SD = 7.79), and the moderate risk cohort (7% ≤ A1c ≤ 9%) reported the highest average (36.6; SD = 7.77). At 12 weeks, patients reported a significant decrease in Alc, and high-risk participants reduced their levels by the greatest margin (2.28 points; P < .0001). Across cohorts, BMI improved by 0.82 (P < .0001), with the moderate risk cohort showing the greatest reduction (-0.88; P < .0001). Overall, participants reported significant improvements for PROMIS scores, with the greatest change occurring in the high-risk cohort for whom physical health improved 3.84 points (P < .001) and mental health improved 3.3 points (P < .001). However, the lowest risk cohort showed the greatest improvements in diabetes distress (-0.76; P < .0052). CONCLUSIONS Acknowledging the limitations in this real-world study design, the results reported here suggest that adults with type 2 diabetes with a high baseline A1c or high BMI may benefit the most from patient-centered digital health coaching programs when compared to their lower risk counterparts. While all participants improved in physical and mental health categories, participants with high A1c experienced the greatest A1c reduction, while individuals with the highest baseline BMI lost the most weight. These results may be used to inform referrals for patients who are more likely to benefit from digital health coaching.


BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e022265 ◽  
Author(s):  
Teresa N Brockie ◽  
Jessica H L Elm ◽  
Melissa L Walls

ObjectivesThe purpose of this study was to determine the frequency of select adverse childhood experiences (ACEs) among a sample of American Indian (AI) adults living with type 2 diabetes (T2D) and the associations between ACEs and self-rated physical and mental health. We also examined associations between sociocultural factors and health, including possible buffering processes.DesignSurvey data for this observational study were collected using computer-assisted survey interviewing techniques between 2013 and 2015.SettingParticipants were randomly selected from AI tribal clinic facilities on five reservations in the upper Midwestern USA.ParticipantsInclusion criteria were a diagnosis of T2D, age 18 years or older and self-identified as AI. The sample includes n=192 adults (55.7% female; mean age=46.3 years).Primary measuresWe assessed nine ACEs related to household dysfunction and child maltreatment. Independent variables included social support, diabetes support and two cultural factors: spiritual activities and connectedness. Primary outcomes were self-rated physical and mental health.ResultsAn average of 3.05 ACEs were reported by participants and 81.9% (n=149) said they had experienced at least one ACE. Controlling for gender, age and income, ACEs were negatively associated with self-rated physical and mental health (p<0.05). Connectedness and social support were positively and significantly associated with physical and mental health. Involvement in spiritual activities was positively associated with mental health and diabetes-specific support was positively associated with physical health. Social support and diabetes-specific social support moderated associations between ACEs and physical health.ConclusionsThis research demonstrates inverse associations between ACEs and well-being of adult AI patients with diabetes. The findings further demonstrate the promise of social and cultural integration as a critical component of wellness, a point of relevance for all cultures. Health professionals can use findings from this study to augment their assessment of patients and guide them to health-promoting social support services and resources for cultural involvement.


2019 ◽  
Author(s):  
Marcia Johansson ◽  
Ponrathi Athilingam

BACKGROUND Presently, 6.5 million Americans are living with heart failure (HF). These patients are expected to follow a complex self-management regimen at home. Several demographic and psychosocial factors limit patients with HF in following the prescribed self-management recommendations at home. Poor self-care is associated with increased hospital readmissions. Under the Affordable Care Act, there are financial implications related to hospital readmissions for hospitals and programs such as the <i>Program of All-Inclusive Care for the Elderly</i> (PACE) in Pinellas County, Florida. Previous studies and systematic reviews demonstrated improvement in self-management and quality of life (QoL) in patients with HF with structured telephone support (STS) and SMS text messaging. OBJECTIVE This study aimed to evaluate the effects of STS and SMS on self-care, knowledge, medication adherence, and QoL of patients with HF. METHODS A prospective quality improvement project using a pre-post design was implemented. Data were collected at baseline, 30 days, and 3 months from 51 patients with HF who were enrolled in PACE in Pinellas County, Florida. All participants received STS and SMS for 30 days. The feasibility and sustained benefit of using STS and SMS was assessed at a 3-month follow-up. RESULTS A paired <i>t</i> test was used to compare the mean difference in HF outcomes at the baseline and 30-day follow-up, which demonstrated improved HF self-care maintenance (<i>t</i> <sub>49</sub>=0.66; <i>P</i>=.01), HF knowledge (<i>t</i> <sub>49</sub>=0.71; <i>P</i>=.01), medication adherence (<i>t</i> <sub>49</sub>=0.92; <i>P</i>=.01), and physical and mental health measured using Short-Form-12 (SF-12; <i>t</i> <sub>49</sub>=0.81; <i>P</i>=.01). The results also demonstrated the sustained benefit with improved HF self-care maintenance, self-care management, self-care confidence, knowledge, medication adherence, and physical and mental health (SF-12) at 3 months with <i>P</i>&lt;.05 for all outcomes. Living status and social support had a strong correlation with HF outcomes. Younger participants (aged less than 65 years) performed extremely well compared with older adults. CONCLUSIONS STS and SMS were feasible to use among PACE participants with sustained benefits at 3 months. Implementing STS and SMS may serve as viable options to improve HF outcomes. Improving outcomes with HF affects hospital systems and the agencies that monitor and provide care for outpatients and those in independent or assisted-living facilities. Investigating viable options and support for implementation will improve outcomes.


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