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Mandana Jamali; Mohammad Hossein Dabbaghmanesh; Adis Kraskian Mojmbarii; Maryam Bahrami Hidaji
Abstract
Objective: Diabetes is one of the common chronic endocrine diseases and is considered a significant and growing public health concern worldwide. The importance of diabetes is mainly due to its high prevalence and the numerous complications that arise as a result. Today, diabetes is regarded as one of ...
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Objective: Diabetes is one of the common chronic endocrine diseases and is considered a significant and growing public health concern worldwide. The importance of diabetes is mainly due to its high prevalence and the numerous complications that arise as a result. Today, diabetes is regarded as one of the most important health, treatment, and socio-economic issues globally. One aspect that helps identify individuals with diabetes today is assisting patients and medical staff in better assessing the control of the disease. One of the factors related to blood sugar control is the concept of lifestyle and adherence to treatment, which is seen as a multidimensional and multifactorial phenomenon that ensures the individual's health. Various theoretical perspectives with different approaches have been proposed for the prevention and control of diseases. In recent decades, in addition to medication, behavioral and psychological interventions have been used for diabetic patients to reduce cognitive issues alongside other treatments. Among the psychological approaches that have been the focus of various studies regarding their effectiveness on the treatment process of patients with type 2 diabetes, the effectiveness of reality therapy and dialectical behavior therapy has been confirmed. The aim of this research was to compare group reality therapy and dialectical group therapy on lifestyle and treatment adherence in women with type 2 diabetes effectively. Method: The study method was semi-experimental with a pre-test, post-test, and two-month follow-up design with a control group. The statistical population of this research included all women with type 2 diabetes visiting a specialized diabetes clinic in Shiraz in the spring of 1403 (2024). Among women with type 2 diabetes, a sample of 45 individuals (15 in the first experimental group; 15 in the second experimental group; 15 in the control group) was selected using purposive sampling (based on the inclusion criteria of the study) and randomly assigned to the groups (using a random number table). The inclusion criteria for the study included: female gender, age of participants between 40 to 60 years, at least one year since the diagnosis of type 2 diabetes (based on medical records), consent to participate in the educational and therapeutic program, informed consent to participate in the research, at least literacy, no use of other psychological services simultaneously or within the past 6 months, absence of severe neurological diseases such as psychosis based on the physician's diagnosis, and physical ability to participate in the research. The exclusion criteria included: more than 2 absences in therapy sessions and unwillingness to continue therapy sessions. The questionnaires used were the lifestyle questionnaire by Lali et al. (2012) and the treatment adherence questionnaire by Madanlu (2013). Additionally, the first experimental group underwent dialectical group therapy training for 12 weekly sessions of 90 minutes each, while the second experimental group received reality therapy training for 12 weekly sessions of 90 minutes each. The data were analyzed using two-way analysis of variance with repeated measures on one factor (mixed ANOVA). Results: There was no significant difference between reality therapy and dialectical behavior therapy with the control group in lifestyle and treatment compliance in women with type 2 diabetes (P>0.05), but the mean difference indicates that reality therapy is better than dialectical behavior therapy. Analysis method (P>0/005). Conclusion: According to the findings of the present study, both reality therapy and dialectical behavior can be suggested as an efficient method in order to increase lifestyle and adherence to treatment in women with type 2 diabetes.
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Bahareh Mirahmadi; Massoud Lavasani; Ahmed Alipour; Gholam Ali Afrooz
Abstract
Objective: The purpose of this study was to investigate the effectiveness of the family-oriented program on psychological distress and adherence to treatment in people with diabetes and hypertension. Method: The present study was a semi-experimental with pre-test-post-test design with a control group ...
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Objective: The purpose of this study was to investigate the effectiveness of the family-oriented program on psychological distress and adherence to treatment in people with diabetes and hypertension. Method: The present study was a semi-experimental with pre-test-post-test design with a control group and a three-month follow-up. 40 people with diabetes and hypertension were selected to enter the study. Then, 40 volunteers participating in the research and eligible to enter the research were randomly assigned to two groups of 20 people by matching them in terms of age and history of diabetes. The data collection tool included demographic information questionnaire, depression, anxiety and stress scale and Madanlo's questionnaire of adherence to treatment orders. Results: The comparison of means indicates the effectiveness of the family-based program against the control group. Considering the different experimental and control groups, there is a significant difference between the anxiety scores in the pre-test, post-test, and follow-up stages. For the depression variable, the main effect of the group is substantial (Ƞ2=0.423 Ƞ^2=0.423 Ƞ2=0.423, p<0.05 p<0.05 p<0.05, F=27.846 F=27.846 F=27.846), indicating a significant overall difference in mean depression scores between the two groups. The results show that the main effect of time is substantial (Ƞ2=0.781 Ƞ^2=0.781 Ƞ2=0.781, p<0.05 p<0.05 p<0.05, F=135.824 F=135.824 F=135.824). For the stress variable, the main effect of the group is significant (Ƞ2=0.634 Ƞ^2=0.634 Ƞ2=0.634, p<0.05 p<0.05 p<0.05, F=65.767 F=65.767 F=65.767), indicating a significant overall difference in mean stress scores between the two groups. For the treatment adherence variable, the main effect of the group is substantial (Ƞ2=0.80 Ƞ^2=0.80 Ƞ2=0.80, p<0.05 p<0.05 p<0.05, F=172.726 F=172.726 F=172.726). The main effect of time is significant (Ƞ2=0.985 Ƞ^2=0.985 Ƞ2=0.985, p<0.05 p<0.05 p<0.05, F=2516.562 F=2516.562 F=2516.562), meaning that the changes in mean scores from the pre-test to the post-test and follow-up stages are significant regardless of the experimental and control groups. Conclusion: The results of this research showed that the family-based program is efficacious in improving treatment adherence and psychological distress in employees with diabetes and hypertension. Family empowerment involves providing and teaching a health-promoting lifestyle to families of individuals with chronic disorders, helping families cope with familial problems related to chronic disorders, and strengthening family strengths to improve the safety, well-being, and adaptation of the affected individual. Family empowerment in self-management and self-care for chronic disorders is an intervention that focuses on strengthening the core values of caregivers (families). Family empowerment can also increase positive control of mind and body, preventive care, and constructive relationships with the environment, enhance positive emotions, and improve the family's ability to manage the disorder independently. The more individuals control and master their living environment, particularly stressful life conditions, the greater their sense of inner satisfaction, self-efficacy, and self-belief, leading to better psychological well-being. Conversely, individuals suffering from stress-induced hypertension often lack cognitive and behavioral skills to control stressful environmental events, generally doubting their abilities and constantly worrying about negative evaluations from others regarding themselves and their behaviors.
