SELF-CARE ACTIVITIES AMONG PATIENTS WITH TYPE 2 DIABETES MELLITUS IN PENAMPANG, SABAH AND ITS ASSOCIATION WITH DEPRESSION, ANXIETY AND STRESS
Keywords:self-care activities, depression, anxiety, stress, type 2 diabetes mellitus
Performing self-care activities can be challenging but it is important for favourable outcomes of type 2 diabetes mellitus (T2DM). It may be influenced by psychological problems. Therefore, this study examined the level of self-care activities and the presence of psychological problems among patients with T2DM. The association between these activities and the psychological problems was assessed too. This cross-sectional study was conducted at a public health clinic in Sabah. Data was collected between July and September 2017 using a validated self-administered questionnaire which include the depression, anxiety and stress scale-21 (DASS-21) and the summary of diabetes self-care activities (SDSCA) questionnaire. About 91% of 331 participants took diabetes medications in ?6 days per week. They followed a healthful eating plan, inspected feet and exercised 30 minutes a day in 5.0 (IQR 4.0), 4.0 (IQR 7.0) and 1.0 (IQR 4.0) days per week respectively. Among owners of glucometer, the median (IQR) of monitoring blood glucose was 1.0 (1.0) days per week. The participants with depression, anxiety and stress were 4.5%, 8.8% and 5.7% respectively. Following a healthful eating plan (p<0.001) was found to be significantly associated with anxiety; those with anxiety practised this activity in fewer days than those without anxiety. Generally, self-care activities were poorly practiced by the participants, except for taking diabetes medications. Thus, the patients should be encouraged to improve their self-care activities. Psychological problems were also found to be uncommon. However, anxiety symptoms should not be ignored as it may negatively affect their adherence to healthy diet.
World Health Organization. Global Report on Diabetes. Geneva: World Health Organization 2016. http://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf (accessed 22 January 2019).
Institute for Public Health (IPH). National Health and Morbidity Survey 2015 (NHMS 2015) Vol. II: Non-Communicable Diseases, Risk Factors & Other Health Problems; 2015.
Institute for Public Health (IPH). National Health and Morbidity Survey 2011: Fact Sheet; 2011.
American Diabetes Association (ADA). Standards of Medical Care in Diabetes - 2017: Abridged for Primary Care Providers. Diabetes Care 2017; 40(1): S1–S135.
Toobert D, Hampson S, Glasgow R. The summary of Diabetes Self-care Activities Measure. Result from 7 studies and a revised scale. Diabetes Care 2000; 23(7); 943-50.
Song M, Ratcliffe SJ, Tkacs NC, et al. Self-care and health outcomes of diabetes mellitus. Clin Nurs Res 2012; 21(3): 309–26.
Jannoo Z, Wah YB, Lazim AM, et al. Examining diabetes distress, medication adherence, diabetes self- care activities, diabetes-specific quality of life and health-related quality of life among type 2 diabates mellitus patients. J Clin Transl Endocrinol 2017; 9: 48–54.
Hou YY, Li W, Qiu JB, et al. Efficacy of blood glucose self-monitoring on glycaemic control in patient with non-insulin-treated type2 diabetes: A meta-analysis. Int J Nurs Sci 2014; 1(2): 191-5.
Coyle ME, Francis K, Chapman Y. Self-management activities in diabetes care: A systematic review. Aust Health Rev 2013; 37: 513–22.
Shigaki C, Kruse RL, Mehr D, et al. Motivation and diabetes self-management. Chronic Illn 2010; 6(3): 202–14.
Al Johani KA, Kendall GE, Snider PD. Self-management practices among type 2 diabetes patients attending primary health-care centres in Medina, Saudi Arabia. East Mediterr Health J 2015; 21(9):621-8.
Tol A, Shojaeezadeh D, Eslami A, et al. Evaluation of self-care practices and relative components among type 2 diabetic patients. J Educ Health Promot 2012; 1:19
Wu SFV, Huang YC, Liang SY, et al. Relationships among depression, anxiety, self-care behavior and diabetes education difficulties in patients with type-2 diabetes: A cross-sectional questionnaire survey. Int J Nurs Stud 2011; 48(11):1376-83.
Simon-Tuval T, Smueli A, Harman-Boehm I. Adherence to self- care behaviours among Type 2 Diabetes - The role of risk preference. Value Health 2016; 19(6): 844-51.
Kav S, Yilmaz AA, Bulut Y, et al. Self-efficacy, depression and self-care activities of people with type 2 diabetes in Turkey. Collegian 2017; 24(1): 27-35.
Siti Khuzaimah AS, Aini A, Surindar Kaur SS, et al. Self-care behaviour among type 2 diabetes patients. Pertanika J Sci & Technol 2014; 22(2): 471-88.
Bariyyah NKMH, Bujang MA, Baharum N, et al. Self-care activities among diabetic patients and factors affecting glycaemic control in primary health care, Malaysia. J Diabetes Clin Prac 2018; 1: 103.
Tharek Z, Ramli AS, Whitford DL, et al. Relationship between self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting. BMC Family Practice 2018; 19: 39.
Yee KC, Md Said S, Abdul Manaf R, et al. Identifying self-care behaviour and its predictors among type 2 diabetes mellitus patients at a district of Northern Peninsular Malaysia. Mal J Med Health Sci 2018; 14(2): 17-29.
Luo X, Liu T, Yuan X, et al. Factors influencing self-management in Chinese adults with type 2 diabetes: A systematic review and meta-analysis. Int J Environ Res Public Health 2015; 12(9): 11304-27.
Wilkinson A, Whitehead L, Ritchie L. Factors influencing the ability to self-manage diabetes for adults living with type 1 or 2 diabetes. Int J Nurs Stud 2014; 51(1): 111-22.
Ganasegaran K, Renganathan P, Abdul Manaf R, et al. Factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia: A descriptive cross-sectional single-centre study. BMJ Open 2014; 4: e004794.
Kaur G, Tee GH, Ariaratnam S, et al. Depression, anxiety and stress symptoms among diabetic in Malaysia: A cross sectional study in an urban primary care setting. BMC Family Practice 2013; 14: 69.
Mohamed R, Abdul Kadir A, Yaacob LH. A study on depression among patient with type 2 diabetes mellitus in north-east coast Malaysia. International Journal of Collaborative Research on Internal Medicine & Public Health 2012; 4(8): 1589-600.
Abd. Hamid S, Ab. Manan N. Stress coping skills among diabetes sufferers in Sepang Selangor Malaysia. International Journal of Education and Research 2013; 1(10): 1-10.
Sumalin LL, Garcia TJ, Brown SA. Depression and adherence to lifestyle changes in type 2 diabetes: A systematic review. Diabetes Educ 2014; 40(6): 731-44.
Gonzalez JS, Peyrot M, McCarl LA, et al. Depression and diabetes treatment nonadherence: A Meta-Analysis. Diabetes Care 2008; 31:2394-403.
Gonzalez JS, Safren SA, Cagliero E, et al. Depression, self-care, and medication adherence in type 2 diabetes: Relationships across the full range of symptom severity. Diabetes Care 2007; 30(9): 2222–7.
Lin EHB, Katon W, Von Korff M, et al. Relationship of depression and diabetes self-care, medication adherence, and preventive care. Diabetes Care 2004; 27:2154-60.
Walker RJ, Gebregziabher M, Martin-Harris B, et al. Independent effects of socioeconomic and psychological social determinants of health on self-care and outcomes in type 2 diabetes. Gen Hosp Psychiatry 2014; 36(6): 662–8.
Maneze D, Everett B, Astorga C, et al. The influence of health literacy and depression on diabetes self-management: A cross-sectional study. J Diabetes Res 2016; 2016: 3458969.
Egede LE, Ellis C, Grubaugh AL. The effect of depression on self- care behaviours and quality of care in a national sample of adults with diabetes. Gen Hosp Psychiatry 2009; 31(5): 422-7.
Al-Hayek AA, Robert AA, Alzaid AA, et al. Association between diabetes self-care, medication adherence, anxiety, depression, and glycemic control in type 2 diabetes. Saudi Med J 2012; 33(6):681-3.
Jalaludin MY, Fuziah MZ, Hong JYH, et al. Reliability and Validity of the Revised Summary of Diabetes Self-Care Activities (SDSCA) for Malaysian Children and Adolescent. Malays Fam Physician 2012; 7(2-3): 10-20.
Bujang MA, Ismail M, Bariyyah NK, et al. Validation of the summary of diabetes self-care activities (SDSCA) in Malay language for Malaysian adults. MJPHM 2016; 16(3): 227-34.
Musa R, Fadzil MA, Zain Z. Translation, validation and psychometric properties of Bahasa Malaysia version of the Depression, Anxiety and Stress Scales (DASS). ASEAN Journal of Psychiatry 2007; 8(2): 82-9.
Department of Statistics Malaysia. Report of household income and basic amenities survey 2016.https://www.dosm.gov.my/v1/index.php?r=column/cthemeByCat&cat=120&bul_id=RUZ5REwveU1ra1hGL21JWVlPRmU2Zz09&menu_id=amVoWU54UTl0a21NWmdhMjFMMWcyZz09 (accessed 22 January 2019).
Poh BK, Safiah MY, Tahir A, et al. Physical activity pattern and energy expenditure of Malaysian adults: Findings from the Malaysian Adult Nutrition Survey (MANS). Mal J Nutr 2010; 16(1): 13-37.