The influence of therapeutic education on diabetes-related distress and therapeutic adherence among patients with type 2 diabetes in Tetouan, Morocco
DOI:
https://doi.org/10.15584/ejcem.2024.1.28Keywords:
diabetes-related distress, therapeutic education, type 2 diabetesAbstract
Introduction and aim. Diabetes-related distress is a prevalent issue that affects many patients, leading to challenges in ad hering to treatment plans and lifestyle modifications. By implementing therapeutic education programs, healthcare providers seek to enhance patients’ understanding of their condition, coping mechanisms, and treatment adherence. This study aims to explore the impact of therapeutic education on diabetes-related distress and therapeutic adherence among individuals diag nosed with type 2 diabetes.
Material and methods. This quasi-experimental study involved 40 patients with type 2 diabetes receiving therapeutic educa tion during 6 Months from March 24 to September 30, 2022. Diabetes-related distress and adherence were assessed before and after the intervention using the Diabetes Distress Scale (DDS-17) and glycated hemoglobin (HbA1c) levels.
Results. Wilcoxon signed rank tests revealed statistically significant improvements for all measures after the intervention. Patients showed improved DDS-17 scores (p<0.001) across all dimensions, and lower HbA1c levels (p<0.001). Pre- and post-inter vention mean difference across all measures show that the greatest improvements were seen in emotional distress (1.37) and treatment-related distress (1.2).
Conclusion. Therapeutic education had a positive impact on therapeutic adherence and diabetes-related distress. It should be an integral part of type 2 diabetes care protocols in Morocco.
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References
Taleb N. Management of Insulin-Treated Diabetes and Hypoglycaemia: Role of Technology and Review of Treatment Recommendations. (Free Translation). University of Montreal; 2020. https://papyrus.bib.umontreal.ca/xmlui/handle/1866/26323. Accessed April 21, 2023.
WHO. Diabetes. 2021. https://www.who.int/fr/news-room/fact-sheets/detail/diabetes. Accessed September 15, 2022.
IDF. IDF Diabetes Atlas | Tenth Edition. https://diabetesatlas.org/. Published 2021. Accessed April 9, 2023.
Arredondo A, Azar A, Recamán AL. Diabetes, a global public health challenge with a high epidemiological and economic burden on health systems in Latin America. Glob Public Health. 2018;13(7):780-787. doi: 10.1080/17441692.2017.1316414
Wanvoegbe FA, Agbodande KA, Alassani A, et al. Evaluation of therapeutic compliance among diabetics in Benin (Free translation). Med Afr Noire En Ligne. 2018:355-361.
WHO. Diabetes profiles. Published 2016. https://www.who.int/teams/noncommunicable-diseases/surveillance/data/diabetes-profiles. Accessed April 23, 2023.
Chetoui A, Kamal K, Abdeslam El Kardoudi. Epidemiology of diabetes in Morocco: review of data, analysis and outlook (Free translation). Int J Sci Eng Rés. 2018;9:1310-1316.
Ministry of Health and Social Protection. Action plan, the national program to combat diabetes. https://extranet.who.int/ncdccs/Data/MAR_B6_44.%20Plan%20national%20de%20pr%C3%A9vention%20et%20de%20contr%C3%B4le%20du%20diab%C3%A8te.doc. Published online 2012 2008. Accessed September 1, 2023.
WHO EMRO. World Health Day: together against diabetes Morocco. https://www.emro.who.int/fr/mor/morocco-news/journee-mondiale-de-la-sante-ensemble-contre-le-diabete.html. Published 2016. Accessed November 6, 2023.
American Diabetes Association Professional Practice Committee. 6. Glycemic Targets: Standards of Medical Care in Diabetes—2022. Diabetes Care. 2022;45(1):83-96. doi: 10.2337/dc22-S006
Chadli A, El Aziz S, El Ansari N, et al. Management of diabetes in Morocco: results of the International Diabetes Management Practices Study (IDMPS)–wave 5. Ther Adv Endocrinol Metab. 2016;7(3):101-109.
Polonsky WH, Henry RR. Poor medication adherence in type 2 diabetes: recognizing the scope of the problem and its key contributors. Patient Prefer Adherence. 2016;10:1299.
Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomark Insights. 2016;11:95-104. doi: 10.4137/BMI.S38440
Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HAW. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008;359(15):1577-1589. doi: 10.1056/NEJMoa0806470
Linkeviciute-Ulinskiene D, Kaceniene A, Dulskas A, Patasius A, Zabuliene L, Smailyte G. Increased mortality risk in people with type 2 diabetes mellitus in Lithuania. Int J Environ Res Public Health. 2020;17(18):6870. doi: 10.3390/ijerph17186870
Dack C, Ross J, Stevenson F, et al. A digital self-management intervention for adults with type 2 diabetes: Combining theory, data and participatory design to develop HeLP-Diabetes. Internet Interv. 2019;17:100241.
Zoungas S, Chalmers J, Neal B, et al. Follow-up of Blood-Pressure Lowering and Glucose Control in Type 2 Diabetes. N Engl J Med. 2014;371(15):1392-1406. doi: 10.1056/NEJMoa1407963
Cramer JA. A systematic review of adherence with medications for diabetes. Diabetes Care. 2004;27(5):1218-1224.
Krass I, Schieback P, Dhippayom T. Adherence to diabetes medication: a systematic review. Diabet Med. 2015;32(6):725-737. doi: 10.1111/dme.12651
Fisher L, Skaff MM, Mullan JT, et al. Clinical Depression Versus Distress Among Patients With Type 2 Diabetes. Diabetes Care. 2007;30(3):542-548. doi: 10.2337/dc06-1614
Fisher L, Polonsky WH, Hessler D. Addressing diabetes distress in clinical care: a practical guide. Diabet Med. 2019;36(7):803-812. doi: 10.1111/dme.13967
Perrin N, Davies M, Robertson N, Snoek F, Khunti K. The prevalence of diabetes-specific emotional distress in people with Type 2 diabetes: a systematic review and meta-analysis. Diabet Med. 2017;34(11):1508-1520. doi: 10.1111/dme.13448
Huang CJ, Chiu HC, Lee MH, Wang SY. Prevalence and incidence of anxiety disorders in diabetic patients: a national population-based cohort study. Gen Hosp Psychiatry. 2011;33(1):8-15. doi: 10.1016/j.genhosppsych.2010.10.008
Snoek FJ, Bremmer MA, Hermanns N. Constructs of depression and distress in diabetes: time for an appraisal. Lancet Diabetes Endocrinol. 2015;3(6):450-460. doi: 10.1016/S2213-8587(15)00135-7
Tiv M, Viel JF, Mauny F, et al. Medication adherence in type 2 diabetes: the ENTRED study 2007, a French population-based study. PloS One. 2012;7(3):e32412. doi: 10.1371/journal.pone.0032412
Polonsky WH, Fisher L, Earles J, et al. Assessing psychosocial distress in diabetes: development of the diabetes distress scale. Diabetes Care. 2005;28(3):626-631. doi: 10.2337/diacare.28.3.626
Adarmouch L, Sebbani M, Elyacoubi A, Amine M. Psychometric properties of a moroccan version of the summary of diabetes self-care activities measure. J Diabetes Res. 2016;2016:5479216. doi: 10.1155/2016/5479216
Diabetes Distress Assessment & Resource Center. https://diabetesdistress.org/dd-assess-score-3/. Accessed December 3, 2023.
Jackson-Koku G. Beck depression inventory. Occup Med. 2016;66(2):174-175.
Sebbani M, Adarmouch L, Elouarradi N, Elansari N, Amine M. Cross-cultural adaptation and validation of the Moroccan version of the Diabetes Distress Scale" DDS17" among adult type 1 diabetic patients. Rev Marocaine Santé Publique. 2020;7(11).
Mardis C, Foohey L. Laboratory-Quality Hemoglobin A1c Results at the Point of Care With DCA Vantage Analyzer. Point Care. 2017;16(1):63. doi: 10.1097/POC.0000000000000130
Timm M, Soares Rodrigues MC, Bertonha Machado V. Adherence to treatment of type 2 diabetes mellitus: a systematic review of randomized clinical essays. J Nurs UFPERevista Enferm UFPE. 2013;7(4).
Bhandari P, Kim M. Self-Care Behaviors of Nepalese Adults With Type 2 Diabetes: A Mixed Methods Analysis. Nurs Res. 2016;65(3):202-214. doi: 10.1097/NNR.0000000000000153
Cheng C. The impact of nursing-led intervention on the health outcome ofpeople with type 2 diabetes: A systematic literature review. Published online 2011. Accessed November 6, 2023.
Fisher L, Hessler D, Glasgow RE, et al. REDEEM: A Pragmatic Trial to Reduce Diabetes Distress. Diabetes Care. 2013;36(9):2551-2558. doi: 10.2337/dc12-2493
Sturt J, Dennick K, Due-Christensen M, McCarthy K. The Detection and Management of Diabetes Distress in People With Type 1 Diabetes. Curr Diab Rep. 2015;15(11):101. doi: 10.1007/s11892-015-0660-z
Summers-Gibson L. The relationships between diabetes self-care, diabetes time management, and diabetes distress in women with type 2 diabetes mellitus. Sci Diabetes Self-Manag Care. 2021;47(4):245-254.
Klein HA, Jackson SM, Street K, Whitacre JC, Klein G. Diabetes self-management education: miles to go. Nurs Res Pract. 2013;2013:581012. doi: 10.1155/2013/581012
Hu Y, Li L, Zhang J. Diabetes distress in young adults with type 2 diabetes: a cross-sectional survey in China. J Diabetes Res. 2020;2020:4814378. doi: 10.1155/2020/4814378
Naik AD, McCullough LB. Health intuitions inform patient-centered care. Am J Bioeth AJOB. 2014;14(6):1-3. doi: 10.1080/15265161.2014.915650
Naik AD, Dindo L, Van Liew J, et al. Development of a Clinically-Feasible Process for Identifying Patient Health Priorities. J Am Geriatr Soc. 2018;66(10):1872-1879. doi: 10.1111/jgs.15437
Tinetti ME, Naik AD, Dindo L, et al. Association of Patient Priorities–Aligned Decision-Making With Patient Outcomes and Ambulatory Health Care Burden Among Older Adults With Multiple Chronic Conditions. JAMA Intern Med. 2019;179(12):1688-1697. doi: 10.1001/jamainternmed.2019.4235
Tinetti ME, Costello DM, Naik AD, et al. Outcome Goals and Health Care Preferences of Older Adults With Multiple Chronic Conditions. JAMA Netw Open. 2021;4(3):e211271. doi: 10.1001/jamanetworkopen.2021.1271
Atallah R, Côté J, Bekarian G. Evaluation of the effects of a nursing intervention on therapeutic adherence in people with type 2 diabetes (Free translation). Rech Soins Infirm. 2019;136(1):28-42.
Lutes LD, Cummings DM, Littlewood K, et al. A Tailored Cognitive-Behavioural Intervention Produces Comparable Reductions in Regimen-Related Distress in Adults With Type 2 Diabetes Regardless of Insulin Use: 12-Month Outcomes From the COMRADE Trial. Can J Diabetes. 2020;44(6):530-536. doi: 10.1016/j.jcjd.2020.05.016
Guo J, Wang H, Ge L, Valimaki M, Wiley J, Whittemore R. Effectiveness of a nurse‐led mindfulness stress‐reduction intervention on diabetes distress, diabetes self‐management, and HbA1c levels among people with type 2 diabetes: A pilot randomized controlled trial. Res Nurs Health. 2022;45(1):46-58. doi: 10.1002/nur.22195
Ismail K, Winkley K, De Zoysa N, et al. Nurse-led psychological intervention for type 2 diabetes: a cluster randomised controlled trial (Diabetes-6 study) in primary care. Br J Gen Pract. 2018;68(673):e531-e540. doi: 10.3399/bjgp18X696185
Amira A, Ben Rejeb M, Chihaoui M. The Effect of a Therapeutic Education Program on the Feeling of Self-Efficacy, Self-Care Behaviors and Glycemic Control in Type 2 Diabetic Patients: Literature Review. OALib. 2022;09:1-12. doi: 10.4236/oalib.1109448
Alonso-Domínguez R, García-Ortiz L, Patino-Alonso M, Sánchez-Aguadero N, Gómez-Marcos M, Recio-Rodríguez J. Effectiveness of A Multifactorial Intervention in Increasing Adherence to the Mediterranean Diet among Patients with Diabetes Mellitus Type 2: A Controlled and Randomized Study (EMID Study). Nutrients. 2019;11(1):162. doi: 10.3390/nu11010162
Valenzuela Mencía J, Fernández Castillo R, Martos Cabrera MB, et al. Low-carbohydrate diets for type 2 diabetics. Systematic review (Free translation). Nutr Hosp. 2017;34(1):224. doi: 10.20960/nh.999
Holtz B, Lauckner C. Diabetes management via mobile phones: a systematic review. Telemed J E-Health Off J Am Telemed Assoc. 2012;18(3):175-184. doi: 10.1089/tmj.2011.0119
Suksomboon N, Poolsup N, Nge YL. Impact of phone call intervention on glycemic control in diabetes patients: a systematic review and meta-analysis of randomized, controlled trials. PloS One. 2014;9(2):e89207. doi: 10.1371/journal.pone.0089207
Trief PM, Fisher L, Sandberg J, et al. Health and Psychosocial Outcomes of a Telephonic Couples Behavior Change Intervention in Patients With Poorly Controlled Type 2 Diabetes: A Randomized Clinical Trial. Diabetes Care. 2016;39(12):2165-2173. doi: 10.2337/dc16-0035
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