The Effect of a Peer Social Support Network Intervention on Self-management of the Elderly With Type 2 Diabetes

Background: Participation in peer social groups could be used in health promotion programs for the elderly. The current study investigates the effectiveness of participation in a peer social support network intervention on the self-management of the elderly with type 2 diabetes. Methods: This research is a quasi-experimental study with a pre-test-pos-ttest design with a control group conducted in 2019. Two health centers were selected as research settings from a single district in Qom Province, Iran. From each center, 46 subjects were randomly selected. Subjects in the intervention group participated in a peer social support network for 3 months (12 sessions), and the control group received only usual care. The outcome variable was self-management. The components of this variable include the level of hemoglobin A1C (HbA1C), diabetes distress (measured with Diabetes Distress Scale), awareness (measured with Davoodi’s knowledge of diabetes questionnaire), attitude (measured with diabetes attitude scale [DAS-3]), self-efficacy (measured with diabetes empowerment scale, [DES-28]), weight and blood pressure. Subjects were evaluated at baseline and at a 6-month follow-up. The obtained data were analyzed using t-test, Chi-Square, and Fisher test in SPSS software, version 22. The significance level was set at less than 0.5. Results: The change in mean HbA1C of the intervention and control groups at baseline and 6-month follow-up was -0.7 and 0.1, respectively, which was significant (P≤0.0001). Moreover, the difference in changes in the mean values of diabetes distress (P=0.008), self-efficacy (P≤0.0001), and attitude (P≤0.0001) were significant. No significant changes were found in knowledge, weight, systolic and diastolic blood pressure (P>0.05). Conclusion: The formation of social support groups may help control blood sugar in the elderly with type 2 diabetes. Seemingly, social groups can mainly impact through psychological factors such as distress control, attitude improvement, and self-efficacy enhancement.

[1]  Yaqiong Yan,et al.  Prevalence, awareness and control of type 2 diabetes mellitus and risk factors in Chinese elderly population , 2022, BMC Public Health.

[2]  B. Duncan,et al.  IDF diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045 , 2021, Diabetes Research and Clinical Practice.

[3]  V. Mohan,et al.  Impact of age at type 2 diabetes mellitus diagnosis on mortality and vascular complications: systematic review and meta-analyses , 2020, Diabetologia.

[4]  J. Byles,et al.  Age and cohort rise in diabetes prevalence among older Australian women: Case ascertainment using survey and healthcare administrative data , 2020, PloS one.

[5]  R. Govender,et al.  Epidemiology of Type 2 Diabetes – Global Burden of Disease and Forecasted Trends , 2019, Journal of epidemiology and global health.

[6]  J. Shubrook,et al.  Impact of Diabetes-Related Distress on Predicted Cardiovascular Complications in Patients with Type 2 Diabetes , 2018, Diabetes.

[7]  Q. Guan,et al.  Prevalence, awareness, treatment and control of diabetes mellitus among middle-aged and elderly people in a rural Chinese population: A cross-sectional study , 2018, PloS one.

[8]  E. Bonora,et al.  Sex differences in the association of psychological status with measures of physical activity and sedentary behaviour in adults with type 2 diabetes , 2018, Acta Diabetologica.

[9]  A. McConnachie,et al.  Community-based group guided self-help intervention for low mood and stress: randomised controlled trial† , 2018, The British Journal of Psychiatry.

[10]  4. Lifestyle Management: Standards of Medical Care in Diabetes—2018 , 2017, Diabetes Care.

[11]  K. Khunti,et al.  The prevalence of diabetes‐specific emotional distress in people with Type 2 diabetes: a systematic review and meta‐analysis , 2017, Diabetic medicine : a journal of the British Diabetic Association.

[12]  V. Zamanzadeh,et al.  Distance education and diabetes empowerment: A single-blind randomized control trial. , 2017, Diabetes & metabolic syndrome.

[13]  F. Hu,et al.  Time Trends of Dietary and Lifestyle Factors and Their Potential Impact on Diabetes Burden in China , 2017, Diabetes Care.

[14]  Dwi Nurviyandari Kusumawati,et al.  Improved Health Status and Life Satisfaction among Older People following Self-Help Group Intervention in Jakarta , 2017, Current gerontology and geriatrics research.

[15]  Hyojung Park,et al.  Effect of empowerment on the quality of life of the survivors of breast cancer: The moderating effect of self‐help group participation , 2017, Japan journal of nursing science : JJNS.

[16]  C. Cooper,et al.  Attitudes to Ageing and Change in Frailty Status: The English Longitudinal Study of Ageing , 2017, Gerontology.

[17]  J. Segar,et al.  Accessing support and empowerment online: The experiences of individuals with diabetes , 2017, Health expectations : an international journal of public participation in health care and health policy.

[18]  A. Fish,et al.  Diabetes-related distress and its associated factors among patients with type 2 diabetes mellitus in China , 2017, Psychiatry Research.

[19]  B. Erci,et al.  Turkish validity and reliability of the Diabetes Self-Efficacy Scale , 2017, International journal of nursing sciences.

[20]  K. Chinna,et al.  Depression, distress and self-efficacy: The impact on diabetes self-care practices , 2017, PloS one.

[21]  T. Kawada.  Depressive Symptoms, Diabetes Distress and Serum Hemoglobin A1C in South Asians With Type 2 Diabetes Mellitus Living in Canada. , 2017, Canadian journal of diabetes.

[22]  M. de Groot,et al.  Psychosocial Care for People With Diabetes: A Position Statement of the American Diabetes Association , 2016, Diabetes Care.

[23]  Hae-Ra Han,et al.  The Effect of a Community-Based Self-Help Intervention: Korean Americans With Type 2 Diabetes. , 2015, American journal of preventive medicine.

[24]  Mehdi Moradinazar,et al.  The prevalence of diabetes mellitus (DM) type II among Iranian elderly population and its association with other age-related diseases, 2012. , 2015, Archives of gerontology and geriatrics.

[25]  Hochang B. Lee,et al.  The effect of a community-based self-help multimodal behavioral intervention in Korean American seniors with high blood pressure. , 2014, American journal of hypertension.

[26]  M. Khamseh,et al.  Diabetes Distress and its Association with Depression in Patients with Type 2 Diabetes in Iran , 2013, International journal of preventive medicine.

[27]  A. Baghbanian,et al.  Empowerment assessment and influential factors among patients with type 2 diabetes , 2013, Journal of Diabetes & Metabolic Disorders.

[28]  Ha T. Nguyen,et al.  The association of mental conditions with blood glucose levels in older adults with diabetes , 2012, Aging & mental health.

[29]  R. Sahaf,et al.  Study of Health and Social Indicators of Elderly Women in Iran , 2012 .

[30]  Jennifer J. Richler,et al.  Effect size estimates: current use, calculations, and interpretation. , 2012, Journal of experimental psychology. General.

[31]  J. Fleury,et al.  Empowerment Interventions for Older Adults , 2012, Western journal of nursing research.

[32]  V. Basevi,et al.  Standards of Medical Care in Diabetes—2012 , 2011, Diabetes Care.

[33]  Andrea L. Cherrington,et al.  Intervention Mapping as a Guide for the Development of a Diabetes Peer Support Intervention in Rural Alabama , 2011, Preventing chronic disease.

[34]  S. Hawkins.  Improving Glycemic Control in Older Adults Using a Videophone Motivational Diabetes Self-Management Intervention , 2010, Research and Theory for Nursing Practice.

[35]  R. Plotnikoff,et al.  Peer Telephone Counseling for Adults With Type 2 Diabetes Mellitus , 2010, The Diabetes educator.

[36]  R. Glasgow,et al.  The Relationship Between Diabetes Distress and Clinical Depression With Glycemic Control Among Patients With Type 2 Diabetes , 2010, Diabetes Care.

[37]  P. Brantley,et al.  The interaction of locus of control, self-efficacy, and outcome expectancy in relation to HbA1c in medically underserved individuals with type 2 diabetes , 2009, Journal of Behavioral Medicine.

[38]  Richard W Grant,et al.  Depression, Self-Care, and Medication Adherence in Type 2 Diabetes , 2007, Diabetes Care.

[39]  K. Wikblad,et al.  Patient education in type 2 diabetes: a randomized controlled 1-year follow-up study. , 2007, Diabetes research and clinical practice.

[40]  L. Yardley,et al.  How does social comparison within a self-help group influence adjustment to chronic illness? A longitudinal study. , 2006, Social science & medicine.

[41]  V. Decoster,et al.  An Empowerment Approach for Elders Living With Diabetes: A Pilot Study of a Community-Based Self-Help Group—The Diabetes Club , 2005 .

[42]  K. Mohammad,et al.  INFLUENCE OF EDUCATIONAL INTERVENTION USING INTERACTION APPROACH ON BEHAVIOR CHANGE,HEMOGLOBIN Alc AND HEALTH - RELATED QUALITY OF LIFE IN DIABETIC PATIENTS , 2005 .

[43]  M. Peyrot,et al.  The Diabetes Attitudes, Wishes, and Needs (DAWN) program: A new approach to improving outcomes of diabetes care , 2005 .

[44]  W. Polonsky,et al.  Assessing psychosocial distress in diabetes: development of the diabetes distress scale. , 2005, Diabetes care.

[45]  K. Kotani,et al.  Effects of a self-help group for diabetes care in long-term patients with type 2 diabetes mellitus: an experience in a Japanese rural community. , 2004, The Australian journal of rural health.

[46]  I. Levav,et al.  Treatment gap in mental health care. , 2004, The Israel journal of psychiatry and related sciences.

[47]  Bong-ho Mok.  Self-help Group Participation and Empowerment in Hong Kong , 2004, The Journal of Sociology & Social Welfare.

[48]  M. Chin,et al.  Developing a Conceptual Framework for Understanding Illness and Attitudes in Older, Urban African Americans With Diabetes , 2000, The Diabetes educator.

[49]  L. Gruppen,et al.  The Third Version of the Diabetes Attitude Scale , 1998, Diabetes Care.

[50]  M. Madmoli.  A systematic Review Study on the Results of Empowerment-Based Interventions in Diabetic Patients , 2019, International Research in Medical and Health Science.

[51]  Dilek Büyükkaya Besen,et al.  Predictors of Empowerment in Individuals With Type 2 Diabetes Mellitus , 2018, Journal of transcultural nursing : official journal of the Transcultural Nursing Society.

[52]  Selma Petra Chaves Sá,et al.  Educational technology: a facilitating instrument for the elderly care. , 2018, Revista brasileira de enfermagem.

[53]  M. Qorbani,et al.  Evaluation of psychometric properties of the third version of the Iranian Diabetes Attitude Scale (IR-DAS-3) , 2011 .

[54]  R. Heshmat,et al.  Status of diabetes care in elderly diabetic patients of a developing country , 2011 .

[55]  H. Livneh,et al.  Psychosocial Adaptation to Chronic Illness and Disability: A Primer for Counselors. , 2005 .

[56]  Ann C. Greiner,et al.  The 1st Annual Crossing the Quality Chasm Summit: A Focus on Communities , 2004 .

[57]  T. Murray,et al.  Volume 9 , 1998 .

[58]  Cde,et al.  The Diabetes Empowerment Scale A measure of psychosocial self-efficacy , 2022 .