فصلنامه پرستاری دیابت
سال نهم شماره 1 (زمستان 1399)

Diabetes is a chronic, metabolic, and progressive disease that can lead to physiological and psychological disorders, such as increased blood glucose and emotional behavioral disorders, and results in poor quality of life. Therefore, the present study aimed to determine the effect of self-care education on blood glucose, diabetic quality of life, and emotional/behavioral disorders in adolescents with diabetes.

This was a semi-experimental study with a pretest, posttest, and follow-up design and experimental and control groups. The study population consisted of an adolescent diabetic member of the Tehran Diabetes Association in 2019. In total, 30 diabetic adolescents were selected using a simple random sampling method from among members of the Tehran Diabetes Association and were randomly divided into experimental (n=15) and control (n=15) groups. The experimental group received self-care education for 10 sessions of 45 minutes (two sessions per week) and the control group did not receive any education. Data were collected through blood glucose test, diabetes quality-of-life questionnaire, and emotional behavioral disorders scale and analyzed using repeated measures and Bonferroni post-hoc test in SPSS software (version 21).

Based on the obtained results, a significant difference was observed between the experimental and control groups in terms of blood glucose, diabetic quality of life, and externalizing disorders (P<0.001). However, no significant difference was observed in terms of internalizing disorders (P>0.05). In the other words, self-care education led to a decrease in blood glucose and externalizing disorders and increased quality of diabetic life in adolescents with diabetes. The results remained consistent in the follow-up stage (P<0.001).

The results revealed the effect of self-care education on improving blood glucose, diabetic quality of life, and externalizing disorders in adolescents with diabetes. The results remained consistent in the follow-up phase. Therefore, health professionals can use self-care education to improve health-related problems, especially decreased blood glucose, externalizing disorders, and diabetic quality of life.

Diabetes-related social stigma is a common phenomenon in many countries associated with several negative effects. This qualitative study explored some strategies to overcome diabetes-related stigma in diabetes-care centers.

This qualitative study was conducted based on the content analysis design in Isfahan in 2012-2014. A number of 74 volunteers were selected via purposive sampling from the medical staff, community members, and diabetic individuals. The needed data were selected using 27 semistructured in-depth interviews, 10 group discussions, email, Short Message Service (SMS), and telephone interviews. Data analysis was performed using an inductive content analysis approach.

Two main categories were emerged from data analysis, including "change in medical staff chr('39')s care approach " and "change in the policies of diabetes centers". Healthcare staff need to "change their care approach" which can be achieved through the sub-categories of "changing the treatment staff approach from disease-centered to person-centered", "updating the treatment staff information" and "changing the treatment staff approach to the education of diabetic patients". Changes in system policies should also be considered under the categories of "accelerating the activities of diabetes centers" and "improving the environment of diabetes centers".

The emerged strategies demonstrated that"change in medical staff chr('39')s care approach " and "change in the policies of diabetes centers"  can help people with diabetes to do not feel lonely, different, and worthless (two determines in developing and strengthening of social stigma). Organizational-level solutions proposed in the present study are relatively novel solutions not only in the field of diabetes but also in comparison with other stigmatized situations.

The first month after childbirth is the most critical time for mothers and is associated with increased postpartum stress such as stress, disturbed psychological and social balance, rejection of the role of mother and negative physical changes and lack of social support.  Medical problems such as gestational diabetes may lead to postpartum stress. The present study was conducted to determine the relationship between gestational diabetes and postpartum stress in patients referred to Zabol health centers.

In this descriptive-analytical study in 2009-2010 on 50 pregnant women with a definite diagnosis of diabetes and 50 healthy pregnant women referred to health centers in Zabol.  Research data were collected using the Midwifery Demographic Questionnaire and the Hyung Postpartum Stress Questionnaire, which include three areas of maternal duties and responsibilities, social and interpersonal problems, and negative physical changes.  Data analysis was performed using SPSS statistical software (version 21) and t-test.  P value less than 0/05 Was considered significant.

Statistical and midwifery variables were similar between the two groups.  Mean postpartum stress score related to achieving maternal role in gestational diabetes group was 110/64±15/46 and control group was 57/76 ± 11/11, mean postpartum stress score associated with negative physical changes in the group.  Gestational diabetes was determined to be 47/05 ± 6/50 and in the control group was 26/32 ± 6/70, the mean score of postpartum stress related to lack of social support in women in the gestational diabetes group was 57/79 ± 8/17and in  The control group was identified as 32/28 ± 4/67. Independent t-test showed that the mean score of postpartum stress related to motherhood, negative physical changes and lack of social support in the two groups of gestational diabetes and control were significantly different. P=  (0/0001)

Gestational diabetes can be a potential risk factor for postpartum stress and tensions. Women in the gestational diabetes group experience more perceived stress.Therefore, in addition to controlling blood sugar, pregnant women with diabetes should pay more attention to their mental and emotional state and the presence of symptoms of postpartum stress in these patients to prevent its complications.

Numerous studies have demonstrated different serum changes in vitamin B12 and folic acid levels in patients taking metformin. The present study aimed to make a comparison between patients with type II diabetes (T2DM) taking metformin and healthy individuals in terms of serum levels of vitamin B12 and folic acid.

In this cross-sectional observational study, 40 patients with T2DM and 40 healthy subjects were selected based on inclusion and exclusion criteria. After recording individual characteristics and taking fasting blood, glucose, triglyceride, cholesterol, High-density lipoprotein (HDL) cholesterol, and Low-density lipoprotein (HDL) cholesterol levels were measured using commercial kits employing spectrophotometric methods. Moreover,  folic acid and vitamin B12 levels were measured by enzyme-linked immunosorbent assay.

The results indicated that the mean scores of folic acid levels in T2DM patients and healthy subjects were obtained at 3.4±1.69 (ng/ml) and 9.1±4.78 (ng/ml), respectively. Moreover, the mean scores of vitamin B12 level were 176.05± 34.56 and 227.20± 56.84 (pg/ml) in T2DM patients and healthy subjects, respectively (P=0.0001). Except for the cholesterol level, the mean values of fasting blood glucose and lipid profile were significantly different between the two groups. With regard to the risk of a high level of biochemical indicators compared to standard, these indicators showed more increase in the patient group than healthy subjects.

As evidenced by the obtained results, there was a reduction in the vitamin B12 and folic acid levels significant changes in biochemical indicators in patients with T2DM, as compared to healthy subjects. This process can be dangerous in terms of complications and disease progression; therefore, it is recommended to prescribe the abovementioned vitamin supplements for these patients.

Diabetes is a chronic disorder of the bodychr('39')s metabolism and is characterized by high blood sugar. One of the most common causes of coronavirus in Iran today is a dramatic increase in death anxiety in these patients. Training based on the BASNEF model on reducing death anxiety in Iran with the coronavirus was conducted.

The present study was an experimental study with a control group. The research samples included 70. Data collection tools in this study included demographic information questionnaire and death anxiety questionnaire. Before the intervention, the mentioned questionnaires were completed by the samples. Then the samples were randomly divided into intervention and control groups. Then, one session was held every week for the intervention group of 8 training sessions. There was no intervention in the control group. Data analysis was performed by SPSS software.

The mean score of death anxiety in the control group was 48.0 9 18.9 before the intervention and 21.0 41 41.10 after the intervention. Comparison of these two scores did not show a statistically significant difference (P = 0.11). Also, the mean score of death anxiety in the intervention group, before the intervention, was 74.0 21 21.10 and after the intervention was 39.0 81 81.5. Comparison of these two scores before and after the intervention showed a statistically significant difference in this group (P <0.0001).

According to the findings of the present study, it can be concluded that BASNEF educational model can be effective in reducing death anxiety. Therefore, it is recommended that regular educational programs with this method be developed for diabetic patients and other patients with chronic diseases and integrated into the health system.

Due to the importance of review studies in obtaining, retrieving, reviewing, combining, analyzing, and integrating the results of original and fundamental studies to achieve the required knowledge, the present study was conducted to introduce the characteristics and application of various reviews methods and their role in promoting nursing knowledge.

To achieve the objectives of the study, the library research method was used. For this purpose, data were extracted and analyzed from PubMed, Google Scholar, Magiran, and SID.

Based on the results of studies, all review studies had a growing trend in recent years, and researchers realized its importance in advancing knowledge in the medical sciences. Among the types of review studies, 10 types of them were discussed more and their selection and characteristics were explained.

It was found that due to the increase in the volume and number of specialized information in todaychr('39')s world, knowledge and use of the results of review studies were highly effective in publishing the results of various studies and in evidence-based clinical decision-making. Moreover, considering that most studies in Iran are limited to systematic and meta-analysis methods, the present article introduced several other types of review studies to draw researcherschr('39') attention to the value of other review studies and their role in clinical decisions.

Self-care not only reduces patientschr('39') hospitalization but also prevents their various problems. Therefore, this systematic review and meta-analysis aimed to evaluate the self-care behaviors of diabetic foot prevention in patients with diabetic foot ulcers.

The present systematic review study was conducted on studies performed on the application of the self-care model of diabetic foot prevention in patients with diabetic foot ulcers. To access the articles, detailed research was carried out on Google Scholar, SID Iran Doc, Iran Medex, and Magiran databases, and the search process was performed using the following Persian keywords: "Self-care", "Self-care frame", and "Diabetic foot ulcers". Moreover, English databases, namely Web of Sciences, PubMed, ProQuest, Google Scholar, Scopus, and Science Direct, were searched using the English keywords of "Diabetic foot" and "Self-care". All English and Persian articles performed 2001-2020 were included. At the end of this stage, seven articles were selected aligned with the purposes of this study, reviewed by two members of the research team separately regarding their quality, and confirmed and analyzed using the Consolidated Standards of Reporting Trials tool in terms of their quality.

Out of the reviewed articles, 7 articles were included in the study, including 1 (14%) and 6 (86%) articles published in English and Persian, respectively. Regarding the research place, two articles were conducted in Urmia, Iran, and five articles were performed in Tehran, Saveh, Yazd, Shahrekord, and Torbat Heydariyeh, Iran. The results of studies generally emphasized the effectiveness of training on the evaluation of self-care behaviors and its effect on diabetic wound healing.

It is suggested that due to the chronic nature of diabetes, high prevalence of foot ulcers in patients with diabetes, and high costs of healthcare for these wounds, self-care programs developed based on standard methods be used as safe, non-pharmacological, non-invasive, and inexpensive methods in controlling physical and psychological problems.