Self-Care Interventions as a Health Technology for Managing Type 2 Diabetes: A Population-Based Study in Iran
,
Abstract
Background: The prevalence of type 2 diabetes represents a significant public health challenge, and effective disease management is essential for improving patient outcomes. Perceived social support and self-care are critical factors in the health of individuals with type 2 diabetes.
Objectives: This study aimed to explore the relationship between social support, perceived stress, and self-care behaviors in patients with type 2 diabetes in Rasht.
Methods: In this cross-sectional descriptive study, 384 participants were selected from a population of 40,000 people with type 2 diabetes in Rasht city, using the Karjesi and Morgan table. Tobert’s self-care questionnaires, the Perceived Social Support Scale by Zimmet, Dalhem, Zimmet, and Farley, and the Perceived Stress Scale by Cohen, Kamark, and Mermelstein were utilized for data collection. The data obtained from field investigations were analyzed using descriptive and analytical statistical tests, including Pearson correlation and linear regression, at a significance level of 0.01 and a confidence interval of 0.99, in SPSS software version 16.
Results: The results of the study revealed a positive correlation between perceived social support and self-care (r = 0.35), family support and self-care (r = 0.25), friends’ support and self-care (r = 0.33), and support from significant individuals and self-care (r = 0.37). Conversely, a negative relationship was observed between perceived stress and self-care (r = -0.22).
Conclusions: These findings can assist healthcare providers in expanding existing knowledge and designing diabetes self-care management education programs tailored to the psychosocial and cultural needs of adults in the study region.
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2. Bravi MC, Armiento A, Laurenti O, Cassone-Faldetta M, De Luca O, Moretti A, et al. Insulin decreases intracellular oxidative stress in patients with type 2 diabetes mellitus. Metab. 2006;55(5):691-5. [PubMed ID:16631447]. https://doi.org/10.1016/j. metabol.2006.01.003.
3. Faulenbach M, Uthoff H, Schwegler K, Spinas GA, Schmid C, Wiesli P. Effect of psychological stress on glucose control in patients with Type 2 diabetes. Diabet Med. 2012;29(1):128-31. [PubMed ID:21883440]. https://doi.org/10.1111/j.1464-5491.2011.03431.x.
4. Tahrani AA, Bailey CJ, Del Prato S, Barnett AH. Management of type 2 diabetes: new and future developments in treatment. Lancet. 2011;378(9786):182-97. [PubMed ID:21705062]. https://doi.org/10.1016/S0140-6736(11)60207-9.
5. Grade Study Research Group, Nathan DM, Lachin JM, Balasubramanyam A, Burch HB, Buse JB, et al. Glycemia Reduction in Type
2 Diabetes - Glycemic Outcomes. N Engl J Med. 2022;387(12):1063-74. [PubMed ID:36129996]. [PubMed Central ID:PMC9829320]. https://doi.org/10.1056/NEJMoa2200433.
6. Majidzadeh R, Rezaei S, Akbari B. Self-Compassion Reduces the Destructive Effects of Perceived Stress on Psychological WellBeing and Self-Care Behaviors: Results from Type II Diabetes Mellitus Patients. Iran j diabetes obes. 2022;14(4):189-201. https://doi.org/10.18502/ijdo.v14i4.11226.
7. Masjoudi M, Aslani A, Seifi M, Khazaeian S, Fathnezhad-Kazemi A. Association between perceived stress, fear and anxiety of COVID 19 with self-care in pregnant women: a cross-sectional study. Psychol Health Med. 2022;27(2):289-300. [PubMed ID:33632035]. https://doi.org/10.1080/13548506.2021.1894344.
8. Dehvan F, Qasim Nasif F, Dalvand S, Ausili D, Hasanpour Dehkordi A, Ghanei Gheshlagh R. Self-care in Iranian patients with diabetes: A systematic review and meta-analysis. Prim Care Diabetes. 2021;15(1):80-7. [PubMed ID:32921619]. https://doi.org/10.1016/j.pcd.2020.08.013.
9. Moradi F, Ziapour A, Abbas J, Najafi S, Rezaeian S, Faraji O, et al. Comparing the Associated Factors on Lifestyle Between Type 2 Diabetic Patients and Healthy People: A Case-Control Study. Commun Health Equity Res Policy. 2023;43(3):293-9. [PubMed ID:34098794]. https://doi.org/10.1177/0272684X211022158.
10. Mohebi S, Parham M, Sharifirad G, Gharlipour Z, Mohammadbeigi A, Rajati F. Relationship between perceived social support and self-care behavior in type 2 diabetics: A cross-sectional study. J Educ Health Promot. 2018;7(1):48. [PubMed ID:29693029]. [PubMed Central ID:PMC5903155]. https://doi.org/10.4103/jehp.jehp_73_17.
11. Kim CJ, Schlenk EA, Kim DJ, Kim M, Erlen JA, Kim SE. The role of social support on the relationship of depressive symptoms to medication adherence and self-care activities in adults with type 2 diabetes. J Adv Nurs. 2015;71(9):2164-75. [PubMed ID:25976591]. https://doi.org/10.1111/jan.12682.
12. Robat Sarpooshi D, Mahdizadeh M, Jaferi A, Robatsarpooshi H, Haddadi M, Peyman N. The relationship between social support and self-care behavior in patients with diabetes mellitus. Fam Med Prim Care Rev. 2021;23(2):227-31. https://doi.org/10.5114/fmpcr.2021.105932.
13. Farzan R, Ghorbani Vajargah P, Mollaei A, Karkhah S, Samidoust P, Takasi P, et al. A systematic review of social support and related factors among burns patients. Int Wound J. 2023;20(8):3349-61.
[PubMed ID:36960557]. [PubMed Central ID:PMC10502254]. https://doi.org/10.1111/iwj.14166.
14. Eimer S, Mahmoodi-Shan GR. Self-care Behaviour of the Elderly with Heart Failure and its Associated Factors in Hospitals of Gonbad Kavus in 2018. J Res Dev Nurs Midw. 2020;17(1):12-21. https://doi.org/10.29252/jgbfnm.17.1.12.
15. Long Q, Guo J, Zhong Q, Jiang S, Wiley J, Chen JL. General self-efficacy and social support as mediators of the association between perceived stress and quality of life among rural women with previous gestational diabetes mellitus. J Clin Nurs. 2021;30(7-8):1026-
36. [PubMed ID:33434309]. https://doi.org/10.1111/jocn.15648.16. Ramkisson S, Pillay BJ, Sibanda W. Social support and coping in adults with type 2 diabetes. Afr J Prim Health Care Fam Med. 2017;9(1):e1-e8. [PubMed ID:28828879]. [PubMed Central ID:PMC5566130]. https://doi.org/10.4102/phcfm.v9i1.1405.
17. Musavian AS, Pasha A, Rahebi SM, Atrkar Roushan Z, Ghanbari
A. Health promoting Behaviors Among Adolescents: A Crosssectional Study. Nurs Midwifery Stud. 2014;3(1):e14560. [PubMed ID:25414892]. [PubMed Central ID:PMC4228521]. https://doi.org/10.17795/nmsjournal14560.
18. Tol A, Baghbanian A, Rahimi A, Shojaeizadeh D, Mohebbi B, Majlessi F. The Relationship between perceived social support from family and diabetes control among patients with diabetes type 1 and type 2. J Diabetes Metab Disord. 2011;10(21):1-8.
19. Walker RJ, Gebregziabher M, Martin-Harris B, Egede LE. 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. [PubMed ID:25103544]. [PubMed Central ID:PMC4254055]. https://doi.org/10.1016/j.genhosppsych.2014.06.011.
20. Wang F, Huang L, Zhang H, Jiang H, Chang X, Chu Y. The mediating role of perceived stress on the relationship between perceived social support and self-care ability among Chinese enterostomy patients. Support Care Cancer. 2021;29(6):3155-62. [PubMed ID:33074359]. https://doi.org/10.1007/s00520-020-05829-8.
21. Borhaninejad V, Shati M, Bhalla D, Iranpour A, Fadayevatan R. A Population-Based Survey to Determine Association of Perceived Social Support and Self-Efficacy With Self-Care Among Elderly With Diabetes Mellitus (Kerman City, Iran). Int J Aging Hum Dev. 2017;85(4):504-17. [PubMed ID:28114826]. https://doi.org/10.1177/0091415016689474.
22. Young CF, Shubrook JH, Valencerina E, Wong S, Henry Lo SN, Dugan JA. Associations Between Social Support and Diabetes-Related Distress in People With Type 2 Diabetes Mellitus. J Am Osteopath Assoc. 2020;120(11):721-31. [PubMed ID:33033833]. https://doi.org/10.7556/jaoa.2020.145.
23. Nojima H, Watanabe H, Yamane K, Kitahara Y, Sekikawa K, Yamamoto H, et al. Effect of aerobic exercise training on oxidative stress in patients with type 2 diabetes mellitus. Metab. 2008;57(2):170-6. [PubMed ID:18191045]. https://doi.org/10.1016/j. metabol.2007.08.021.
24. Chu Y, Zhang Y, Wang S, Dai H. Resilience mediates the influence of hope, optimism, social support, and stress on anxiety severity among Chinese patients with cervical spondylosis. Front Psychiatry. 2022;13:997541. [PubMed ID:36213904]. [PubMed Central ID:PMC9539388]. https://doi.org/10.3389/fpsyt.2022.997541.
25. Mohammadpour M, Mohammad-Alizadeh Charandabi S, Malakouti J, Nadar Mohammadi M, Mirghafourvand M. Effect of counselling with men on perceived stress and social support of their pregnant wives. J Reprod Infant Psychol. 2022;40(2):118-32. [PubMed ID:32673065]. https://doi.org/10.1080/02646838.2020.1
792428.
26. Rostami A, Ghazinour M, Nygren L, Nojumi M, Richter J. Healthrelated quality of life, marital satisfaction, and social support in medical staff in Iran. Applied Research in Quality of Life. 2013;8:385-402.
27. Kayed H, Kazemian Moghadam K. [Causal relationship between personality traits and psychological well-being with quality of work life through the mediation of perceived social support in nurses]. J Principles Mental Health. 2021;23(6):433-42. Persian.
28. Mimura C, Griffiths P. A Japanese version of the perceived stress scale: translation and preliminary test. International journal of nursing studies. 2004;41(4):379-85.
29. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. Journal of health and social behavior. 1983:385-96.
30. Morowatisharifabad MA, Tonekaboni NR. [Social support and self-care behaviors in diabetic patients referring to Yazd Diabetes Research Center]. Zahedan Journal of Research in Medical Sciences. 2007;9(4). Persian.
31. Ghasemi M, Hosseini H, Sabouhi F. Effect of peer group education on the quality of life of elderly individuals with diabetes: A randomized clinical trial. Iranian journal of nursing and midwifery research. 2019;24(1):44-9.
32. DeFronzo RA, Ferrannini E, Groop L, Henry RR, Herman WH, Holst JJ, et al. Type 2 diabetes mellitus. Nat Rev Dis Primers. 2015;1(1):15019. [PubMed ID:27189025]. https://doi.org/10.1038/nrdp.2015.19.
33. Morze J, Wittenbecher C, Schwingshackl L, Danielewicz A, Rynkie-wicz A, Hu FB, et al. Metabolomics and Type 2 Diabetes Risk: An Updated Systematic Review and Meta-analysis of Prospective Cohort Studies. Diabetes Care. 2022;45(4):1013-24. [PubMed ID:35349649]. [PubMed Central ID:PMC9016744]. https://doi.org/10.2337/dc21-1705.
34. Ozbay F, Johnson DC, Dimoulas E, Morgan CA, Charney D, Southwick S. Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry. 2007;4(5):35-40. [PubMed ID:20806028]. [PubMed Central ID:PMC2921311].
35. Mai Y, Wu YJ, Huang Y. What Type of Social Support Is Important for Student Resilience During COVID-19? A Latent Profile Analysis. Front Psychol. 2021;12:646145. [PubMed ID:34239476]. [PubMed Central ID:PMC8258314]. https://doi.org/10.3389/fpsyg.2021.646145.
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| Files | ||
| Issue | Vol 9 No 1 (2025) | |
| Section | Articles | |
| DOI | https://doi.org/10.18502/htaa.v9i1.17864 | |
| Keywords | ||
| Social Support Stress Disorders Diabetes Mellitus Perceived Stress Scale | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Yousefi Malekroodi Z, Majidi SA, Taalipasand A. Self-Care Interventions as a Health Technology for Managing Type 2 Diabetes: A Population-Based Study in Iran. Health Tech Ass Act. 2025;9(1).
