Relationship between Self-Management and Depression among Elderly Diabetic Patients (Type 2)

Abstract

Abstract: This study used a descriptive correlational design aiming to identify the relationship between selfmanagement (self-care, self-efficacy, patient knowledge & depression among elderly diabetic patients type 2. The study was conducted at the Diabetic Outpatient Clinic in Ain Shams University Hospitals. Sample of 120 elderly patients (males & females), with type 2 diabetes mellitus was recruited during their follow up at the outpatient clinic.They were chosen according to stratified random sample over a period of 11 weeks. Two tools were used to collect data:-1) A questionnaire to assess participants’ demographic data and medical history (which included age, sex, marital status, educational level, occupation, duration of diabetes, BMI, and the last HBA1C level. 2) Brief Diabetes Knowledge Test (1998). 3) The HANDS depression screening tool was developed by Screening for Mental Health, Inc. and the Department of Psychiatry, Harvard Medical School (2002) .(It consists of 10 items ranged from (0-3) in which (0) reflects none or little of the time (1) Some of the time,(2) Most of the time, while (3) All of the time. 4)Chinese Diabetes Self-Efficacy Scale by. (It is a checklist with 26 items divided into 6 items for diet, 4 items about exercises, 3 items about medication taking, 4 items about blood glucose testing- 5 items about foot care- 4 items about prevention of hyperglycemia and hypoglycemia and how to treat. 5)Summary of Diabetes Self –Care Activities Scale. This study recommended that the education, counseling, skill building, and support through behavioral interventions to offered by health care providers to enable diabetic patients to manage their diabetes and recognize deal with depressive illness . Diabetic management intervention has emerged as a resource to assist patients in managing daily diabetic care through dissemination of information and facilitation of diabetic management behaviors that has effect on diabetes related self-efficacy. (Research shows that psychosocial factors such as family support play a central role in the success or failure of diabetes management regimen. A combination of medication and psychotherapy is recommended by this research for people with diabetes experiencing moderate to severe depression to alleviate suffering more quickly than either alone and may help reduce relapse and patients with depression should always be asked about suicidal ideation, when risk is high. Cognitive-behavioral therapy is frequently cited as effective in treating depression in people with diabetes. (Further research is needed to determine and evaluate integrating depression screening and treatment into comprehensive care of diabetes, including specific support for diabetes medication adherence and self-care activities, as well as systematic depression care, can help patients achieve better psychological and diabetes outcomes).