PANDEMİ DÖNEMİNDE DİYABETLİLERDE GÖRÜLEN YEME BOZUKLUKLARI, ÖZ-ETKİLİLİK, ANKSİYETE BOZUKLUKLARI: KESİTSEL BİR ÇALIŞMA

Yıl 2022, Cilt: 3 Sayı: 2, 78 - 84, 31.08.2022

Ayfer Bayındır Çevik , Gizem Akcan

https://doi.org/10.52831/kjhs.1069603

Öz

Amaç: Bu çalışmada, COVID-19 pandemi döneminde diyabetiklerde yeme bozukluklarının ve semptomlarının görülme sıklığı, anksiyete ve öz-etkililik durumunu ve yeme bozukluklarına etkisi olan faktörlerin belirlenmesi amaçlandı.
Yöntem: Bu kesitsel web tabanlı çalışmada, Sosyo-Demografik Bilgi Formu, Edinburgh Bulimiya Araştırma Testi (BITE), Diyabette Öz-Yönetim Algısı Skalası (DÖYAS) ve Yaygın Anksiyete Bozukluğu (YAB-7) testi kullanıldı. Değişkenlere Bağımsız Örneklemler T Testi, Mann Whitney U Testi ve Ki Kare Testi, Pearson Korelasyon Analizi ve Basit Regresyon Analizi uygulandı.
Bulgular: Çalışmaya 18-65 yaşlarında toplam 110 (52 Tip 1, 58 Tip 2) diyabet hastası katıldı. BITE toplam puanı 20.92±7.99 (Min:8; Max:32) olarak belirlendi. Yeme bozukluğunun sıklığı %29,1, anksiyete bozukluklarının sıklığı %30,9’du. Diyabette Öz-Yönetim Algısı Skalası (DÖYAS) puanı 24.80±3.85'tir (Min:8; Max:40). Evli bireylerde ve anksiyete bozukluğu olan diyabet hastalarında yeme bozukluğunun daha fazla görüldüğü saptandı (p<.005). Katılımcıların anksiyete bozukluğu, yeme bozukluğu ve DÖYAS puanları ile sosyodemografik özellikleri arasında anlamlı bir ilişki bulunmadı (p>.05). Anksiyete, diyabetiklerde yeme bozukluklarının önemli bir yordayıcısıdır (R=.45; R2 =.20; F(1.108)=28.61, p< .001).
Sonuç: Pandemi döneminde diyabet hastalarının yeme bozukluğu belirtileri ve şiddeti, anksiyete ile başa çıkma yöntemleri diyabet bakımı ile çalışan uzmanlar tarafından belirlenmelidir. Yeme bozukluklarını azaltmak için ailede yeme alışkanlıkları ve anksiyete bozukluklarının varlığı dikkate alınmalıdır. Diyabetli kişiler, çevrimiçi eğitim ve danışmanlık yoluyla duygusal ve öz yönetim açısından güçlendirilebilir.

Anahtar Kelimeler

Yeme Bozuklukları, Anksiyete Bozuklukları, Öz Yönetim, COVID 19, Diyabet

EATING DISORDERS, SELF-MANAGEMENT, AND ANXIETY DISORDERS IN DIABETICS DURING THE COVID-19 PANDEMIC: A CROSS-SECTIONAL STUDY

Öz

Objective: This study aimed to determine the frequency of eating disorders and symptoms, anxiety and self-care management status, and factors that have an impact on eating disorders in diabetics during the COVID-19 pandemic.
Method: This cross-sectional web-based study used a survey comprising a socio-demographic information form, the Bulimic Investigation Test of Edinburgh (BITE), Perceived Diabetes Self-Management Scale (PDSMS), and Generalized Anxiety Disorder Scale (GAD-7). Independent samples t Test, Mann Whitney U Test, Chi Square Test, Pearson correlation analysis, and Simple Regression Analysis were applied to the variables.
Results: Totally, 110 (52 Type 1, 58 Type 2) diabetics aged 18-65 participated in the study. BITE total score was determined as 20.92±7.99 (Min:8; Max:32). Eating disorder frequency was 29.1% while anxiety disorders frequency was 30.9%. Perceived Diabetes Self-Management Scale point is 24.80±3.85 (Min:8; Max:40). Married individuals and diabetics with anxiety disorder mostly had eating disorders (p<.005). There was no significant relationship between anxiety disorder, eating disorder and PDSMS scores of the participants and socio-demographics (p>.05). Anxiety was a significant predictor of eating disorders in diabetics (R=.45; R2 =.20; F (1.108)=28.61, p<.001).
Conclusion: Eating disorder symptoms and severity of diabetics, and their coping styles with anxiety should be determined during the pandemic by diabetes care and specialist. Family eating habits and the presence of anxiety disorders should be taken into account to reduce eating disorders. People with diabetes can be emotionally and self-management empowered through online training and counseling.

Anahtar Kelimeler

Eating disorders, Anxiety Disorders, Self-Management, COVID 19, Diabetic

Kaynakça

• Diabetes UK. Chapter 8. Eating Problems. Retrieved from: https://www.diabetes.org.uk/ March 14,2021.
• American Psychiatric Association (APA).2013. The Diagnostic and Statistical Manual of Mental Disorders: DSM-5(5th ed.). Washington DC: American Psychiatric Association; 2013.
• Ammar A, Brach M, Trabelsi K, et al. Effects of COVID-19 home confinement on eating behaviour and physical activity: results of the ECLB-COVID19 international online survey. Nutr. 2020;12(6):1583-1596.
• Wang A, Zhao W, Xu Z, Gu J. Timely blood glucose management for the outbreak of 2019 novel coronavirus disease (COVID-19) is urgently needed. Diabetes Res Clin Pract. 2020;162:108118.
• Hartmann-Boyce J, Kamal RM. Supporting people with long-term conditions (LTCs) during national emergencies. The Cent Evid Based Med. 2020.
• International Diabetes Federation. Coronavirus COVID-19. 2020. Retrieved from:https://www.idf.org/e-library/welcome.html.
• Brooks SK, Webster RK, Smith LE, Woodland S, Greenberg N, Rubin GJ. The psychological impact of quarantine and how to reduce it: Rapid review of evidence. Lancet. 2020;395:912-920.
• Touyz S, Huber TL, Phillipa H. Eating disorders in the time of COVID-19. J Eat Disord. 2020;20(8):1-3.
• Dening J, Shariful Islam SM, George E, Maddison R. Web-based interventions for dietary behavior in adults with type 2 diabetes: systematic review of randomized controlled trials. J Med Int Res. 2020;22(8):e16437.
• Khan P, Qayyum N, Malik F, Khan T, Khan M, Tahir A. Incidence of anxiety and depression among patients with type 2 diabetes and the predicting factors. Cureus. 2019;11(3):e4254.
• Dumont E, Jansen A, Kroes D, de Haan E, Mulkens S. A new cognitive behavior therapy for adolescents with avoidant/restrictive food intake disorders in a day treatment setting: A clinical case series. Int J Eat Disord. 2019; 52(4):447-458.
• Oldham-Cooper R, Semple C. Prevention and early help for eating disorders in young people with type 1 diabetes. Clin Child Psychol Psychiatry. 2021;18:1-13.
• Linardon J. The relationship between dietary restraint and binge eating: Examining eating-related self-efficacy as a moderator. Appetite. 2018;127:126-129.
• Bayındır Çevik A. Relations between health belief and self-efficacy and cardiovascular risk factors in people with Type 2 diabetes. Istanbul University, Health Science Institute, Medical Nursing Department. Doctorate Dissertation. İstanbul; 2010.
• Hartmann-Boyce J, Morris E, Goyder C, et al. Diabetes and COVID-19: risks, management, and learnings from other national disasters. Diab Care. 2020;43(8):1695-1703.
• World Health Organization (WHO). 2020. Retrieved from: https://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy lifestyle/body-mass-index-bmi. June 05, 2020.
• American Diabetes Association (ADA). 6. Glycemic targets: Standards of medical care in Diabetes-2020. Diabetes Care. 2020;43(Suppl 1):66-76.
• Henderson M, Freeman CP. A self-rating scale for bulimia. The 'BITE'. Br J Psychiatry. 1987;150:18-24.
• Güzel S. Determining the eating and eating habits and quality of life levels of individuals with type 2 diabetes. Başkent University Institute of Health Sciences, Nutrition and Dietetics Department. Master Thesis. Ankara; 2014.
• Wallston KA, Rothman RL, Cherrington A. Psychometric properties of the perceived diabetes self-management scale (PDSMS). J Behav Med. 2007; 30(5):395-401.
• Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Int Med. 2006; 166:1092-1097.
• Konkan R, Şenormancı O, Güçlü O, Aydın E, Sungur MZ. Validity and reliability study for the Turkish adaptation of the generalized anxiety disorder-7(GAD-7) scale. Arch Neuropsychiatry. 2013;50:53-58.
• Blanca MJ, Arnau J, Lopez-Montiel D. Skewness and kurtosis in real data samples. Methodology. 2013;9:78-84.
• Torrance A, Chlanese A, Zanfardino A, et al. Disordered eating behaviors among Italian adolescents with type 1 diabetes: Exploring relationships with parents’ eating disorder symptoms, externalizing and internalizing behaviors, and body image problems. J Clin Psychol Med Settings. 2020;27(4):727-745.
• Araia E, Hendrieckx C, Skinner T, Pouwer F, Speight J, King RM. Gender differences in disordered eating behaviors and body dissatisfaction among adolescents with Type 1 diabetes: Results from diabetes MILES youth-Australia. Int J Eat Disord. 2017;50(10):118-193.
• Broadley MM, Zaremba N, Andrew B, et al. 25 years of psychological research investigating disordered eating in people with diabetes: what have we learnt? Diabet Med. 2020;37(3):401-408.
• Clery P, Stahl D, Ismail K, Treasure J, Kan C. Systematic review and meta-analysis of the efficacy of interventions for people with Type 1 diabetes mellitus and disordered eating. Diabet Med. 2017;34(12):1667-1675.
• Nezami L, Abiri F, Kheirjoo E. Bulimia in diabetic patients: A review on diabulimia. Iranian J Diabetes Obes. 2018;10(2):102-105.
• Leal GV. da S, Philippi ST, Alvarenga M dos S. Unhealthy weight control behaviors, disordered eating, and body image dissatisfaction in adolescents from São Paulo, Brazil. Braz J Psychiatry. 2020;42(3):264-270.
• Romano KA, Heron KE, Amerson R, Howard LM, MacIntyre RI, Mason TB. Changes in disordered eating behaviors over 10 or more years: A meta‐analysis. Int J Eat Disord. 2020;53:1034-1055.
• Nip AS, Reboussin BA, Dabelea D, et al. Disordered eating behaviors in youth and young adults with type 1 or type 2 diabetes receiving insulin therapy: The SEARCH for diabetes in youth study. Diabetes Care. 2019;42(5):859-866.
• Khan P, Qayyum N, Malik F, Khan T, Khan M, Tahir A. Incidence of anxiety and depression among patients with type 2 diabetes and the predicting factors. Cureus. 2019;11(3):e4254.
• Rose M, Streisand R, Tully C, et al. Risk of disordered eating behaviors in adolescents with type 1 diabetes. J Pediatr Psycho. 2020;45(5):583-591.
• Iwajomo T, Bondy S, De Oliveira C, Colton P, Trottier K, Kurdyak P. Excess mortality associated with eating disorders: Population-based cohort study. Br J Psychiatry. 2020;29:1-7.
• Wisting L, Skrivarhaug T, Dahl-Jørgensen K, Rø Ø. Prevalence of disturbed eating behavior and associated symptoms of anxiety and depression among adult males and females with type 1 diabetes. J Eat Disord. 2018;11(6):28-37.
• Castellano-Guerrero AM, Guerrero R, Relimpio F, et al. Prevalence and predictors of depression and anxiety in adult patients with type 1 diabetes in tertiary care setting. Acta Diabetol. 2018;55(9):943-953.
• Rescorla LA, Ewing G, Ivanova MY, et al. Parent-adolescent cross-informant agreement in clinically referred samples: Findings from seven societies. J Clin Child Adolesc Psychol. 2017;46(1):74-87.
• Monteleone AM, Ruzzi V, Patriciello G, et al. Emotional reactivity and eating disorder-related attitudes in response to the trier social stress test: An experimental study in people with anorexia nervosa and with bulimia nervosa. J Affect Disord. 2020;274:23-30.
• Pace CS, Muzi S. Binge-Eating Symptoms, Emotional-Behavioral Problems and Gender Differences among Adolescents: A Brief Report. Mediterr J Clin Psychol. 2019;7(2):1-9.
• Petroni ML, Barbanti FA, Bonadonna R, et al. Dysfunctional eating in type 2 diabetes mellitus: A multicenter Italian study of socio-demographic and clinical associations. Nutr Metab Cardiovasc Dis. 2019;29(9):983-990.