DİYABET ÖZYÖNETİMİNDE ENGELLER VE KOLAYLAŞTIRICILAR
Year 2022,
, 143 - 148, 01.03.2022
Özlem Canbolat
,
Şükrü Ekenler
,
Ülkü Polat
Abstract
Diyabet, vücutta insülin azlığı/yokluğu nedeniyle ya
da yeterince insülin olmasına rağmen istenilen düzeyde
etki göstermemesi sonucunda kan şekeri yüksekliğiyle
karakterize kronik bir hastalıktır. Diyabette istenilen
glisemik kontrolün sağlanmasında öz yönetimin
önemi büyüktür. Diyabetin yönetiminde engellerin belirlenmesi
optimal sağlığa ulaşmada kritik bir adımdır.
Diyabetin öz yönetiminde başlıca engeller; diyabetle
ilgili yetersiz bilgi, inanç ve davranışları, kaynak yetersizliği,
sağlık sorunları, olumsuz duygular ve destek
eksikliğidir. Diyabetli bireylerin öz yönetimde karşılaştıkları
sorunların farkında olmak ve bu sorunların üstesinden
gelinmesinde hastayı desteklemek diyabet
hemşirelerinin temel rollerinden birisidir. Bu derlemenin
amacı diyabet öz yönetimindeki kolaylaştırıcılar
ve engelleri tartışmaktır. Yapılan çalışmalar diyabet
öz yönetiminde hastaların algıladıkları destek ve engellerin
farkında olunarak yapılan diyabet öz yönetim
eğitimlerinin daha etkili olduğunu ortaya koymaktadır.
Supporting Institution
yok
References
- 1. ADA. 2. Classification and Diagnosis of Diabetes: Standards of
Medical Care in Diabetes-2021. Diabetes Care. 2021;44(Suppl
1):15-33.
- 2. Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S,
Unwin N, et al. Global and regional diabetes prevalence estimates
for 2019 and projections for 2030 and 2045: Results
from the International Diabetes Federation Diabetes
Atlas, 9th edition. Diabetes Research and Clinical Practice.
2019;157:107843.
- 3. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N,
et al. Twelve-year trends in the prevalence and risk factors of
diabetes and prediabetes in Turkish adults. Eur J Epidemiol.
2013;28(2):169-80.
- 4. Chatterjee S, Davies MJ, Heller S, Speight J, Snoek FJ, Khunti
K. Diabetes structured self-management education programmes:
a narrative review and current innovations. Lancet Diabetes
Endocrinol. 2018;6(2):130-42.
- 5. Greenwood DA, Gee PM, Fatkin KJ, Peeples M. A Systematic
Review of Reviews Evaluating Technology-Enabled Diabetes
Self-Management Education and Support. J Diabetes Sci Technol.
2017;11(5):1015-27.
- 6. Banerjee M, Chakraborty S, Pal R. Diabetes self-management
amid COVID-19 pandemic. Diabetes Metab Syndr.
2020;14(4):351-4.
- 7. AADE. Role of the diabetes educator in inpatient diabetes management.
The Diabetes Educator. 2018;44(1):57-62.
- 8. Hermanns N, Ehrmann D, Finke-Groene K, Kulzer B. Trends
in diabetes self-management education: where are we coming
from and where are we going? A narrative review. Diabetic Medicine.
2020;37(3):436-47.
- 9. He X, Li J, Wang B, Yao Q, Li L, Song R, et al. Diabetes self-
management education reduces risk of all-cause mortality in
type 2 diabetes patients: a systematic review and meta-analysis.
Endocrine. 2017;55(3):712-31.
- 10. Mohamed A, Staite E, Ismail K, Winkley K. A systematic review
of diabetes self-management education interventions for people
with type 2 diabetes mellitus in the Asian Western Pacific
(AWP) region. Nurs Open. 2019;6(4):1424-37.
- 11. Adu MD, Malabu UH, Malau-Aduli AEO, Malau-Aduli BS. Enablers
and barriers to effective diabetes self-management: A multi-
national investigation. PLoS One. 2019;14(6):e0217771.
- 12. Muslu L, Öncel S. Diyabet hastalarında öz yönetim ve izlemin
önemi. R HA, editor. Ankara: Türkiye Klinikleri; 2019.
- 13. Eroğlu N, Sabuncu N. Diyabet Öz Yönetim Skalası’nın (DÖYS)
Türk Toplumuna Uyarlanması: Geçerlik ve Güvenirlik Çalışması.
Hemşirelik Bilimi Dergisi. 2019;1(3):1-6.
- 14. Hailu FB, Hjortdahl P, Moen A. Nurse-Led Diabetes Self-Management
Education Improves Clinical Parameters in Ethiopia.
Front Public Health. 2018;6:302.
- 15. Azami G, Soh KL, Sazlina SG, Salmiah MS, Aazami S, Mozafari
M, et al. Effect of a Nurse-Led Diabetes Self-Management
Education Program on Glycosylated Hemoglobin among Adults
with Type 2 Diabetes. J Diabetes Res. 2018;2018:4930157.
- 16. Steinsbekk A, Rygg L, Lisulo M, Rise MB, Fretheim A. Group
based diabetes self-management education compared to
routine treatment for people with type 2 diabetes mellitus. A
systematic review with meta-analysis. BMC Health Serv Res.
2012;12:213.
- 17. Tshiananga JK, Kocher S, Weber C, Erny-Albrecht K, Berndt K,
Neeser K. The effect of nurse-led diabetes self-management
education on glycosylated hemoglobin and cardiovascular risk
factors: a meta-analysis. Diabetes Educ. 2012;38(1):108-23.
- 18. Pillay J, Armstrong MJ, Butalia S, Donovan LE, Sigal RJ, Vandermeer
B, et al. Behavioral Programs for Type 2 Diabetes
Mellitus: A Systematic Review and Network Meta-analysis. Ann
Intern Med. 2015;163(11):848-60.
- 19. Gonzalez JS, Tanenbaum ML, Commissariat PV. Psychosocial
factors in medication adherence and diabetes self-management:
Implications for research and practice. Am Psychol.
2016;71(7):539-51.
- 20. Yüksel M, Bektaş H. Diyabete Bağlı Kronik Komplikasyonların
Yönetiminde Güncel Yaklaşımlar. Current Approaches in the
Administration of Chronic Complications Related to Diabetes.
2020;12(1):133-57.
- 21. Hemmingsen B, Gimenez-Perez G, Mauricio D, Roqué IFM,
Metzendorf MI, Richter B. Diet, physical activity or both for
prevention or delay of type 2 diabetes mellitus and its associated
complications in people at increased risk of developing
type 2 diabetes mellitus. Cochrane Database Syst Rev.
2017;12(12):Cd003054.
- 22. Wang Y, Xue H, Huang Y, Huang L, Zhang D. A Systematic Review
of Application and Effectiveness of mHealth Interventions
for Obesity and Diabetes Treatment and Self-Management.
Adv Nutr. 2017;8(3):449-62.
- 23. Shan R, Sarkar S, Martin SS. Digital health technology and mobile
devices for the management of diabetes mellitus: state of
the art. Diabetologia. 2019;62(6):877-87.
- 24. Cahn A, Akirov A, Raz I. Digital health technology and diabetes
management. J Diabetes. 2018;10(1):10-7.
- 25. Hunt CW. Technology and diabetes self-management: An integrative
review. World J Diabetes. 2015;6(2):225-33.
- 26. Yüksel M, Bektaş H. Tip 2 Diyabet Öz Yönetiminin Güçlendirilmesinde
Mobil Sağlık Uygulamalarının Kullanımı: Literatür
Derlemesi. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi.
2021;13(2):424-34.
- 27. Quinn CC, Shardell MD, Terrin ML, Barr EA, Ballew SH, Gruber-
Baldini AL. Cluster-randomized trial of a mobile phone
personalized behavioral intervention for blood glucose control.
Diabetes Care. 2011;34(9):1934-42.
- 28. Goh G, Tan NC, Malhotra R, Padmanabhan U, Barbier S,
Allen JC, Jr., et al. Short-term trajectories of use of a caloric-
monitoring mobile phone app among patients with type 2 diabetes
mellitus in a primary care setting. J Med Internet Res.
2015;17(2):e33.
- 29. Robat Sarpooshi D, Taghipour A, Mahdizadeh M, Peyman
N. Enablers of and Barriers to Effective Diabetes Self-Care
in Iran: A Qualitative Study. Patient Relat Outcome Meas.
2020;11:109-18.
- 30. Browne JL, Ventura A, Mosely K, Speight J. 'I'm not a druggie,
I'm just a diabetic': a qualitative study of stigma from
the perspective of adults with type 1 diabetes. BMJ Open.
2014;4(7):e005625.
- 31. Chepulis L, Morison B, Cassim S, Norman K, Keenan R, Paul
R, et al. Barriers to Diabetes Self-Management in a Subset of
New Zealand Adults with Type 2 Diabetes and Poor Glycaemic
Control. J Diabetes Res. 2021;2021:5531146.
- 32. Adhikari M, Devkota HR, Cesuroglu T. Barriers to and facilitators
of diabetes self-management practices in Rupandehi,
Nepal- multiple stakeholders' perspective. BMC Public Health.
2021;21(1):1269.
- 33. Nam S, Chesla C, Stotts NA, Kroon L, Janson SL. Barriers to
diabetes management: Patient and provider factors. Diabetes
Research and Clinical Practice. 2011;93(1):1-9.
- 34. Grant JS, Steadman LA. Barriers to Diabetes Self-Management
Among Rural Individuals in the Workplace. Workplace
Health Saf. 2016;64(6):243-8.
- 35. Kim SH, Lee A. Health-Literacy-Sensitive Diabetes Self-Management
Interventions: A Systematic Review and Meta-Analysis.
Worldviews Evid Based Nurs. 2016;13(4):324-33.
- 36. Mackey LM, Doody C, Werner EL, Fullen B. Self-Management
Skills in Chronic Disease Management: What Role Does Health
Literacy Have? Med Decis Making. 2016;36(6):741-59.
- 37. Bains SS, Egede LE. Associations between health literacy, diabetes
knowledge, self-care behaviors, and glycemic control in
a low income population with type 2 diabetes. Diabetes Technol
Ther. 2011;13(3):335-41.
- 38. Powell CK, Hill EG, Clancy DE. The relationship between health
literacy and diabetes knowledge and readiness to take health
actions. Diabetes Educ. 2007;33(1):144-51.
- 39. Marciano L, Camerini AL, Schulz PJ. The Role of Health Literacy
in Diabetes Knowledge, Self-Care, and Glycemic Control: a
Meta-analysis. J Gen Intern Med. 2019;34(6):1007-17.
BARRIERS AND FACILITATORS IN DIABETES SELF-MANAGEMENT
Year 2022,
, 143 - 148, 01.03.2022
Özlem Canbolat
,
Şükrü Ekenler
,
Ülkü Polat
Abstract
Diabetes is a chronic disease characterized by high
blood sugar as a result of insufficient/absence of
insulin in the body or not having the desired effect
despite having enough insulin. Self-management
is of great importance in achieving the desired
glycemic control in diabetes. Identifying barriers in the
management of diabetes is a critical step in achieving
optimal health. The main barriers in diabetes selfmanagement
are; lack of knowledge, beliefs and
behaviors about diabetes, lack of resources, health
problems, negative emotions and lack of support.
Being aware of the problems faced by individuals
with diabetes in self-management and supporting the
patient in overcoming these problems is one of the
basic roles of the diabetes nurse. The purpose of this
review is to discuss the pillars and barriers in diabetes
self-management. Studies show that diabetes selfmanagement
trainings, which are made by being
aware of the support and obstacles perceived by
the patients, are more effective in diabetes selfmanagement.
References
- 1. ADA. 2. Classification and Diagnosis of Diabetes: Standards of
Medical Care in Diabetes-2021. Diabetes Care. 2021;44(Suppl
1):15-33.
- 2. Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S,
Unwin N, et al. Global and regional diabetes prevalence estimates
for 2019 and projections for 2030 and 2045: Results
from the International Diabetes Federation Diabetes
Atlas, 9th edition. Diabetes Research and Clinical Practice.
2019;157:107843.
- 3. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N,
et al. Twelve-year trends in the prevalence and risk factors of
diabetes and prediabetes in Turkish adults. Eur J Epidemiol.
2013;28(2):169-80.
- 4. Chatterjee S, Davies MJ, Heller S, Speight J, Snoek FJ, Khunti
K. Diabetes structured self-management education programmes:
a narrative review and current innovations. Lancet Diabetes
Endocrinol. 2018;6(2):130-42.
- 5. Greenwood DA, Gee PM, Fatkin KJ, Peeples M. A Systematic
Review of Reviews Evaluating Technology-Enabled Diabetes
Self-Management Education and Support. J Diabetes Sci Technol.
2017;11(5):1015-27.
- 6. Banerjee M, Chakraborty S, Pal R. Diabetes self-management
amid COVID-19 pandemic. Diabetes Metab Syndr.
2020;14(4):351-4.
- 7. AADE. Role of the diabetes educator in inpatient diabetes management.
The Diabetes Educator. 2018;44(1):57-62.
- 8. Hermanns N, Ehrmann D, Finke-Groene K, Kulzer B. Trends
in diabetes self-management education: where are we coming
from and where are we going? A narrative review. Diabetic Medicine.
2020;37(3):436-47.
- 9. He X, Li J, Wang B, Yao Q, Li L, Song R, et al. Diabetes self-
management education reduces risk of all-cause mortality in
type 2 diabetes patients: a systematic review and meta-analysis.
Endocrine. 2017;55(3):712-31.
- 10. Mohamed A, Staite E, Ismail K, Winkley K. A systematic review
of diabetes self-management education interventions for people
with type 2 diabetes mellitus in the Asian Western Pacific
(AWP) region. Nurs Open. 2019;6(4):1424-37.
- 11. Adu MD, Malabu UH, Malau-Aduli AEO, Malau-Aduli BS. Enablers
and barriers to effective diabetes self-management: A multi-
national investigation. PLoS One. 2019;14(6):e0217771.
- 12. Muslu L, Öncel S. Diyabet hastalarında öz yönetim ve izlemin
önemi. R HA, editor. Ankara: Türkiye Klinikleri; 2019.
- 13. Eroğlu N, Sabuncu N. Diyabet Öz Yönetim Skalası’nın (DÖYS)
Türk Toplumuna Uyarlanması: Geçerlik ve Güvenirlik Çalışması.
Hemşirelik Bilimi Dergisi. 2019;1(3):1-6.
- 14. Hailu FB, Hjortdahl P, Moen A. Nurse-Led Diabetes Self-Management
Education Improves Clinical Parameters in Ethiopia.
Front Public Health. 2018;6:302.
- 15. Azami G, Soh KL, Sazlina SG, Salmiah MS, Aazami S, Mozafari
M, et al. Effect of a Nurse-Led Diabetes Self-Management
Education Program on Glycosylated Hemoglobin among Adults
with Type 2 Diabetes. J Diabetes Res. 2018;2018:4930157.
- 16. Steinsbekk A, Rygg L, Lisulo M, Rise MB, Fretheim A. Group
based diabetes self-management education compared to
routine treatment for people with type 2 diabetes mellitus. A
systematic review with meta-analysis. BMC Health Serv Res.
2012;12:213.
- 17. Tshiananga JK, Kocher S, Weber C, Erny-Albrecht K, Berndt K,
Neeser K. The effect of nurse-led diabetes self-management
education on glycosylated hemoglobin and cardiovascular risk
factors: a meta-analysis. Diabetes Educ. 2012;38(1):108-23.
- 18. Pillay J, Armstrong MJ, Butalia S, Donovan LE, Sigal RJ, Vandermeer
B, et al. Behavioral Programs for Type 2 Diabetes
Mellitus: A Systematic Review and Network Meta-analysis. Ann
Intern Med. 2015;163(11):848-60.
- 19. Gonzalez JS, Tanenbaum ML, Commissariat PV. Psychosocial
factors in medication adherence and diabetes self-management:
Implications for research and practice. Am Psychol.
2016;71(7):539-51.
- 20. Yüksel M, Bektaş H. Diyabete Bağlı Kronik Komplikasyonların
Yönetiminde Güncel Yaklaşımlar. Current Approaches in the
Administration of Chronic Complications Related to Diabetes.
2020;12(1):133-57.
- 21. Hemmingsen B, Gimenez-Perez G, Mauricio D, Roqué IFM,
Metzendorf MI, Richter B. Diet, physical activity or both for
prevention or delay of type 2 diabetes mellitus and its associated
complications in people at increased risk of developing
type 2 diabetes mellitus. Cochrane Database Syst Rev.
2017;12(12):Cd003054.
- 22. Wang Y, Xue H, Huang Y, Huang L, Zhang D. A Systematic Review
of Application and Effectiveness of mHealth Interventions
for Obesity and Diabetes Treatment and Self-Management.
Adv Nutr. 2017;8(3):449-62.
- 23. Shan R, Sarkar S, Martin SS. Digital health technology and mobile
devices for the management of diabetes mellitus: state of
the art. Diabetologia. 2019;62(6):877-87.
- 24. Cahn A, Akirov A, Raz I. Digital health technology and diabetes
management. J Diabetes. 2018;10(1):10-7.
- 25. Hunt CW. Technology and diabetes self-management: An integrative
review. World J Diabetes. 2015;6(2):225-33.
- 26. Yüksel M, Bektaş H. Tip 2 Diyabet Öz Yönetiminin Güçlendirilmesinde
Mobil Sağlık Uygulamalarının Kullanımı: Literatür
Derlemesi. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi.
2021;13(2):424-34.
- 27. Quinn CC, Shardell MD, Terrin ML, Barr EA, Ballew SH, Gruber-
Baldini AL. Cluster-randomized trial of a mobile phone
personalized behavioral intervention for blood glucose control.
Diabetes Care. 2011;34(9):1934-42.
- 28. Goh G, Tan NC, Malhotra R, Padmanabhan U, Barbier S,
Allen JC, Jr., et al. Short-term trajectories of use of a caloric-
monitoring mobile phone app among patients with type 2 diabetes
mellitus in a primary care setting. J Med Internet Res.
2015;17(2):e33.
- 29. Robat Sarpooshi D, Taghipour A, Mahdizadeh M, Peyman
N. Enablers of and Barriers to Effective Diabetes Self-Care
in Iran: A Qualitative Study. Patient Relat Outcome Meas.
2020;11:109-18.
- 30. Browne JL, Ventura A, Mosely K, Speight J. 'I'm not a druggie,
I'm just a diabetic': a qualitative study of stigma from
the perspective of adults with type 1 diabetes. BMJ Open.
2014;4(7):e005625.
- 31. Chepulis L, Morison B, Cassim S, Norman K, Keenan R, Paul
R, et al. Barriers to Diabetes Self-Management in a Subset of
New Zealand Adults with Type 2 Diabetes and Poor Glycaemic
Control. J Diabetes Res. 2021;2021:5531146.
- 32. Adhikari M, Devkota HR, Cesuroglu T. Barriers to and facilitators
of diabetes self-management practices in Rupandehi,
Nepal- multiple stakeholders' perspective. BMC Public Health.
2021;21(1):1269.
- 33. Nam S, Chesla C, Stotts NA, Kroon L, Janson SL. Barriers to
diabetes management: Patient and provider factors. Diabetes
Research and Clinical Practice. 2011;93(1):1-9.
- 34. Grant JS, Steadman LA. Barriers to Diabetes Self-Management
Among Rural Individuals in the Workplace. Workplace
Health Saf. 2016;64(6):243-8.
- 35. Kim SH, Lee A. Health-Literacy-Sensitive Diabetes Self-Management
Interventions: A Systematic Review and Meta-Analysis.
Worldviews Evid Based Nurs. 2016;13(4):324-33.
- 36. Mackey LM, Doody C, Werner EL, Fullen B. Self-Management
Skills in Chronic Disease Management: What Role Does Health
Literacy Have? Med Decis Making. 2016;36(6):741-59.
- 37. Bains SS, Egede LE. Associations between health literacy, diabetes
knowledge, self-care behaviors, and glycemic control in
a low income population with type 2 diabetes. Diabetes Technol
Ther. 2011;13(3):335-41.
- 38. Powell CK, Hill EG, Clancy DE. The relationship between health
literacy and diabetes knowledge and readiness to take health
actions. Diabetes Educ. 2007;33(1):144-51.
- 39. Marciano L, Camerini AL, Schulz PJ. The Role of Health Literacy
in Diabetes Knowledge, Self-Care, and Glycemic Control: a
Meta-analysis. J Gen Intern Med. 2019;34(6):1007-17.