Tip-1 Diyabetli Adolesan ve Genç Yetişkinlerde Öz-yeterliliğe Yönelik Ergoterapi Müdahalelerinin Etkinliği: Sistematik Bir Derleme

Yıl 2025, Cilt: 8 Sayı: 2, 83 - 91, 30.08.2025

Leyla Gürel , Gülşah Zengin Yazıcı

https://doi.org/10.56150/tjhsl.1453274

Öz

Bu derlemenin amacı, ergoterapi literatüründe Tip-1 diyabetli (T1D) adolesan ve genç yetişkin bireylerde öz-yeterliliğe yönelik yapılan müdahaleleri araştırmak, yapılan müdahalelerin yeterliliğini tartışmak, ergoterapistler ve diğer sağlık çalışanlarını öz-yeterliliğe yönelik yapılan ergoterapi uygulamaları hakkında bilgilendirmektir. Derlemede PubMed, SicenceDirect, OTSeeker veri tabanları ve Google Akademik kullanılmıştır. Dahil etme kriterleri olarak, T1D’li bireylere yönelik ergoterapi müdahalesi içeren çalışmalar, adolesan ve/ veya genç yetişkinleri içeren çalışmalar, 2018-2023 yılları arasında yayımlanan çalışmalar ve İngilizce tam metin erişimi olan makaleler belirlenmiştir. Makale seçiminde PRISMA akış diyagramı kullanılmıştır. Yapılan tarama sonucunda 672 çalışmaya ulaşılmış, tam metin erişimi ve İngilizce dilinde olmayan çalışmalar ve tekrarlanan çalışmalar çıkarıldıktan sonra çalışma kapsamında toplam 5 çalışma ele alınmıştır. Bu çalışmaların hepsi yayımlanmış araştırma makaleleridir. Çalışmaların betimleyici özellikleri ve sonuçları okupasyon temelli müdahaleler ve psikososyal müdahaleler olmak üzere iki ayrı başlık altında ele alınmıştır. T1D’li bireylerde öz yeterliliğe yönelik ergoterapi müdahalelerini inceleyen ilk sistematik derleme olan bu çalışmanın sonuçları, literatürde analiz edilen çalışmalardan elde edilen bulgularla uyumlu bir şekilde bireylere yönelik gerçekleştirilen ergoterapi müdahalelerinin olumlu etkilerini ortaya koymaktadır. Öz yeterliliğe yönelik uygulanan ergoterapi programlarının T1D’li adolesan ve genç yetişkin bireylerde yaşam kalitesi, sosyal işlevsellik, tedaviye uyum, duygu durumu, problem çözme ve baş etme becerileri, stres, depresyon ve anksiyete gibi alanlarda olumlu yönde etkide bulunduğu ortaya çıkmıştır. Bu bağlamda literatürde sınırlı olan öz-yeterliliğe yönelik ergoterapi programlarının yaygınlaştırılması ve rutin klinik uygulamanın bir parçası haline getirilmesi büyük önem arz etmektedir.

Anahtar Kelimeler

Tip-1 Diyabet , Adolesan , Genç Yetişkin , Öz-yeterlilik

Effectiveness of Occupational Therapy for Self-Efficacy in Adolescents and Young Adults with Type-1 Diabetes: A Systematic Review

Öz

The aim of this review was to investigate interventions aimed at enhancing self-efficacy in adolescents and young adults diagnosed with Type-1 diabetes (T1D) in the occupational therapy literature. The review searched through PubMed, ScienceDirect, OTSeeker databases, and Google Scholar. The study's inclusion criteria comprised occupational therapy interventions for individuals with T1D, studies involving adolescents and/or young adults, and articles published between 2018-2023 with full text access in English. The article selection process utilized PRISMA. After screening, a total of 672 studies were identified. After excluding studies that were not accessible in full-text or not in English, as well as removing duplicates, only five research articles met the inclusion criteria and were included in the study. The descriptive characteristics and results of the studies are discussed under two separate headings: reading-based interventions and psychosocial interventions. The study's results show that occupational therapy interventions can improve self-efficacy in individuals with T1D, which is consistent with previous literature. It is important to note that these interventions have been particularly effective for adolescents and young adults with T1D. Occupational therapy programs can improve quality of life, social functionality, treatment compliance, mood, problem-solving, and coping skills while reducing stress, depression, and anxiety. It is important to disseminate these programs to improve self-efficacy. However, such programs are limited in the literature and should be incorporated into routine clinical practice.

Anahtar Kelimeler

Type-1 diabetes , adolescent , young adult , self-efficacy

Teşekkür

This study was presented orally at the 7th International Health Science and Life Congress (IHSLC 2024). It was produced from an undergraduate thesis.

Kaynakça

• Eberhard Standl, Kamlesh Khunti, Tina Birgitte Hansen, Oliver Schnell, The global epidemics of diabetes in the 21st century: Current situation and perspectives, European Journal of Preventive Cardiology, 26 (2), (2019), 7–14, https://doi.org/10.1177/2047487319881021
• Bhattacharya S, Rathore A, Parwani D, Mallick C, Asati V, Agarwal S, et al. An exhaustive perspective on structural insights of SGLT2 inhibitors: A novel class of antidiabetic agent. Eur J Med Chem, 204 (112523), (2020). https://doi.org/10.1016/j.ejmech.2020.112523
• Rubin, R. R., & Peyrot, M. Quality of life and diabetes. Diabetes/metabolism research and reviews, 15(3), (1999), 205-218. https://doi.org/10.1002/(SICI)1520-7560(199905/06)15:3%3C205::AID-DMRR29%3E3.0.CO;2-O
• Trikkalinou, A., Papazafiropoulou, A. K., & Melidonis, A. Type 2 diabetes and quality of life. World journal of diabetes, 8(4), (2017), 120. https://doi.org/10.4239%2Fwjd.v8.i4.120
• Kaufman FR. (Ed.). (2012). Medical management of type 1 diabetes. American Diabetes Association.
• Jin, H., Gonzalez, J. S., Pyatak, E. A., Schneider, S., Hoogendoorn, C. J., Hernandez, R., ... & Spruijt-Metz, D. Within-person relationships of sleep duration with next-day stress and affect in the daily life of adults with Type-1 diabetes. Journal of Psychosomatic Research, 173, (2023), 111442. https://doi.org/10.1016/j.jpsychores.2023.111442
• DiMeglio, L. A., Evans-Molina, C., & Oram, R. A. Type 1 diabetes. The Lancet, 391(10138), (2018), 2449-2462. https://doi.org/10.1016/S0140-6736(18)31320-5
• Mobasseri, M., Shirmohammadi, M., Amiri, T., Vahed, N., Fard, H. H., & Ghojazadeh, M. Prevalence and incidence of type 1 diabetes in the world: a systematic review and meta-analysis. Health promotion perspectives, 10(2), (2020), 98. https://doi.org/10.34172%2Fhpp.2020.18
• Miller, R. G., Secrest, A. M., Sharma, R. K., Songer, T. J., & Orchard, T. J. Improvements in the life expectancy of type 1 diabetes: the Pittsburgh Epidemiology of Diabetes Complications study cohort. Diabetes, 61(11), (2012), 2987-2992. https://doi.org/10.2337/db11-1625
• Bandura, A. Self-efficacy: toward a unifying theory of behavioral change. Psychological review, 84(2), (1977), 191. https://psycnet.apa.org/doi/10.1037/0033-295X.84.2.191
• Tamborlane, W. V., & Sherwin, R. S. Diabetes control and complications: New strategies and insights. The Journal of Pediatrics, 102(6), (1983), 805-813. https://doi.org/10.1016/S0022-3476(83)80003-1
• Zeltzer, L., Kellerman, J., Ellenberg, L., Dash, J., & Rigler, D. Psychologic effects of illness in adolescence. II. Impact of illness in adolescents—crucial issues and coping styles. The Journal of Pediatrics, 97(1), (1980), 132-138. https://doi.org/10.1016/S0022-3476(80)80153-3
• Andrew, M. A. The occupational therapist’s role in the management of diabetes. Canadian Journal of Occupational Therapy, 54, (1987), 11-15. https://doi.org/10.1177/000841748705400104
• Clark, F., Azen, S. P., Zemke, R., Jackson, J., Carlson, M., Mandel, D., et al. Occupational therapy for independent-living older adults: A randomized controlled trial. Journal of the American Medical Association, 278, (1997), 1321-1326. https://doi.org/10.1001/jama.1997.03550160041036
• Pyatak, E. A., Carandang, K., Vigen, C. L., Blanchard, J., Diaz, J., Concha-Chavez, A., ... & Peters, A. L. Occupational therapy intervention improves glycemic control and quality of life among young adults with diabetes: The Resilient, Empowered, Active Living with Diabetes (REAL Diabetes) randomized controlled trial. Diabetes care, 41(4), (2018), 696-704. https://doi.org/10.2337/dc17-1634
• Lorig, K. R., & Holman, H. Self-management education: history, definition, outcomes, and mechanisms. Annals of Behavioral Medicine, 26, (2003), 1-7. https://doi.org/10.1207/S15324796ABM2601_01
• Passmore A. A Measure of Perceptions of Generalized Self-Efficacy Adapted for Adolescents. OTJR: Occupational Therapy Journal of Research. 24(2), (2004), 64-71. https://doi.org/10.1177/153944920402400204
• Edraki, M., Rambod, M., & Molazem, Z. The effect of coping skills training on depression, anxiety, stress, and self-efficacy in adolescents with diabetes: a randomized controlled trial. International journal of community based nursing and midwifery, 6(4), (2018), 324.
• Wei, C., Allen, R. J., Tallis, P. M., Ryan, F. J., Hunt, L. P., Shield, J. P., & Crowne, E. C. Cognitive behavioural therapy stabilises glycaemic control in adolescents with type 1 diabetes—Outcomes from a randomised control trial. Pediatric diabetes, 19(1), (2018), 106-113. https://doi.org/10.1111/pedi.12519
• Brorsson, A. L., Leksell, J., Andersson Franko, M., & Lindholm Olinder, A. (2019). A person‐centered education for adolescents with type 1 diabetes—A randomized controlled trial. Pediatric diabetes, 20(7), (2019), 986-996. https://doi.org/10.1111/pedi.12888
• Bisno DI, Reid MW, Fogel JL, Pyatak EA, Majidi S, Raymond JK. Virtual Group Appointments Reduce Distress and Improve Care Management in Young Adults with Type 1 Diabetes. Journal of Diabetes Science and Technology. 16(6), (2022), 1419-1427. https://doi.org/10.1177/19322968211035768
• Pound, N., Sturrock, N. D. C., & Jeffcoate, W. J. Age related changes in glycated haemoglobin in patients with insulin‐dependent diabetes mellitus. Diabetic Medicine, 13(6), (1996), 510-513. https://doi.org/10.1002/(SICI)1096-9136(199606)13:6%3C510::AID-DIA122%3E3.0.CO;2-W
• Vanelli, M., Chiari, G., Adinolfi, B., Street, M. E., Capuano, C., Nizzia, P., & Terzi, C. Management of insulin-dependent diabetes mellitus in adolescents. Hormone Research in Paediatrics, 48(Suppl. 4), (1997), 71-75. https://doi.org/10.1159/000191319
• Barber, C. J., & Lowes, L. Eating disorders and adolescent diabetes: is there a link?. British Journal of Nursing, 7(7), (1998), 398-402. https://doi.org/10.12968/bjon.1998.7.7.398
• Luyckx, K., Seiffge-Krenke, I., Schwartz, S. J., Goossens, L., Weets, I., Hendrieckx, C., & Groven, C. Identity development, coping, and adjustment in emerging adults with a chronic illness: The sample case of type 1 diabetes. Journal of Adolescent Health, 43(5), (2008), 451-458. https://doi.org/10.1016/j.jadohealth.2008.04.005
• Hamburg, B. A., & Inoff, G. E. Relationships between behavioral factors and diabetic control in children and adolescents: a camp study. Psychosomatic Medicine, 44(4), (1982), 321-339.
• Samuelsson, U., Anderzén, J., Gudbjörnsdottir, S., Steineck, I., Åkesson, K., & Hanberger, L. Teenage girls with type 1 diabetes have poorer metabolic control than boys and face more complications in early adulthood. Journal of Diabetes and its Complications, 30(5), (2016), 917-922. https://doi.org/10.1016/j.jdiacomp.2016.02.007
• Viklund, G., Örtqvist, E., & Wikblad, K. Assessment of an empowerment education programme. A randomized study in teenagers with diabetes. Diabetic Medicine, 24(5), (2007), 550-556. https://doi.org/10.1111/j.1464-5491.2007.02114.x
• Sand, P., Kleiberg, A. N., & Forsander, G. The reliability and validity of the revised D iabetes F amily C onflict S cale questionnaire, in a sample of S wedish children. Acta Paediatrica, 102(6), (2013), 650-654. https://doi.org/10.1111/apa.12228
• Wysocki, T., Nansel, T. R., Holmbeck, G. N., Chen, R., Laffel, L., Anderson, B. J., ... & Steering Committee of the Family Management of Childhood Diabetes Study. Collaborative involvement of primary and secondary caregivers: associations with youths' diabetes outcomes. Journal of pediatric psychology, 34(8), (2009), 869-881. https://doi.org/10.1093/jpepsy/jsn136
• Brorsson, A. L., Olinder, A. L., Viklund, G., Granström, T., & Leksell, J. Adolescents’ perceptions of participation in group education using the Guided Self-Determination-Young method: a qualitative study. BMJ Open Diabetes Research and Care, 5(1), (2017), e000432. https://doi.org/10.1136/bmjdrc-2017-000432
• Hessler, D. M., Fisher, L., Polonsky, W. H., Masharani, U., Strycker, L. A., Peters, A. L., ... & Bowyer, V. Diabetes distress is linked with worsening diabetes management over time in adults with type 1 diabetes. Diabetic Medicine, 34(9), (2017), 1228-1234. https://doi.org/10.1111/dme.13381
• Ambrosino, J. M., Fennie, K., Whittemore, R., Jaser, S., Dowd, M. F., & Grey, M. Short‐term effects of coping skills training in school‐age children with type 1 diabetes. Pediatric diabetes, 9(3pt2), (2008), 74-82. https://doi.org/10.1111/j.1399-5448.2007.00356.x
• Habibi, Z., Tourani, S., Sadeghi, H., & Abolghasemi, A. Effectiveness of stress management skill training on the depression, anxiety and stress levels in drug addicts after drug withdrawal. International journal of high risk behaviors & addiction, 2(2), (2013), 82. https://doi.org/10.5812%2Fijhrba.10695
• Grey, M., Whittemore, R., Jaser, S., Ambrosino, J., Lindemann, E., Liberti, L., ... & Dziura, J. Effects of coping skills training in school‐age children with type 1 diabetes. Research in nursing & health, 32(4), (2009), 405-418. https://doi.org/10.1002/nur.20336
• Grey, M., Boland, E. A., Davidson, M., Yu, C., & Tamborlane, W. V. Coping skills training for youths with diabetes on intensive therapy. Applied Nursing Research, 12(1), (1999), 3-12. https://doi.org/10.1016/S0897-1897(99)80123-2
• Snoek, F. J., Van Der Ven, N. C. W., Twisk, J. W. R., Hogenelst, M. H. E., Tromp‐Wever, A. M. E., Van Der Ploeg, H. M., & Heine, R. J. Cognitive behavioural therapy (CBT) compared with blood glucose awareness training (BGAT) in poorly controlled Type 1 diabetic patients: long‐term effects on HbA1c moderated by depression. A randomized controlled trial. Diabetic Medicine, 25(11), (2008), 1337-1342. https://doi.org/10.1111/j.1464-5491.2008.02595.x
• McGrady, M. E., & Hood, K. K. Cognitive-behavioral therapy for adolescents with type 1 diabetes and subclinical depressive symptoms. Diabetes Management, 3(3), (2013), 207. https://doi.org/10.2217/dmt.13.11
• Berkowitz, R. I., Marcus, M. D., Anderson, B. J., Delahanty, L., Grover, N., Kriska, A., ... & TODAY Study Group. Adherence to a lifestyle program for youth with type 2 diabetes and its association with treatment outcome in the TODAY clinical trial. Pediatric diabetes, 19(2), (2018), 191-198. https://doi.org/10.1111/pedi.12555
• Dabelea, D., Stafford, J. M., Mayer-Davis, E. J., D’Agostino, R., Dolan, L., Imperatore, G., ... & SEARCH for Diabetes in Youth Research Group. Association of type 1 diabetes vs type 2 diabetes diagnosed during childhood and adolescence with complications during teenage years and young adulthood. Jama, 317(8), (2017), 825-835. https://doi.org/10.1001/jama.2017.0686
• Rhodes, E. T., Prosser, L. A., Hoerger, T. J., Lieu, T., Ludwig, D. S., & Laffel, L. M. Estimated morbidity and mortality in adolescents and young adults diagnosed with type 2 diabetes mellitus. Diabetic medicine, 29(4), (2012), 453-463. https://doi.org/10.1111/j.1464-5491.2011.03542.x