Diyabetik Hastalarda Bütünlük Duygusu ile Glisemik Kontrol İlişkisi

Yıl 2021, , 124 - 130, 29.08.2021

Levent Çoban , Ceren Beyca , Hacer Hicran Mutlu

https://doi.org/10.25048/tudod.835154

Öz

Amaç: Bütünlük (tutarlık) duygusu, kişilerin sağlığına olumlu katkıda bulunacak şekilde stresle başa çıkma durumlarını yansıtan bir kavramdır. Bu kavramın kronik hastalıklarla ilişkisi ilgi çekmiştir. Buradan yola çıkarak çalışmamızda diyabetli hastalarda bütünlük (tutarlık) duygusu ile glisemik kontrol arasındaki ilişkiyi araştırmaktır.
Gereç ve Yöntem: Bu kesitsel çalışmaya 10 yıldan az süredir diyabeti olan, üç ay arayla ölçülen iki HbA1c değeri arasındaki sürede tedavi değişikliği yapılmamış olan 319 Tip 2 Diyabet tanılı hasta dahil edildi. Hastalar HbA1C düzeyine göre iki gruba ayrıldı. HbA1c düzeyi 7 ve üstünde olanlar glisemik kontrolü kötü olan, HbA1c düzeyi 7’nin altında olanlar glisemik kontrolü iyi olanlar gruba alındı. Glisemik kontrolü iyi ve kötü olan grup arasındaki depresyon, anksiyete ve bütünlük (tutarlılık) duygusu karşılaştırıldı.
Bulgular: Glisemik konrolü iyi ve kötü olan grup arasında depresyon, anksiyete ve bütünlük (tutarlık) duygusu açısından fark bulunamamıştır (p=0,441; p=0,688; p=0,761).
Sonuç: Çalışmamızda da glisemik kontrol ve bütünlük duygusu arasında ilişki bulunamamıştır

Anahtar Kelimeler

Diyabetes mellitus, depresyon, anksiyete, psikolojik uyum

The Impact of Sense of Coherence on Glycemic Control in Diabetic Patients

Öz

Aim: The sense of coherence is a concept that reflects people’s coping with stress in a way that contributes positively to their health. The relationship of this concept with chronic diseases has attracted attention. Based on this, our study aims to investigate the relationship between the sense of coherence and glycemic control in patients with diabetes who applied to our Obesity outpatient clinic.
Material and Methods: In this cross-sectional study, 319 Type 2 Diabetes patients who had diabetes for less than 10 years and who did not receive treatment changes between two HbA1c values measured at three months intervals were included in this cross-sectional study. The patients were divided into two groups according to the HbA1c level. Those with a HbA1c level of 7 and above were included in the
group with poor glycemic control, those with a HbA1c level below 7, and those with optimal glycemic control. Depression, anxiety, and sense of coherence were compared between the group with good and poor glycemic control. In order to test the differences between the two measurements; independent samples t test for parametric tests, Mann-Whitney-U test for non-parametric tests and Pearson chisquare analysis for testing the differences between categoric measurements was performed.
Results: No difference was found between the groups with poor and glycemic control in terms of depression, anxiety and sense of coherence (p = 0.441; p = 0.688; p = 0.761).
Conclusion: In our study, no relationship was found between glycemic control and sense of coherence.

Anahtar Kelimeler

Diabetes mellitus, Depression, Anxiety, Psychological adaptation, Sense of coherence

Kaynakça

• 1. Ahola AJ, Saraheimo M, Forsblom C, Hietala K, Groop P-H, Group FS. The cross-sectional associations between sense of coherence and diabetic microvascular complications, glycaemic control, and patients’ conceptions of type 1 diabetes. Health Qual Life Outcomes. 2010;8(1):142.
• 2. Bag B. Ruh Sağlığı ve Psikiyatri Hemşireliğinde Salutogenez Modeli. Curr Approaches Psychiatry/Psikiyatride Guncel Yaklasimlar. 2017;9(3).
• 3. Antonovsky A. Salutogenese: Zur Entmystifizierung der Gesundheit. In: Forum für Verhaltenstherapie und psychosoziale Praxis. dgvt-Verlag; 1997.
• 4. Naftali T, Eindor-Abarbanel A, Ruhimovich N, Shitrit AB-G, Sklerovsky-Benjaminov F, Laish I, et al. Sense of coherence in people with and without inflammatory bowel diseases-is there a difference? J Gastrointest Liver Dis. 2019;28(1).
• 5. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An Inventory for Measuring Depression. Arch Gen Psychiatry. 1961;4(6):561–71.
• 6. Beck AT, Epstein N, Brown G, Steer RA. An Inventory for Measuring Clinical Anxiety: Psychometric Properties. J Consult Clin Psychol. 1988;56(6):893–7.
• 7. Antonovsky A. Unraveling the Mystery of Health: How People Manage Stress and Stay Well. San Francisco, Jossey-Ba; 1987.
• 8. Scherler,R.H., Lajunen T. A comparison of Finnish and Turkish university students on the short form of the sense of coherence scale. In: Fifth Congress of European Psychology. Dublin, Ireland; 1997.
• 9. The ACCORD Study Group. Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial. Diabetes Care. 2011;
• 10. Heller SR. A Summary of the ADVANCE Trial. Diabetes Care [Internet]. 2009 Nov 1;32(suppl 2):S357 LP-S361. Available from: http://care.diabetesjournals.org/content/32/suppl_2/S357.abstract
• 11. Reus GZ, dos Santos MAB, Strassi AP, Abelaira HM, Ceretta LB, Quevedo J. Pathophysiological mechanisms involved in the relationship between diabetes and major depressive disorder. Life Sci. 2017;183:78–82.
• 12. Kalra B, Kalra S, Balhara YPS. Psychological assessment and management in diabetes. J Pak Med Assoc. 2013 Dec;63(12):1555–7.
• 13. Eren I, Erdi O, Ozcankaya R. Relationship between blood glucose control and psychiatric disorders in type II diabetic patients. Turk Psikiyatr dergisi= Turkish J psychiatry. 2003;14(3):184–91.
• 14. Mooy JM, de Vries H, Grootenhuis PA, Bouter LM, Heine RJ. Major stressful life events in relation to prevalence of undetected type 2 diabetes: the Hoorn Study. Diabetes Care. 2000 Feb;23(2):197–201.
• 15. Novak M, Björck L, Giang KW, Heden-Ståhl C, Wilhelmsen L, Rosengren A. Perceived stress and incidence of Type 2 diabetes: A 35-year follow-up study of middle-aged Swedish men. Diabet Med. 2013;
• 16. Eriksson AK, Van Den Donk M, Hilding A, Östenson CG. Work stress, sense of coherence, and risk of type 2 diabetes in a prospective study of middle-aged Swedish men and women. Diabetes Care. 2013;
• 17. Cohen M, Kanter Y. Relation between sense of coherence and glycemic control in type 1 and type 2 diabetes. Behav Med. 2004;29(4):175–85.
• 18. Madhu S V, Siddiqui A, Desai NG, Sharma SB, Bansal AK. Chronic stress, sense of coherence and risk of type 2 diabetes mellitus. Diabetes Metab Syndr Clin Res Rev. 2019;13(1):18–23.
• 19. Agardh EE, Ahlbom A, Andersson T, Efendic S, Grill V, Hallqvist J, et al. Work stress and low sense of coherence is associated with type 2 diabetes in middle-aged Swedish women. Diabetes Care. 2003;26(3):719–24.
• 20. Kouvonen AM, Väänänen A, Woods SA, Heponiemi T, Koskinen A, Toppinen-Tanner S. Sense of coherence and diabetes: A prospective occupational cohort study. BMC Public Health. 2008;
• 21. Odajima Y, Sumi N. Factors related to sense of coherence in adult patients with Type 2 diabetes. Nagoya J Med Sci. 2018;80(1):61.
• 22. TOGARI T, YAMAZAKI Y. Examination of the reliability and factor validity of 13-item five-point version Sense of Coherence Scale. Japanese J Heal Hum Ecol. 2005;71(4):168–82.
• 23. Lundman B, Norberg A. The significance of a sense of coherence for subjective health in persons with insulin‐dependent diabetes. J Adv Nurs. 1993;18(3):381–6.
• 24. Richardson A, Adner N, Nordström G. Persons with insulin‐dependent diabetes mellitus: acceptance and coping ability. J Adv Nurs. 2001;33(6):758–63.
• 25. Shiu AT-Y. Sense of coherence amongst Hong Kong Chinese adults with insulin-treated type 2 diabetes. Int J Nurs Stud. 2004;41(4):387–96.
• 26. Sandén‐Eriksson B. Coping with type‐2 diabetes: the role of sense of coherence compared with active management. J Adv Nurs. 2000;31(6):1393–7.