The effectiveness of behavioral activation training on self-care behaviors, perceived pain, and reaction to stress in women with diabetes mellitus type 2

Document Type : Research Paper

Authors

1 MSc. in clinical psychology, Branch of Neishabour, Islamic Azad University, Neishabour, Iran.

2 Assistant professor of clinical psychology, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Associate professor of community medicine, Department of Community Medicine, School of Medicine, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.

10.22038/jfmh.2023.23768

Abstract

Introduction: Regarding the high prevalence of adverse complications of diabetes and the importance of psychological intervention to improve self-care behaviors and adaptive coping styles in diabetic patients, the present study aimed to assess the effectiveness of behavioral activation training on self-care behaviors, perceived pain, and reaction to stress in women with diabetes mellitus type 2.
 
Materials and Methods: The statistical population comprises all women with type 2 diabetes who referred to Neishabur health centers. Thirty women were selected based on a voluntary and convenient sampling method. They were divided randomly into the behavioral activation training group and a control group. They fulfilled the Summary of Diabetes Self-Care Activities, Visual Analog Scale (VAS), and Coping Inventory for Stressful Situations (CISS). We analyzed the data using the descriptive statistics, multivariate covariance analysis test, and SPSS-22 software.
 
Results: The results revealed that behavioral activation training improved self-care behaviors (P= 0.001), decreased pain (P= 0.001), increased problem-solving oriented coping to stress (P= 0.001), while it decreased emotion-oriented and avoidant-oriented coping styles (P= 0.001, P= 0.001, respectively) in the experimental group compared to the control group.
 
Conclusion: It seems that behavioral activation training improves self-care behaviors, decreases pain, and increases problem-solving-oriented coping to stress in women with type 2 diabetes.

Keywords

References

  1. Cloete L. Diabetes mellitus: an overview of the types, symptoms, complications and management. Nurs Stand 2021; 37(1): 61-66.‏
  2. Russo MP, Grande-Ratti MF, Burgos MA, Molaro AA, Bonella MB. Prevalence of diabetes, epidemiological characteristics and vascular complications. Arch Cardiol Mex 2023; 93(1): 30-36.‏
  3. Perng W, Conway R, Mayer-Davis E, Dabelea D. Youth-onset type 2 diabetes: The epidemiology of an awakening epidemic. Diabetes Care 2023; 46(3): 490-99.‏

4. Khodakarami R, Abdi Z, Ahmadnezhad E,  Sheidaei A, Asadi-Lari M. Prevalence, awareness, treatment and control of diabetes among Iranian population: Results of four national cross-sectional STEP wise approach to surveillance surveys. BMC Public Health 2022; 22: 1216.

  1. Olokoba AB, Obateru OA, Olokoba LB. Type 2 diabetes mellitus: a review of current trends. Oman Med J 2012; 27(4): 269.‏
  2. Shirin A, Della Rossa F, Klickstein I, Russell J, Sorrentino F. Optimal regulation of blood glucose level in Type I diabetes using insulin and glucagon. PLoS One 2019; 14(3): e0213665. 
  3. Yahaya JJ, Doya IF, Morgan ED, Ngaiza AI, Bintabara D.  Poor glycemic control and associated factors among patients with type 2 diabetes mellitus: A cross-sectional study. Sci Rep 2023; 13(1): 9673.
  4. Balaji R, Duraisamy R, Kumar MP. Complications of diabetes mellitus: A review. Drug Invention Today 2019; 12(1): 98-103.‏
  5. Kim H, Lee H. Risk of stroke and cardiovascular disease according to diabetes mellitus status. West J Nurs Res 2023; 45(6): 520-27.‏
  6. Galiero R, Caturano A, Vetrano E, Beccia D, Brin C, Alfano M, et al. Peripheral neuropathy in diabetes mellitus: Pathogenetic mechanisms and diagnostic options. Int J Mol Sci 2023; 24(4): 3554.‏
  7. Ortiz A, Ferro CJ, Balafa O, Burnier M, Ekart R, Halimi JM, et al. Mineralocorticoid receptor antagonists for nephroprotection and cardioprotection in patients with diabetes mellitus and chronic kidney disease. Nephrol Dial Transplant 2023; 38(1): 10-25.‏
  8. McDermott K, Fang M, Boulton AJ, Selvin E, Hicks CW. Etiology, epidemiology, and disparities in the burden of diabetic foot ulcers. Diabetes Care 2023; 46(1): 209-21.‏
  9. Gomułka K, Ruta M. The role of inflammation and therapeutic concepts in diabetic retinopathy—a short review. Int J Mol Sci 2023; 24(2): 1024.
  10. Singh R, Rao HK, Singh TG. Neuropathic pain in diabetes mellitus: challenges and future trends. Obes Med 2020; 18: 100215.
  11. Karlsen B, Oftedal B, Bru E. The relationship between clinical indicators, coping styles, perceived support and diabetes-related distress among adults with type 2 diabetes. J Adv Nurs 2012; 68(2): 391-401.
  12. McCoy MA, Theeke LA. A systematic review of the relationships among psychosocial factors and coping in adults with type 2 diabetes mellitus. Int J Nurs Sci 2019; 6(4): 468-77.‏
  13. Kim MY, Lee EJ. Factors affecting self-care behavior levels among elderly patients with type 2 diabetes: A quantile regression approach. Medicina2019; 55: 340.
  14. Wilski M, Gabryelski J, Brola W, Tomasz T. Health-related quality of life in multiple sclerosis: Links to acceptance, coping strategies and disease severity. Disabil Health J 2019; 12(4): 608-14.
  15. Russo GB, Tirrell E, Busch A, Carpenter LL. Behavioral activation therapy during transcranial magnetic stimulation for major depressive disorder. J Affect Disord 2018; 236: 101-104.
  16. Predescu I, Tran D, Cassidy-Eagle E, Dunn L. Behavioral activation therapy for older adults with depression: A systematic review of effectiveness. Am J Geriatr Psychiatry 2018; 26(3): S132.
  17. Walsh S, Moseley GL, Gray RJ, Gillam M, Gunn KM, Barker T, et al. Use of behavioural activation to manage pain: a systematic scoping review. BMJ open 2022; 12(6): e056404.‏
  18. Javadi Larijani F, Mojtabaie M, Moghaddasi M, Hatami M. Effectiveness of gestalt therapy, behavioral activation and placebo on symptoms of anxiety in women suffering multiple sclerosis: A randomized controlled trial. Int J Travel Med Glob Health 2023; 11(1): 227-33.‏
  19. Rahjerdi M, Sodani M, Gholamzadeh jofre M, Asgari P. [Effectiveness of behavioral activation therapy on depression and sexual satisfaction in patients with type 2 diabetes]. Journal of excellence in counseling and psychotherapy 2022; 11: 1-10. (Persian)
  20. Fragoulis C, Kontogianni E, Prentakis A, Polyzos D, Kariori M, Kalos T, et al. PS-C08-10: Relationship of physical activity and medication adherence in hypertensive patients: Behavioral cardiology unit data. J Hypertens 2023; 41(Suppl 1): e205.‏
  21. Alfonsson S, Parling T, Ghaderi A. Group behavioral activation for patients with severe obesity and binge eating disorder: A randomized controlled trial. Behav Modif 2015; 39(2): 270-94.‏
  22. Toobert DJ, Glasgow RE. Assessing diabetes self-management and outcome expectations: Impact on self-care behaviors questionnaire. In: Bradley C. (editor). Handbook of psychology and diabetes. London: Routledge; 1994: 351-75.
  23. Noohi E, Khandan M, Mirzazade A. [Effective of electronic education on knowledge and attitude and self-care diabetic patients type 2 refer to diabetic center of Kerman University of Medical Science]. Iranian journal of nursing research 2011; 22(6): 73-80. (Persian)
  24. Gallagher EJ, Bijur PE, Latimer C, Silver W. Reliability and validity of a visual analog scale for acute abdominal pain in the ED. Am J Emerg Med 2002; 20(4): 287-90.
  25. Martin KD, Van Buren JP, Wake J, Dawson L. Comparison of visual analog pain score reported to physician vs nurse. Foot Ankle Int 2018; 39(3): 300-3.
  26. Mousavi FS, Golmakani N. [Comparison and correlation between Visual Analogue Scale and different dimensions of the short form of McGill Pain Questionnaire in post cesarean pain evaluation]. Journal of Urmia Nursing and Midwifery Faculty 2018; 16(9): 622-30. (Persian)
  27. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short‐Form McGill Pain Questionnaire (SF‐MPQ), Chronic Pain Grade Scale (CPGS), Short Form‐36 Bodily Pain Scale (SF‐36 BPS), and measure of Intermittent and Constant OsteoArthritis Pain (ICOAP). Arthritis Care Res (Hoboken) 2011; 63(Suppl 11): S240-S52.
  28. Endler ND, Parker JDA. Multidimensional assessment of coping: A critical evaluation. J Pers Psychol 1990; 54: 466-75.
  29. Endler NS, Parker JDA. Coping Inventory for Stressful Situations (CISS): Manual. 2nd ed. Toronto: Multi-Health Systems; 1999.
  30. Ghoreyshirad F. [Validation of Endler and Parker Coping Scale of Stressful Situations]. Journal of behavioral sciences 2010; 4(1): 1-7. (Persian)
  31. Gollon J, Atlis M, Marlow-O'Conner M. Behavioral activation: Group treatment for depression (pilot version). Chicago: University of Chicago; 2003.
  32. Naji Esfahani F, Seirafi MR, Kraskian Mujembari A. [The effectiveness of behavioral activation intervention in increasing self-care behaviors and life expectancy in the elderly]. Aging psychology 2020; 6(2): 93-105. (Persian)
  33. Winters D, Casten R, Rovner B, Murchison A, Leiby BE, Haller JA, et al. Cost-effectiveness of behavior activation versus supportive therapy on adherence to eye exams in older African Americans with diabetes. Am J Med Qual 2017; 32(6): 661-7.‏
  34. Almutairi N, Hosseinzadeh H, Gopaldasani V. The effectiveness of patient activation intervention on type 2 diabetes mellitus glycemic control and self-management behaviors: A systematic review of RCTs. Prim Care Diabetes 2020; 14(1): 12-20.
  35. Walsh S, Moseley GL, Gray RJ, Gillam M, Gunn KM, Barker T, et al. Use of behavioural activation to manage pain: A systematic scoping review. BMJ Open 2022; 12: e056404.
  36. Tajipoor A, Abbasi Motlagh F. [The effect of behavioral activation therapy on coping strategies in students with generalized anxiety disorder]. Rooyesh-e-Ravanshenasi 2020; 8: 181-88. (Persian)
Journal of Fundamentals of Mental Health
Volume 25, Issue 6
November and December 2023
Pages 395-401

Files

Share

How to cite

Statistics