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Hypoglycemia Fear and Psychological Resilience: Effects on Disease Acceptance in Type II Diabetes

Yıl 2025, Cilt: 19 Sayı: 1, 83 - 90
https://doi.org/10.21763/tjfmpc.1553367

Öz

Aim: This study aimed to evaluate the effects of fear of hypoglycemia and psychological resilience on disease acceptance and action in individuals with type II diabetes.
Methods: This research was conducted as a cross-sectional study online from January 1 to June 30, 2023, involving 105 participants. Data were collected using a Personal Information Form, the Fear of Hypoglycemia Scale (FOH), the Brief Resilience Scale (BRS), and the Acceptance and Action Diabetes Questionnaire (AADQ). Ethical approval was obtained for the study.
Results: The mean age of participants was 49.71±16.21 years, with 53.3% being female. Among the participants, 49.5% used oral diabetic medications, 67.6% had regular medical checkups, and 54.3% had at least one additional chronic condition. Neuropathy was reported by 24.8% of the participants. The mean scores were: FOH 27.93±22.16, BRS 16.63±4.14, and AADQ 45.21±10.98. Multiple regression analysis indicated that factors such as income being less than expenses (p=0.064), regular doctor checkups (p=0.001), and worries about hypoglycemia (p=0.001) predicted 22.6% of the variance in AADQ scores.
Conclusion: The study found a weak, negative relationship between fear of hypoglycemia, psychological resilience, and disease acceptance in individuals with type II diabetes. These findings underscore the need to assess psychological factors during routine checkups to enhance disease management.

Etik Beyan

The Non-Interventional Clinical Research Ethics Committee of X University granted ethical approval ( 2022-127/45) for the research. Participants were informed about the confidentiality and privacy of the study and were assured they could withdraw at any time. Written informed consent was obtained from all participants prior to the commencement of the study.

Destekleyen Kurum

The authors did not receive any funding for the research, writing, or publication of this article.

Kaynakça

  • 1. International Diabetes Federation (2021). Diabetes Atlas. 10th edition, http://www.diabetesatlas.org. Erişim tarihi: 25.08.2024
  • 2. Türkiye İstatistik Kurumu (2022). Türkiye sağlık araştırması.file:///C:/Users/pc/Desktop/turkiye%20saglik%20arastirmasi%202022%20raporu.pdf, Erişim tarihi: 22.08.2024 3. World Health Organisation (2023). Diabetes. https://www.who.int/news-room/fact-sheets/detail/diabetes#:~:text=Type%202%20diabetes%20affects%20how,especially%20nerves%20and%20blood%20vessels, Erişim tarihi: 20.08.2024
  • 4. Fariba A, Amerzadeh M, Banazadeh M, Rashidi S, Myaneh ZT. Fear of hypoglycemia and illness perception in type II diabetes patients. BMC Endocr Disord. 2024;24(1):24. Published 2024 Feb 20. doi:10.1186/s12902-024-01548-x
  • 5. Rossi MC, Nicolucci A, Ozzello A, Gentile S, Aglialoro A, Chiambretti A et al. Impact of severe and symptomatic hypoglycemia on quality of life and fear of hypoglycemia in type 1 and type 2 diabetes. Results of the Hypos-1 observational study. Nutrition, Metabolism and Cardiovascular Diseases, 2019: 29(7), 736-743.).
  • 6. Hendrieckx C, Halliday JA, Beeney LJ, Speight J. Diabetes and emotional health: a practical guide for health professionals supporting adults with type 1 or type 2 diabetes. Canberra: National Diabetes Services Scheme, 2nd edition, 2020. ISBN 978-0-9873835-8-7.
  • 7. Ruiz-Aranda D, Mateo-Rodriguez C, Olmedo IS, García CG, Enríquez AJ, Martinez-Brocca MA. Relationship between resilience and quality of life in patients with fear of hypoglycemia: The mediating effects of anxiety and depression. Sustainability. 2020; 12(20):8512. https://doi.org/10.3390/su12208512.
  • 8. Rutter M. The promotion of resilience in the face of adversity. In A. Clarke-Stewart & J. Dunn (Eds.), The Jacobs Foundation series on adolescence. Families count: Effects on child and adolescent development. Cambridge University Press.2006; 26-52. https://doi.org/10.1017/CBO9780511616259.003
  • 9. Wilson AL, McNaughton D, Meyer SB & Ward PR. Understanding the links between resilience and type-2 diabetes self-management: a qualitative study in South Australia. Archives of Public Health, 2017; 75: 1-13.
  • 10. Crump C, Sundquist J, Winkleby MA, Sundquist K. Stress resilience and subsequent risk of type 2 diabetes in 1.5 million young men. Diabetologia, 2016;59(4):728-733. doi:10.1007/s00125-015-3846-7.
  • 11. Parviniannasab AM, Faramarzian Z, Hosseini SA, Hamidizadeh S, Bijani M. The effect of social support, diabetes management self-efficacy, and diabetes distress on resilience among patients with type 2 diabetes: a moderated mediation analysis. BMC Public Health. 2024;24(1):477. doi:10.1186/s12889-024-18022-x
  • 12. Powers MA, Bardsley JK, Cypress M, et al. Diabetes Self-management Education and Support in Adults With Type 2 Diabetes: A Consensus Report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. Diabetes Care. 2020;43(7):1636-1649. doi:10.2337/dci20-0023
  • 13. Gregg JA, Callaghan GM, Hayes SC, Glenn-Lawson JL. Improving diabetes self-management through acceptance, mindfulness, and values: a randomized controlled trial. J Consult Clin Psychol 2007; 75: 336343
  • 14. Saito J, Kumano H. The patterns of acceptance, mindfulness, and values for Japanese patients with type 2 diabetes mellitus: a web-based survey. BioPsychoSocial medicine, 2022: 16(1), 6. https://doi.org/10.1186/s13030-022-00236-3
  • 15. Soper, D. 2022. Calculator: A-priori sample size calculator for multiple regression. Online Software. Available online: https://www.danielsoper.com/statcalc/calculator.aspx, Erişim tarihi:15.08.2022
  • 16. Cox DJ, Irvine A, Gonder-Frederick L, Nowacek G, Butterfield J. Fear of hypoglycemia: quantification, validation, and utilization. Diabetes Care 1987;10(5):617-621. Doi: https://doi.org/10.1111/j.1464- 5491.2005.01501.x 8.
  • 17. Erol Ö, Enç N. Hypoglycemia fear and self-efficacy of Turkish patients receiving insulin therapy. Asian Nurs Res 2011;5(4):222-228. Doi:https://doi.org/10.1016/j.anr.2011.12.001
  • 18. Smith BW, Dalen J, Wiggins K, Tooley E, Christopher P, Bernard J. The brief resilience scale: assessing the ability to bounce back. Int J Behav Med. 2008;15(3):194-200. doi:10.1080/10705500802222972
  • 19. Doğan, T. Kısa psikolojik sağlamlık ölçeği’nin Türkçe uyarlaması: Geçerlik ve güvenirlik çalışması. The Journal of Happiness & Well-Being, 2015;3(1), 93-102.
  • 20. Karadere ME, Yavuz KF, Asafov EY, Küçükler FK. Reliability and Validity of a Turkish Version of the Acceptance and Action Diabetes Questionnaire. Psychiatry Investig. 2019;16(6):418-424. doi:10.30773/pi.2019.02.26.2
  • 21. Bonikowska I, Szwamel K, Uchmanowicz I. Analysis of the Impact of Disease Acceptance, Demographic, and Clinical Variables on Adherence to Treatment Recommendations in Elderly Type 2 Diabetes Mellitus Patients. International Journal of Environmental Research and Public Health, 2021; 18(16):8658. https://doi.org/10.3390/ijerph18168658
  • 22. Jaworski M, Panczyk M, Cedro M, Kucharska A. Adherence to dietary recommendations in diabetes mellitus: disease acceptance as a potential mediator. Patient Prefer Adherence, 2018;12:163-174 https://doi.org/10.2147/PPA.S147233
  • 23. Taşkın Yılmaz F, Şahin AD, Türesin AK. Tip 2 diyabetli bireylerde hastalığı kabul düzeyinin glisemik kontrol ıle ilişkisi. Cukurova Medical Journal, 2019: (44) 4: 1284-91, doi:10.17826/cumj.528315.
  • 24. Pang J, Zhang L, Li X, et al. Identification of factors associated with fear of hypoglycemia using the capability, opportunity, motivation and behavior model in people with type 2 diabetes mellitus: a cross-sectional study. Acta Diabetol. 2023;60(10):1405-1415. doi:10.1007/s00592-023-02132-w.
  • 25. Li S, Li Y, Zhang L, et al. Impact of fear of hypoglycaemia on self-management in patients with type 2 diabetes mellitus: structural equation modelling [published correction appears in Acta Diabetol. 2022 May;59(5):651. doi: 10.1007/s00592-022-01868-1]. Acta Diabetol. 2022;59(5):641-650. doi:10.1007/s00592-021-01839-y
  • 26. Przezak A, Bielka W, Molęda P. Fear of hypoglycemia-An underestimated problem. Brain Behav. 2022;12(7):e2633. doi:10.1002/brb3.2633
  • 27. Rahimi M, Jalali M, Nouri R, Rahimi M. The mediating role of resilience and diabetes distress in relationship between depression and treatment adherence in Type 2 Diabetes among Iranian patients. Journal of Community Health Research, 2020; 9(2): 107-118.
  • 28. Boell JEW, Silva DMGV, Guanilo MEE, Hegadoren K, Meirelles BHS, Suplici SR. Resilience and self-care in people with diabetes mellitus. Texto & Contexto-Enfermagem, 2020: e20180105.
  • 29. Pesantes MA, Lazo-Porras M, Ávila-Ramírez JR, Caycho M, Villamonte GY, Sánchez-Pérez GP, ... & Miranda JJ. Resilience in vulnerable populations with type 2 diabetes mellitus and hypertension: a systematic review and meta-analysis. Canadian Journal of Cardiology, 2015; 31(9):1180-1188.
  • 30. Wu C, Wang W, Cheng S, et al. The relationship between components of hypoglycemia worries and avoiding hypoglycemia behavior in type 2 diabetes mellitus with hypoglycemia: a network analysis. BMC Psychiatry, 2023;23(1):204. Published 2023 Mar 28. doi:10.1186/s12888-023-04698-9

Hipoglisemi Korkusu ve Psikolojik Dayanıklılık: Tip II Diyabette Hastalığı Kabul Etme Üzerine Etkileri

Yıl 2025, Cilt: 19 Sayı: 1, 83 - 90
https://doi.org/10.21763/tjfmpc.1553367

Öz

Amaç: Bu çalışma, hipoglisemi korkusu ve psikolojik dayanıklılığın Tip II diyabetli bireylerin hastalığı kabul ve eylem durumları üzerindeki etkisini değerlendirmeyi amaçlamıştır.
Yöntem: Bu araştırma kesitsel bir çalışmadır. Çalışma 1 Ocak- 30 Haziran 2023 tarihleri arasında çevrimiçi olarak yürütülmüştür. Çalışma 105 kişiyle tamamlanmıştır. Veriler; Kişisel Bilgi Formu, Hipoglisemi Korkusu Ölçeği (HKÖ), Kısa Dayanıklılık Ölçeği (KDÖ) ve Diyabetliler/Şeker Hastaları için Kabul ve Eylem Formu (DHKEF) kullanılarak toplanmıştır. Bu çalışmayı gerçekleştirmek için etik izin alınmıştır.
Bulgular: Katılımcıların ortalama yaşı 49,71±16,21'dir. %53,3'ü kadındır. %49,5'i oral diyabet ilacı kullanmaktadır. %67,6'sı rutin sağlık kontrollerine gitmektedir. %54,3'ü ek kronik bir hastalığa sahiptir. %24,8'i nöropatiye sahiptir. HKÖ'nün toplam puanı 27,93±22,16, KDÖ 16,63±4,14 ve DHKEF 45,21±10,98’dir. Geriye doğru eleme yöntemiyle yapılan Çoklu Regresyon Analizinde, gelirin giderden az olması, düzenli doktor kontrolleri ve endişeler katılımcıların DHKEF'nin %22,6'sını açıklamaktadır.
Sonuç: Çalışma, tip II diyabetli bireylerde hipoglisemi korkusu, psikolojik dayanıklılık ve hastalığı kabul etme arasında zayıf, negatif bir ilişki buldu. Bu bulgular, hastalık yönetimini geliştirmek için rutin kontroller sırasında psikolojik faktörleri değerlendirme ihtiyacının altını çizmektedir.

Etik Beyan

The Non-Interventional Clinical Research Ethics Committee of X University granted ethical approval ( 2022-127/45) for the research. Participants were informed about the confidentiality and privacy of the study and were assured they could withdraw at any time. Written informed consent was obtained from all participants prior to the commencement of the study.

Destekleyen Kurum

The authors did not receive any funding for the research, writing, or publication of this article.

Kaynakça

  • 1. International Diabetes Federation (2021). Diabetes Atlas. 10th edition, http://www.diabetesatlas.org. Erişim tarihi: 25.08.2024
  • 2. Türkiye İstatistik Kurumu (2022). Türkiye sağlık araştırması.file:///C:/Users/pc/Desktop/turkiye%20saglik%20arastirmasi%202022%20raporu.pdf, Erişim tarihi: 22.08.2024 3. World Health Organisation (2023). Diabetes. https://www.who.int/news-room/fact-sheets/detail/diabetes#:~:text=Type%202%20diabetes%20affects%20how,especially%20nerves%20and%20blood%20vessels, Erişim tarihi: 20.08.2024
  • 4. Fariba A, Amerzadeh M, Banazadeh M, Rashidi S, Myaneh ZT. Fear of hypoglycemia and illness perception in type II diabetes patients. BMC Endocr Disord. 2024;24(1):24. Published 2024 Feb 20. doi:10.1186/s12902-024-01548-x
  • 5. Rossi MC, Nicolucci A, Ozzello A, Gentile S, Aglialoro A, Chiambretti A et al. Impact of severe and symptomatic hypoglycemia on quality of life and fear of hypoglycemia in type 1 and type 2 diabetes. Results of the Hypos-1 observational study. Nutrition, Metabolism and Cardiovascular Diseases, 2019: 29(7), 736-743.).
  • 6. Hendrieckx C, Halliday JA, Beeney LJ, Speight J. Diabetes and emotional health: a practical guide for health professionals supporting adults with type 1 or type 2 diabetes. Canberra: National Diabetes Services Scheme, 2nd edition, 2020. ISBN 978-0-9873835-8-7.
  • 7. Ruiz-Aranda D, Mateo-Rodriguez C, Olmedo IS, García CG, Enríquez AJ, Martinez-Brocca MA. Relationship between resilience and quality of life in patients with fear of hypoglycemia: The mediating effects of anxiety and depression. Sustainability. 2020; 12(20):8512. https://doi.org/10.3390/su12208512.
  • 8. Rutter M. The promotion of resilience in the face of adversity. In A. Clarke-Stewart & J. Dunn (Eds.), The Jacobs Foundation series on adolescence. Families count: Effects on child and adolescent development. Cambridge University Press.2006; 26-52. https://doi.org/10.1017/CBO9780511616259.003
  • 9. Wilson AL, McNaughton D, Meyer SB & Ward PR. Understanding the links between resilience and type-2 diabetes self-management: a qualitative study in South Australia. Archives of Public Health, 2017; 75: 1-13.
  • 10. Crump C, Sundquist J, Winkleby MA, Sundquist K. Stress resilience and subsequent risk of type 2 diabetes in 1.5 million young men. Diabetologia, 2016;59(4):728-733. doi:10.1007/s00125-015-3846-7.
  • 11. Parviniannasab AM, Faramarzian Z, Hosseini SA, Hamidizadeh S, Bijani M. The effect of social support, diabetes management self-efficacy, and diabetes distress on resilience among patients with type 2 diabetes: a moderated mediation analysis. BMC Public Health. 2024;24(1):477. doi:10.1186/s12889-024-18022-x
  • 12. Powers MA, Bardsley JK, Cypress M, et al. Diabetes Self-management Education and Support in Adults With Type 2 Diabetes: A Consensus Report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. Diabetes Care. 2020;43(7):1636-1649. doi:10.2337/dci20-0023
  • 13. Gregg JA, Callaghan GM, Hayes SC, Glenn-Lawson JL. Improving diabetes self-management through acceptance, mindfulness, and values: a randomized controlled trial. J Consult Clin Psychol 2007; 75: 336343
  • 14. Saito J, Kumano H. The patterns of acceptance, mindfulness, and values for Japanese patients with type 2 diabetes mellitus: a web-based survey. BioPsychoSocial medicine, 2022: 16(1), 6. https://doi.org/10.1186/s13030-022-00236-3
  • 15. Soper, D. 2022. Calculator: A-priori sample size calculator for multiple regression. Online Software. Available online: https://www.danielsoper.com/statcalc/calculator.aspx, Erişim tarihi:15.08.2022
  • 16. Cox DJ, Irvine A, Gonder-Frederick L, Nowacek G, Butterfield J. Fear of hypoglycemia: quantification, validation, and utilization. Diabetes Care 1987;10(5):617-621. Doi: https://doi.org/10.1111/j.1464- 5491.2005.01501.x 8.
  • 17. Erol Ö, Enç N. Hypoglycemia fear and self-efficacy of Turkish patients receiving insulin therapy. Asian Nurs Res 2011;5(4):222-228. Doi:https://doi.org/10.1016/j.anr.2011.12.001
  • 18. Smith BW, Dalen J, Wiggins K, Tooley E, Christopher P, Bernard J. The brief resilience scale: assessing the ability to bounce back. Int J Behav Med. 2008;15(3):194-200. doi:10.1080/10705500802222972
  • 19. Doğan, T. Kısa psikolojik sağlamlık ölçeği’nin Türkçe uyarlaması: Geçerlik ve güvenirlik çalışması. The Journal of Happiness & Well-Being, 2015;3(1), 93-102.
  • 20. Karadere ME, Yavuz KF, Asafov EY, Küçükler FK. Reliability and Validity of a Turkish Version of the Acceptance and Action Diabetes Questionnaire. Psychiatry Investig. 2019;16(6):418-424. doi:10.30773/pi.2019.02.26.2
  • 21. Bonikowska I, Szwamel K, Uchmanowicz I. Analysis of the Impact of Disease Acceptance, Demographic, and Clinical Variables on Adherence to Treatment Recommendations in Elderly Type 2 Diabetes Mellitus Patients. International Journal of Environmental Research and Public Health, 2021; 18(16):8658. https://doi.org/10.3390/ijerph18168658
  • 22. Jaworski M, Panczyk M, Cedro M, Kucharska A. Adherence to dietary recommendations in diabetes mellitus: disease acceptance as a potential mediator. Patient Prefer Adherence, 2018;12:163-174 https://doi.org/10.2147/PPA.S147233
  • 23. Taşkın Yılmaz F, Şahin AD, Türesin AK. Tip 2 diyabetli bireylerde hastalığı kabul düzeyinin glisemik kontrol ıle ilişkisi. Cukurova Medical Journal, 2019: (44) 4: 1284-91, doi:10.17826/cumj.528315.
  • 24. Pang J, Zhang L, Li X, et al. Identification of factors associated with fear of hypoglycemia using the capability, opportunity, motivation and behavior model in people with type 2 diabetes mellitus: a cross-sectional study. Acta Diabetol. 2023;60(10):1405-1415. doi:10.1007/s00592-023-02132-w.
  • 25. Li S, Li Y, Zhang L, et al. Impact of fear of hypoglycaemia on self-management in patients with type 2 diabetes mellitus: structural equation modelling [published correction appears in Acta Diabetol. 2022 May;59(5):651. doi: 10.1007/s00592-022-01868-1]. Acta Diabetol. 2022;59(5):641-650. doi:10.1007/s00592-021-01839-y
  • 26. Przezak A, Bielka W, Molęda P. Fear of hypoglycemia-An underestimated problem. Brain Behav. 2022;12(7):e2633. doi:10.1002/brb3.2633
  • 27. Rahimi M, Jalali M, Nouri R, Rahimi M. The mediating role of resilience and diabetes distress in relationship between depression and treatment adherence in Type 2 Diabetes among Iranian patients. Journal of Community Health Research, 2020; 9(2): 107-118.
  • 28. Boell JEW, Silva DMGV, Guanilo MEE, Hegadoren K, Meirelles BHS, Suplici SR. Resilience and self-care in people with diabetes mellitus. Texto & Contexto-Enfermagem, 2020: e20180105.
  • 29. Pesantes MA, Lazo-Porras M, Ávila-Ramírez JR, Caycho M, Villamonte GY, Sánchez-Pérez GP, ... & Miranda JJ. Resilience in vulnerable populations with type 2 diabetes mellitus and hypertension: a systematic review and meta-analysis. Canadian Journal of Cardiology, 2015; 31(9):1180-1188.
  • 30. Wu C, Wang W, Cheng S, et al. The relationship between components of hypoglycemia worries and avoiding hypoglycemia behavior in type 2 diabetes mellitus with hypoglycemia: a network analysis. BMC Psychiatry, 2023;23(1):204. Published 2023 Mar 28. doi:10.1186/s12888-023-04698-9
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlığın Geliştirilmesi, Aile Hekimliği
Bölüm Orijinal Makaleler
Yazarlar

Saliha Bozdoğan Yeşilot 0000-0001-6294-6115

Pınar Yeşil Demirci 0000-0003-2227-6078

Zehra Eskimez 0000-0002-8268-835X

Erken Görünüm Tarihi 21 Şubat 2025
Yayımlanma Tarihi
Gönderilme Tarihi 20 Eylül 2024
Kabul Tarihi 22 Kasım 2024
Yayımlandığı Sayı Yıl 2025 Cilt: 19 Sayı: 1

Kaynak Göster

Vancouver Bozdoğan Yeşilot S, Yeşil Demirci P, Eskimez Z. Hypoglycemia Fear and Psychological Resilience: Effects on Disease Acceptance in Type II Diabetes. TJFMPC. 2025;19(1):83-90.

Sağlığın ve birinci basamak bakımın anlaşılmasına ve geliştirilmesine katkıda bulunacak yeni bilgilere sahip yazarların İngilizce veya Türkçe makaleleri memnuniyetle karşılanmaktadır.

Turkish Journal of Family Medicine and Primary Care © 2024 by Aile Hekimliği Akademisi Derneği is licensed under CC BY-NC-ND 4.0