Psychological Well-Being and Type 2 Diabetes

Gratitude, optimism, and satisfaction with life and patient-reported outcomes in patients undergoing hematopoietic stem cell transplantation

OBJECTIVE

Associations between positive psychological well-being (PPWB) and patient-reported outcomes (PROs, e.g., quality of life [QOL]) have yet to be studied extensively in patients with hematologic malignancies who are allogeneic hematopoietic stem cell transplant (HSCT) survivors, despite substantial evidence that PPWB impacts PROs of other medical populations.

METHODS

We conducted a secondary analysis of cross-sectional data examining the association of PPWB and PROs at day 100 post-transplant among 158 allogeneic HSCT recipients. Optimism, gratitude, life satisfaction, and PROs (i.e., QOL, anxiety, depression, and PTSD symptoms) were assessed using the Life Orientation Test-Revised, Gratitude Questionnaire, Satisfaction with Life Scale, Functional Assessment of Cancer Therapy-Bone Marrow Transplant, Hospital Anxiety and Depression Scale, and Post-Traumatic Stress Disorder (PTSD) Checklist-Civilian Version, respectively. We used linear and multivariate regressions for all analyses and controlled for patient factors.

RESULTS

Optimism was associated with better QOL (β = 1.46; p < 0.001) and lower levels of anxiety (β = -0.28; p < 0.001), depression (β = -0.31; p < 0.001), and PTSD (β = -0.58; p < 0.001). Gratitude was associated with better QOL (β = 1.11; p < 0.001) and lower levels of anxiety (β = -0.21; p = 0.001), depression (β = -0.14; p = 0.021), and PTSD (β = -0.32; p = 0.032). Finally, satisfaction with life was associated with better QOL (β = 1.26; p < 0.001) and lower levels of anxiety (β = -0.18; p < 0.001), depression (β = -0.21; p < 0.001), and PTSD (β = -0.49; p < 0.001).

CONCLUSION

Optimism, gratitude, and satisfaction with life were all associated with better QOL and lower levels of psychological distress in allogeneic HSCT survivors. These data support studies to harness PPWB as a therapeutic intervention for this population throughout HSCT recovery.

Effectiveness of Gratitude Therapy in Diabetes Management: A Qualitative Study

The present study involves a Qualitative research design. The study intends to assess the effectiveness of interventions on the diabetic participants. In the present study, four participants screened with high perceived stress, moderate depression, poor sense of gratitude, were selected. The study consisted of three successive phases such as baseline assessment, intervention, and follow-up. Pre-test and Post-test design were adopted. Qualitative data were expressed as percentages, and Schwartz and Blanchard's technique was administered. Participants have shown improvement in positive dimension scores and there is reduction in negative dimension scores. Blood glucose level readings are also marked before, during, and after the intervention. Participants are found to control their blood glucose level, but the change in the glucose level is not clinically significant.

Laughter yoga as an enjoyable therapeutic approach for glycemic control in individuals with type 2 diabetes: A randomized controlled trial

BACKGROUND

Laughter has been reported to have various health benefits. However, data on the long-term effects of laughter interventions on diabetes are limited. This study aimed to investigate whether laughter yoga can improve glycemic control among individuals with type 2 diabetes.

METHODS

In a single-center, randomized controlled trial, 42 participants with type 2 diabetes were randomly assigned to either the intervention or the control group. The intervention consisted of a 12-week laughter yoga program. Hemoglobin A1c (HbA1c), body weight, waist circumference, psychological factors, and sleep duration were evaluated at baseline and week 12.

RESULTS

Intention-to-treat analysis showed that participants in the laughter yoga group experienced significant improvements in HbA1c levels (between-group difference: -0.31%; 95% CI -0.54, -0.09) and positive affect scores (between-group difference: 0.62 points; 95% CI 0.003, 1.23). Sleep duration tended to increase in the laughter yoga group with a between-group difference of 0.4 hours (95% CI -0.05, 0.86; P = 0.080). The mean attendance rate for laughter yoga program was high (92.9%).

CONCLUSIONS

A 12-week laughter yoga program is feasible for individuals with type 2 diabetes and improves glycemic control. These findings suggest that having fun could be a self-care intervention. Further studies with larger numbers of participants are warranted to better evaluate the effects of laughter yoga.

CLINICAL TRIAL REGISTRATION

http://www.chinadrugtrials.org.cn, identifier UMIN000047164.

Subjective well-being predicts Covid-19 risk in the elderly: a case-control study

BACKGROUND

Covid-19 is a serious public health concern. Previous studies have shown that although there are concerns about the subjective well-being (SWB) of older people in the Covid period, the link between SWB and the risk of Covid-19 is still unclear. This study aimed to investigate the predictive effect of SWB on the Covid-19 risk in the elderly as well as the determinants of SWB.

METHODS

This case-control study was performed in the elderly over 60 years of age. The case group consisted of all hospitalized patients with COVID-19 and the control group from the same population with no history of COVID-19 matched by age, sex, and place of residence. Data collection tools included a demographic questionnaire and SWB scale of Keyes and Magyarmo to measure emotional, psychological and social well-being. All data were analyzed via SPSS and STATA software. Multiple binary logistic regression was run to predict the probability of Covid-19 risk on the values of total SWB and its three subscales and multiple linear regression to identify SWB determinants.

RESULTS

The results showed that increasing one unit in total SWB reduces the risk of Covid-19 by 4% (OR = 0.969, CI = 0.947-0.991, p = 0.006). Emotional well-being with 0.823 had the highest odds ratio for predicting Covid-19 risk, followed by social well-being with an odds ratio of 0.981. Increasing age and education, better economic status, marriage against celibacy, lack of comorbidity, and a better understanding of own health were associated with greater SWB.

DISCUSSION

This study provides evidence for the protective effect of SWB on Covid-19 risk. To promote SWB, we need to focus on the elderly with higher financial worries and comorbidities, as well as those with less education, health perception and SWB. Therefore, it will be important for the elderly to determine strategies to improve SWB during the epidemic.

Expert Panel Guidance and Narrative Review of Treatment Simplification of Complex Insulin Regimens to Improve Outcomes in Type 2 Diabetes

Given the progressive nature of type 2 diabetes (T2D), most individuals with the disease will ultimately undergo treatment intensification. This usually involves the stepwise addition of a new glucose-lowering agent or switching to a more complex insulin regimen. However, complex treatment regimens can result in an increased risk of hypoglycaemia and high treatment burden, which may impact negatively on both therapeutic adherence and overall quality of life. Individuals with good glycaemic control may also be overtreated with unnecessarily complex regimens. Treatment simplification aims to reduce individual treatment burden, without compromising therapeutic effectiveness or safety. Despite data showing that simplifying therapy can achieve good glycaemic control without negatively impacting on treatment efficacy or safety, it is not always implemented in clinical practice. Current clinical guidelines focus on treatment intensification, rather than simplification. Where simplification is recommended, clear guidance is lacking and mostly focused on treatment of the elderly. An expert, multidisciplinary panel evaluated the current treatment landscape with respect to guidance, published evidence, recommendations and approaches regarding simplification of complex insulin regimens. This article outlines the benefits of treatment simplification and provides practical recommendations on simplifying complex insulin treatment strategies in people with T2D using illustrative cases.

Spiritual Emotional Freedom Technique against Anxiety and Psychological Well-being of Type 2 DM Patients during the COVID-19 Pandemic

BACKGROUND: The COVID-19 pandemic makes patients with type 2 diabetes mellitus experience an increase in anxiety, considering that diabetes mellitus is one of the dangerous comorbidities for people infected with the COVID-19 virus so that it affects their psychological well-being. Low psychological well-being will have an impact on decreasing self-care, thereby increasing the occurrence of complications. AIM: The purpose of this study was to analyze the effect of the spiritual emotional freedom technique (SEFT) on anxiety and the psychological well-being of patients with type 2 DM during the COVID-19 pandemic. METHODS: The research design employed is a quasi-experimental research with the untreated control group design with dependent pre-test and post-test samples. The sampling technique used is probability sampling which is a random sampling to meet the inclusion and exclusion criteria with a total sample of 110 respondents with the distribution of the intervention group consisting of 55 respondents and the control group consisting of 55 respondents. The instrument used to measure the level of anxiety is the Hamilton Rating Scale for Anxiety and psychological well-being of Ryff’s psychological well-being. The statistical tests used are Paired Sample t-Test and Independent t-test with significant p < 0.05. RESULTS: The results showed that the mean level of anxiety in the intervention group before the implementation of the intervention was 21.89 (moderate), while after the intervention was 10.98 (mild) and the psychological well-being before the intervention was 147.49 (low), while after the intervention was 170.91 (moderate). Furthermore, in the case of the control group, the mean level of anxiety before the intervention was 19.16 and after the intervention was 19.11 and psychological well-being before the intervention was 146.67 while after the intervention was 146.45. Furthermore, the data analysis obtained that the SEFT affected the level of anxiety and psychological well-being of patients with type 2 diabetes during the COVID-19 pandemic with p = 0.00. CONCLUSION: The SEFT that is routinely implemented can reduce the level of anxiety so that it can improve the psychological well-being of patients with type 2 DM during the COVID-19 pandemic.

Relationships between Psychoeducational Rehabilitation and Health Outcomes-A Systematic Review Focused on Acute Coronary Syndrome

(1) Background: Cardiac rehabilitation is a multidisciplinary program that includes psychoeducational support in addition to physical exercise. Psychoeducational intervention is a component that has had accelerated interest and development in recent decades. The aim was to analyze the current evidence on the effectiveness of psychoeducational interventions for patients with acute coronary syndrome (ACS). (2) Methods: We conducted a systematic search of the literature via four databases: PubMed, CENTRAL, PsycINFO, and EMBASE. We included randomized controlled trials that evaluated the effectiveness of a psychoeducational intervention compared to usual care in ACS patients. We assessed the risk of bias using a modified version of the Cochrane tool. We analyzed data regarding the population, intervention, comparator, outcomes, and timing. (3) Results: We identified 6248 studies. After a rigorous screening, we included in the analysis 11 articles with a total of 3090 participants. Major adverse cardiovascular events, quality of life, hospitalizations, lipidogram, creatinine, NYHA class, smoking, physical behavior, and emotional state were significantly improved. In addition, illness perception, knowledge, and beliefs were substantially ameliorated (all p < 0.001). All this was related to the type and dose of psychological intervention. (4) Conclusions: Patients with ACS can receive significant benefits through individualized psychoeducation sessions. The cardiac rehabilitation program should include personalized psychological and educational intervention by type and dose.