Volume 14, Issue 2 (8-2024)                   PCNM 2024, 14(2): 1-10 | Back to browse issues page

Ethics code: IR.ZUMS.REC.1402.020


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Yousefli Z, Aghvamy M S, Ghahramani Z. The relationship between psychological stress and medication regimen adherence in patients with type 2 diabetes. PCNM 2024; 14 (2) :1-10
URL: http://nmcjournal.zums.ac.ir/article-1-906-en.html
Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran , aghvamym@zums.ac.ir
Abstract:   (691 Views)
Background: Diabetes is considered one of the most arduous chronic diseases emotionally and behaviorally. This disease is an integral part of the patient’s lives, and not paying attention to the psychological stress stemming from it, not only leads to the occurrence of psychological symptoms and frustration, but also influences self-care behaviors, such as blood sugar control, proper use of medicines, and medication regimen adherence.
Objectives: This study was conducted to determine the relationship between psychological stress and medication regimen adherence in patients with type 2 diabetes.
Methods: This descriptive-correlational study was conducted on 101 patients referring to diabetes clinics affiliated with Zanjan University of Medical Sciences in 2023. Sampling was carried out using the convenience sampling method. A demographic characteristics questionnaire, the Problems Areas in Diabetes-5 (PAID-5) Scale, and the Mo risky Medication Adherence Scale-8 (MMAS-8) were used to collect data. Data were analyzed using descriptive statistics, the Mann-Whitney U test, the Kruskal-Wallis test, and Spearman’s test, with SPSS-26 software.
Results: In the present research, 68.3% of the participants were female and 31.7% were male. The mean (standard deviation) stress score was 9.579 (7.448). Also, 58.4% of the participants had a stress score of ≥8, indicating high psychological stress. The mean (standard deviation) of medication adherence was 6.054 (1.874), which based on the findings, 43.6% had a poor adherence score. Spearman’s correlation coefficient showed an inverse and significant statistical relationship between psychological stress and medication adherence (p =0.002, r=-0.307).
Conclusion: According to the results, the higher the psychological stress of diabetic patients, the lower their medication adherence. It is suggested that targeted interventions should be designed to manage psychological stress and improve medication adherence in diabetic patients.
Full-Text [PDF 660 kb]   (216 Downloads)    
Type of Study: Orginal research | Subject: Nursing
Received: 2024/01/30 | Accepted: 2024/08/31 | Published: 2024/08/31

References
1. Alzahrani A, Alghamdi A, Alqarni T, Alshareef R, Alzahrani A. Prevalence and predictors of depression, anxiety, and stress symptoms among patients with type II diabetes attending primary healthcare centers in the western region of Saudi Arabia: a cross-sectional study. Int J Ment Health Syst. 2019;13:48.Available from: http://doi.org/10.1186/s13033-019-0307-6. [Crossref]
2. Khalighi Z, Badfar G, Mahmoudi L, Soleymani A, Azami M, Shohani M. The prevalence of depression and anxiety in Iranian patients with diabetes mellitus: A systematic review and meta-analysis. Diabetes & metabolic syndrome. 2019;13(4):2785-94.Available from: https://doi.org/10.1016/j.dsx.2019.07.004 [Crossref]
3. Bullard KM, Cowie CC, Lessem SE, Saydah SH, Menke A, Geiss LS, et al. Prevalence of diagnosed diabetes in adults by diabetes type United States, 2016. Morbidity and Mortality Weekly Report. 2018;67(12):359-61.Available from: https://www.cdc.gov/mmwr/volumes/67/wr/pdfs/mm6712a2-H.pdf. [Crossref]
4. Chatterjee S, Khunti K, Davies MJ. Type 2 diabetes. The Lancet. 2017;389(10085):2239-51.Available from: https://doi.org/10.1016/S0140-6736(17)30058-2 [Crossref]
5. Cho NH, Shaw J, Karuranga S, Huang Y, da Rocha Fernandes J, Ohlrogge A, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes research and clinical practice. 2018;138:271-81.Available from: https://doi.org/10.1016/j.diabres.2018.02.023 [Crossref]
6. Rashedi V, Asadi-Lari M, Delbari A, Fadayevatan R, Borhaninejad V, Foroughan M. Prevalence of diabetes type 2 in older adults: Findings from a large population-based survey in Tehran, Iran (Urban HEART-2). Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2017;11:S347-S50.Available from: https://doi.org/10.1016/j.dsx.2017.03.014 [Crossref]
7. Asadolahi K, Veisani Y, Momeni K. Investigating the direct and indirect costs of diabetes in Ilam city in 2018. Technology and Research Information System. 2022; 5(1).Available from: http://newresearch.medilam.ac.ir/article-1-670-en.html. [In Persian]
8. Mansuri A, Khammri M, Nooshirvani S, Nooshirvani H. Evaluation of the effect of vitamin C supplements on fasting plasma glucose and glycosylated hemoglobin in patients with type II diabetes. Journal of Diabetes Nursing. 2016;4(3):40-7.Available from: http://jdn.zbmu.ac.ir/article-1-208-en.html. [In Persian
9. Majlessi F, Mohebbi B, Tol A, Azam K. Assessing the effect of educational intervention on treatment adherence based on AIM model among patients with type 2 diabetes. Iranian Journal of Diabetes and Metabolism. 2017;16(3):173-82.Available from: http://ijdld.tums.ac.ir/article-1-5564-en.html. [In Persian]
10. Paquot N. Deleterious effects of lack of compliance to lifestyle and medication in diabetic patients. Revue medicale de Liege. 2010;65(5-6):326-31.Available from: https://europepmc.org/article/med/20684414.
11. Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willett WC. Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes care. 1994;17(9):961-9.Available from: https://doi.org/10.2337/diacare.17.9.961 [Crossref]
12. Kennedy-Martin T, Boye KS, Peng X. Cost of medication adherence and persistence in type 2 diabetes mellitus: a literature review. Patient preference and adherence. 2017;11(null):1103-17.Available from: https://doi.org/10.2147/PPA.S136639 [Crossref]
13. Cramer JA. A systematic review of adherence with medications for diabetes. Diabetes care. 2004;27(5):1218-24.Available from: https://doi.org/10.2337/diacare.27.5.1218 [Crossref]
14. Ghosh A, Gupta R, Misra A. Telemedicine for diabetes care in India during COVID-19 pandemic and national lockdown period: Guidelines for physicians. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020;14(4):273-6.Available from: https://doi.org/10.1016/j.dsx.2020.04.001 [Crossref]
15. Seyed Fatemi N, Modanloo M, et al. Design and Psychometrics of Treatment Adherence Questionnaire in Patients with Chronic Illness: A Combined Study. Koomesh. 2017;20(2):179-91.Available from: https://brieflands.com/articles/koomesh-152948. [In Persian]
16. Coskun S, Bagcivan G. Associated factors with treatment adherence of patients diagnosed with chronic disease: Relationship with health literacy. Applied Nursing Research. 2021;57:151368.Available from: https://doi.org/10.1016/j.apnr.2020.151368 [Crossref]
17. Roka T, Ghimire M. Medication adherence among hypertensive patients attending a tertiary care hospital in Nepal. Journal of Nepal Health Research Council. 2019;17(4):521-7.Available from: https://doi.org/10.33314/jnhrc.v17i4.2337 [Crossref]
18. Pérez-Jover V, Mira JJ, Carratala-Munuera C, Gil-Guillen VF, Basora J, López-Pineda A, et al. Inappropriate use of medication by elderly, polymedicated, or multipathological patients with chronic diseases. International journal of environmental research and public health. 2018;15(2):310.Available from: https://doi.org/10.3390/ijerph15020310 [Crossref]
19. Tavakoli Z. Effect of mindfulness-based stress reduction intervention on distress problems and self-regulation in patients with type 2 diabetes. Iranian journal of nursing research. 2018;13(2):41-9.Available from: [Crossref]
20. Pirmardvand Chegini B, Zahrakar K, Sanai Zaker B. Effects of a Rational Emotive Behavior Therapy-Based Education Program on Marital Stress in Couples Coping with Breast Cancer. Iranian Journal of Breast Diseases. 2019;11(4):28-38. Available from: https://doi.org/10.30699/acadpub.ijbd.11.04.28 [Crossref]
21. Baum A. Stress, intrusive imagery, and chronic distress. Health psychology. 1990;9(6):653.Available from: https://doi/10.1037/0278-6133.9.6.653. [Crossref]
22. Ghezeljeh TN, Kohandany M, Oskouei FH, Malek M. The effect of progressive muscle relaxation on glycated hemoglobin and health-related quality of life in patients with type 2 diabetes mellitus. Applied Nursing Research. 2017;33:142-8.Available from: https://doi.org/10.1016/j.apnr.2016.11.008 [Crossref]
23. Morrison AE, Zaccardi F, Chatterjee S, Brady E, Doherty Y, Robertson N, et al. Self-compassion, metabolic control and health status in individuals with type 2 diabetes: A UK observational study. Experimental and Clinical Endocrinology & Diabetes. 2021;129(06):413-9. Available from: https://doi:10.1055/a-0897-3772. [Crossref]
24. Rahimi M, Jalali M, Nouri R, Rahimi M. The mediating role of resilience and diabetes distress in the relationship between depression and treatment adherence in Type 2 Diabetes among Iranian patients. Journal of Community Health Research. 2020;9(2):107-18.Available from: http://doi.org/10.18502/jchr.v9i2.3404. [Crossref]
25. Gonzalez JS, Kane NS, Binko DH, Shapira A, Hoogendoorn CJ. Tangled up in blue: unraveling the links between emotional distress and treatment adherence in type 2 diabetes. Diabetes care. 2016;39(12):2182-9.Available from: http://doi.org/10.2337/dc16-1657. [Crossref]
26. Eghbali M, Akbari M, Seify K, Fakhrolmobasheri M, Heidarpour M, Roohafza H, et al. Evaluation of Psychological Distress, Self-Care, and Medication Adherence in Association with Hypertension Control. International journal of hypertension. 2022;2022(1):7802792.Available from: [Crossref]
27. Weissman J PL, Miller EA, Parker JD. Serious psychological distress among adults:United States, 2009-2013.NCHS data brief. 2015(203):1-8.Available from: http://www.cdc.gov/nchs/govdelivery.htm.
28. Tol A, Baghbanian A, Sharifirad G, Shojaeizadeh D, Eslami A, Alhani F, et al. Assessment of diabetic distress and disease-related factors in patients with type 2 diabetes in Isfahan: A way to tailor an effective intervention planning in Isfahan-Iran. Journal of Diabetes & Metabolic Disorders. 2012;11(20):1-5.Available from: http://doi.org/10.1186/2251-6581-11-20. [Crossref]
29. Ghanei Gheshlagh R, Ebadi A, Veisi Raygani A, Nourozi Tabrizi K, Dalvandi A, Mahmoodi H. Determining concurrent validity of the Morisky medication adherence scale in patients with type 2 diabetes. Iranian Journal of Rehabilitation Research. 2015;1(3):24-32. Available from: http://ijrn.ir/article-1-98-en.html. [In Persian]
30. Polonsky WH, Anderson BJ, Lohrer PA, Welch G, Jacobson AM, Aponte JE, et al. Assessment of diabetes-related distress. Diabetes care. 1995;18(6):754-60.Available from: http://doi.org/10.2337/diacare.18.6.754 [Crossref]
31. Aliyari R. Short-form of the Iranian version of the problem areas in diabetes scale (IR-PAID-5): Validity and reliability. . Iranian Journal of Endocrinology and Metabolism. 2016;18(1):21-7.Available from: http://ijem.sbmu.ac.ir/article-1-2004-en.html. [In Persian]
32. Hermanns N, Caputo S, Dzida G, Khunti K, Meneghini LF, Snoek F. Screening, evaluation and management of depression in people with diabetes in primary care. Primary care diabetes. 2013;7(1):1-10.Available from: https://doi.org/10.1016/j.pcd.2012.11.002 [Crossref]
33. Dianati M, Taghadosi M. Medication adherence rate and related factors in patients with acute coronary syndrome after discharge from Shahid Beheshti Hospital in Kashan during 2017-2018. Feyz Medical Sciences Journal. 2019;23(2);201-8.Available from: http://feyz.kaums.ac.ir/article-1-3737-en.html. [In Persian]
34. Gonzalez JS, Shreck E, Psaros C, Safren SA. Distress and type 2 diabetes-treatment adherence: A mediating role for perceived control. Health psychology. 2015;34(5):505.Available from: http://doi/10.1037/hea0000131. [Crossref]
35. Kretchy IA, Koduah A, Ohene-Agyei T, Boima V, Appiah B. The association between diabetes-related distress and medication adherence in adult patients with type 2 diabetes mellitus: a cross-sectional study. Journal of diabetes research. 2020;2020(1):4760624.Available from: [Crossref]
36. Fadaeaghdam N, Ameri M, Rezaei S, Mehravar F, Hoseini SS, Merhashemi B. Assessment of psychological distress and related factors in type 2 diabetic patients in diabetes center of Shahroud University of Medical Sciences in 2014. Journal of Clinical Nursing and Midwifery. 2017;5(4):13-21.Available from: https://jcnm.skums.ac.ir/article-1-394-en.pdf. [In Persian]
37. Jafari M, Lotfizadeh M, Hashemi R. Investigating the relationship between stress, anxiety and depression with the quality of life of patients with multiple sclerosis. The Journal of Tolooebehdasht. 2023;23(1):1-15.Available from: https://doi.org/10.18502/tbj.v22i1.12776 [Crossref]
38. Ardouin S, Ball L, Burch E, Barton C, Sturgiss E, Williams LT. The prevalence of psychological distress in adults newly diagnosed with type 2 diabetes: Data from the Australian 3D case series study. Health Promotion Journal of Australia. 2024;35(2):534-41.Available from: https://doi.org/10.1002/hpja.783 [Crossref]
39. Shareinia H, Mamashli F, Mehranipoor B, Sadegh-Moghadam L, Daneshfar M. The Relationship between Spiritual Health and Hope by Adherence to the Medication Regimen in the Elderly with Type 2 Diabetes. Journal of Health System Research. 2023;19(2):95-102.Available from: [Crossref]
40. Mashrouteh M, Khanjani N, Gozashti MH. Evaluation of compliance with drug regimens in diabetic patients referred to the endocrinology clinic of Afzalipour Hospital, Kerman, Iran. Health and Development Journal. 2012;1(3):182-92.Available from: https://jhad.kmu.ac.ir/article_91379_3fc31f244d4f034bb2fe9e7c4c298ebd.pdf. [In Persian]
41. Gholamaliei B, Karimi-Shahanjarini A, Roshanaei G, Rezapour-Shahkolaei F. Medication adherence and its related factors in patients with type II diabetes. Journal of Education and Community Health. 2016;2(4):3-12.Available from: https://doi.org/10.21859/jech-02042 [Crossref]
42. Firooz M, Hosseini SJ, Mazlom SR, Hasan Zadeh F, Kimiyaee SA. Self-care of the patient with diabetes type II. Journal of Sabzevar University of Medical Sciences. 2016;22(6):1018-25.Available from: https://jsums.medsab.ac.ir/article_786_en.html. [In Persian]

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