J Menopausal Med.  2017 Aug;23(2):108-116. 10.6118/jmm.2017.23.2.108.

Effects of Group Counseling on Self-care Behaviors in Menopausal Women with Diabetes

• Parsa P
• Ahmadinia Tabesh R
• Soltani F
• Karami M
• Khorami N

• KMID: 2389226
• DOI: http://doi.org/10.6118/jmm.2017.23.2.108

Abstract

OBJECTIVES
Diabetes is a chronic disease which is common in menopause period. Performing self-care behaviors is effective method for control of diabetes. This study aimed to investigate the effect of counseling on self-care behaviors in menopause diabetes women in 2016 in Hamadan, Iran.
METHODS
In this study, 80 menopausal women were randomly selected and allocated to the experimental and control groups (40 per group). Data collected by a questionnaire included of demographic information, self-care behaviors, fasting blood sugar (FBS) and glycosylated hemoglobin (HbA1c). In the experimental group, training program was run during four sessions in the form of weekly group consulting sessions. During this period, the control group only received routine cares. Three months after intervention (group consultation) self-care behaviors, FBS and HbA1c were compared between two groups. Data were analyzed using SPSS 16 software.
RESULTS
The self-care score in the experimental group increased from 49.6 ± 12.2 before the intervention to 66.6 ± 9.3 after the intervention (P < 0.05). Also in the control group average of self-care score changed from 57.6 ± 11.5 to 62.0 ± 11.6 (P < 0.05). Three months after the group consultation, there was a significant difference between two groups in the dimensions of diet (P = 0.013), exercise (P = 0.009) and foot care (P < 0.001). In the experimental group, FBS decreased from 148.8 ± 62.4 mg/dL to 128.9 ± 46.3 mg/dL. Also, HbA1c changed from 7.2 ± 1.8 g/dL to 6.8 ± 1.6 g/dL three months after intervention (P = 0.058). No significant changes were observed in FBS and HbA1c in the control group.
CONCLUSIONS
The results showed that group counseling promoted self-care behaviors and metabolic indices in menopausal diabetic patients.

Keyword

Blood sugar; Diabetes; HbA1C; Menopause; Self-care; Women

MeSH Terms

Blood Glucose
Chronic Disease
Counseling*
Diet
Education
Fasting
Female
Foot
Hemoglobin A, Glycosylated
Humans
Iran
Menopause
Methods
Self Care*
Blood Glucose

Reference

1. Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA. 2002; 288:321–333.

2. Aghamolaei T, Eftekhar H, Mohammad K, Sobhani A, Shojaeizadeh D, Nakhjavani M, et al. Influence of educational intervention using interaction approach on behavior change, hemoglobin A1c and health-related quality of life in diabetic patients. J Sch Public Health Inst Public Health Res. 2005; 3:1–2.

3. Speroff L, Fritz MA. Clinical gynecologic endocrinology and infertility. 7th ed. Philadelphia, PA: Lippincot Williams Wilkins;2005.

4. Tofighi A. Impact of water training on serum adiponectin level and insulin resistance in obese postmenopausal women. Iran J Endocrinol Metab. 2010; 12:260–267.

5. Chae HD, Choi SY, Cho EJ, Cho YM, Lee SR, Lee ES, et al. Awareness and experience of menopausal symptom and hormone therapy in korean postmenopausal women. J Menopausal Med. 2014; 20:7–13.

6. Shidfar F, Yarahmadi SH, Jalali M, Eftekhari MH, Hosseyni SH, Ahari L. Effects of purified omega-3 fatty acids in postmenopausal women with type 2 diabetes. Iran J Endocrinol Metab. 2007; 9:229–234.

7. Darvishpoor Kakhki A, Abed Saeedi Z, Yaghmaie F, Alavi Majd H, Montazeri A. Survey correlation between quality of life and disease and demographic variables of diabetic patients referred to Tehran hospitals in 2004. Iran J Endocrinol Metab. 2006; 8:49–56.

8. Esmaili A, Asadnia S, Easazadeh A, Amirsardari L, Issazadeghan A, Ansari B. Evaluation of the effectiveness of cognitive behavioral therapy on decreasing depression levels and improving the lifestyle of patients with type 2 diabetes. J Urmia Univ Med Sci. 2013; 24:812–822.

9. Vosoghi Karkazloo N, Abootalebi Daryasari G, Farahani B, Mohammadnezhad E, Sajjadi A. The study of self-care agency in patients with diabetes (Ardabil). Mod Care J. 2012; 8:197–204.

10. Vinter-Repalust N, Petricek G, Katić M. Obstacles which patients with type 2 diabetes meet while adhering to the therapeutic regimen in everyday life: qualitative study. Croat Med J. 2004; 45:630–636.

11. Mazlom S, Firooz M, Hasanzade F, Kimiaee S, Raoufsaeb A. The effect of group counseling on physiological aspect of self-care and HbA1C level of patients with diabetes type II. Evid Based Care J. 2015; 5:25–36.

12. Aghvamy MS, Mohammadzadeh S, Gallalmanesh M, Zare R. Assessment the education compariment to two ways: groupe education and computer education on quality of life in the children 8-12 years suffering from asthma in the Valiasr hospital of Zanjan. ZUMS J. 2011; 19:78–85.

13. Gallant MP. The influence of social support on chronic illness self-management: a review and directions for research. Health Educ Behav. 2003; 30:170–195.

14. Mahmoodi A, Alavi M, Mosavi N. The relationship between self-care behaviors and HbA1c in diabetic patients. Sci J Hamadan Nurs Midwifery Fac. 2012; 20:20–30.

15. United States Agency for International Development. Population reports GATHER approach to counseling about injectables: Depo-Provera and Noristerat. Baltimore, MD: United States Agency for International Development;Cited by 1995 Aug 2. Available from: https://www. k4health.org/sites/default/files/305360.pdf.

16. Adler AI, Stratton IM, Neil HA, Yudkin JS, Matthews DR, Cull CA, et al. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. BMJ. 2000; 321:412–419.

17. Baghery H, Memarian R, Elhani F. Survey the effect of group counseling on quality of life in myocardial infarction patients who have been referred to the clinics of Imam Khomeini and Shariati Hospitals in Tehran. Hakim. 2004; 6:89–95.

18. Karimoi HM, Pourdehghan M, Faghihzadeh S, Montazeri A, Milani JM. The effects of group counseling on symptom scales of life quality in patients with breast cancer treated by chemotherapy. J Kermanshah Univ Med Sci. 2006; 10:10–22.

19. Taylor CR, Lillis C, LeMone P, Lynn P, LeBon M. Study guide for fundamentals of nursing: the art and science of nursing care. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins;2011.

20. Taechakraichana N, Jaisamrarn U, Panyakhamlerd K, Chaikittisilpa S, Limpaphayom KK. Climacteric: concept, consequence and care. J Med Assoc Thai. 2002; 85:Suppl 1. S1–S15.

21. Lazarus JV, Rasch V, Liljestrand J. Midwifery at the crossroads in Estonia: attitudes of midwives and other key stakeholders. Acta Obstet Gynecol Scand. 2005; 84:339–348.

22. Parsa P, Tabesh RA, Soltani F, Karami M. Effect of group counseling on quality of life among postmenopausal women in Hamadan, Iran. J Menopausal Med. 2017; 23:49–55.

23. Barati M, Ahmadpanah M, Shirahmadi S, Bashirian S, Parsa P, Holsboer-Trachsler E, et al. Differential impact of sociodemographic variables on the quality of life of menopausal Iranian women. Avicenna J Neuro Psycho Physiol. 2016; 3:e39026.

24. Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, et al. National standards for diabetes self-management education. Diabetes Care. 2010; 33:S89–S96.

25. Parizad N, Hemmati Maslakpak M, Khalkhali HR. Promoting self-care in patients with type 2 diabetes: Teleeducation. Hakim. 2013; 16:220–227.

26. Toobert D, Glasgow R. Assessing diabetes self-management: the summary of diabetes self-care activities questionnaire. In: Bradley C, editor. Handbook of psychology and diabetes: a guide to psychological measurement in diabetes research and practice. London, UK: Harwood Academic Publishers;1994.

27. Karlsen B, Idsoe T, Dirdal I, Rokne Hanestad B, Bru E. Effects of a group-based counselling programme on diabetes-related stress, coping, psychological well-being and metabolic control in adults with type 1 or type 2 diabetes. Patient Educ Couns. 2004; 53:299–308.

28. Jalilian F, Motlagh FZ, Solhi M. Effectiveness of education program on increasing self management among patients with type II diabetes. J Ilam Univ Med Sci. 2012; 20:26–34.

29. Hazavehei S, Sharifirad G, Mohabi S. The effect of educational program based on health belief model on diabetic foot care. Int J Diabetes Dev Ctries. 2007; 27:82–90.

30. Rubin RR, Peyrot M, Saudek CD. Differential effect of diabetes education on self-regulation and life-style behaviors. Diabetes Care. 1991; 14:335–338.

31. Parham M, Riahin AA, Jandaghi M, Darivandpour A. Self care behaviors of diabetic patients in Qom. Qom Univ Med Sci J. 2012; 6:81–87.

32. Hordern MD, Dunstan DW, Prins JB, Baker MK, Singh MA, Coombes JS. Exercise prescription for patients with type 2 diabetes and pre-diabetes: a position statement from Exercise and Sport Science Australia. J Sci Med Sport. 2012; 15:25–31.

33. Aghamilaei T, Sobhani A, Yusefi H, Asadi Noghabi F. Behavior and metabolic control in diabetic patients in Bandar Abbas diabetic clinic. Med J Hormozgan Univ. 2003; 7:5–11.

34. Shayeghian Z, Aguilar-Vafaie M, Ali Besharat M, Amiri P, Parvin M, Roohi Gilani K. The association between self-care and control of blood sugar and health-related quality of life in type II diabetes patients. Iran J Endocrinol Metab. 2014; 15:545–551.

35. Rakhshandero S, Ghafari M, Heidarnia AR, Rajab A. Effectiveness of an educational intervention on metabolic control of diabetic patients attending Iranian diabetes association. Iran J Diabetes Lipid Disord. 2009; 1:57–64.

36. Kashfi SM, Khani Jyhouni A, Bahadori Khalili R, Hatami M. Evaluation of the effects of educating about nutrition and jogging on the blood sugar of type II diabetic patients of a clinic in Shiraz, Iran. Hakim Health Sys Res. 2009; 12:54–60.

37. Milenković T, Gavrilović S, Percan V, Petrovski G. Influence of diabetic education on patient well-being and metabolic control. Diabetol Croat. 2004; 33:91–96.

38. Kim TH, Choi SD, Woo SH. An ethical issue in medical education of obstetrics and gynecology. J Menopausal Med. 2015; 21:130–132.