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Relationship Between Self-care Activities and Stigmatization in Patients with Type 2 Diabetes

Year 2025, Volume: 12 Issue: 1, 80 - 86, 22.04.2025

Hilal Türkben Polat , Zeynep Büşra Teke

https://doi.org/10.31125/hunhemsire.1478586

Abstract

Aims: This study was performed to determine the relationship between diabetes self-care activities (SCA) and stigmatization of patients with Type 2 Diabetes Mellitus (T2DM).
Materials and Methods: This is a descriptive and correlational study. The data were collected using the Sociodemographic Information Form, Summary of Diabetes Self-Care Activities (SDSCA) Measure, and Type-2 Diabetes Stigma Assessment Scale (DSAS-2)
Results: Patients with T2DM experience moderate levels of stigmatization. They have a moderate level of self-care activities (SCA) in the Diet, Blood Glucose, and Foot care subscales and low levels of SCA in the Exercise subscale. A negative correlation exists between stigmatization and exercise, blood glucose, and foot care—which are subscales of the self-care activities scale (p < 0.05). A positive correlation exists between BMI (Body Mass Index) and stigmatization and a negative correlation between BMI and Diet, Blood Glucose, Foot care, and Exercise subscales (p < 0.05).
Conclusion: Within the scope of holistic care, determining psychosocial factors including stigmatization as well as physiological parameters is important in routine follow-up of patients. Preventing stigmatization will positively affect self-care activities and, consequently, disease management.

Keywords

Nursing self -care stigmatization type 2 diabetes mellitus

Ethical Statement

The ethical permission of the study was obtained from Necmettin Erbakan University Health Sciences Scientific Research Ethics Committee (04.01.2023, 2022/362)

References

  • Akyirem, S., Ekpor, E., Namumbejja Abwoye, D., Batten, J., & Nelson, L. E. (2023). Type 2 diabetes stigma and its association with clinical, psychological, and behavioral outcomes: A systematic review and meta-analysis. Diabetes Research and Clinical Practice, 202, 110774.
  • Akyirem, S., Forbes, A., Wad, J. L., & Due-Christensen, M. (2022). Psychosocial interventions for adults with newly diagnosed chronic disease: A systematic review. Journal of Health Psychology, 27(7), 1753–1782.
  • Aslan, E. Ö., Toygar, İ., Feyizoğlu, G., Polat, S., & Eti Aslan, F. (2023). Relationship between insulin use and stigma in type 2 diabetes mellitus. Primary Care Diabetes, 17(4), 373–378.
  • Bonner, T., Foster, M., & Spears-Lanoix, E. (2016). Type 2 diabetes-related foot care knowledge and foot self-care practice interventions in the United States: A systematic review of the literature. Diabetic Foot & Ankle, 7, 29758.
  • Browne, J. L., Ventura, A. D., Mosely, K., & Speight, J. (2013). 'I call it the blame and shame disease': A qualitative study about perceptions of social stigma surrounding type 2 diabetes. BMJ Open, 3(11), e003384.
  • Browne, J. L., Ventura, A. D., Mosely, K., & Speight, J. (2016). Measuring the stigma surrounding type 2 diabetes: Development and validation of the Type 2 Diabetes Stigma Assessment Scale (DSAS-2). Diabetes Care, 39(12), 2141–2148. https://doi.org/10.2337/dc16-0117
  • Bukhsh, A., Goh, B. H., Zimbudzi, E., Lo, C., Zoungas, S., Chan, K. G., & Khan, T. M. (2020). Type 2 diabetes patients' perspectives, experiences, and barriers toward diabetes-related self-care: A qualitative study from Pakistan. Frontiers in Endocrinology, 11, 534873.
  • Cho, S. E., Kwon, M., & Kim, S. A. (2022). Influence of diabetes knowledge, self-stigma, and self-care behavior on quality of life in patients with diabetes. Healthcare, 10(10), 1983.
  • Coşansu Kuzu, G. (2009). Tip 2 diyabetlilerde özbakım aktiviteleri ve diyabete ilişkin bilişsel-sosyal faktörler [Doktora tezi, İstanbul Üniversitesi]. İstanbul Üniversitesi Tez Merkezi.
  • da Rocha, R. B., Silva, C. S., & Cardoso, V. S. (2020). Self-care in adults with type 2 diabetes mellitus: A systematic review. Current Diabetes Reviews, 16(6), 598–607.
  • Fransen, M. P., Beune, E. J., Baim-Lance, A. M., Bruessing, R. C., & Essink-Bot, M. L. (2015). Diabetes self-management support for patients with low health literacy: Perceptions of patients and providers. Journal of Diabetes, 7(3), 418–425.
  • Gredig, D., & Bartelsen-Raemy, A. (2017). Diabetes-related stigma affects the quality of life of people living with diabetes mellitus in Switzerland: Implications for healthcare providers. Health & Social Care in the Community, 25(5), 1620–1633.
  • Himmelstein, M. S., & Puhl, R. M. (2021). At multiple fronts: Diabetes stigma and weight stigma in adults with type 2 diabetes. Diabetic Medicine, 38(1), e14387.
  • IDF Diabetes Atlas. (2021). Diabetes around the world in 2021. Retrieved June 20, 2023, from https://diabetesatlas.org
  • İnkaya, B., & Karadağ, E. (2021). Turkish validity and reliability study of type 2 diabetes stigma assessment scale. Turkish Journal of Medical Sciences, 51, 1302–1309.
  • Kanaley, J. A., Colberg, S. R., Corcoran, M. H., Malin, S. K., Rodriguez, N. R., Crespo, C. J., & ACSM. (2022). Exercise/physical activity in individuals with type 2 diabetes: A consensus statement from the American College of Sports Medicine. Medicine & Science in Sports & Exercise, 54(2), 353–368.
  • Kato, A., Fujimaki, Y., Fujimori, S., Izumida, Y., Suzuki, R., & Ueki, K. (2016). Qualitative study on the impact of internalized stigma on type 2 diabetes self-management. Patient Education and Counseling, 99(7), 1233–1239.
  • Krzemińska, S., Lomper, K., Chudiak, A., Ausili, D., & Uchmanowicz, I. (2021). The association of the level of self-care on adherence to treatment in patients diagnosed with type 2 diabetes. Acta Diabetologica, 58(4), 437–445.
  • Li, X., Wu, L., Yun, J., & Sun, Q. (2023). The status of stigma in patients with type 2 diabetes mellitus and its association with medication adherence and quality of life in China: A cross-sectional study. Medicine, 102(26), e34242.
  • Liu, N. F., Brown, A. S., Folias, A. E., Guzman, S. J., Close, K. L., & Wood, R. (2017). Stigma in people with type 1 or type 2 diabetes. Clinical Diabetes, 35(1), 27–34.
  • Orem, D. E. (1985). A concept of self-care for the rehabilitation client. Rehabilitation Nursing, 10, 33–36.
  • Ozturk, A., Akin, S., & Kundakci, N. (2022). Self-esteem mediates the relationship perceived stigma with self-efficacy for diabetes management in individuals with type 2 diabetes mellitus. Saudi Medical Journal, 43(10), 1157–1164.
  • Pearl, R. L. (2018). Weight bias and stigma: Public health implications and structural solutions. Social Issues & Policy Review, 12, 146–182.
  • Puhl, R. M., Himmelstein, M. S., Hateley-Browne, J. L., & Speight, J. (2020). Weight stigma and diabetes stigma in U.S. adults with type 2 diabetes: Associations with diabetes self-care behaviors and perceptions of health care. Diabetes Research and Clinical Practice, 168, 108387.
  • Schabert, J., Browne, J. L., Mosely, K., & Speight, J. (2013). Social stigma in diabetes: A framework to understand a growing problem for an increasing epidemic. Patient, 6(1), 1–10.
  • TEMD Diabetes Mellitus Çalışma ve Eğitim Grubu. (2022). TEMD diabetes mellitus ve komplikasyonlarının tanı, tedavi ve izlem kılavuzu 2022. Retrieved June 15, 2023, from https://file.temd.org.tr/Uploads/publications/guides/documents/diabetes-mellitus_2022.pdf
  • Toobert, D. J., & Glasgow, R. E. (1994). Assessing diabetes of self-management: The summary of diabetes self-care activities questionnaire. In C. Bradley (Ed.), Handbook of Psychology and Diabetes (pp. 351–375). Harwood Academic Publishers.
  • Toobert, D. J., Hampson, S. E., & Glasgow, R. E. (2000). The summary of diabetes self-care activities measure: Results from 7 studies and a revised scale. Diabetes Care, 23(7), 943–950.
  • Woon, L. S., Sidi, H. B., Ravindran, A., Gosse, P. J., Mainland, R. L., Kaunismaa, E. S., et al. (2020). Depression, anxiety, and associated factors in patients with diabetes: Evidence from the Anxiety, Depression, and Personality Traits in Diabetes Mellitus (ADAPT-DM) study. BMC Psychiatry, 20, 227.

Tip 2 Diyabetli Hastaların Kendini Damgalamaları ile Özbakım Aktiviteleri Arasındaki İlişki

Year 2025, Volume: 12 Issue: 1, 80 - 86, 22.04.2025

Hilal Türkben Polat , Zeynep Büşra Teke

https://doi.org/10.31125/hunhemsire.1478586

Abstract

Amaç: Bu çalışma, tip 2 Diyabetes Mellituslu (T2DM) hastaların diyabet öz bakım aktiviteleri ile damgalanmaları arasındaki ilişkiyi belirlemek amacıyla yapıldı.
Gereç ve Yöntem: Tanımlayıcı ve ilişkisel bir çalışmadır. Veriler Sosyodemografik Bilgi Formu, Diyabet Öz Bakım Faaliyetleri Anketi (SDSCA) ve Tip 2 Diyabet için Stigma Değerlendirme Ölçeği (DSAS-2) kullanılarak toplanmıştır.
Bulgular: T2DM'li hastalar orta düzeyde damgalanma yaşamaktadır. Diyet, Kan Şekeri ve Ayak Bakımı alt ölçeklerinde orta düzeyde öz bakım aktivitelerine (SCA) ve Egzersiz alt ölçeğinde düşük düzeyde SCA'ya sahiptirler. Damgalama ile öz bakım aktiviteleri ölçeğinin alt ölçekleri olan egzersiz, kan şekeri ve ayak bakımı arasında negatif korelasyon bulunmaktadır (p < 0,05). BKI (Beden Kitle İndeksi) ile damgalanma arasında pozitif, BKI ile Diyet, Kan Şekeri, Ayak Bakımı ve Egzersiz alt ölçekleri arasında ise negatif korelasyon vardır (p < 0.05).
Sonuç: Bütünsel bakım kapsamında hastaların rutin takibinde fizyolojik parametrelerin yanı sıra damgalanmayı da içeren psikososyal faktörlerin belirlenmesi önemlidir. Damgalanmanın önlenmesi öz bakım faaliyetlerini ve dolayısıyla hastalık yönetimini olumlu yönde etkileyecektir.

Keywords

Damgalama hemşirelik özbakım tip 2 diabetes mellitus

References

  • Akyirem, S., Ekpor, E., Namumbejja Abwoye, D., Batten, J., & Nelson, L. E. (2023). Type 2 diabetes stigma and its association with clinical, psychological, and behavioral outcomes: A systematic review and meta-analysis. Diabetes Research and Clinical Practice, 202, 110774.
  • Akyirem, S., Forbes, A., Wad, J. L., & Due-Christensen, M. (2022). Psychosocial interventions for adults with newly diagnosed chronic disease: A systematic review. Journal of Health Psychology, 27(7), 1753–1782.
  • Aslan, E. Ö., Toygar, İ., Feyizoğlu, G., Polat, S., & Eti Aslan, F. (2023). Relationship between insulin use and stigma in type 2 diabetes mellitus. Primary Care Diabetes, 17(4), 373–378.
  • Bonner, T., Foster, M., & Spears-Lanoix, E. (2016). Type 2 diabetes-related foot care knowledge and foot self-care practice interventions in the United States: A systematic review of the literature. Diabetic Foot & Ankle, 7, 29758.
  • Browne, J. L., Ventura, A. D., Mosely, K., & Speight, J. (2013). 'I call it the blame and shame disease': A qualitative study about perceptions of social stigma surrounding type 2 diabetes. BMJ Open, 3(11), e003384.
  • Browne, J. L., Ventura, A. D., Mosely, K., & Speight, J. (2016). Measuring the stigma surrounding type 2 diabetes: Development and validation of the Type 2 Diabetes Stigma Assessment Scale (DSAS-2). Diabetes Care, 39(12), 2141–2148. https://doi.org/10.2337/dc16-0117
  • Bukhsh, A., Goh, B. H., Zimbudzi, E., Lo, C., Zoungas, S., Chan, K. G., & Khan, T. M. (2020). Type 2 diabetes patients' perspectives, experiences, and barriers toward diabetes-related self-care: A qualitative study from Pakistan. Frontiers in Endocrinology, 11, 534873.
  • Cho, S. E., Kwon, M., & Kim, S. A. (2022). Influence of diabetes knowledge, self-stigma, and self-care behavior on quality of life in patients with diabetes. Healthcare, 10(10), 1983.
  • Coşansu Kuzu, G. (2009). Tip 2 diyabetlilerde özbakım aktiviteleri ve diyabete ilişkin bilişsel-sosyal faktörler [Doktora tezi, İstanbul Üniversitesi]. İstanbul Üniversitesi Tez Merkezi.
  • da Rocha, R. B., Silva, C. S., & Cardoso, V. S. (2020). Self-care in adults with type 2 diabetes mellitus: A systematic review. Current Diabetes Reviews, 16(6), 598–607.
  • Fransen, M. P., Beune, E. J., Baim-Lance, A. M., Bruessing, R. C., & Essink-Bot, M. L. (2015). Diabetes self-management support for patients with low health literacy: Perceptions of patients and providers. Journal of Diabetes, 7(3), 418–425.
  • Gredig, D., & Bartelsen-Raemy, A. (2017). Diabetes-related stigma affects the quality of life of people living with diabetes mellitus in Switzerland: Implications for healthcare providers. Health & Social Care in the Community, 25(5), 1620–1633.
  • Himmelstein, M. S., & Puhl, R. M. (2021). At multiple fronts: Diabetes stigma and weight stigma in adults with type 2 diabetes. Diabetic Medicine, 38(1), e14387.
  • IDF Diabetes Atlas. (2021). Diabetes around the world in 2021. Retrieved June 20, 2023, from https://diabetesatlas.org
  • İnkaya, B., & Karadağ, E. (2021). Turkish validity and reliability study of type 2 diabetes stigma assessment scale. Turkish Journal of Medical Sciences, 51, 1302–1309.
  • Kanaley, J. A., Colberg, S. R., Corcoran, M. H., Malin, S. K., Rodriguez, N. R., Crespo, C. J., & ACSM. (2022). Exercise/physical activity in individuals with type 2 diabetes: A consensus statement from the American College of Sports Medicine. Medicine & Science in Sports & Exercise, 54(2), 353–368.
  • Kato, A., Fujimaki, Y., Fujimori, S., Izumida, Y., Suzuki, R., & Ueki, K. (2016). Qualitative study on the impact of internalized stigma on type 2 diabetes self-management. Patient Education and Counseling, 99(7), 1233–1239.
  • Krzemińska, S., Lomper, K., Chudiak, A., Ausili, D., & Uchmanowicz, I. (2021). The association of the level of self-care on adherence to treatment in patients diagnosed with type 2 diabetes. Acta Diabetologica, 58(4), 437–445.
  • Li, X., Wu, L., Yun, J., & Sun, Q. (2023). The status of stigma in patients with type 2 diabetes mellitus and its association with medication adherence and quality of life in China: A cross-sectional study. Medicine, 102(26), e34242.
  • Liu, N. F., Brown, A. S., Folias, A. E., Guzman, S. J., Close, K. L., & Wood, R. (2017). Stigma in people with type 1 or type 2 diabetes. Clinical Diabetes, 35(1), 27–34.
  • Orem, D. E. (1985). A concept of self-care for the rehabilitation client. Rehabilitation Nursing, 10, 33–36.
  • Ozturk, A., Akin, S., & Kundakci, N. (2022). Self-esteem mediates the relationship perceived stigma with self-efficacy for diabetes management in individuals with type 2 diabetes mellitus. Saudi Medical Journal, 43(10), 1157–1164.
  • Pearl, R. L. (2018). Weight bias and stigma: Public health implications and structural solutions. Social Issues & Policy Review, 12, 146–182.
  • Puhl, R. M., Himmelstein, M. S., Hateley-Browne, J. L., & Speight, J. (2020). Weight stigma and diabetes stigma in U.S. adults with type 2 diabetes: Associations with diabetes self-care behaviors and perceptions of health care. Diabetes Research and Clinical Practice, 168, 108387.
  • Schabert, J., Browne, J. L., Mosely, K., & Speight, J. (2013). Social stigma in diabetes: A framework to understand a growing problem for an increasing epidemic. Patient, 6(1), 1–10.
  • TEMD Diabetes Mellitus Çalışma ve Eğitim Grubu. (2022). TEMD diabetes mellitus ve komplikasyonlarının tanı, tedavi ve izlem kılavuzu 2022. Retrieved June 15, 2023, from https://file.temd.org.tr/Uploads/publications/guides/documents/diabetes-mellitus_2022.pdf
  • Toobert, D. J., & Glasgow, R. E. (1994). Assessing diabetes of self-management: The summary of diabetes self-care activities questionnaire. In C. Bradley (Ed.), Handbook of Psychology and Diabetes (pp. 351–375). Harwood Academic Publishers.
  • Toobert, D. J., Hampson, S. E., & Glasgow, R. E. (2000). The summary of diabetes self-care activities measure: Results from 7 studies and a revised scale. Diabetes Care, 23(7), 943–950.
  • Woon, L. S., Sidi, H. B., Ravindran, A., Gosse, P. J., Mainland, R. L., Kaunismaa, E. S., et al. (2020). Depression, anxiety, and associated factors in patients with diabetes: Evidence from the Anxiety, Depression, and Personality Traits in Diabetes Mellitus (ADAPT-DM) study. BMC Psychiatry, 20, 227.
There are 29 citations in total.

Details

Primary Language English
Subjects Fundamentals of Nursing
Journal Section Research Article
Authors

Hilal Türkben Polat 0000-0002-4848-0993

Zeynep Büşra Teke 0000-0001-6268-2789

Publication Date April 22, 2025
Submission Date May 4, 2024
Acceptance Date January 18, 2025
Published in Issue Year 2025 Volume: 12 Issue: 1

Cite

APA Türkben Polat, H., & Teke, Z. B. (2025). Relationship Between Self-care Activities and Stigmatization in Patients with Type 2 Diabetes. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi, 12(1), 80-86. https://doi.org/10.31125/hunhemsire.1478586