Community Health Journal

Community Health Journal

The Effect of Self-care Training on Perceived Stress, Health Literacy, and Self-care Behaviors in Women with Gestational Diabetes

Document Type : Original Article

Authors
F S Karbalai Harafteh 1
Z Karami Mohajeri 2
S Kia 2
1 Assistant Prof, Dept of Educational Sciences, Zahedan Branch, Islamic Azad University, Zahedan, Iran.
2 Ph.D. Student, Dept of Psychology, Zahedan Branch, Islamic Azad University, Zahedan, Iran.
10.22123/chj.2020.221529.1450
Abstract
Introduction: Gestational diabetes is one of the most common health problems during pregnancy that sometimes can lead to disability, death, and type 2 diabetes. Self-care training is one of the effective methods to improve health-related characteristics. Accordingly, the present study aims to determine the effect of self-care training on perceived stress, health literacy, and self-care behaviors in women with gestational diabetes.
Materials and Methods: The present study was semi-experimental with pretest-posttest design with experimental and control groups. The research population was women with gestational diabetes referred to health and care centers of Zahedan city in 2019, from whom 50 people were selected by the available sampling method. Those selected were assigned to two equal groups via a simple random method with a lottery. The experimental group received 6 60-minute sessions of self-care training, and the control group did not receive any except for routine training. Research instruments were the questionnaires of perceived stress, health literacy, and self-care behaviors. Data were analyzed using the chi-square test, independent t-test, and multivariate analysis of covariance.
Results: The experimental and control groups in the pretest stage showed no significant difference in terms of perceived stress, health literacy, and self-care behaviors (p>0/05); however, in the posttest stage, there was a significant difference in three mentioned variables (p<0/001). In other words, the self-care training method led to a significant decrease in perceived stress and a significant increase in health literacy and self-care behaviors in women with gestational diabetes (p<0/001).
Conclusion: The results indicate the positive effect of self-care training on decreasing perceived stress and increasing health literacy and self-care behaviors. Therefore, it is essential to plan diabetes self-care training for women with gestational diabetes and even those who intend to become pregnant to improve health-related characteristics.
Keywords
Self-care training
Perceived stress
Health literacy
Self-care behaviors
Gestational diabetes
  1. Zhang J, Zhang Y, Wang J, Yu F. Characteristics of bone turnover markers in women with gestational diabetes mellitus. Clinical Biochemistry 2020;77:36-40.
  2. Arafa A, Dong J-Y. Gestational diabetes and risk of postpartum depressive symptoms: A meta-analysis of cohort studies. Journal of affective disorders 2019;253:312-6.
  3. Vince K, Poljičanin T, Brkić M, Rodin U, Matijević R. Prevalence of diabetes five years after having gestational diabetes during pregnancy—Croatian national study. Primary care diabetes 2018;12(4):325-30.
  4. Arda Sürücü H, Büyükkaya Besen D, Duman M, Erbil EY, Ay I. Are levels of coping with stress in pregnancy with gestational diabetes worse than in healthy pregnancy? Journal of Psychosomatic Obstetrics & Gynecology 2019;40(2):114-22.
  5. Xia Y, Ma Z. Social integration, perceived stress, locus of control, and psychological wellbeing among Chinese emerging adult migrants: A conditional process analysis. Journal of Affective Disorders 2020;267:9-16.
  6. Turel O, Cavagnaro DR, Meshi D. Short abstinence from online social networking sites reduces perceived stress, especially in excessive users. Psychiatry research 2018;270:947-53.
  7. Mohamed SH, Ahmed AA. Educational program for health literacy among pregnant women with gestational diabetes: Its effect on Maternal & fetal outcomes. International Journal of Nursing Didactics2019 9 (4): 61-72.
  8. Zuercher E, Diatta ID, Burnand B, Peytremann-Bridevaux I. Health literacy and quality of care of patients with diabetes: A cross-sectional analysis. Primary care diabetes 2017;11(3):233-40.
  9. Lee E-H, Lee YW, Lee K-W, Nam M, Kim SH. A new comprehensive diabetes health literacy scale: Development and psychometric evaluation. International journal of nursing studies 2018;88:1-8.
  10. Moses M, Olenik NL. Perceived impact of caregiver’s participation in diabetes education classes on implementation of self-care behaviors. Journal of the American Pharmacists Association 2019;59(4):S47-S51. e1.
  11. Creber RM, Patey M, Lee CS, Kuan A, Jurgens C, Riegel B. Motivational interviewing to improve self-care for patients with chronic heart failure: MITI-HF randomized controlled trial. Patient education and counseling 2016;99(2):256-64.
  12. Han A, Choi JS. Factors influencing infection prevention self-care behaviors in patients with hematologic cancer after discharge. European Journal of Oncology Nursing 2018;35:102-6.
  13. Wang Z, Yin G, Jia R. Impacts of self-care education on adverse events and mental health related quality of life in breast cancer patients under chemotherapy. Complementary therapies in medicine 2019;43:165-9.
  14. Jerant A, Hanson B, Kravitz RL, Tancredi DJ, Hanes E, Grewal S, et al. Detecting the effects of physician training in self-care interviewing skills: Coding of standardized patient (SP) visit recordings versus SP post-visit ratings. Patient education and counseling 2017;100(2):367-71.
  15. Baraz S, Zarea K, Shahbazian HB. Impact of the self-care education program on quality of life in patients with type II diabetes. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2017;11:S1065-S8.
  16. Khadivzadeh T, Azhari S, Esmaily H, Akhlaghi F, Sardar MA. Effects of self-care education on perceived stress in women with gestational diabetes under insulin treatment. Evidence Based Care. 2015;5(3):7-18. [Persian]
  17. Rostami F, Ramezani Badr F, Amini K, Pezeshki A. Effect of a self-care educational program based on Orem's model on stress in patients undergoing hemodialysis. Preventive Care in Nursing & Midwifery Journal 2015;5(1):13-22. [Persian]
  18. Myers SB, Sweeney AC, Popick V, Wesley K, Bordfeld A, Fingerhut R. Self-care practices and perceived stress levels among psychology graduate students. Training and Education in Professional Psychology 2012;6(1):55-66.
  19. Ganji S, Peyman N, Meysami BS, Esmaily H. Effect of self-care training program on quality of life and health literacy in the patients with essential hypertension. MJMUM 2018; 60(6): 792-803. [Persian]
  20. Lee E-H, Lee YW, Moon SH. A structural equation model linking health literacy to self-efficacy, self-care activities, and health-related quality of life in patients with type 2 diabetes. Asian nursing research 2016;10(1):82-7.
  21. Ghotbi N. Seyed Bagher Maddah S, Dalvandi A, Arsalani N, Farzi M. The effect of education of self care behaviors based on family-centered empowerment model in type II diabetes. Journal of Shahid Beheshti School of Nursing & Midwifery 2014;23(83):43-50. [Persian]
  22. Ahmadi Z, Sadeghi T, Loripoor M. The effect of peer education on self-care behaviors among diabetic patients. Iranian Journal of Diabetes and Metabolism 2016;15(6):382-91. [Persian]
  23. Madmoli M, Khodadadi M, Ahmadi FP, Niksefat M. A Systematic review on the impact of peer education on self-care behaviors of patients. International Journal of Health and Biological Sciences 2019;2(1):1-5.
  24. Aghakhani N, Khademvatan K, Baghaei R, Sanae K. The impact of educational-supportive self-care package on anxiety, depression and stress in myocardial infarction patients hospitalized in shahid gholipour hospital, boukan, Iran, 2016. The J Urmia Nurs Midwifery Fac 2017;15(4):281-91. [Persian]
  25. Abbasi Fashami M, Hajian S, Afrakhteh M, Khabaz Khoob M. Relationship between level of red blood cell indices and risk of gestational diabetes mellitus: a case-control study. The Iranian Journal of Obstetrics, Gynecology and Infertility 2019;22(4):36-43. [Persian]
  26. Baigan K, Khoshkonesh A, Habibi Askarabad M, Fallahzade H. Effectiveness of dialectical behavioral group therapy in alexithymia, stress, and diabetes symptoms among type 2 diabetes patients. Journal of Diabetes Nursing 2016;4(3):8-18. [Persian]
  27. Mahdi H, Maddah SMB, Mahammadi F. The effectiveness of self-care training on quality of life among elderlies with diabetes. Iranian Journal of Rehabilitation Research 2016;2(4):32-9. [Persian]
  28. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. Journal of health and social behavior 1983;24(4):385-96.
  29. Azizi A, Dehghan Manshadi S, Mohamadi J. Comparison of the Quality of Life and Perceived Stress in Gastric and Lung Cancer Patients and Normal Subjects in the city of Tabriz in 2014. Community Health Journal 2017;9(3):1-8. [Persian]
  30. Ishikawa H, Takeuchi T, Yano E. Measuring functional, communicative, and critical health literacy among diabetic patients. Diabetes care 2008;31(5):874-9.
  31. Reisi M, Mostafavi F, Javadzade H, Mahaki B, Tavassoli E, Sharifirad G. Communicative and critical health literacy and self-care behaviors in patients with type 2 diabetes. Iranian journal of Diabetes and Metabolism 2016;14(3):199-208. [Persian]
  32. Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes care 2000;23(7):943-50.
  33. Hamadzadeh S, Ezatti Z, Abedsaeidi Z, Nasiri N. Coping styles and self-care behaviors among diabetic patients. Iran Journal of Nursing 2013;25(80):24-33. [Persian]