Integrating Theory and Research: Directions for Promoting Mental Health for Managing Diabetes Distress

Abstract

Diabetes, a common chronic illness, witnessed a sharp increase in its prevalence globally after COVID 19. Presently, about 20 million people in India and 537 million globally are suffering from diabetes. Factors to be inculpated for the illness include biological, social, environmental and psychological factors, along with lifestyle. Thus, the treatment should focus on all the aspects for a fully functioning individual. Further, the diabetes care regimen may become overwhelming resulting in diabetes distress and interfering with diabetes management. Interventions tailored for diabetics have been suggested as a solution to increase adherence to medications and diabetes care regimen, while improving physical and mental health. This systematic review examined intervention-based studies on Gratitude, Hope, Humor and Mindfulness, from 2000 to July 2023, having effects on psychological, medical, behavioural and psycho-social outcomes in diabetics. The review followed PRISMA (2020) guidelines; 15 studies were extracted according to set PICOS framework which supported significance of positive psychological interventions in diabetes care. Quality of studies were determined using “Quality Assessment Tool for Quantitative Studies” developed by Effective Public Health Practice Project (EPHPP, 1998). Results indicate improvement in psychological outcomes, most commonly stress, anxiety and depression. Medical outcomes such as glycaemic control, cortisol levels and glucose monitoring approached close to optimum levels. Behavioural outcomes including diabetes self-management, adherence and diabetes-care, and psycho-social outcomes enhanced after interventions. Significant results in diverse outcomes indicates importance of interventions while guiding for development of more specific diabetes-tailored interventions to manage diabetes distress and promote overall health.

PUBLIC SIGNIFICANCE STATEMENT

The review suggest the effectiveness of psychological interventions, based on Gratitude, Hope, Humor and Mindfulness, in improving psychological, medical, behavioural and psycho-social outcomes in diabetics. It presents the need for development of diabetes-specific interventions which will benefit health practitioners, healthcare organizations and social workers to take better care of people’s health. The policy makers get support towards implementation of interdisciplinary modules for treatment to enhance healthcare system.