Iran Journal of Nursing
نشریه پرستاری ایران
IJN
Medical Sciences
http://ijn.iums.ac.ir
108
journal108
2008-5931
2008-5931
10.52547/ijn
fa
jalali
1399
11
1
gregorian
2021
2
1
33
128
online
1
fulltext
fa
احساس تنهایی و عوامل مرتبط با آن در سالمندان مبتلا به دیابت نوع دو: یک مطالعه توصیفی- مقطعی
Loneliness and the Contributing Factors in the Elderly Patients with Type II Diabetes: A Descriptive Cross-sectional Study
پرستاری
nursing
پژوهشي
Research
<div style="text-align: justify;"><strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">زمینه و هدف:</span></span></strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">. شناسایی مشکلات روانشناختی مرتبط با بیماری دیابت به یکی از اولویتهای مراقبتهای بهداشتی تبدیل شده است</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">.</span></span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> احساس تنهایی یکی از شاخصهای مهم سلامت روانشناختی محسوب میشود و این شاخص ارتباط دوطرفهای با بیماری دیابت دارد و عامل مهمی در درمان این بیماران است. بنابراین این مطالعه با هدف تعیین احساس تنهایی و عوامل مرتبط با آن در سالمندان مبتلا به دیابت نوع دو انجام شده است.</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"></span></span></span><br>
<strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">روش بررسی: </span></span></strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">پژوهش حاضر، یک مطالعه توصیفی- مقطعی </span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">است. در این مطالعه</span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> 257 نفر از سالمندان مبتلا به دیابت نوع دو وابسته به انسولین مراجعه کننده به </span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">مراکز بهداشتی مراقبت جامع سالمندان دانشگاه علوم پزشکی ایران</span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">، به مدت سه ماه (مهر ماه تا آذر ماه سال 1398) وارد مطالعه شدند. نمونهگیری به روش مستمر انجام شد. ابزار گردآوری دادهها شامل <span style="color:black;">فرم کوتاه شدهی آزمون شناختی، فرم مشخصات جمعیت شناختی و پرسشنامه </span></span><span style="color:black;">احساس تنهایی بود. </span></span>دادهها با آمار توصیفی و آمار استنباطی همچون<span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> آزمون تی مستقل و آنالیز واریانس</span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> در <span style="color:black;">نرم افزار </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">SPSS</span></span></span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> نسخه 16 در سطح معنیداری (</span></span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">05/0</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">p≤ </span></span></span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">) مورد تجزیه و تحلیل قرار گرفت</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">.</span></span></span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"></span></span><br>
<strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">یافتهها: </span></span></strong><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">نتایج نشان داد</span></span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> 3/55 درصد از سالمندان مورد مطالعه در محدوده سنی بین 60 تا 69 سال بودند. </span></span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">3/55 درصد </span></span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">نمونهها زن و 7/44 درصد </span></span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">مرد بودند. 4/65 درصد آنها با همسر خود زندگی میکردند و 9/96 درصد نمونهها دارای بیمه بودند. </span></span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">نتایج مطالعه در خصوص ارتباط احساس تنهایی با مشخصات جمعیت شناختی در بیماران نشان داد که احساس تنهایی با سن (001/0</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">p<</span></span></span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">)، وضعیت تأهل (001/0</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">p<</span></span></span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">)، وضعیت شغلی (001/0</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">p<</span></span></span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">)،</span></span></span> <span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">فردی که در کنار سالمند زندگی میکند (001/0</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">p<</span></span></span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">)، بیشترین پشتیبان (001/0</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">p<</span></span></span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">)، مهم ترین نیاز در زندگی (001/0</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">p<</span></span></span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">) و وضعیت بیمه (032/0</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">p=</span></span></span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">) ارتباط معنیدار آماری داشته است. مقایسه دو به دو آزمون توکی نشان دهنده آن بود که احساس تنهایی در سالمندان با سن بیشتر از 80 سال به طور معنیداری بیشتر از سالمندان 60 تا 69 سال بود. احساس تنهایی در متأهلین به طور معنیداری کمتر از دیگر سالمندان مطلقه، بیوه و مجرد بود و همچنین در سالمندان بیوه نیز به طور معنیداری کمتر از سالمندان مجرد (003/0</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">p=</span></span></span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">) بود. به طور کلی </span></span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">در این مطالعه، 1/82 درصد سالمندان مورد مطالعه، احساس تنهایی پایین و 9/17 درصد احساس تنهایی بالا را گزارش کردند.</span></span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"></span></span></span><br>
<span dir="RTL"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">نتیجهگیری کلی:</span></span></span><strong><span dir="RTL"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> <span style="color:black;">یافتههای این مطالعه نشان داد</span></span></span></span> <span dir="RTL"><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">احساس تنهایی با مشخصههای جمعیت شناختی و مشخصات بالینی سالمندان دیابت</span></span></span></span> <span dir="RTL"><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">نوع</span></span></span></span> <span dir="RTL"><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">دو وابسته به انسولین</span></span></span></span> <span dir="RTL"><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">ارتباط دارد. در این مطالعه برخلاف بیشتر مطالعات، نمره احساس تنهایی در سطح پایین بود این مغایرت میتواند به علت حضور پرستاران سالمند آموزش دیده در بخش و ویژگیهای جمعیت شناختی و بالینی نمونههای مورد مطالعه باشد.</span></span></span></span></strong></div>
<div style="text-align: justify;"><strong>Background & Aims:</strong> Diabetes is a chronic, lifelong disease that could occur at any age. The incidence of type II diabetes increases with age. According to the International Diabetes Federation (IDF), the prevalence of type II diabetes is higher among the elderly compared to other age groups. Type II diabetes is associated with various complications and may lead to several physical and mental problems in the elderly. Loneliness is one of the psychological complications in the elderly with chronic diseases such as diabetes. Loneliness is a unique psychological structure, which is characterized by feeling unhappy due to the lack or reduction of the expected interpersonal relationships. Loneliness is an important indicator of psychological health, with a two-way relationship with diabetes as it is also an important factor in the treatment of these patients. Loneliness in the elderly could lead to chronic diseases such as cardiac disorders, hypertension, stroke, obesity, diabetes, lung diseases, and even death. Identifying the psychological issues associated with diabetes is prioritized in health care. The present study aimed to assess loneliness and the contributing factors in the elderly with type II diabetes in order to determine the significant factors that may be associated with loneliness. Examining the state of loneliness as a psychological component in the elderly with diabetes could lay the groundwork for nursing interventions and improving healthcare resources for these patients.<br>
<strong>Materials & Methods:</strong> This descriptive, cross-sectional study was conducted on 257 elderlies diagnosed with insulin-dependent type II diabetes referring to the comprehensive health centers of the elderly affiliated to Iran University of Medical Sciences during October-December, 2019. The participants were selected via continuous sampling. The inclusion criteria were consent to participate, age of 60 years or more, no cognitive impairment (minimum score of 7 out of 10 in cognitive impairment test), ability to communicate, no known mental illnesses (based on the medical records statement of the patient), and definitive diagnosis of insulin-dependent diabetes (based on medical record). Data were collected using a demographic questionnaire consisting of data on age, gender, marital status, occupation status, education level, insurance status, type of insurance, housing state, having a companion/support in life, the most important needs in life, and living with others. In addition, we used the abbreviated mental test (AMT), which is a short cognitive test for the cognitive assessment of the elderly. AMT consists of 10 items, with scores ≤7 indicating the presence of a cognitive disorder (maximum score: 10). Another tool was the University of California at Los Angeles (UCLA) questionnaire, which was developed by Russell et al. in 1980 and has 20 four-response items, 10 negative statements, and 10 positive statements. This scale is used to measure the degree of loneliness. In the present study, the revised version of the loneliness questionnaire was used, and the content validity was confirmed by two faculty members. In addition, the reliability was confirmed at the Cronbach's alpha of 0.9. Data analysis was performed in SPSS version 16 using descriptive statistics, including absolute frequency distribution and frequency percentage for qualitative variables and mean and standard deviation for quantitative variables, to describe the characteristics of the samples. Independent t-test and analysis of variance (ANOVA) were also applied for statistical analysis.<br>
<strong>Results:</strong> In total, 55.3% of the elderlies were aged 60-69 years. The sample population included 55.3% women and 44.7% men. Approximately 65.4% the participants lived with their spouse, and 96.9% had insurance. Regarding the correlation between loneliness and demographic characteristics in the patients, it was observed that age (P<0.001), marital status (P<0.001), occupation status (P<0.001), living with another elderly (P<0.001), maximum support (P<0.001), the most important needs in life (P<0.001) and insurance status (P=0.032) were significantly correlated with loneliness. In addition, paired comparison by Tukey's test indicated that the feeling of loneliness was more significant in the elderly aged more than 80 years compared to those aged 60-69 years. Loneliness was significantly less in the married patients compared to the divorced, widowed, and single elderlies, while it was also significantly less in the widowed elderlies compared to the singles (P=0.003). Overall, 82.1% of the elderly patients reported slight loneliness, whereas 17.9% reported significant feelings of loneliness.<br>
<strong>Conclusion:</strong> According to the results, feelings of loneliness were associated with the demographic and clinical characteristics of the elderly with insulin-dependent type II diabetes. Unlike most studies, the score of loneliness was relatively low in the current research, and the discrepancy may be due to the presence of trained elderly nurses in the ward and the demographic and clinical characteristics of the participants. Given the growing number of the elderly patients with type II diabetes, proper strategies should be adopted to improve physiological and psychological health of these individuals. Patients with type II diabetes (especially insulin-dependent diabetes) are more likely to feel lonely, and increased loneliness may reduce their desire and motivation for treatment. Therefore, we believe that nurses, physicians, and other healthcare providers should pay attention to the effects of loneliness on these patients during treatment and clinical care. In addition, preventive measures should be taken, and the importance of the issue should be explained to patients and their caregivers. It is recommended that interventional studies be performed to reduce the feeling of loneliness in the elderly with chronic diseases (e.g., diabetes). Furthermore, opportunities should be provided for the public awareness of the importance of loneliness as a mental health alert that may affect chronic illnesses (e.g., diabetes) and even mortality.</div>
سالمند, احساس تنهایی, دیابت نوع دو وابسته به انسولین, پرسشنامه احساس تنهایی UCLA
Elderly, Loneliness, Insulin-dependent Type II Diabetes, University of California at Los Angeles (UCLA) Questionnaire
27
39
http://ijn.iums.ac.ir/browse.php?a_code=A-10-2588-2&slc_lang=fa&sid=1
P
Yousefzadeh
پروین
یوسفزاده
10800319475328460025800
10800319475328460025800
No
Master of Geriatric Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
کارشناسی ارشد، پرستاری سالمندی، دانشکده پرستاری مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران
F
Bastani
فریده
باستانی
10800319475328460025801
10800319475328460025801
Yes
Department of Nursing, Community Health, and Ageing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (Corresponding author) Tel: +98-02143651820 Email: bastani.f@iums.ac.ir
گروه پرستاری، سلامت جامعه و سالمندی، دانشکده پرستاری مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران (نویسنده مسئول) شماره تماس: 43651820 021 bastani.f@iums.ac.ir Email:
H
Haghani
حمید
حقانی
10800319475328460025802
10800319475328460025802
No
Department of Biostatistics, School of Health, Iran University of Medical Sciences, Tehran, Iran
گروه آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی ایران، تهران، ایران
RS
Hosseini
راضیه سادات
حسینی
10800319475328460025803
10800319475328460025803
No
Nursing Care Research Center, Department of Community Health Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
مرکز تحقیقات مراقبتهای پرستاری، گروه پرستاری سلامت جامعه و سالمندی، دانشکده پرستاری مامایی دانشگاه علوم پزشکی ایران، تهران، ایران