Volume 20, Issue 4 (winter 2019)
JHC 2019, 20(4): 280-291 |
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Department of Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
Abstract: (6068 Views)
Background & objectives: Fatigue is a common complaint in patients with type 2 diabetes, which can affect self-care behaviors and people's efforts to control diabetes. This study was conducted to determine the severity of fatigue and its related factors in patients with type 2 diabetes.
Methods: In this descriptive-correlational study, 218 patients with type 2 diabetes mellitus who were referred to diabetes clinic of Imam Khomeini Hospital in Ardabil in 2017 were selected by available sampling. Data were collected by five questionnaires including: socio-demographic form, Fatigue Questionnaire, Pittsburgh Sleep Quality, Beck Depression, and Visual Analogue Scale. Data analysis was done by using descriptive (mean, standard deviation and frequency) and Inferential statistics (Pearson correlation coefficient, simple and multiple regression model) in SPSS software v22.
Results: The mean fatigue score of the participants was 57.07±17.16, which indicated moderate fatigue. Pearson correlation test revealed a significant correlation between fatigue and pain (r=0.440 p<0.01), depression (r =0.590, p<0.01), Number of complications of the disease (r=38.0, p<0.01), Duration of diabetes (r=0.21, p<0.01), duration of exercise (r=-0.305, p<0.01), and sleep quality (r=0.390, p<0.01). However, no significant correlation was found between fatigue and glycosylated hemoglobin and BMI. Data analysis using multivariate linear regression showed that four factors of pain, depression, duration of disease, and duration of exercise were predictors of fatigue in patients with type II diabetes.
Conclusion: The present study showed that fatigue was a relatively common problem in patients with type 2 diabetes and factors such as pain, depression, duration of disease and duration of exercise were factors that affect fatigue. Health care providers need to pay special attention to fatigue assessment in patients with diabetes and proper interventions be taken to reduce pain and diagnosis and control depression in these patients.
Methods: In this descriptive-correlational study, 218 patients with type 2 diabetes mellitus who were referred to diabetes clinic of Imam Khomeini Hospital in Ardabil in 2017 were selected by available sampling. Data were collected by five questionnaires including: socio-demographic form, Fatigue Questionnaire, Pittsburgh Sleep Quality, Beck Depression, and Visual Analogue Scale. Data analysis was done by using descriptive (mean, standard deviation and frequency) and Inferential statistics (Pearson correlation coefficient, simple and multiple regression model) in SPSS software v22.
Results: The mean fatigue score of the participants was 57.07±17.16, which indicated moderate fatigue. Pearson correlation test revealed a significant correlation between fatigue and pain (r=0.440 p<0.01), depression (r =0.590, p<0.01), Number of complications of the disease (r=38.0, p<0.01), Duration of diabetes (r=0.21, p<0.01), duration of exercise (r=-0.305, p<0.01), and sleep quality (r=0.390, p<0.01). However, no significant correlation was found between fatigue and glycosylated hemoglobin and BMI. Data analysis using multivariate linear regression showed that four factors of pain, depression, duration of disease, and duration of exercise were predictors of fatigue in patients with type II diabetes.
Conclusion: The present study showed that fatigue was a relatively common problem in patients with type 2 diabetes and factors such as pain, depression, duration of disease and duration of exercise were factors that affect fatigue. Health care providers need to pay special attention to fatigue assessment in patients with diabetes and proper interventions be taken to reduce pain and diagnosis and control depression in these patients.
Type of Study: correlation design |
Received: 2018/06/11 | Accepted: 2018/09/12 | Published: 2018/12/26
Received: 2018/06/11 | Accepted: 2018/09/12 | Published: 2018/12/26
References
1. Amaducci CM, Mota DDCF, Pimenta CAM. Fatigue among nursing undergraduate students. Revista da Escola de Enfermagem da USP. 2010;44(4):1052-58. [DOI:10.1590/S0080-62342010000400028]
2. Najafi MPS, Mahmoudi H, Ebadi A, Qanei M. Study of fatigue of respiratory disease in veterans with respiratory disease. Veteran Medical Journals. 2010;44(4):1052-58 [Persian].
3. Singh R. Understanding fatigue in persons with type 2 diabetes: a mixed methods study. Ph.D Dissertion. Faculty of the University of Kansas; 2013.
4. Hebert J, Corboy J. The association between multiple sclerosis-related fatigue and balance as a function of central sensory integration. Gait & Posture. 2013;38(1):37-42. [DOI:10.1016/j.gaitpost.2012.10.015] [PMID]
5. Stridsman C, Müllerova H, Skär L, Lindberg A. Fatigue in COPD and the impact of respiratory symptoms and heart disease: a population-based study. Journal of Chronic Obstructive Pulmonary Disease. 2013;10(2):125-32. [DOI:10.3109/15412555.2012.728642] [PMID]
6. Cleanthous S, Tyagi M, Isenberg DA, Newman SP. What do we know about self-reported fatigue in systemic lupus erythematosus? Lupus. 2012;21(5):465-76. [DOI:10.1177/0961203312436863] [PMID]
7. van Hoogmoed D, Fransen J, Bleijenberg G, van Riel P. Physical and psychosocial correlates of severe fatigue in rheumatoid arthritis. Rheumatology .2010;49(7):1294-302. [DOI:10.1093/rheumatology/keq043] [PMID]
8. Seo YM, Hahm JR, Kim TK, Choi WH. Factors affecting fatigue in patients with type II diabetes mellitus in Korea. Asian Nursing Research. 2015;9(1):60-64. [DOI:10.1016/j.anr.2014.09.004] [PMID]
9. Swain MG. Fatigue in chronic disease. Clinical Science. 2000;99(1):1-8.
https://doi.org/10.1042/CS19990372 [DOI:10.1042/cs0990001]
10. Fritschi C, Quinn L. Fatigue in patients with diabetes: a review. Journal of Psychosomatic Research. 2010;69(1):33-41. [DOI:10.1016/j.jpsychores.2010.01.021] [PMID] [PMCID]
11. Drivsholm T, de Fine Olivarius N, Nielsen ABS, Siersma V. Symptoms, signs and complications in newly diagnosed type 2 diabetic patients, and their relationship to glycaemia, blood pressure and weight. Diabetologia. 2005;48(2):210-14. [DOI:10.1007/s00125-004-1625-y] [PMID]
12. Fritschi C, Fink AM. Fatigue in adults with type 2 diabetes– An overview of current understanding and management approaches. European Endocrinology. 2012;8(2):80-83. [DOI:10.17925/EE.2012.08.02.80]
13. Chasens ER, Sereika SM, Burke LE. Daytime sleepiness and functional outcomes in older adults with diabetes. The Diabetes Educator. 2009;35(3):455-64. [DOI:10.1177/0145721709333857] [PMID]
14. Balbo M, Leproult R, Van Cauter E. Impact of sleep and its disturbances on hypothalamo-pituitary-adrenal axis activity. International Journal of Endocrinology. 2010;(1):33-41. [DOI:10.1155/2010/759234]
15. Trento M, Broglio F, Riganti F, Basile M, Borgo E, Kucich C, et al. Sleep abnormalities in type 2 diabetes may be associated with glycemic control. Acta Diabetologica. 2008;45(4):225-29. [DOI:10.1007/s00592-008-0047-6] [PMID]
16. Cuellar, Norma G, Ratcliffe, Sarah J. A comparison of glycemic control, sleep, fatigue, and depression in type 2 diabetes with and without restless legs syndrome. Journal of Clinical Sleep Medicine. 2008;4(1):50-56. [PMID] [PMCID]
17. Zimmerman M, McGlinchey JB, Young D, Chelminski I. Diagnosing major depressive disorder III: can some symptoms be eliminated from the diagnostic criteria? The Journal of Nervous and Mental Disease. 2006;194(5):313-17. [DOI:10.1097/01.nmd.0000217806.16329.ff] [PMID]
18. Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes a meta-analysis. Diabetes Care. 2001;24(6):1069-78. [DOI:10.2337/diacare.24.6.1069] [PMID]
19. Singh R, Teel C, Sabus C, McGinnis P, Kluding P. Fatigue in type 2 diabetes: impact on quality of life and predictors. PloS One. 2016;11(11):e0165652. [DOI:10.1371/journal.pone.0165652] [PMID] [PMCID]
20. Anandacoomarasamy A, Caterson ID, Leibman S, Smith GS, Sambrook PN, Fransen M, et al. Influence of BMI on health related quality of life: comparison between an obese adult cohort and age- matched population norms. Obesity. 2009;17(11):2114-218. [DOI:10.1038/oby.2009.121] [PMID]
21. Theorell-Haglöw J, Lindberg E, Janson C. What are the important risk factors for daytime sleepiness and fatigue in women. Sleep. 2006;29(6):751-57. [DOI:10.1093/sleep/29.6.751] [PMID]
22. Vgontzas AN, Bixler EO, Chrousos GP. Obesity‐related sleepiness and fatigue. Annals of the New York Academy of Sciences. 2006;1083(1):329-44. [DOI:10.1196/annals.1367.023] [PMID]
23. Morsch CM, Gonçalves LF, Barros E. Health‐related quality of life among haemodialysis patients–relationship with clinical indicators, morbidity and mortality. Journal of Clinical Nursing. 2006;15(4):498-504. [DOI:10.1111/j.1365-2702.2006.01349.x] [PMID]
24. Vard N, Abedi HA, Amini M. Effective factors on fatigue rate in type two diabetes patients: an investigation. Jundishapur Journal of Chronic Disease Care. 2015;4(1):e26611 [Persian]. [DOI:10.5812/jjcdc.26611]
25. Rijken P, Dekker J, Dekker E, Lankhorst G, Bakker K, Dooren J, et al. Clinical and functional correlates of foot pain in diabetic patients. Disability and Rehabilitation. 1998;20(9):330-36. [DOI:10.3109/09638289809166090]
26. Biniyaz V, Tayebi A, Sadeghi Shermeh M, Ebadi A, Neamati E. The effect of supplementation with intravenous vitamin C on fatigue of hemodialysis patients. Iranian Journal of Critical Care Nursing. 2013;6(3):145-54.
27. Ghanei R, Hemati-Maslak-Pak M, Ghosi S, Hossein-Pour H, Amin-Pour E, Baghi V. Restless legs syndrome and the quality of sleep in type II diabetes. Kashan University of Medical Sciences Journal (FEYZ). 2011;15(3):240-46 [Persian].
28. Amin MR. Correlation between visual analogue scale and short form of McGill questionnaire in patients with chronic low back pain. Qom University of Medical Sciences Journal. 2012;6(1):31-34 [Persian].
29. Shahhosseini Z, Amin G, Danesh M, Abedian K. Double blind study of anti primary dysmenorrhea effects of vitagnus. Journal of Mazandaran University of Medical Sciences. 2006;15(50):15-22 [Persian].
30. Mahmoodi A, Sharifi A. Compare the prevalence and factors associated with depression in diabetics and non-diabetics. Journal of Urmia Nursing and Midwifery Faculty. 2008;6(2):93-87 [Persian].
31. Fritschi C, Quinn L, Hacker ED, Penckofer SM, Wang E, Foreman M, et al. Fatigue in women with type 2 diabetes. Diabetes Educator. 2012;38(5):662-72. [DOI:10.1177/0145721712450925] [PMID] [PMCID]
32. Bensing JM, Hulsman RL, Schreurs KM. Gender differences in fatigue: biopsychosocial factors relating to fatigue in men and women. Medical Care. 1999;37(10):1078-83. [DOI:10.1097/00005650-199910000-00011]
33. Lasselin J, Laye S, Barreau JB, Rivet A, Dulucq MJ, Gin H, et al. Fatigue and cognitive symptoms in patients with diabetes: relationship with disease phenotype and insulin treatment. Psychoneuroendocrinology. 2012;37(9):1468-478. [DOI:10.1016/j.psyneuen.2012.01.016] [PMID]
34. Park H, Park C, Quinn L, Fritschi C. Glucose control and fatigue in type 2 diabetes: the mediating roles of diabetes symptoms and distress. Journal of Advanced Nursing. 2015;71(7):1650-660. [DOI:10.1111/jan.12632] [PMID] [PMCID]
35. Goedendorp MM, Tack CJ, Steggink E, Bloot L, Bazelmans E, Knoop H. Chronic fatigue in type I diabetes: highly prevalent but not explained by hyperglycemia or glucose variability. Diabetes Care. 2014;37(1):73-80. [DOI:10.2337/dc13-0515] [PMID]
36. Gonzalez J, Delahanty L, Safren S, Meigs J, Grant R. Differentiating symptoms of depression from diabetes-specific distress: relationships with self-care in type 2 diabetes. Diabetologia. 2008;51(10):1822-5. [DOI:10.1007/s00125-008-1113-x] [PMID] [PMCID]
37. Menting J, Nikolaus S, van der Veld WM, Goedendorp MM, Tack CJ, Knoop H. Severe fatigue in type 1 diabetes: exploring its course, predictors and relationship with HbA1c in a prospective study. Diabetes Research and Clinical Practice. 2016;121:127-34. [DOI:10.1016/j.diabres.2016.09.011] [PMID]
38. Benbow S, Wallymahmed M, MacFarlane I. Diabetic peripheral neuropathy and quality of life. Journal of the Association of Physicians. 1998;91(11):733-37. [DOI:10.1093/qjmed/91.11.733]
39. Puetz TW, O'connor PJ, Dishman RK. Effects of chronic exercise on feelings of energy and fatigue: a quantitative synthesis. Psychological bulletin. 2006;132(6):866. [DOI:10.1037/0033-2909.132.6.866] [PMID]
40. Grandner MA, Patel NP, Perlis ML, Gehrman PR, Dawei Xie, Daohang Sha, et al. Obesity, diabetes, and exercise associated with sleep-related complaints in the American population. Journal of Public Health. 2011;19(5):463-74. [DOI:10.1007/s10389-011-0398-2] [PMID] [PMCID]
41. Morrato EH, Hill JO, Wyatt HR, Ghushchyan V, Sullivan PW. Physical activity in US adults with diabetes and at risk for developing diabetes, 2003. Diabetes Care. 2007;30(2):203-9. [DOI:10.2337/dc06-1128] [PMID]
42. Kanade R, van Deursen R, Harding K, Price P. Walking performance in people with diabetic neuropathy: benefits and threats. Diabetologia. 2006;49(8):1747-754. [DOI:10.1007/s00125-006-0309-1] [PMID]
43. Van der Does FE, De Neeling JND, Snoek FJ, Kostense PJ, Grootenhuis PA, Bouter LM, et al. Symptoms and well-being in relation to glycemic control in type II diabetes. Diabetes Care. 1996;19(3):204-10. [DOI:10.2337/diacare.19.3.204]
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