The effectiveness of positive-focus therapy on self-care and glycosylated hemoglobin in female patients with type 2 diabetes.

Authors
zeinab avish
fariborz dortaj
‏Fatemeh ghaemi
Noorali Farrokhi
‏Professor of educational psychology, Allameh Tabataba’i University
Abstract
The aim of this study was to evaluate the effectiveness of positive psychology intervention on self-care and glycated hemoglobin (HbA1c) levels in women with type 2 diabetes. This quasi-experimental study utilized a pretest-posttest design with a control group. A total of 30 women with type 2 diabetes who visited the endocrinology department of Shahid Dr. Labbafi Nejad Hospital between June and July 2024 were randomly selected. Participants were then randomly assigned to experimental (n=15) and control (n=15) groups using Microsoft Excel. The experimental group received positive psychology intervention for eight weekly sessions (90 minutes each), while the control group received routine hospital care. Data were collected using the Diabetes Self-Care Scale and HbA1c measurements at three time points: baseline, post-intervention, and three-month follow-up. Data were analyzed using SPSS version 21 and multivariate repeated measures analysis of variance (RM-ANOVA). The results indicated a significant increase in self-care scores in the intervention group compared to the control group. Additionally, the experimental group showed a significant reduction in HbA1c levels compared to the control group. These findings suggest that positive psychology intervention can be an effective approach to improving self-care behaviors and reducing HbA1c levels in women with type 2 diabetes.
Keywords
Self-care
type 2 diabetes
positive treatment
glycosylated hemoglobin
1. Hayden MR, Grant DG, Aroor AR, DeMarco VG. Empagliflozin ameliorates type 2 diabetes-induced ultrastructural remodeling of the neurovascular unit and neuroglia in the female db/db mouse. Brain sciences. 2019 Mar; 9(3):57.
2. Rådholm K, Zhou Z, Clemens K, Neal B, Woodward M. Effects of sodium‐glucose co‐transporter‐2 inhibitors in type 2 diabetes in women versus men. Diabetes, Obesity and Metabolism. 2020 Feb; 22(2):263-6.
3. Banitalebi E, Kazemi A, Faramarzi M, Nasiri S, Haghighi MM. Effects of sprint interval or combined aerobic and resistance training on myokines in overweight women with type 2 diabetes: A randomized controlled trial. Life sciences. 2019 Jan 15; 217:101-9.
4. Razavizadeh Tabadkan B B Z, Jajarmi M. The Effectiveness of Mindfulness-based Cognitive Therapy (MBCT) on Depression, Rumination and Perceived Stress in Women with Type 2 Diabetes. JNKUMS. 2019; 11 (1) :1-8
5. Assarzadegan, M., Raeisi, Z. The Effectiveness of Training Based on Positive-Psychology on Quality of life and Happiness of Patients with Type 2 Diabetes. QUARTERLY JOURNAL OF HEALTH PSYCHOLOGY, 2019; 8(30): 97-116. doi: 10.30473/hpj.2019.40538.4025
6. Ballon A, Neuenschwander M, Schlesinger S. Breakfast skipping is associated with increased risk of type 2 diabetes among adults: A systematic review and meta-analysis of prospective cohort studies. The Journal of nutrition. 2019 Jan 1; 149(1):106-13.
7. Gadgil MD, Oza‐Frank R, Kandula NR, Kanaya AM. Type 2 diabetes after gestational diabetes mellitus in South Asian women in the United States. Diabetes/metabolism research and reviews. 2017 Jul; 33(5):e2891.
8. Dennison RA, Ward RJ, Griffin SJ, Usher‐Smith JA. Women's views on lifestyle changes to reduce the risk of developing type 2 diabetes after gestational diabetes: a systematic review, qualitative synthesis and recommendations for practice. Diabetic Medicine. 2019 Jun; 36(6):702-17.
9. Wang L, Li T, Liu J, Wu X, Wang H, Li X, Xu E, Chen Q, Yan C, Li H, Xu Y. Association between glycosylated hemoglobin A1c and bone biochemical markers in type 2 diabetic postmenopausal women: a cross-sectional study. BMC endocrine disorders. 2019 Dec; 19(1):31.
10. Jang JE, Cho Y, Lee BW, Shin ES, Lee SH. Effectiveness of exercise intervention in reducing body weight and glycosylated hemoglobin levels in patients with type 2 diabetes mellitus in Korea: a systematic review and meta-analysis. Diabetes & metabolism journal. 2019 Jun 1; 43(3):302-18.
11. Kav S, Yilmaz AA, Bulut Y, Dogan N. Self-efficacy, depression and self-care activities of people with type 2 diabetes in Turkey. Collegian. 2017 Feb 1; 24(1):27-35.
12. Tan CC, Cheng KK, Sum CF, Shew JS, Holydard E, Wenru WA. Perceptions of diabetes self-care management among older Singaporeans with type 2 diabetes: A qualitative study. Journal of Nursing Research. 2018 Aug 1; 26(4):242-9.
13. Moghadam FH, Abadi HJ, Fardin M. Effectiveness of positive psychotherapy training on thought control and emotional adjustment of 17-15-year-old female students recovered from the Corona Pandemic (Covid-19). Journal of Adolescent and Youth Psychological Studies (JAYPS). 2023 Jun 1; 4(5):47-58.
14. Akbari B, Kiamarsi A. Effectiveness of Positive Psychotherapy on Systolic and Diastolic Blood Pressure and Psychological Well-Being of Women with Hypertension: A Quasi-Experimental Study. Journal of Rafsanjan University of Medical Sciences. 2023 Dec 10; 22(9):999-1014.
15. Suweni K, Maay JK, Arifin SR, Yousuf A. Application of group positive psychotherapy to improve psychological well-being for people with HIV in Papua. Bali Medical Journal. 2023 Jan 16; 12(1):261-6.
16. Dobiała E, Winkler P. Positive psychotherapy’according to Seligman and ‘Positive Psychotherapy’according to Peseschkian: A Comparison. Int J Psychother. 2016 Nov; 20(3):3.
17. Walsh S, Cassidy M, Priebe S. The application of positive psychotherapy in mental health care: A systematic review. Journal of Clinical Psychology. 2017 Jun; 73(6):638-51.
18. Peseschkian H, Remmers A. Positive psychotherapy: an introduction. Positive Psychiatry, Psychotherapy and Psychology: Clinical Applications. 2020:11-32.
19. Jankowski PJ, Sandage SJ, Bell CA, Davis DE, Porter E, Jessen M, Motzny CL, Ross KV, Owen J. Virtue, flourishing, and positive psychology in psychotherapy: An overview and research prospectus. Psychotherapy. 2020 Sep; 57(3):291.
20. Heydari M, Nouri M, Niaei AM. The Effectiveness of Group Positive Psychotherapy on Psychological Well-being and Hope of Cancer Patients Undergoing Chemotherapy. Journal of Social Behavior and Community Health. 2023 May 28.
21. Hoppen TH, Morina N. Efficacy of positive psychotherapy in reducing negative and enhancing positive psychological outcomes: a meta-analysis of randomised controlled trials. BMJ open. 2021 Sep 1; 11(9):e046017.
22. Seshadri A, Orth SS, Adaji A, Singh B, Clark MM, Frye MA, McGillivray J, Fuller-Tyszkiewicz M. Mindfulness-based cognitive therapy, acceptance and commitment therapy, and positive psychotherapy for major depression. American journal of psychotherapy. 2021 Mar 1; 74(1):4-12.
23. Choi H, Shin S, Lee G. Effects of Positive Psychotherapy for People with Psychosis: A Systematic Review and Meta-Analysis. Issues in Mental Health Nursing. 2023 Mar 4; 44(3):180-93.
24. Boumparis N, Karyotaki E, Kleiboer A, Hofmann SG, Cuijpers P. The effect of psychotherapeutic interventions on positive and negative affect in depression: A systematic review and meta-analysis. Journal of Affective Disorders. 2016 Sep 15; 202:153-62.
25. Andayani LA. Meta-Analysis Study: Positive Psychotherapy to Lower Depression Levels. International Journal of Social Service and Research. 2021 Oct 12; 1(2):112-7.
26. Carr A, Cullen K, Keeney C, Canning C, Mooney O, Chinseallaigh E, O’Dowd A. Effectiveness of positive psychology interventions: a systematic review and meta-analysis. The Journal of Positive Psychology. 2021 Nov 2; 16(6):749-69.
27. Bolier L, Haverman M, Westerhof GJ, Riper H, Smit F, Bohlmeijer E. Positive psychology interventions: A meta-analysis of randomized controlled studies. BMC public health. 2013 Dec; 13(1):1-20.
28. Hendriks, T., Schotanus-Dijkstra, M., Hassankhan, A., De Jong, J., & Bohlmeijer, E. (2020). The efficacy of multi-component positive psychology interventions: A systematic review and meta-analysis of randomized controlled trials. Journal of happiness studies, 21, 357-390.
29. Carr A, Finneran L, Boyd C, Shirey C, Canning C, Stafford O, Lyons J, Cullen K, Prendergast C, Corbett C, Drumm C. The evidence-base for positive psychology interventions: A mega-analysis of meta-analyses. The Journal of Positive Psychology. 2024 Mar 3; 19(2):191-205.
30. Chakhssi F, Kraiss JT, Sommers-Spijkerman M, Bohlmeijer ET. The effect of positive psychology interventions on well-being and distress in clinical samples with psychiatric or somatic disorders: A systematic review and meta-analysis. BMC psychiatry. 2018 Dec; 18:1-7.
31. Gonzalez-Hernandez, E., Romero, R., Campos, D., Burichka, D., Diego-Pedro, R., Baños, R., & Cebolla, A. (2018). Cognitively-Based Compassion Training (CBCT) in Breast Cancer Survivors: A Randomized Clinical Trial.
32. Tol A, Baghbanian A, Mohebbi B, Shojaeizadeh D, Azam K, Shahmirzadi SE, Asfia A. Empowerment assessment and influential factors among patients with type 2 diabetes. Journal of Diabetes & Metabolic Disorders. 2013 Dec; 12(1):6.