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The influences of the environment and information on the complications of diabetes on patient outcomes

Abstract

This letter was written to address two concerns about the results of the paper published by Zeynep et al. (BMC Health Qual Life Outcomes 18:265, 2020). First, the differences between the two groups in the environment with or without occupation may strengthen the primary outcome results. Second, lack of information on the complications and treatments of diabetes makes interpretation of the results difficult.

Dear Editor,

We read with great interest this study, which clarified the effects of problem-solving therapy (PST) on the occupational performance, self-efficacy, and well-being of type 2 diabetic patients in Turkey [1]. However, we have two concerns about the methodology of this study.

First, the difference between the two groups in terms of whether they were in an environment with or without occupation might have significantly affected the results, so the results should be subtracted. In this study, although the participants were randomly assigned at Baseline, more participants in the intervention group than in the control group were engaged in work. Therefore, the Canadian Occupational Performance Measure (COPM) for primary outcomes is more likely to have a stronger effect on the amount of change because it affects the client’s environment [2]. The COPM is a questionnaire that asks about self-perceptions of occupational performance. Participants in the environment with occupation might find it easier to visualize and practice “problem definition,” “generation of alternatives,” “decision-making,” “solution implementation and verification,” in PST.

Second, this study does not describe the complications and treatment of diabetes, which we would like to know about. Hypoglycemia, a complication of diabetes, is said to reduce the work productivity of diabetic patients [3]. In addition, patients with type 2 diabetes are limited by the social and emotional aspects of insulin therapy [4]; they refuse insulin therapy because they feel that starting insulin will stigmatize them socially [5]. Thus, depending on the complications and treatment of diabetes, the results of this study may be weakened.

Availability of data and materials

Date sharing is not applicable to this article as no datasets were generated or analyzed during the present study.

Abbreviations

PST:

Problem-solving therapy

COPM:

The Canadian Occupational Performance Measure

References

  1. 1.

    Ağce ZB, Ekici G. Person-centred, occupation-based intervention program supported with problem-solving therapy for type 2 diabetes: a randomized controlled trial. BMC Qual Life Outcomes. 2020;18:265. https://0-doi-org.brum.beds.ac.uk/10.1186/s12955-020-01521-x.

    Article  Google Scholar 

  2. 2.

    Enemark Larsen A, Rasmussen B, Christensen JR. Enhancing a client-centred practice with the Canadian Occupational Performance Measure. Occup Ther Int. 2018;2018:5956301. https://0-doi-org.brum.beds.ac.uk/10.1155/2018/5956301.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  3. 3.

    Fulcher G, Singer J, Castañeda R, Filho FF, Maffei L, Snyman J, Brod M. The psychosocial and financial impact of non-severe hypoglycemic events on people with diabetes: two international surveys. J Med Econ. 2014;17(10):751–61. https://0-doi-org.brum.beds.ac.uk/10.3111/13696998.2014.946992.

    Article  PubMed  Google Scholar 

  4. 4.

    Reis ACD, Cunha MV, Bianchin MA, Freitas MTR, Castiglioni L. Comparison of quality of life and functionality in type 2 diabetics with and without insulin. Rev Assoc Med Bras. 2019;65(12):1464–9.

    Article  Google Scholar 

  5. 5.

    Raghavendran S, Inbaraj LR, Norman G. Reason for refusal of insulin therapy among type 2 diabetes mellitus patients in primary care clinic in Bangalore. J Family Med Prim Care. 2020;9(2):854–8.

    Article  Google Scholar 

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All authors discussed the study. All authors read and approved the final manuscript.

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Correspondence to Kazuoki Inoue.

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Inoue, K., Watanabe, J. & Kakehi, E. The influences of the environment and information on the complications of diabetes on patient outcomes. Health Qual Life Outcomes 19, 161 (2021). https://0-doi-org.brum.beds.ac.uk/10.1186/s12955-021-01798-6

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Keywords

  • Diabetes mellitus
  • Occupation-based
  • Problem-solving
  • Quality of life