Psychological issues


Meeting psycho-social needs in Poland: a new priority

The results of the Diabetes Attitudes, Wishes and Needs (DAWN) study confirmed the beliefs of many people with diabetes and health-care providers: that addressing only the physical symptoms of diabetes is not enough; to be truly effective, diabetes care must also take into account psychological issues. Nowhere was this more apparent than in Poland, where people with diabetes showed consistently higher concern for psycho-social issues than respondents in other countries. Andrzej Kokoszka reports from Poland on an award-winning educational initiative in response to these needs.

The psycho-social impact of diabetes foot damage

Over half of all lower-extremity amputations are related to diabetes. Indeed, foot ulceration is an increasing problem worldwide and there is little evidence of a reduction in the numbers of foot ulcers and amputations in people with diabetes.

Improving the quality of life of young people with diabetes in Egypt

In 2000, a group of committed members of the diabetes community in Egypt, including parents of children with the condition and health-care professionals, established ‘Assistance to Youngsters with Diabetes’ (AYD). This is an ambitious project. The ultimate objective of AYD – which recently won the DAWN International Award – is to enhance the quality of life of children with diabetes in

Improving psycho-social care: the Indian experience

The number of people with diabetes in the Indian subcontinent has been increasing dramatically: approximately 30-33 million people have diabetes in India and this number could double by 2025. Compared to other ethnic groups, Indians have a high risk of developing diabetes. However, the impact of psycho-social factors related to diabetes care has also contributed to the growing pandemic.

Diabetes-related websites: are they readable?

The Internet has become a useful tool that is relatively easy to operate. With little effort, huge amounts of information can be found about specific health conditions or health in general. Views and concerns about health can be shared with literally millions of other people; spreading health information to people around the world is a simple process. Clearly however, there is a need to evaluate this information

The impact of low health literacy on diabetes outcome

According to the 1993 US National Adult Literacy Survey, approximately 90 million people in the USA have deficiencies in reading or computational skills that prevent them from fully participating in normal daily activities – such as reading a bus schedule or entering background information on an application form. Although the Survey did not evaluate the ability to read and comprehend health-related materials,

Enhancing health communication: the German experience

The recent euphoria surrounding the positive effects of preventative measures with people with impaired glucose tolerance or manifest Type 2 diabetes is rarely reflected in the experience of the health-care professionals working with people with diabetes. Despite efforts to advise and inform, there is very little lasting change in health-care behaviour. Many health-care professionals report feelings of frustration and anger. They often describe the people in their care as 'difficult'.

In practice: DAWN in Latin America and the Caribbean

Relatively few studies have examined the psycho-social impact of diabetes. The Diabetes Attitudes, Wishes and Needs (DAWN) Programme addressed this issue in a study involving people with diabetes from 13 countries. A key finding was that depression was much more common in people with diabetes than in those without the condition, and was associated with impaired self-management and quality of life. Other studies confirm that depression often impairs metabolic control in people with the condition.

Keeping people at the centre of care: a challenge to health professionals?

The establishment of a practice which puts the person at the centre of care will require a change in the attitudes and beliefs of health professionals, and people with diabetes. A service which places the person with diabetes at the centre of care will undoubtedly demand the adoption of this philosophy by the organizations responsible for the delivery of diabetes care, as well as those networks serving the

Integrating psycho-social issues into national diabetes programmes

It is widely agreed that people with diabetes can lead a 'normal' life. Like people who do not have the condition, people with diabetes can function fully in family, workplace, and community settings. However, it is also accepted that diabetes self-care is complex and demanding. Being obliged to balance food intake and exercise against medication, self-administer injections, and self-test blood for glucose levels is not 'normal'. The demands of diabetes self-management can impact negatively on the psychological status of people with the condition. In this article, Ruth