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Effect of Psychological counseling in overcoming fear of self injecting and self testing among type 2 diabetic patients on insulin initiation

Author: 
Mary Jenifer Amalraj and Vijay Viswanathan
Subject Area: 
Health Sciences
Abstract: 

Background: The initiation of insulin therapy is often one of the most difficult and important choices that individuals with diabetes have to make. Insulin therapy among Type 2 Diabetic patients (T2DM) often becomes necessary when oral hypoglycemic agents are no longer effective. During the initiation of insulin therapy patient experiences various psychological disturbances which leads to fear of self injecting among self testing. Although the number of studies was limited and identified adverse treatment outcomes in diabetes patients with fear of insulin, self injection and self testing no studies have being focused on overcoming fear of self injecting and self testing and evaluating its impact on glycemic level. Thus, the current study aims at evaluating the effect of psychological counseling in overcoming fear of self injecting and self testing among type 2 diabetic patients on first time insulin. Method: The study conducted among 80 patients with uncontrolled Type 2 Diabetes Mellitus and who were prescribed with first time insulin injection. These patients were randomly assigned to control arm and study arm. The short Diabetes Fear of Injecting and Self-testing Questionnaire (D-FISQ) composed by two subscales that access fear of self injection (FSI) and fear of self testing (FST) was administered individually to all the patients based on the inclusion criteria. In the control arm patients prescribed with first time insulin was counseled by Diabetes Educators and they were administered with DFISQ Questionnaire at baseline and during the follow up visit to the hospital. For patients in the study group, patients prescribed with first time insulin was counseled by Diabetes Educators in addition to Diabetes Education counseling they were rendered with psychological counseling with regular intervals of follow up and was administered with DFISQ Questionnaire at baseline and during the follow up visit to the hospital. Result: The finding highlights that patients on first time insulin injection rendered with diabetes education and followed by psychological counseling had better psychological outcomes in overcoming fear of self injecting and self testing. Conclusion: Thus psychological counseling has to be included as routine management for the patients prescribed with insulin injection for the first time.

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