BACKGROUND: Insulin distress, an emotional response of the patient to the suggested use of insulin, acts as a major barrier to insulin therapy in the management of DM. Addressing patient-, physician- and drug-related factors is important to overcome insulin distress. Strengthening of communication between physicians and patients with diabetes and enhancing the patients' coping skills are prerequisites to create a sense of comfort with the use of insulin. Insulin motivation is key to achieving targeted goals in diabetes care. A group of endocrinologists came together at an international meeting held in India to develop tool kits that would aid a practitioner in implementing insulin motivation strategies at different stages of the journey through insulin therapy, including pre-initiation, initiation, titration and intensification. During the meeting, emphasis was placed on the challenges and limitations faced by both physicians and patients with diabetes during each stage of the journey through insulinization.
REVIEW RESULTS: After review of evidence and discussions, the expert group provided recommendations on strategies for improved insulin acceptance, empowering behavior change in patients with DM, approaches for motivating patients to initiate and maintain insulin therapy and best practices for insulin motivation at the pre-initiation, initiation, titration and intensification stages of insulin therapy.
CONCLUSIONS: In the management of DM, bringing in positive behavioral change by motivating the patient to improve treatment adherence helps overcome insulin distress and achieve treatment goals.
BACKGROUND: Given the high incidence of coronavirus and shortage of nurses in Iranian hospitals, learning about nurses' intention to care for patients with COVID-19 is important.
DESIGN: In this cross-sectional study, 648 Iranian nurses were surveyed during March 2020. The online questionnaire consisted of two parts. The mediating role was explored for the following: job satisfaction and commitment in the association of workload, quality of supervisor, extra-role behaviours, and pay satisfaction with the intention to care. The study adhered to STROBE checklist for cross-sectional studies.
RESULTS: The results of this study show that job satisfaction and organisational commitment mediated the relationship of nurses' workload, quality of supervisor, extra-role behaviours, and pay satisfaction with the intention to care for patients with COVID-19.
CONCLUSION: The results of the study indicate the importance of job satisfaction and organisational commitment as mechanisms that help to understand the association of nurses' workload, quality of supervisor, extra-role behaviours and pay satisfaction with the intention to care during the COVID-19 pandemic.
RELEVANCE TO CLINICAL PRACTICE: Hospital managers need to attend to the role of nurses' job satisfaction and other organisational factors to ensure that they can cope with the challenges of the COVID-19 pandemic.
Methods: It is a cross-sectional study conducted at the Department of Psychological Medicine, Universiti Malaya Medical Centre, Malaysia. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression among ATS users. Religiosity and religious coping were measured with Duke University Religious Index and Brief RCOPE.
Results: This study involved 215 ATS users. Almost half of the ATS users had either anxiety (n = 96; 44.6%) or depression (n = 108; 50.2%), which were associated with polysubstance use or having an existing psychiatric disorder. Subjects with higher religiosity and positive religious coping were less anxious or depressed. However, negative religious coping was significantly associated with anxiety and depression in ATS users.
Conclusion: Anxiety and depression are prevalent in ATS users. Integrating religiosity and religious coping into the ATS users' treatment plan helps to improve their mental well-being.