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Volume 9, Issue 2 (Summer 2022)                   J Prevent Med 2022, 9(2): 132-143 | Back to browse issues page

Ethics code: IR.IAU.SRB.REC.1400.209


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Omidi B, Sabet M, Ahadi H, Nejat H. Effectiveness of Emotion Regulation Training on Perceived Stress, Self-Efficacy and Sleep Quality in the Elderly With Type 2 Diabetes (T2D). J Prevent Med 2022; 9 (2) :132-143
URL: http://jpm.hums.ac.ir/article-1-627-en.html
1- Department of Psychology, United Arab Emirates International Branch, Islamic Azad University, Dubai, United Arab Emirates.
2- Department of Psychometrics, Roodehen Branch, Islamic Azad University, Roodehen, Iran.
3- Department of Psychology, Faculty of Psychology and Education, Allameh Tabatabai University of Tehran, Tehran, Iran.
4- Department of Educational Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran.
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Introduction
The aging population is increasing in the countries worldwide due to the decrease in mortality and the progress of medical sciences, health, education, and the increase in life expectancy. The elderly people are prone to many chronic diseases, including type 2 diabetes (T2D). People react differently to a chronic disease such as diabetes such as having stress and anxiety in coping with it. For a person who is under stressful conditions, it is important to evaluate stress levels and how to deal with the conditions. High, continuous and long-term stress can lead to incompatibility in the person and cause physical and emotional problems. In addition to perceived stress, self-efficacy is also affected in older people with diabetes. Studies have shown that self-efficacy is a key psychological factor in adapting to chronic diseases, especially diabetes; therefore, promoting self-efficacy can be effective in improving self-care. Insomnia is other common disorders in the elderly, especially those with diabetes. Sleep disorders in the elderly may lead to depression, falls, memory disorders, problems in concentration, excitability, low quality of life, dementia, fatigue, unstable mood and anxiety. This study aims to evaluate the effect of emotion regulation training on reducing perceived stress and increasing self-efficacy and quality of sleep in the elderly with T2D.
Methods
This is a quasi-experimental study with a pre-test/post-test/ follow-up design using a control group. The study population includes all older people with T2D living in Kish Island in Iran in 2021, 30 of whom were selected using a purposive sampling method and randomly assigned to two training and control groups. Participants were selected based on the inclusion criteria and conducting a clinical interview based on the diagnostic criteria of DSM-5. The inclusion criteria were no history of participation in the emotional regulation training programs, no history of mental disorder and other specific and chronic physical diseases, while the exclusion criteria were the absence from more than two training sessions and having severe complications leading to hospitalization. A written informed consent was obtained from all participants. They were free to leave the study at any time. Emotion regulation training was conducted at 8 sessions, two sessions per week, each for 90 minutes. Then, the participants were evaluated in three phases: pre-test, post-test, and follow-up (2 months) using the Perceived Stress Scale of Cohen et al. (2004), General Self-Efficacy Scale by Scherer et al. (1989), and Pittsburgh Sleep Quality Index developed by Pittsburgh (1989). Data analysis was conducted using repeated measures analysis of variance in SPSS v. 26 software.
Results
The Mean±SD of the age was 70.40±4.50 in the intervention group and 70.40±4.89 in the control group. In the intervention group, 9 (60%) were men and 6 (40%) were women. In the control group, there were 7 men (46.6%) and 8 women (53.4%). The results of the Shapiro-Wilk test showed that the assumption of normal data distribution was established. The assumption of sphericity was also confirmed. The results showed that the interaction effect of group and time on perceived stress (F(4, 84)=42.065, P=0.001, η2=0.667), self-efficacy (F(4, 84)=91.845, P=0.001, η2=0.814), and sleep quality (F(4, 84)=5.410, P=0.001, η2=0.205) were significant (P<0.001) (Table 1).


Discussion
Based on the findings, emotional regulation training was effective in reducing perceived stress, and improving self-efficacy and sleep quality of older people with T2D. The cognitive emotion regulation strategies are among the methods that determine the ways of accepting or coping with stressful situations and events. Executive functions based on the consistent use of cognitive processes might help the elderly solve problems, plan, act, regulate and monitor their emotions and thus have reduced perceived stress. As a behavioral and cognitive ability, it can stabilize a person's relationship with the environment by coordinating mental, biological and motivational processes, and equip her/him with efficient and appropriate responses in dealing with situations, increase the feeling of control over affairs, strengthen the belief in influencing situations, and improve the self-efficiency. Emotion regulation training made effective use of positive emotion regulation strategies by the elderly. Therefore, in facing problems, they turn their minds to positive activities and experiences, emphasize the positive aspects of the unfortunate events, and reduce their importance and seriousness. So, positive emotion regulation could improve their sleep quality. The results of this study cannot be generalized to the entire elderly people in Iran, but it paves the way for other studies that can verify the use of emotion regulation strategies for different aspects of mental health in the elderly and improve their quality of life.

Ethical Considerations
Compliance with ethical guidelines

Ethical considerations included receiving a written informed consent form to participate in the research stating that the participation in the research was voluntary, the right to withdraw from the study at any time, taking care of the sample, his rights and health. The subject was assured that he would be informed of any new information that would affect his cooperation.

Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Authors' contributions
Writing, conceptualization, editing, implementation of experimental intervention and statistical analysis: Badri Omidi; Conceptualization, editing and validation: Mehrdad Sabet; Management, validation and editing: Hassan Ahadi; Management and editing: Hamid Nejat.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
We are grateful to the elderly participants in the research who patiently helped us in conducting this research.
 

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Type of Study: Orginal | Subject: Psychology
Received: 2022/05/9 | Accepted: 2022/07/2 | Published: 2022/09/1

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