الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
 |  | from | 77 |  |  |
| | | from | 77 | | |
Abstract
Life satisfaction is an important indicator of one’s wellbeing and is associated with mental and physical health, also has been associated with adverse effects on mortality and morbidity (Rajani, Skianis & Filippidis, 2019). People throughout the world desire better lives in the pursuit of happiness. Accordingly, researchers have increasingly focused on what affects individuals’ life satisfaction. There is a widespread idea that individuals’ traits can explain why some are more satisfied with life than others in the same environment. Family, friends, finance, culture, and grit are an important predictor of life satisfaction (Li, et al., 2018).
Life satisfaction has been associated with a reduced need for health care and thus also with reduced health expenditures (Rissanen, 2015). Added to that, satisfied people manifest fewer psychopathological symptoms, such as depression, phobia or anxiety, and are less prone to substance abuse. They tend to feel more energetic, healthier and report lower pain intensity. Knowing the importance of life satisfaction for human daily functioning, it is crucial to foster and maintain its high level. However, shaping high life satisfaction may improve the psychological and social functioning and ameliorate various health disorders (Szymańska, 2020).
According to (Sabri, et al., 2014), the development of SE is a process that lasts throughout life, and is related to the interactions that the individuals have with their families and people who are significant to them. Self-esteem is considered an integral part of success in the treatment and management of diabetes disease especially with reference to the distress associated with it. Humans are always in constant struggle to enhance their self-esteem despite their conditions (Chukwuemeka, Afamefuna & Nkechi, 2017).
In this respect, high self-esteem is not only a personal expectation but also the central psychological source of many positive behavior and outcomes. That is, self-esteem has profound influences on every aspect of life. The need for high self-esteem has risen from an individual concern to a societal concern such that high self-esteem bears psychological resources (e.g., optimism and personal resilience) that benefit individuals and societies, whereas low self-esteem lies at the root of individual and societal problems (Li et al., 2018).
Patients suffering from chronic disease like diabetes are usually at risk of low self-esteem and less life satisfaction (Friday et al., 2017). Life satisfaction may be a valuable asset in assessing risk of type II diabetes and in the development of more effective prevention strategies to deter onset of diabetes (Piciu et al., 2017). Also, higher self-esteem is associated with more healthful behaviors in patients treated for type II diabetes (Ozluk et al., 2018).
Aim of the study:
This study aimed to assess life satisfaction and its relation to self-esteem among patients with type II diabetes mellitus.
Research question:
What is the relationship between life satisfaction and self-esteem among patients with type II diabetes mellitus?
Research setting:
The study was conducted in outpatient diabetes clinic at Damanhur medical national institute.
Research subjects:
Sample type: Random simple sample was used in the current study.
Sample size: The subjects of the present study included 130 patients who matched the following criteria:
Inclusion criteria:
- Diabetes Mellitus: Type II
- Age: above 18 years (adult)
- gender: both sexes
- Agree to participate in the study
- Free from Psychotic disorders
Tools of data collection:
Data were collected using the following tools:
1. Interviewing questionnaire:(Appendix I)
This tool was developed by the researcher, which divided in to three parts to elicit data about:
Part 1: Demographic data such as (age, gender, marital status, educational level, occupation ... etc.
Part 2: Clinical data such as treatment type, compliance with treatment, family history ... etc.
Part 3: Patient’s knowledge about diabetes mellitus such as meaning of diabetes, normal range of blood glucose, risk factors … etc.
2. Life Satisfaction Index Z questionnaire (1969): (Appendix II):
Life Satisfaction Index Z scale (LSI-Z) tool developed by Wood, Wylie and Sheafor (1969), and was adopted to evaluate person’s perceived life satisfaction. This tool was used in a chronically ill population. The LSI-Z consists of thirteen statements to measure life satisfaction such as: As I grow older, things seem better than I thought they would be (Role Function); I have gotten more of the breaks in life than most of the people I know (Role Function); I am just as happy as when I was younger (Self Concept); The things I do are as interesting to me as they ever were (Self Concept); This is the most depressing time of my life (Interdependence); Most of the things I do are boring or monotonous (Interdependence) … etc. Three responses are possible: agree, disagree and uncertain. Scores range from 0 to 26, with high scores (14 or above) indicating a higher perceived life satisfaction. An agree response =2, an uncertain or no response =1, disagree response= 0.
Negatively worded statements (3, 6, 10, 11, and 13) were reversed score. For example, an agree response to any or all statements (3, 6, 10, 11, and 13) was given zero points. Conversely, if the respondents disagreed with any or all of the statements, two points were assigned (Bertch, 1993).
3. Rosenberg’s Self- Esteem Scale (1965): (Appendix II):
Rosenberg Self- Esteem Scale developed by Rosenberg (1965) and was adopted to measure self-esteem. It consists of 10 items such as: I feel that I’m a person of worth, at least on an equal level with others; I feel that I have a number of good qualities; All in all, I’m inclined to feel that I’m a failure … etc. Items answered in 4-point Likert scale: strongly agree, agree, disagree, and strongly disagree. Rosenberg’ global Self- Esteem Scale was scored from 1to 6 points according to Guttman scoring.
The Guttman scale items are presented in order from the strongest to the weakest responses. Positive and negative statements were presented alternately in order to reduce the danger of respondent set. In the scale, positive responses are indicated by asterisks. The possible range of scores is 0-2 for high self-esteem, 3-5 for medium self-esteem, and 5 or greater for low self-esteem. Thus, the score is inversely proportional to the level of self-esteem (Hosny, 1982).
Pilot study:
A pilot study was conducted after the adaptation of the tools and before starting the data collection. The pilot study was carried out for 10% of the sample. It was conducted on (13) patients with type II Diabetes Mellitus using tools (1), (2), (3). The purpose of the pilot study was to test the applicability, feasibility and clarity of the tools. In addition, it served to estimate the approximate time required for interviewing the patients as well as to find out any problems that might interfere with data collection. After obtaining the result of the pilot study, no modifications as (excluded questions, added questions & revised) were found. These patients were excluded later from the actual study. The time needed to fill out the tool was about 20 to 30 minutes.
The main findings of this study revealed that:
1. The socio-demographic characteristics of the studied patients with type II DM; patient’s age ranged between <40-70 or more. It can be observed that, more than one third (37.7%) of the patients with type II diabetes mellitus their age ranged between 60- <70 years old. More than three fifth (61.5%) of them were female. The highest percentages (87.7%) were from rural area/zone. Three fifth (60%) of them were illiterate. On the other hand, nearly two thirds (64.6%) don’t work. More than three quarters (79.2%) of them were married. In addition, almost three quarter (74.6%) were non-smoker.
2. The clinical data of the studied patients with type II DM; it can be observed that, the highest percentage (85.4%) of them have DM for more than three years. More than half (50.8%) of them use tablets as regard the type of treatment. On the other hand, the majority (81.5%) were compliant with treatment. Almost two thirds (66.2%) were not hospitalized due to DM. Also, nearly half (45.4%) of them replied parents regarding the relatives with diabetes. It can be showed that, the highest percentages (92.3%) don’t play sport. Additionally, more than half (56.2%) follow special diet for diabetes. Nearly three quarter (74.6%) of the studied patients mentioned compliance with treatment regarding practices used to avoid complications of DM; on the other hand, none of them (0.0%) updates his knowledge about DM.
3. Regarding patients’ knowledge about diabetes mellitus; it can be observed that, more than half (56.2%) have a lack of information that enables them to maintain the normal glucose level. More than half (53.1%) of them replied high blood glucose regarding the meaning of DM. It’s clear that, more than one half (52.3%) of the studied patients with type II DM don’t know the normal range of fasting blood glucose, nearly three fifth (59.2%) don’t know the normal range of post-prandial blood glucose, and less than three quarters (72.3%) don’t know the normal range of random blood glucose.
4. More than one half (51.5%) of them replied aging regarding the risk factors of DM. On the other hand, almost two thirds (65.4%) of patients with type II DM replied inherited regarding Causes of DM. It can be showed that, less than three quarters (72.3%) of them replied frequent urination regarding symptoms associated with diabetes. In addition, more than two thirds (66.2%) of them replied retinopathy as regard Complications of DM. The majority (82.3%) are suffering from physical burdens. On the other hand, more than three quarter (77.7%) of them have physical changes as regard the new in their life after knowing that they have diabetes. It can be observed that, more than two thirds of the studied subjects (66.2%) had unsatisfactory level of knowledge.
5. Regarding life satisfaction of the studied patients with type II DM; it can be observed that, the highest percentage (85.4 %) of the studied subjects who agree regarding question (The person, who grows up, is in a deteriorating state); while the majority (84.6%) of them who disagree regarding question (I am just as happy as when I was younger). Also, it’s clear that more than two thirds (67.7%) were unsatisfied with life.
6. Regarding self-esteem of the studied patients with type II DM; it can be observed that, highest percentage (86.2%) of the studied subjects who agree and strongly agree regarding question (On the whole, I’m satisfied with myself); while nearly two thirds (64.6%) who disagree and strongly disagree regarding questions (All in all, I’m inclined to feel that I’m a failure). Also, it’s clear that, less than one half (41.5%) had medium self-esteem, nearly one third (32.3%) had low self-esteem, and more than one quarter (26.2%) had high self-esteem.
7. Regarding relation between life satisfaction and self- esteem; it can be observed that, nearly one third (31.5%) was totally unsatisfied regarding their life satisfaction and had low self-esteem.
8. Regarding relation between knowledge with self- esteem and life satisfaction; it’s clear that, there is highly statistically significant difference between knowledge and self- esteems and life satisfaction.
9. Regarding relation between socio-demographic characteristics of studied patients with type II DM and their knowledge; it can be observed that, there is statistically significant difference between knowledge and age, residence, educational level, job and smoking.
10. Regarding relation between socio-demographic characteristics of studied patients with type II DM and their Life Satisfaction; it can be observed that, there is statistically significant difference between life satisfaction and gender, educational level and job.
11. Regarding relation between socio-demographic characteristics of studied patients with type II DM and their self-esteem; there is statistically significant difference between self-esteem and residence, educational level, and job.
In the light of these findings, it is recommended that:
1) For patients:
Periodic training programs for patients with type II DM and their caregivers to improve their knowledge and consequently their coping methods with disease, hence their life satisfaction and self-esteem. Training sessions and workshops should be organized to improve life satisfaction and self-esteem of patients with II DM. A booklet, pamphlet and posters for illiterate people should be available in the different health setting to enhance their knowledge.
2) For nurses:
Regular assessment of factors affecting life satisfaction and self-esteem of the chronically ill patients such as patients with diabetes, counseling patients to discuss obstacles if present and accordingly adopt proper intervention to empower positive coping and managing disease.
3) For research:
Emphasize the importance of more prospective studies to shed light on life satisfaction and self-esteem among patients with type II DM, to help preventing related burdens, suffering, and negative effect on patient or caregiver; and so, raising level of life satisfaction and self-esteem.
4) For Health institutions:
A training program must be prepared and submitted to the Egyptian Ministry of Health to enforce psychiatric liaison nursing consultation in these hospitals to conduct structured training program.
5) For community:
Emphasize the importance of cooperation and coordination between policy makers, health services providers as well as social workers and mass media to help patients with type II DM overcome their feeling of unsatisfied or worthless and cope positively with their chronic disease.