The effects of social support on the management of diabetes in elderly diabetic with cognitive impairment

This study aimed to determine how social support influences the management of diabetes in diabetic elderly patients with cognitive impairment. The population of the present cross-sectional study was composed of diabetic elderly in-patients receiving treatment in the Geriatrics Clinic of the İbni Sina Hospital of Ankara University Faculty of Medicine, with the study sample involving a total of 113 diabetic elderly patients meeting the inclusion criteria. Power analysis was employed for the calculation of the sample size of 113, with the sample power of 80%, standard deviation of 6, and level of type I error (α) of 0.05. Data were collected through face-to-face interview method using the measures of the Introduction Form, created by the researcher as a result of the literature review, the Revised Mini Mental State Examination in Educated and Uneducated Elderly, Diabetes Self-Care Activities Questionnaire, the "Support Attitudes" subscale of Diabetes Care Profile Questionnaire, and KATZ Daily Life Activities Scale, and were analyzed by means of numerical, percentile, standard deviation, ANOVA, Mann-Whitney U, Kruskal Wallis, Tukey, and Pearson correlation analysis methodology on SPSS (ver. 23) package software according to the significance value of p˂0.05. The findings of the analyses showed that, in terms of the correlation between socio-demographic variables and support attitudes in diabetic elderly patients with cognitive impairment, it was only the participants that were employed that had higher scores of social support than those who were unemployed (p˂0.05). On the other hand, there were no statistically significant differences between social support and diabetics-related characteristics (p>0.05), nor did the support attitudes subscale of diabetics care profile scale scores correlate significantly with the total scores of diabetics self-care activities or its subscales (p>0.05). Support attitudes were found to have significant negative linear correlation with the HbA1c value (p<0.05), suggesting that the HbA1c value tended to decrease with increased social support. Support attitudes and KATZ daily life activities scale total scores showed a significant negative linear correlation (p<0.05), indicating that the level of independence of the individual decreases with increased levels of social support. While support attitudes did not significantly correlate with the continence or dressing activities of KATZ (p>0.05), there were significant negative linear correlations between support attitudes and the activities of feeding, toileting, bathing, and transferring (p<0.05). Diabetics self-care activities scale total score was found to be higher in diabetic geriatric patients living with their spouses, having received training in diabetes, and taking insulin+diet+oral anti-diabetic drugs (p<0.05). Self-care total scores did not correlate significantly with HbA1c, whereas they had significant positive and negative linear relationships with the sub dimensions of blood glucose and exercise, respectively (p<0.05), which suggests that HbA1c value tends to increase with less exercise and higher blood glucose levels. The scores of the Self-Care Scale and the KATZ Daily Life Activities Scale were found to have a significant negative linear correlation (p<0.05). Based on the findings stated above, it can be concluded that social support has an important effect on the management of diabetes in elderly patients diabetes with cognitive impairment. Training of the caregivers of such patients is particularly crucial in ensuring glycemic control, preventing or decreasing possible complications, improving self-care, and maintenance of individuals' independence in their daily lives. Nurses play an important part in this matter, as they need to ensure the participation of family members or caregivers of diabetic geriatric patients with cognitive disorders in the training process of such patients, and training programmes aiming to demonstrate the importance and active roles of social support in the management of diabetes and to develop supporting behaviours for best caregiving, in addition to providing psychological support when necessary.