Explaining the Self-Care Behaviors in Type 2 Diabetic Patients Based on Adverse Childhood Experiences, Subjective Socioeconomic Status, and Mindfulness in Isfahan, Iran

Abstract

Background and AimsAs reported by the World Health Organization, the prevalence of Type 2 diabetes has increased fourfold since 1980, with approximately 422 million individuals affected globally. Projections indicate that the number of people living with Type 2 diabetes could more than double in the next two decades. Given the expected increase in the prevalence of Type 2 diabetes in Iran, it is crucial to conduct a thorough investigation to evaluate the primary psychosocial factors associated with individuals suffering from Type 2 diabetes. Therefore, this study aims to investigate the relationship between mindfulness, subjective socioeconomic status (SES), and adverse childhood experiences (ACEs) in the context of self-care practices among Type 2 diabetes patients in Isfahan, Iran.MethodsA cross-sectional study involving 350 Type 2 diabetic patients, aged 20-44, was undertaken in 2023. Participants were randomly selected from six comprehensive health centers located in Isfahan. Summary of Diabetes Self-Care Activities (SDSCA) measure, Brown's Mindful Attention Awareness Scale, ACEs module (CDC, 2010), and socio-demographic factors, including age, gender, education, and subjective SES, were employed to collect data. The data was analyzed using a multivariate logistic regression model.ResultsThe study results indicate that 58.6 of all participants reported experiencing at least one ACE, while 50.9 of individuals with Type 2 diabetes exhibited inadequate self-care practices. After adjusting for demographic factors, individuals who reported experiencing one to four ACEs (OR: 0.38; 95 CI: 0.17-0.63) and those with six or more ACEs (OR: 0.32; 95 CI: 0.15-0.78) exhibited a higher likelihood of engaging in poor diabetes self-care behaviors compared to those who had no ACEs.ConclusionsResearch suggests a strong correlation between childhood adversity and suboptimal self-care practices in Type 2 diabetic patients. This finding underscores the importance of collaborative efforts between healthcare and social service organizations to implement effective screening, prevention, and early intervention strategies for individuals with Type 2 diabetes who have experienced ACEs.