Overcoming diabetes-related stigma in Iran: A participatory action research

Objective: The study aimed to overcome diabetes-related stigma in individuals living with type 1 Diabetes Mellitus (T1DM) in Iran. The study proposed that if individuals with T1DM and the community work together to develop and implement an anti-stigma program, diabetes-related stigma in individuals with T1DM can be reduced. Research design and method: This study was conducted as a participatory action research study based on Kemmis and McTaggert's (2000) Model to design and implement an anti-stigma program for T1DM. Participants were selected among individuals with T1DM, their family members, health care providers, and residents without diabetes in Isfahan, Iran. Data collection was conducted using interviews, focus groups, emails, and text messages. Content analysis was used to analyze the data to develop anti-stigma interventions. Interventions were prioritized based on the Suitability, Feasibility and Flexibility (SFF) Matrix. Anti-stigma interventions were implemented in different levels in Isfahan, Iran, from 2011 to 2014. The effect of the program was evaluated based on interviews, feedback, and focus groups at the individual level. However, interventions were implemented in different levels including community, organization, family, and individual. Results: Participants with T1DM experienced significant empowerment during the project to overcome diabetes related stigma. The three main themes indicating this feeling of empowerment are ``from doubt to trust'', ``from shadow to light'', and ``from me to us''. Conclusion: Participatory action research can be an effective way to reduce diabetes-related stigma in individuals living with T1DM. It integrates the voices of the marginalized group reducing stigma and discrimination against diabetes. (C) 2017 Published by Elsevier Inc

Living in the Shadow and Light: Iranian Youths’ Responses to Diabetes-Related Stigma

This study aimed to explore the responses of Iranian young people with type 1 diabetes to the diabetes-related stigma. Conventional qualitative content analysis approach guided this inquiry. Volunteered people with type 1 diabetes were recruited by purposeful sampling from one endocrine and metabolism center in Isfahan in 2012. Data gathering was done through 17 individual unstructured in-depth interviews and 3 focus groups. Data saturation was achieved through 33 participants. The data were analyzed using qualitative content analysis. All participants acknowledged stigma and responded it in different ways, which was categorized in two main categories including living in the shadow (hide and seek, missing diabetes, withdrawal) and moving toward light (diabetes disclosure, destruction of the false bubbles). The most response especially for girls was to live in the shadow of silence that can be associated with negative consequences affecting diabetes management. Moving towards the light, suggests that it is possible to help people with type-1-diabetes to achieve a normal life as much as possible. It is necessary to plan the anti-stigma programs and engage them actively to reduce stigma and mitigate or prevent its negative impacts

Breaking stigma within us: the role of people with type 1 diabetes in overcoming diabetes-related stigma

This study explored the strategies to overcome type 1 diabetes-related stigma at the individual level in Iran. This paper is part of the findings of an action research study, which was designed in Iran in 2012 to plan and implement a program for overcoming diabetes-related stigma. Participants were 44 people with type 1 diabetes. Unstructured in-depth interviews, focus groups, email, short message service (SMS) and telephone interview was used to extract strategies to overcome the diabetes-related stigma. Due to the qualitative nature of the data in this phase of the action research, data were analyzed using inductive content analysis approach. Findings showed that in the viewpoint of people with diabetes, their behaviors and reactions are important factors in their resistance to diabetes-related stigma, reducing social stigma, and avoiding its harmful effects. They referred to the interconnected strategies as disease acceptance, accepting social stigma, reinforcing spirituality, enhancing self-esteem and self-confidence, effective self-care activities, and forming real and distant groups. Individual interventions are important steps to initiate overcoming diabetes-related stigma, and social activities will not be successful without them. They are much more economical and more practical than social level measures. These findings can help healthcare teams to integrate anti-stigma strategies in their routine care plan to reduce stigma as well as providing diabetes management

An Umbrella Named Action Research

Action research is a means for creating meaning and promoting understanding of complex social situations, and improving the quality of human interactions and performance in those situations. Action research is one of the words that can be heard now frequently in the education al cycle, but there are several definitions for it. Literature review shows that several writers have referred to this concept and have mentioned several categories of action research. They identify its models, types, approaches, typologies, and taxonomy

Praxis: a Paradigm for Action Research

Action research is a research methodology with a dual purpose (action and research). Action research as other research approach is led through a paradigm or a philosophical perspective. This article briefly describes paradigm, research paradigm and discuss about “which paradigm (positivism, interpretive, or praxis) does cover action research?”

Living in the Shadow and Light: Iranian Youths’ Responses to Diabetes-Related Stigma

This study aimed to explore the responses of Iranian young people with type 1 diabetes to the diabetes-related stigma. Conventional qualitative content analysis approach guided this inquiry. Volunteered people with type 1 diabetes were recruited by purposeful sampling from one endocrine and metabolism center in Isfahan in 2012. Data gathering was done through 17 individual unstructured in-depth interviews and 3 focus groups. Data saturation was achieved through 33 participants. The data were analyzed using qualitative content analysis. All participants acknowledged stigma and responded it in different ways, which was categorized in two main categories including living in the shadow (hide and seek, missing diabetes, withdrawal) and moving toward light (diabetes disclosure, destruction of the false bubbles). The most response especially for girls was to live in the shadow of silence that can be associated with negative consequences affecting diabetes management. Moving towards the light, suggests that it is possible to help people with type-1-diabetes to achieve a normal life as much as possible. It is necessary to plan the anti-stigma programs and engage them actively to reduce stigma and mitigate or prevent its negative impacts

Living in the Shadow and Light: Iranian Youths’ Responses to Diabetes-Related Stigma

This study aimed to explore the responses of Iranian young people with type 1 diabetes to the diabetes-related stigma. Conventional qualitative content analysis approach guided this inquiry. Volunteered people with type 1 diabetes were recruited by purposeful sampling from one endocrine and metabolism center in Isfahan in 2012. Data gathering was done through 17 individual unstructured in-depth interviews and 3 focus groups. Data saturation was achieved through 33 participants. The data were analyzed using qualitative content analysis. All participants acknowledged stigma and responded it in different ways, which was categorized in two main categories including living in the shadow (hide and seek, missing diabetes, withdrawal) and moving toward light (diabetes disclosure, destruction of the false bubbles). The most response especially for girls was to live in the shadow of silence that can be associated with negative consequences affecting diabetes management. Moving towards the light, suggests that it is possible to help people with type-1-diabetes to achieve a normal life as much as possible. It is necessary to plan the anti-stigma programs and engage them actively to reduce stigma and mitigate or prevent its negative impacts

Strategies to overcome type 1 diabetes–related social stigma in the Iranian society

Background: This study explored the strategies to overcome diabetes-related social stigma in Iran. Materials and Methods: This paper is part of an action research study which was designed in Iran in 2012 to plan and implement a program for overcoming diabetes-related stigma. Participants were people with type 1 diabetes, their family members, people without diabetes, and care providers in a diabetes center. Data collection was done through unstructured in-depth interviews, focus groups, e-mail, Short Message Service (SMS), and telephone interview. Data were analyzed using inductive content analysis approach. Results: Participants believed that it is impossible to overcome the stigma without community-based strategies. Community-based strategies include education, advocacy, contact, and protest. Conclusions: The anti-stigma strategies obtained in the study are based on the cultural context in Iran. They are extracted from statements of a wide range of people (with and without diabetes). However, during planning for stigma reduction, it is necessary to note that the effectiveness of social strategies varies in different studies and in different stigmatizing conditions and many factors are involved. These strategies should be implemented simultaneously at different levels to produce structural and social changes. It should be accepted that research on reducing health-related stigma has shown that it is very diffi cult to change beliefs and behavior. Evidence suggests that individuals and their families should be involved in all aspects of the program, and plans should be made according to the local conditions

Hopelessness and Dysfunctional Attitude in Children Under the Support of Child Labor Centers in the South of Tehran in 2021

Background & Aims One of the problems that threatens children in developing countries is the issue of child labor. Working children have lower hope for the future than their normal peers. Working in childhood can have a negative effect on the growth and cognitive performance of children. This study aims to investigate the prevalence of hopelessness and dysfunctional attitudes in working children of southern Tehran. Materials & Methods This is a descriptive-cross-sectional study. The study population consists of all working children and adolescents engaged in child labor aged 10-18 years under the support of child laborers support centers in the south of Tehran. Of these, 247 were selected for the study using a continuous sampling method that lasted 8 months from April to November 2021. The data collection tools were a demographic checklist and the children's dysfunctional attitude scale (DAS) of D’Alessandro and Burton, and the children's hopelessness scale (CHS) of Kazdin (1986). The collected data were analyzed using descriptive statistics (mean, standard deviation, frequency and percentage) and inferential statistics (analysis of variance, independent t-test, and Pearson's correlation test) in SPSS software, version 16. The significance level was set at 0.05. Results The results showed that the average score of hopelessness (5.78±2.60) with a standard deviation of 5.78±2.60 was at a favorable level, among the dimensions of hopelessness, the average score of the dimension of future expectations (3.87±1.87) in hopelessness was higher than the dimension of happiness (2.00±1.39). The average ineffective attitude in the study was 96.16±74.11. Hopelessness only had a statistically significant relationship with the work status of the children in the study (P=0.029). There was no statistically significant correlation between ineffective attitude and hopelessness of working children (P<0.050). Hopelessness only had a statistically significant relationship with the work status of the children in the study (P=0.029). Conclusion It is recommended that interventional studies be conducted to improve the future expectations of children, and focus more on working children whose guardian is someone other than parents. Given the lack of a significant relationship between dysfunctional attitudes and hopelessness in working children in the south of Tehran, it is recommended that the mediating and confounding variables be investigated

Demographic factors associated with quality of life in Iraqis people with diabetic foot ulcers

Background: DFU is a chronic complex wound that has a chief influence on mortality, morbidity, and personal satisfaction for patients. It affects the life of a person with diabetes by up to 25 percent, and thus affects the quality of life of the patient. Objectives: The purpose of this study was to determine Demographic factors associated with QOL in patients with DFU. Patients and Methods: This cross-sectional study was performed on 150 patients (90 males and 60 females) hospitalized for DFU, carried out using a convenience sampling, Demographic data and quality of life questionnaire for patients with DFU were a brief, this questionnaire has 29 questions in six domains, of Leisure, physical health, daily activities dependence, negative emotions, Worried about ulcers, and wound caring, which assess the quality of life in DFU patients. The scoring method for this tool is five optional Likert. The data were analysed using descriptive and analytical statistical approaches. Results: Of the 150 patients with DFU, 60% were male and 40% female with the majority was participants 51-58 years (25.3%) and average QOL of 58.41± 17.09