Effect of Peer Group Education on the Quality of Life of Elderly Individuals with Diabetes: A Randomized Clinical Trial Abstract

Maryam Ghasemi, Habibolah Hosseini, Fakhri Sabouhi


Background: Considering the important role of education and the benefits of peer education in increasing patients’ independence in self‑care, as well as the socio‑economic benefit of using peer education, the present study was conducted to assess the effect of peer education on the quality of life (QOL) of elderly people with diabetes.

Materials and Methods: This clinical trial was conducted with 44 diabetic people aged over 65 years in selected health centers of Isfahan, Iran, in 2014. After preparing the peer group, 8 educational sessions were held for the participants of the groups by their peers (intervention group) and by the researcher (control group). The Diabetes Quality‑of‑Life (DQOL) measure was used to assess their QOL before, immediately after, and 1 month after the intervention.

Results: The difference between the groups in terms of the total quality of life score immediately after the intervention was significant (t = 8.63; p = 0.001). The results showed that the QOL score in the dimensions of worries about diabetes effects (t = 12.13, p = 0.042), impact of diabetes treatment, (t = 8.63, p = 0.001), and satisfaction with diabetes treatment (t = 11.33, p = 0.001) was significantly different in the groups immediately after the intervention.

Conclusions: Peer education increased the QOL of patients with diabetes, with significantly better results than the researcher training group immediately after the training. Thus, this method can be used to improve the QOL of the aged population.



Aged, diabetes mellitus, Iran, peer group, quality of life

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Noroozian M. The elderly population in iran: An ever growing concern in the health system. Iran J Psychiatry Behav Sci 2012;6:1‑6.

Beltran‑Sanchez H, Soneji S, Crimmins EM. Past, present, and future of healthy life expectancy. Cold Spring Harb Perspect Med 2015;5.

Esmaeili Shahmirzadi S, Shojaeizadeh D, Azam K, Salehi L, Tol A, Moradian Sorkhkolaei M. The impact of chronic diseases on the quality of life among the elderly people in the east of Tehran. J Payavard Salamat 2012;6:225‑35.

Vrdoljak D, Pavlov R. Diabetes in elderly. Coll Antropol 2014;38(Suppl 2):243‑6.

Morovati SMA, Rouhani TN. Social support and self‑care behaviors in diabetic patients referring to Yazd diabetes research center. Zahedan J Res Med Sci (Tabib‑E‑Shargh) 2008;9:275‑84.

Sharif F, Masoudi M, Ghanizadeh A, Dabbaghmanesh MH, Ghaem H, Masoumi S. The effect of cognitive‑behavioral group therapy on depressive symptoms in people with type 2 diabetes: A randomized controlled clinical trial. Iran J Nurs Midwifery Res 2014;19:529‑36.

Yin J, Wong R, Au S, Chung H, Lau M, Lin L, et al. Effects of providing peer support on diabetes management in people with type 2 diabetes. Ann Fam Med 2015;13(Suppl 1):S42‑9.

Taleghani F, Babazadeh S, Mosavi S, Tavazohi H. The effects of peer support group on promoting quality of life in patients with breast cancer. Iran J Nurs Midwifery Res 2012;17:S125‑30.

Biabanakigoortani A, Namnabati M, Abdeyazdan Z, Badii Z. Effect of peer education on the noise management in Iranian neonatal intensive care unit. Iran J Nurs Midwifery Res 2016;21:317‑21.

Piette JD, Resnicow K, Choi H, Heisler M. A diabetes peer support intervention that improved glycemic control: Mediators and moderators of intervention effectiveness. Chronic Illness 2013;9:258‑67.

Philis‑Tsimikas A, Fortmann A, Lleva‑Ocana L, Walker C, Gallo LC. Peer‑led diabetes education programs in high‑risk Mexican Americans improve glycemic control compared with standard approaches: A Project Dulce promotora randomized trial. Diabetes Care 2011;34:1926‑31.

Safford MM, Andreae S, Cherrington AL, Martin MY, Halanych J, Lewis M, et al. Peer coaches to improve diabetes outcomes in rural alabama: A cluster randomized trial. Ann Fam Med 2015;13(Suppl 1):S18‑26.

Group DR. Reliability and validity of a diabetes quality‑of‑life measure for the diabetes control and complications trial (DCCT). Diabetes Care 1988;11:725‑32.

Pakpour AH, Saffari M, Burri A. Translation and validation of an Iranian version of the Diabetes Quality of Life measure. J Diabetes Investig 2012;3:471‑8.

Masaeli N, Attari A, Molavi H, Najafi M, Siavash M. Normative data and psychometric properties of the quality of life questionnaire for patients with diabetes mellitus. Koomesh 2010;11:263‑9.

Uccelli MM, Mohr LM, Battaglia M, Zagami P, Mohr D. Peer support groups in multiple sclerosis: Current effectiveness and future directions. Mult Scler J 2004;10:80‑4.

Mohr DC, Burke H, Beckner V, Merluzzi N. A preliminary report on a skills‑based telephone‑administered peer support programme for patients with multiple sclerosis. Mult Scler J 2005;11:222‑6.

Rosenzweig S, Reibel DK, Greeson JM, Edman JS. Mindfulness‑based stress reduction is associated with improved glycemic control in type 2 diabetes mellitus: A pilot study. Altern Ther Health Med 2007;13:36‑8.

Faude‑Lang V, Hartmann M, Schmidt E‑M, Humpert P, Nawroth P, Herzog W. Acceptance‑and mindfulness‑based group intervention in advanced type 2 diabetes patients: Therapeutic concept and practical experiences. Psychother Psychosom Med Psychol 2010;60:185‑9.

Borhani F, Lashkari T, Sabzevari S, Abbaszadeh A. Effect of telenursing (telephone follow‑up) on glycemic control and body mass index (BMI) of type 2 diabetes patients. Iran J Nurs Midwifery Res 2013;18:451‑6.

Ridge K, Bartlett J, Cheah Y, Thomas S, Lawrence‑Smith G, Winkley K, et al. Do the effects of psychological treatments on improving glycemic control in type 1 diabetes persist over time? A long‑term follow‑up of a randomized controlled trial. Psychosom Med 2012;74:319‑23.

Van Tam V, Larsson M, Pharris A, Diedrichs B, Nguyen HP, Nguyen CTK, et al. Peer support and improved quality of life among persons living with HIV on antiretroviral treatment: A randomised controlled trial from north‑eastern Vietnam. Health Qual Life Outcomes 2012;10:53.

Berkman LF, Kawachi I, Glymour MM. Social epidemiology. Oxford University Press; 2014.

Liu Y, Han Y, Shi J, Li R, Li S, Jin N, et al. Effect of peer education on self‑management and psychological status in type 2 diabetes patients with emotional disorders. J Diabetes Investig 2015;6:479‑86.

Ferrans C, Powers M. Quality of life index: Development and psychometric properties. Rech Soins Infirm 2007:32‑7.

van der Wulp I, de Leeuw JR, Gorter KJ, Rutten GE. Effectiveness of peer‑led self‑management coaching for patients recently diagnosed with Type 2 diabetes mellitus in primary care: A randomized controlled trial. Diabet Med 2012;29:e390‑7.

Shafiei F, Shahgholian N, Amini M, Abazari P, Amini P. Barriers to blood glucose level management in the health care system: View points of patients, families and medical personnel. Indian J Endocr Metab 2012;14:25‑311.


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