1

Chapter I
THE PROBLEM AND THE REVIEW OF RELATED LITERATURE
Introduction
Diabetes mellitus is a disease in which the pancreas
produces insufficient amounts of insulin, or in which the
bodys cells fail to respond appropriately to insulin. There
are two types of diabetes mellitus, the type I and the type
II. This study focuses on the type II diabetes mellitus
since it accounts mostly of the cases compared to type I
Diabetes Mellitus.
Diabetes

Mellitus

Type

II

is

non-communicable

lifestyle disease. It is also a chronic metabolic disease in

which

the

body

cannot

effectively

use

the

insulin

it

produces. Thus, it leads to an increased concentration of

glucose in the blood (hyperglycemia). In this case, the
disease is expected to affect the patients quality life. It
demands a lot to the lifestyle, poses debilitating and life
threatening complications and has significant effect on the
well-being of the patient.
The managements for diabetes mellitus and its related
health risk factors are often highly complex and require
considerable
monitoring

patient
to

education

prevent

the

and

frequent

occurrence

of

medical
severe

complications.

This

disease

has

long-term

complications,

such as retinopathy, neuropathy, heart disease,nephropathy,

and stroke, which have a detrimental effect to the quality
of life.
With the following complications, it is important for
the patient to learn how to cope up to its effect. Coping
mechanism is a way of patient on how to deal with the
consequences

of

their

disease.

Many

people

have

characteristic way of coping with situation based on their

personality. People who cope well tend to believe that they
can personally influence what happens to them. They usually
make

more

optimistic

and

persevere

even

under

extremely

adverse circumstances. Most significantly, they choose the

appropriate

strategies

to

cope

with

the

situations

they

have. In opposite, people who cope poorly with the situation

tend to have somewhat opposite behaviour, such as being
pessimistic and lower self-esteem.
As of 2011, the estimated number of adults living with
diabetes has soared to 366 million, representing 8.3% of the
global adult population. This number is expected to increase
to 522 million people by 2030, or 9.9% of adults, which
equates to approximately three more people with diabetes
every ten seconds.

In

most

countries,

Diabetes

is

now

among

the

five

leading causes of death. Indeed, here in the Philippines it

is

one

among

the

top

ten

leading

causes

of

mortality.

Besides, it ranks as the ninth (9th) top killer disease

nowadays.

It

is

according

to

World

deaths

will

also

double

alarming

Health

to

know

Organization

between

2005

and

that

recently

(WHO),

diabetes

2030

in

developing

countries including the Philippines.

Those data show that Diabetes Mellitus incidence are
not

just

rampant

internationally

but

also

in

our

own

nationality.
With

the

above

problem,

the

researchers

decided

to

conduct a study to find out the coping mechanism of the

respondents with the common effects of diabetes mellitus
type II. With these, it would be helpful in the prevention
of the occurrence of further complications of the disease.
Review of Related Literature
Included

in

this

section

are

related

studies

about

diabetes mellitus, Type 2 diabetes mellitus and its impact

on

the

different

aspects

of

life

such

as

physical

and

psychological/emotional, the coping strategies of patients

with Type 2 diabetes mellitus and as well as the ways of
prevention and treatment.

It

is

generally

believed

that

the

prevalence

of

Diabetes Mellitus is increasing worldwide and it represents

a large burden for patients and society. Diabetes Mellitus
must be considered a major public health problem however it
does not stop those people who have this disease in living
their life. People with diabetes have to live their life,
and deal with whatever life throws at them.
Most authors defined diabetes mellitus or better known
just

as

"diabetes"

as

a chronic disease

associated

with

abnormally high levels of the sugar glucose in the blood.

Diabetes
Inadequate

is

due

production

to

one

of

two

mechanisms:

of insulin (which

is

(1)

made

by

the pancreas and lowers blood glucose) or (2) Inadequate

sensitivity of cells to the action of insulin. The two main
types of diabetes correspond to these two mechanisms and are
called insulin-dependent (type I) and non-insulin-dependent
(type

II)

diabetes.

(Retrieved

from:

http://www.medterms.com/script/main/art.asp?articlekey=2974
on February 24, 2012)
According

to

Barbara

L.

Bullock

and

Reet

(2000), the prevalence of DM increases with age.

L.

Henze

Over 10 %

of individuals over the age of 65 have DM as compared with

0.8% of individuals younger than 38.
greater in women (55%) than men (45%).

The incidence is also

In type II diabetes, there is no insulin or not enough

of

it.

In

type

II

diabetes,

there

is

generally

enough

insulin but the cells upon it are not normally sensitive to

its action. Type II Diabetes Mellitus accounts mostly of the
cases compared to Type I Diabetes Mellitus.
Diabetes Mellitus type II is known to be a chronic
disease

that

According

mainly

to

Brunner

affects
&

the

metabolism

Suddarths

(2010)

of

sugar.

Textbook

of

Medical-Surgical Nursing 12th edition, the two main problems

in type II diabetes are insulin resistance and impaired
insulin

secretion.

Thus,

it

leads

to

decreased

tissue

sensitivity to insulin. With type II diabetes, the body

either resists the effects of insulin a hormone that
regulates the movement of sugar into cells or does not
produce enough insulin to maintain a normal glucose level.
(Retrieved

from:

http://www.mayoclinic.com/health/type-2-

diabetes/DS00585 on March 3, 2012)

Diabetes mellitus type II is a metabolic disorder that
is

characterized

of insulin

by

high blood

resistance and

glucose in

the

context

relative insulin deficiency

(Retrieved
http://en.wikipedia.org/wiki/Diabetes_mellitus_type_2
March 3, 2012).

from:
on

In
chronic
fat,

addition,

hyperglycemia

and

insulin

type

protein

II

diabetes

with

characterized

disturbances

metabolism

secretion,

is

insulin

resulting

action,

or

of

by

carbohydrate,

from

defects

both.

in

(Retrieved

from: http://www.staff.ncl.ac.uk/ on February 29, 2012).

Type II diabetes, the most common type of diabetes is
multifactorial.

It

susceptibility genes

is

due

plus

to

the

inheritance

environmental

factors

of
such

as obesity. Obesity, in turn, clearly is multifactorial in

causation.

(Retrieved

from:

http://www.medterms.com/script/main on March 3, 2012.

Type II diabetes is primarily be seen in middle-aged
adults (40-65 years old), and be in contrast to type I
diabetes,
stage.

which

is

(Retrieved

usually
from:

diagnosed

at

much

earlier

http://www.diabetes.co.uk/type2-

diabetes.html on March 8, 2012) However, Cases of type 2

diabetes is already increasing in children throughout the
country. One problem that is thought to be causing the
increase in obesity rates is the misconception that many
parents have of puppy fat, i.e. the belief that extra fat
on young children is healthy, and that they will eventually
shed the fat as they grow older. The fact is, puppy fat is
something that babies have. From the time children are on
their feet and walking they should not be carry excess fat,

and certainly not at the age of 4 years and over. (Retrieved

from

http://www.motleyhealth.com/lose-weight/the-puppy-

fat-myth-and-child-obesity on March 8, 2012).

In addition, Type II diabetes was once rare in children
and adolescents but has recently become more common. About
15% of people older than 70 have type 2 diabetes. People of
certain racial and ethnic backgrounds are at increased risk
of developing type 2 diabetes: blacks, Native Americans, and
Hispanics who live in the United States have a twofold to
threefold increased risk. Type 2 diabetes also tends to run
in

families.

(Retrieved

from:

http://www.merckmanuals.com/home/hormonal_and_metabolic_dis
orders/diabetes_mellitus_dm/diabetes_mellitus.html on March
9, 2012)
Generally, type II diabetes develops more slowly than
type I diabetes. As a result, some people can be diagnosed
with type II diabetes (and some other diabetes types) years
after they first developed the condition. In some cases,
diabetes may only be diagnosed after noticing the signs
of diabetic complications that is a serious position.
Untreated, type II diabetes can be life threatening.
Higher blood sugars over a period of time allow diabetic
complications

to

set

in,

such

as

diabetic retinopathy,

kidney disease, and cardiovascular disease (heart disease).

(Retrieved

from:

http://www.diabetes.co.uk/diabetes-life-

expectancy.html on March 8, 2012.)

People with type II diabetes may not have any symptoms
for years or decades before they are diagnosed. Symptoms may
be subtle. Increased urination and thirst are mild at first
and

gradually

people

feel

worsen
extremely

over

weeks

fatigued,

or

months.

are

likely

Eventually,
to

develop

blurred vision, and may become dehydrated. (Retrieved from:

http://www.merckmanuals.com/home/hormonal_and_metabolic_dis
orders/diabetes_mellitus_dm/diabetes_mellitus.html on March
9, 2012)
People with type II diabetes often do not have any
symptoms. When symptoms do occur, they are often ignored
because

they

may

not

seem

serious.

Symptoms

in

type

diabetes usually come on much more suddenly and are often

severe. Common symptoms of diabetes include excessive thirst
and appetite, increased urination (sometimes as often as
every hour), unusual weight loss or gain, fatigue, nausea
perhaps vomiting, blurred vision, in women, frequent vaginal
infections, in men and women, yeast infections, dry mouth,
slow-healing sores or cuts and itching skin, especially in
the groin or vaginal area.

If a person with diabetes is

having weakness or fainting spells; experiencing a rapid

heartbeat,

trembling,

and

excessive

sweating;

and

feel

irritable,

hungry,

or

suddenly

drowsy.

He/she

could

be

developing hypoglycemia -- low blood sugar that can occur

with

diabetes

treatment.

(Retrieved

from

http://diabetes.webmd.com/understanding-diabetes-symptoms
on September 18, 2012)
People with type II diabetes are especially at risk for
hypoglycemia,

which

is

also

called

low

blood

sugar

or

insulin shock. This may be caused by insufficient intake of

food, too much exercise or excessive alcohol intake. One of
the most common causes of hypoglycemia is injecting too much
insulin.

Usually

occasionally

it

can

the
be

condition

is

severe

even

or

manageable,

though

life-threatening,

particularly if the patient fails to recognize the symptoms.

Managing diabetes as effectively as possible to increase
insulin

sensitivity

hypoglycemia.

can

greatly

reduce

the

risk

of

It is also essential to manage exercise and

food intake responsibly, as directed by a doctor.

Mild hypoglycemia is common among people with type II
diabetes. Severe episodes are rare, even among those who are
taking insulin. However, everyone who is controlling glucose
levels should be aware of warning symptoms. Persons with
diabetes at highest risk for severe hypoglycemia are those
who have a previous history of the disorder or those who

10

develop

"hypoglycemia

unawareness."

(Retrieved

from:

http://diabetesmanagement.insulitelabs.com/index.php?
q=hypoglycemia.php on October 19, 2012)
Based on a study conducted by Wim JC de Grauw, Eloy H
van de Lisdonk, Robert RA Behr, Willem HEM van Gerwen, Henk
JM van den Hoogen and Chris van Weel (1999), The physical
fitness of type II diabetes mellitus patients was clearly
impaired. Functional health status decreased significantly
with

the

presence

cardiovascular

of

co-morbidity

co-morbidity
and

in

longer

particular
duration

of

diabetes. Cardiovascular co-morbidity turns out to be not

only a predominant factor in the decreased life expectancy
of

type

II

diabetes

mellitus

patients:

it

impairs

the

patient's functional health status long before as well.

In

people

with

diabetes,

stress

can

change

blood

glucose levels in two ways: (1) People under stress may not
take good care of themselves; they may drink more alcohol or
exercise less. They may forget, or not have time, to check
their glucose levels or plan good meals. (2) Stress hormones
may also alter blood glucose levels directly. Scientists
have studied the effects of stress on glucose levels in
animals and people. Diabetic mice under physical or mental
stress have elevated glucose levels. The effects in people

11

with type I diabetes are more mixed. While most people's

glucose levels go up with mental stress, others' glucose
levels can go down. In people with type II diabetes, mental
stress often raises blood glucose levels. Physical stress,
such

as

illness

or

injury,

causes

higher

blood

glucose

levels in people with either type of diabetes. Some sources

of stress are never going to go away, no matter what you do.
Having diabetes is one of those. Still, there are ways to
reduce the stresses of living with diabetes. Support groups
can help. Knowing other people in the same situation helps
those with diabetes feel less alone. They can also learn
other

people's

friends

in

hints

for

support

coping

group

can

with

problems.

lighten

the

Making

burden

of

diabetes-related stresses. Dealing directly with diabetes

care

issues

can

also

help.

(Retrieved

from: http://www.diabetes.org/living-withdiabetes/complications/stress.html on March 02, 2012)

Living
person
normal,

with

type

discouraged.
but

its

Some

diabetes

may

emotional

necessary

to

sometimes

highs

recognize

and
when

cause
lows

are

emotional

changes signal unusual stress so that a person with DM

can

begin to find ways to cope with it.

In regards with stress brought by diabetes, there are
general guidelines for managing it: (1) Stay active. It can

12

improve blood sugar levels as well as mood; (2) Meditate.

Short periods of quiet reflection can improve ones ability
to cope with stress; (3) Be positive or avoid negative
thoughts; (4) Laugh. Laughter may lower blood pressure and
reduce stress hormones; (6) Consider yoga. This form of
full-body stretching can help someone feel calm; (7) Get
plenty of sleep. Sleep loss may lead to weight gain and may
interfere with bodys ability to use insulin; (8)Make sure
to have a good support network.
(Retrieved

from:

http://www.victoza.com/manage/diabetes-

stress-management.aspx on October 19, 2012)

Depression

is

the most

common psychiatric

disorder

witnessed in the diabetic population. Depression and anxiety

can

interfere

with

the

health

care

of

individuals

with

diabetes. Diabetic individuals with depression or anxiety

are at greater risk for being noncompliant with medical
treatment

and

for

developing

medical

complications,

according to a review of studies in the May/June 1999 issue

of "Diabetes and Metabolism Research Reviews."
Those with diabetes may experience depression and
anxiety.
"Diabetes

study

Care"

published

investigated

in

the

the

June

rates

2001

of

issue

diabetes

of
and

depression, finding that having diabetes doubles the odds of

13

being depressed and women with diabetes are more likely to

have depression than men with diabetes. Diabetic individuals
also have higher levels of anxiety, as noted in the December
2002 edition of "The Journal of Psychosomatic Research."
(Retrieved

from:

www.livestrong.com/article/94222-mental-

social-effects-diabetes/ on March 8, 2012)

While complications could be understood to upset
people and the more of them the more upset they may cause,
there is an additional effect of duration of diabetes. The
longer the duration the greater the distress this would
mean that depression and anxiety is not simply linked to
initial adjustment problems to having diabetes but it is not
clear from this component of the study why people with
longer duration of diabetes seem to be more depressed and
anxious. Factors such as age, education (and occupational
status, which was not included in the regression analyses
due to its 81 correlation with education), and the perceived
effort expended on dealing with all chronic conditions were
not found to be predictors of distress in this group in the
presence

of

the

effects

of

complications

and

diabetes

duration.
(Retrieved from: http://www.chronicillness.org.au/downloads
/Diabetesanddepression.pdf on January 27, 2012.)

14

According to Richard M. Weil, MEd, CDE (2000), its no

coincidence that the rate of Type II diabetes is rising. The
two are strongly related: The heavier people are, the more
likely

they

are

to

develop

diabetes.

So

strong

is

the

connection between obesity and diabetes that a new word,

diabesity, has been coined by the medical community. (The
first diabesity conference was held in Virginia in March
2001.)

Its also no coincidence that Type II diabetes and

obesity are on the rise at a time when physical inactivity

is commonplace. People who are physically inactive tend to
be heavier than people who are active, and they tend to have
more diabetes too.

While the rises in obesity and Type II

diabetes show no signs of slowing any time soon, research

suggests that something can be done to increase the number
of people who are physically active and to decrease the
number

who

develop

obesity

and

Type

II

diabetes.

This

article offers suggestions to help individuals make informed

decisions about losing weight and becoming more physically
active.
Despite the risks associated with type II diabetes,
most people can lead active lives and continue to enjoy the
foods and activities that they previously enjoyed. Diabetes
does

not

birthday

mean
cake,

an
and

end

to

most

"special
people

occasion"

with

diabetes

foods

like

can

enjoy

15

exercise

in

almost

any

form.

(Retrieved

from:

http://www.uptodate.com/contents/patient-informationdiabetes-mellitus-type-2-overview-beyond-the-basics

on

March 9, 2012)
Managing diabetes can seem like an overwhelming task,
particularly for the newly diagnosed patient. Many diabetics
struggle to cope with the requirements and this can lead to
depression.
Diabetes is a unique disease because people diagnosed
with it must be responsible for the majority of their own
care.

There

are

lot

of

areas

to

cover.

Insulin,

medication, blood glucose monitoring, diet, and exercise are

all important parts of diabetes management that must be
incorporated into peoples lifestyle who have this.
Nutrition is very important in managing diabetes. Being
overweight or obese can also make managing diabetes more
difficult. Losing weight, even 5-7% of total body weight,
can greatly improve glucose control, and overall health.
Monitoring blood glucose levels is an extremely important
part of diabetes management. But most importantly, blood
glucose monitoring lets a person know if his/her levels are
too high or too low. Exercise is also an important way to
manage diabetes. Not only can physical activity helps to
achieve beneficial weight loss, but it can lower blood sugar

16

and

help

person

cells

has

accept

insulin

diabetes,

excess

more

efficiently.

weight

can

make

When

his/her

condition more difficult to control. Fat cells are more

resistant to insulin than lean muscle cells, so having too
much body fat makes it that much harder to use the insulin
that body makes. Maintaining a healthy weight is key to
managing

diabetes.

(Retrieved from:

http://diabetes.about.com/od/doctorsandspecialists/u/coping
withdiabetes.htm on September 18, 2012)
According to Mc Culloch (2001,) For most people, the
first

few

emotional

months
highs

after
and

being

lows.

diagnosed

If

person

are

filled

with

just

been

has

diagnosed with diabetes, hi/her family should use this time

to learn as much as possible so that caring for diabetes
(including

testing

appointments,

and

blood

taking

sugar,

going

medications)

to

becomes

medical

part

of

his/her daily routine.

However,

basing

on

Birgitta

Sandn-Eriksson,

PhD

(2000) Diabetes had little impact on daily living and it

affected the individual more than the family. The emotional
relationship between the patients and their diabetes was
relaxed

and

strong

but

they

still

felt

high

levels

of

independence, freedom, and safety. As expected, the social

situation

changed

with

increasing

age.

The

number

of

17

subjects still at work and the number of households with

children

decreased

and

the

number

of

old-age

pensioners

increased.
According to Diana Rodriguez (2011), Having type II
diabetes changes

ones

life

relationships. Diabetes
attention

and

focus,

and

can

management
which

may

certainly

requires

be

There

is

affect
lot

of

need

to

carefully monitor the food that a person with diabetes eats

and check his/her blood sugar frequently throughout the day.
Even

if

relationship,

person

is

diabetes

dating life

not
can

currently
have

an

in

impact

long-term
on

his/her

(Retrieved

from:

http://www.everydayhealth.com/type-2-diabetes/type-2diabetes-and-relationships.aspx March 8, 2012)

In addition, a person with diabetes either Type I or
Type II should talk to a doctor or nurse about resources
that are available for medical as well as psychological
support. These may include group classes, meetings with a
nutritionist, social worker, or nurse educator, and other
educational
magazines.

resources

such

as

books,

web

sites,

(Retrieved

http://www.uptodate.com/contents/patient-informationdiabetes-mellitus-type-2-overview on January 31, 2012)

or

from:

18

Type

diabetes

is

serious

Following pre-diabetes or metabolic

diabetes

can

health

condition.

disorder,

potentially

type

be

avoided

through diet and exercise. Such a diagnosis can be viewed as

a useful, if urgent, wake up call. If resistance to insulin
increases, people with type 2 diabetes may need to take oral
anti-diabetic medications, or take insulin to keep their
blood

sugar

levels

stable.

(Retrieved

http://www.diabetes.co.uk/type2-diabetes.html,

from:

March

02,

2012)
Coping

has

been

defined

as

response

aimed

at

diminishing the physical, emotional and psychological burden

that

is

linked

to

stressful

life

events

and

daily

hassles Coping is understood to be adaptational activity

that involves effort. It is the element of effort which
enables us to draw the distinction between coping and readymade

adaptational

devices

such

as

reflexes.

Coping

constitutes constantly changing cognitive, behavioural and

emotional

efforts

to

manage

particular

external

and/or

internal demands that are appraised as taxing or exceeding

the resources of the individual.
Coping with the implications of one's diabetes related
problems could be a difficult and often lifelong process.

19

Patients may cope by adjusting their social role to fit the

demands and challenges associated with the illness, or they
may cope by trying to reframe their experiences viewing the
situation in a more positive light. Accepting the reality of
the

diagnosis

and

developing

positive

attitude

toward

treatment is thought to be critical for successful coping

and recovery.
(

Retrieved

from:

http://www.hqlo.com/content/6/1/79,

October 02,2012)
Healthy

coping

and

managing

negative

emotions

are

central to diabetes self management, all of which influence

health and quality of life. Depression and other negative
emotions can make diabetes worse, and problems with diabetes
can worsen emotional health. Mediating both of these is self
management.
Problem-solving skills that are central to diabetes
self management are also central to managing emotions. For
example, if people set a goal to increase their physical
activity maybe something as simple as walking five days a
week and they meet that goal, the achievement helps their
emotions,

and

the

physical

emotions and their diabetes.

activity

helps

both

their

20

In

addition

to

the

above

mentioned,

there

are

key

skills for healthy coping which

are (1) Problem-solving

and

problems

goal

setting

appraising

and

challenges,

generating alternatives for dealing with them, testing those

alternatives, and assessing results, (2)
including

how

to

express

ones

Social skills,

feelings

and

choices

effectively, (3) Cognitive skills and (4)

Stress management

skills

(Retrieved

like

relaxation

and

meditation.

from:

http://www.diabetesinitiative.org/documents/Coping_1025.pdf on September 03, 2012)

Treatment
control,
glucose

typically

regular

and

testing and

and/or insulin

includes
appropriate

in

some

diet

exercise, home

cases,

injections.

modification

oral

(Retrieved

http://www.diabetes.co.uk/type2-diabetes.html

on

and
blood

medication
from:
March

8,

2012)
Recently a number of new and effective treatments have
become

available,

such

as

Byetta,

Victoza

and

Bydureon.

Maintaining good control of blood glucose levels is vital in

reducing the risk of diabetic complications. If you are
overweight, weight loss can often help to improve the extent
of

diabetes

symptoms.

(Retrieved

from

21

http://www.diabetes.co.uk/type2-diabetes.html

on

March

8,

2012).

Conceptual Framework:
Input

Type Ii
Diabetes
Mellitus
Patients

Process

Output

Information
gathering

Baseline data
on the
patients
coping
mechanisms to
the common
effects of
Diabetes
Mellitus Type
II

-Floating of
questionnaires

-Profile

Age: 3185
Gender
Year of

Figure

: Interrelationships among input, process and

output. The IOP represents the profile of the respondents

with

diabetes

developed

mellitus

structured

type

II

as

questionnaire

the
was

input.
utilized

self-

as

the

process to obtain the output which is the common effects of

diabetes

mellitus

and

the

coping

mechanisms

of

the

respondents.

Statement of the Problem:

The
patients

research
coping

study

generally

mechanisms

to

aims
the

to

determine

common

effects

the
of

22

Diabetes Mellitus Type II. The research study specifically

aims to answer the following:
1 What is the profile of the respondents in terms of
the following
1 Age
2 Gender
3 Year of diagnosis
2 What are the common effects of Type II DM to the
respondents?
3 What are the coping mechanisms of the respondents on
1
2
3
4

the effects of DM Type II in terms of

Psychological
Spiritual
Physical
Socioeconomic

Statement of the Hypothesis:

1. The more effective the patients coping mechanism,
the lesser the complication of diabetes mellitus type 2 that
may occur.
2.

The

lesser

the

complication

of

the

diabetes

mellitus, the better quality of life of the patients.

23

Significance of Study:
The

results

of

this

study

on

the

patients

coping

mechanism to the common effects or complications of Diabetes

Mellitus type II will be essential to the following:
The Nursing Administrators. The results of this study
will make them aware about the scenario so that they can
make

ways

to

improve

their

conditions

like

implementing

health programs providing education to the community people

regarding the prevention and rehabilitation of the disease.
The Nursing Institutions. The results of this study
will help them point the most common complication involved
in having a Diabetes Mellitus Type II. With this, they are
able to focus on that identified human aspect which have the
greatest impact to the respondents life and intervene.
The selected respondents. The results of this study
will help them manage the impact of Diabetes Mellitus to
their lives and able to cope with the long term consequence
of their illness.
The future researchers. The results of the study will
serve

as

guide

and

encouragement

for

them

to

further

research, improve and investigate for changes and updates

for this study.

24

Scope and Delimitation:

This study is primarily focused on the patients coping
mechanisms to the common effects of Diabetes Mellitus type
II. Assessment is limited to the awareness of the chosen
respondents regarding the effects or complications of type
II Diabetes Mellitus and the different measures they take to
cope with it. This research is also limited with the number
of respondents which were randomly selected from Lutheran
Clinic and Divine Mercy Wellness Center. The research is
further limited to a time frame period of two semesters and
it is strictly conducted within the City of Tuguegarao.

Definition of Terms:

Diabetes
diabetes.

mellitus

It

is

simply

referred

to

as

It is a group of metabolic diseases in which

a person has high blood sugar, either because the body

does not produce enough insulin, or because cells do not
respond to the insulin that is produced.
Diabetes mellitus type 1 - This
autoimmune destruction of insulin-

results

from

producing

beta

cells of the pancreas.[2] The subsequent

lack

of

25

insulin

leads

to

increased

blood

glucose.
Diabetes mellitus type 2 - It is a
disorder

that

is

and

urine

metabolic

characterized

by

high

blood

glucose in the context of insulin resistance and

relative insulin deficiency.

Insulin- It is a hormone produced by the pancreas which
is

central

to

regulating

metabolism in the body.

carbohydrate

Insulin

causes

liver, muscle, and fat tissue

cells

fat

in

the

to take up glucose

from the blood, storing it as glycogen

and

in

the

liver

and muscle.
Hyperglycaemia -or high blood sugar, is a condition in
which an excessive amount of glucose circulates in the

blood plasma.
Coping mechanisms -Coping mechanisms are the methods
used to cope with stress, including illness. It is an
adaptation to environmental stress that is based as
conscious

or

unconscious

choice

and

that

enhances

control over behaviour or gives psychological comfort.

Patients coping mechanism - It is a set of
behaviour or practice of patient for
of

his/her

appropriate

Type

management

II Diabetes Mellitus including

behavior

related

to

health

professionals, investigations and treatment.

care

26

Common effects - A change or changed state occurring as

a direct result of action by somebody or something else

that frequently occurs.

Common effects of Type II Diabetes Mellitus - These are
the usual complications that are experienced by patient
with type II diabetes mellitus.
Psychological-directed toward the will or toward

the mind specifically in its cognitive function.

Spiritual - Relating to or affecting the human
spirit or soul as opposed to material or physical

things.
Physical-

organism.
Social-economic - refers to a characteristic of

Body,

the

physical

living organisms as applied

to

structure

of

an

populations

humans and other animals. It always refers

to

the interaction of organisms with other organisms

and to their collective co-existence, irrespective
of whether they
irrespective

of

are aware of it or not, and

whether

the

interaction

is

voluntary or involuntary. And also, how patients

use their resources for their treatment.

27

CHAPTER II
RESEARCH METHODOLOGY AND PROCEDURES
This chapter provides a view on the research methods
and procedures undertaken by the researchers in the conduct
of the study.
Research Design
The study used quantitative approach. Specifically, the
study

use

information.

descriptive

survey

The

of

purpose

method

descriptive

in

gathering

studies

is

to

observe, describe, and document aspects of a situation as it

naturally occurs and sometimes to serve as a starting point
for

hypothesis

generation

or

theory

development.

Descriptive survey typically seeks to ascertain respondents

perspectives or experiences on a specified subject in a
predetermined structured manner. In this particular study,
the

researchers

aim

to

determine

the

patients

coping

mechanisms to the common effects of Diabetes Mellitus Type

II. Also, the researchers aim to determine if

there is a

significant

and

relationship

mechanisms.
Respondents of the Study

between

the

effects

coping

28

Respondents

came

from

the

two

of

the

clinical

institutions within Tuguegarao City that caters to Diabetic

patients namely Lutheran Clinic and Divine Mercy Wellness
Center. The survey was conducted with 12 and 10 patients at
Lutheran

Clinic

and

Divine

Mercy

Wellness

Center

respectively. Random sampling was being used in getting the

respondents from both institutions specifically, fish bowl
technique. The patients age, gender and length of incurring
the disease was being considered in the study.
Instrumentation
The researchers designed a four pages questionnaire to
be used in collecting the necessary data for this study. The
first part consists of instructions on why and how the
respondents

will

answer

the

tool.

It

also

contains

the

biographic data of the patient (name, age, date of birth,

gender,

marital

status,

cellphone

number,

educational

attainment, year of diagnosis, latest blood glucose level).

The second page contains the most common listed effects of
Diabetes Mellitus while the third and fourth pages contain
the different coping mechanisms observed by patients.
In these questionnaires, the researchers used closed
ended questions wherein the respondent will have to put
check on the space provided labeled from a range of 1-5 on

29

the common effects; 1 if strongly disagree,2 if disagree, 3

if agree, 4 if strongly agree, 5 if very strongly agree; and
1-4 on the complications of DM type II; 1 if never (never
experienced),2 if seldom ( have experienced it at least once
a month),3 if sometimes ( have experienced it at least
weekly),

if

always

(have

experienced

it

everyday)

depending on their chosen answers.

They were also assured that their replies are to be
treated strictly confidential

since all items in the

questionnaires pertains to the respondents personal opinions

of thoughts believing they are requested to answer in all
honesty and genuineness

QUESTIONNAIRE:
ITEM

POSITIVE

MECHANISMS
PSYCHOLOGICAL
I feel good

general health.
I am trying to cope with 4

high.
I feel discouraged with

the

my

COPING ITEM

interfere

COPING

MECHANISMS
about

complications

diabetes.
My
diabetes

NEGATIVE

does

with

my 2

of
not 6
other

My

level

of

diabetes

stress

is

treatment

plan.
I worry about the future
and

the

possibility

of

30

aspects of my life.
I struggle with making 8

serious complications.
I have feelings of guilt

changes

to

on having the disease

my 10

my

to

make

changes.
SPIRITUAL
I can still
attend

dietary

manage

such

to 2

can

support

still

my

I was not able to attend

mass regularly.

join

religious

accept

as

rosary.
My faith increases.
I

cant

diabetes.

spiritual

activities
3

life

care for my diabetes.

I am confident in
ability

in

and 5

groups

am

not

praying

anymore.
I blame God for having
the disease.

(missionary activities of
8

10

nuns and priests).

I believe that God

I consider my disease as

help me to overcome this

a punishment of God.

challenge.
I still look myself as a 9

I lost hope.

beautiful

will 7

creation

God.
PHYSICAL
I have undergone
examination.

an

of

eye 2

was

not

physical

able

to

activity

fit
into

my daily routine (e.g.,

I take elevators instead

31

start

low- 4

of stairs).
I
feel

tired

and

carbohydrate diet 9fruits

restless during work or

and vegetables).

while

upstairs.
I did not practice oral

exercise

continuously 6

for at least 20 minutes.

walking,

climbing

care regularly (brushing

teeth every after meal,

7*

8*

(FOR

SMOKERS)

stop 9

use of mouth wash).

I
am
not
performing

smoking.

wound care when I have

(FOR SMOKERS) I decrease 11

injury.
I
am
not

taking

the no. of sticks that I

prescribed

medications

smoke.

on regular basis and I

am

not

blood

my

monitoring
glucose

my
and

cholesterol regularly.
10

wash

my

remembering
12

13*

14*

to

between my toes.
I am eating 5
per

day

of

feet,
dry

servings

fruits

and

vegetables.
(FOR ALCOHOLICS)

drinking

alcohol

stop

beverages.
(FOR ALCOHOLICS) I limit

32

drinking

alcoholic

beverages.
SOCIO-ECONOMIC
I have a wide

family 2

support system.

My

familys

mostly

goes

treatment
3

still

have

positive 4

outlook about life.

to

my

with

disease.
I
believe

the

that

my

scheduled routine checkups

income

are

burden

to

our

I still find time to talk 6

financial status.
I spend my time

and

staying in the house.

communicate

loved ones.
I
still

with

my

attend 8

just

Seeking help from health

gatherings/parties like I

professionals is costly.

used to do.
My loved ones,

and

even

understand
does

not

friends, 10

co-workers
that

hinder

fulfilling
responsibilities
some precautions.

Data Gathering Procedure

diabetes
me

from
my

despite

cant

the

afford

prescribed

medications.

to

buy

diabetic

33

The
doctors

researchers
of

each

sought

clinical

permission

to

the

resident

institution.

In

Divine

Mercy

Wellness Center, Dr. Abigail Lejos Cureg, and in Lutheran

Clinic, Dr. Joseph Richard Pagela Guzman through a letter
noted by the Mrs. Josephine Lorica PhD. adviser and Dr.
Elizabeth Baua, Dean of School of Health Sciences inclusive
of the floating of questionnaires. The questionnaires were
being distributed personally to 22 patients having type II
DM patients.

The answered questionnaires were retrieved,

collated and interpreted.

Data Analysis
The
subjected

data

gathered

through

to

statistical

the

treatment

questionnaires
using

the

were

following

statistical tools:
Frequency

and

percentage

distribution

was

determine the profile variables and reader usage.

mean

was

used

to

determine

the

common

used

to

Weighted

effects

or

complications of Type II DM to the patients in terms of

their

coping

mechanism

(physical,

psychological,

socio-

economic, sexual and spiritual aspects).

To further understand the value of weighted means, the
range below was used:

34

I.COMMON

EFFECTS

OR

COMPLICATIONS

OF

TYPE

II

DIABETES

MELLITUS
Range

Descriptive Interpretation

very strongly agree

strongly agree

agree

disagree

strongly disagree

II.COPING MECHANISMS
4

always (have experienced it everyday)

sometimes (have experienced it at least weekly)

seldom (have experienced it at least once a month)

never (never experienced)

After getting the mean of the coping mechanism, the

positive and negative coping mechanisms were ranked from 1-4
with

corresponding

points

to

evaluate

the

most

utilized

coping mechanism by the respondents. For rank one (1)-four

(4) points, rank two (2)- three (3) points, rank three (3)two (2) points, rank four (4)- one (1) point.

35

CHAPTER III
PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA
This chapter includes the results and discussion of
this said research study. It contains the profile of the
respondents along with the means and percentages of the data
collected

and

collated

after

the

retrieval

of

questionnaires.
Profile of the Respondents
Table 1.1: Age of the Respondents
AGE
1(31-35)

Number of Respondents
1

Percentage
5%

2(36-40)
3(41-45)
4 (46-50)
5 (51-55)
6(56-60)
7 (61-65)
8 (66-70)
9 (71-75)
10 (76-80)
11 (81-85)
TOTAL

1
2
4
1
1
3
1
3
1
4
22

5%
9%
18%
5%
5%
14%
5%
14%
5%
18%
100%

Interpretation: This table shows that majority of the

respondents comprised of those with ages ranging from 46-50
(middle-aged adults) and from 81-85 (late adulthood) with a
percentage of 18%. This then is followed by the ages ranging

36

from 61-65 41-45 with a percentage of 9%. Lastly, the least

number of respondents are with ages ranging from ages 31-35,
36-40, 51-55, 56-60, 66-70 and 76-80 with a percentage of 5
%.
Therefore,

this

study

shows

that

patients

that

are

mostly affected with Diabetes Mellitus are those in middle

and late adulthood.

Table 1.2: Gender of the Respondents

Gender
1(Female)
2(Male)
Total

Female
16
6
22

Percentage
73%
27%
100%

Interpretation: This table shows that majority of the

respondents comprised of female patients, 16 out of the 22
respondents with the percentage of 73%.
In conclusion, this research shows results that women
are more affected than men.
(Barbara L. Bullock and Reet L. Henze (2000))

Table 1.3: Disease Span of the Respondents

37

Disease span (year)

(1-5)
(6-10)
(11-15)
(16-20)
Total

Frequency
14
5
2
1
22

Percentage
64%
23%
9%
5%
100%

Interpretation: This table shows that the majority of

the respondents were diagnosed with Type 2 Diabetes Mellitus
for about 1 to 5 years with the percentage of 64%.

Then it

is

with

followed

by

the

disease

span

of

6-10

years

percentage of 23%, followed by a disease span of 11-15 years

with the percentage of 9%

and lastly the least no. of

respondents have the disease span of about 16-20 years with

the percentage of 5%.

Table 2.1 Mean scores of the Common Effects of Diabetes

Mellitus Type II to the Respondents
Rank
1
2
3
4
5
6
7
8
9
10
11

Common Effects of DM type II

Qa1
Qa2
Qa3
Qa4,Qa20,Qa26
Qa6,Qa17
Qa12,Qa30
Qa19
Qa7,Qa25
Qa9
Qa5,Qa27
Qa22

Mean
3.7727
3.6818
3.6364
3.5000
3.4091
3.2727
3.1818
3.0455
3.0000
2.9545
2.9091

38

12
13
14
15
16
17
18
19
20
21
22
23
24

Qa8,Qa28
Qa11
Qa10
Qa23
Qa18
Qa15,Qa29
Qa31
Qa14,Qa16
Qa32
Qa13,Qa21,Qa24
Qa33
Qa35
Qa34

Interpretation:

The

table

2.8636
2.8182
2.7727
2.6818
2.5455
2.4091
2.3636
2.3182
2.2857
2.2273
1.8182
1.8750
1.6875

shows

the

ranking

of

the

identified common effects of diabetes mellitus type II to

the respondents. Question number 1 has the highest mean
which is 3.7727. It was followed by Question number 2 with a
mean of 3.618. Then Question number 3 with a mean of 3.6364.
Then followed by question number 4, 20 and 26 with a mean of
3.5000. Question number 6 and 17 with a mean of 3. 4091.
Question number 12 and 30 with a mean of 3.2727. It was
followed by Question number 19 with a mean of 3.1818. Then,
Question number 7 and 25 with a mean of 3. 0455. Question
number 9 with a mean of 3.0000. Question number 5 and 27
with a mean of 2.9545. These was followed by question number
22 with a mean of 2.9091, then number 8 and 28 with a mean
of 2.8636. question number 11 has a mean of 2.8182, question
number 10 has a mean of 2,7727. Then question number 23 has

39

a mean of 2.6818. It was followed by question number 18

which has a mean of 2.5455, then question number 15 and 29
with 2.4091 mean. These were followed by question 31 with
2.3636 mean and 14 and 16 with 2.3182. This was followed by
question number 32 with a mean of 2.2857. Then question
number 13, 21 and 24 with a mean of 2.2273. a mean of 1.8182
in question number 33 and 1.8750 and question number 35.
Question number 34 has the least mean in the questions
regarding

the

common

effects

of

the

DM

Type

to

the

respondents.

Table 3.1 Mean of the Answers With Regards to the

Questions on the Category of Psychological Coping Mechanism
Psychological Coping Mechanism
Positive
Negative
PsyCM
Mean
PsyCM
Qb1.1
3.0909
Qb1.2
Qb1.3
3.5909
Qb1.4
Qb1.5
2.6818
Qb1.6
Qb1.7
3.0909
Qb1.8
Qb1.9
3.3182
Qb1.10
Weighted
Weighted mean
3.1545
mean

Mean
2.5455
2.3636
3.0455
2.4545
2.2727
2.5364

Interpretation: The table shows that the weighted mean

for the positive Psychological Coping Mechanism is 3.1545,
while the negative Psychological Coping Mechanism is 2.5364.

40

Table 3.2 Mean of the Answers With Regards to the

Questions on the Category of Spiritual Coping Mechanism.
Spiritual Coping Mechanism
Negative
Positive SCM
Mean
SCM
3.318
Qb2.1
2
Qb2.2
3.500
Qb2.3
0
Qb2.4
3.136
Qb2.6
4
Qb2.5
3.681
Qb2.8
8
Qb2.7
3.954
Qb2.10
5
Qb2.9
3.518
Weighted
Weighted mean
2
mean

Mean
2.181
8
2.000
0
1.450
0
1.500
0
1.545
5
1.735
5

Interpretation: The table shows that the weighted mean

for the positive Psychological Coping Mechanism is 3.5182,
while the negative Psychological Coping Mechanism is 1.7355.

Table 3.3 Mean of the Answers With Regards to the

Questions on the Category of Physical Coping Mechanism.

P
o
s
i
t

Physical Coping
Mechanism
M
N
e
e
a
g
n
a
t

M
e
a
n

41

i
v
e

i
v
e

P
h
y
C
M

P
h
y
C
M

Q
b
3
.
1
Q
b
3
.
3
Q
b
3
.
5
Q
b
3
.
7
Q
b
3
.
8
Q
b
3
.
1
0

2
.
6
3
6
4
3
.
4
5
4
5
2
.
9
5
4
5
2
.
1
0
0
0
2
.
3
0
0
0
3
.
5
9
0
9

Q
b
3
.
2
Q
b
3
.
4
Q
b
3
.
6
Q
b
3
.
9
Q
b
3
.
1
1
W
e
i
g
h
t
e
d

2
.
5
9
0
9
1
.
1
3
6
4
1
.
5
0
0
0
1
.
6
3
6
4
1
.
6
3
6
4
1
.
7
0
0
0

42

m
e
a
n
Q
b
3
.
1
2
Q
b
3
.
1
3
Q
b
3
.
1
4
W
e
i
g
h
t
e
d
m
e
a
n

3
.
1
3
6
4
2
.
3
7
5
0
3
.
2
5
0
0

2
.
8
6
6
4

Interpretation: The table shows that the weighted mean

for the positive Psychological Coping Mechanism is 2.8664,
while the negative Psychological Coping Mechanism is 1.7000.

43

Table 3.4 Mean of the Answers With Regards to the

Questions on the Category Questions of Socio-Economic Coping
Mechanism.

Socio-Economic Coping Mechanism

Negative
Mean
SECM
3.6818
Qb4.2
3.7727
Qb4.4
3.7273
Qb4.
3.0000
Qb4.8
3.6364
Qb4.10
Weighted
3.5636
mean

Positive
SECM
Qb4.1
Qb4.3
Qb4.5
Qb4.7
Qb4.9
Weighted
mean

Mean
2.2273
2.4091
2.4091
3.3182
2.2727
2.5273

Interpretation: The table shows that the weighted mean

for the positive Psychological Coping Mechanism is 3.5636,
while the negative Psychological Coping Mechanism is 2.5273.

Table

3.5

Ranking

of

the

Coping

Mechanism

Respondents
Ran
k

Positive
CM
Mean

Negative
CM

SECM

3.5636

PhyCM

SCM

3.5182

SCM

PsyCM

3.1545

SECM

4
Note

PhyCM

2.8664

PsyCM

Mean
1.700
0
1.735
5
2.527
3
2.536
4

of

the

44

:
Rank

1
2
3
4

Categories
SECM
SCM
PsyCM
PhyCM

4pts
3pts
2pts
1pts
Positve
CM
(points
)
4
3
2
1

Negative
CM(points
)
2
3
1
4

Total
6
6
3
5

Fina
l
Rank
1
1
3
2

The above table shows that the Socio-economic

and Spiritual Coping Mechanism were ranked as number
one (1)with a total points of six (6). The Physical
Coping Mechanism was ranked as number two (2) with
three (3) points and the Physical Coping Mechanism as
rank
three
(3)
with
two
(2) points.
CHAPTER IV
SUMMARY OF FINDINGS, CONCLUSION AND RECOMMENDATION

Summary of Findings
Based on the analysis from the data gathered by the
researchers, it has been found out that the weighted mean of
the response from the respondents on the common effects are
associated

with

acute

complication

of

DM

which

is

hypoglycemia. The hypoglycemic signs and symptoms identified

were hunger, nervousness, excessive sweating, tachycardia,
and tremors. Other common effects mostly experienced by the

45

respondents

are

polydipsia,

hypertension,

palpitation,

polyuria, memory lapses, weakness, weight loss, sleepiness,

numbness, and headache. However, their blood glucose levels
were not identified to further evaluate the condition of the
respondents.
Furthermore, the categories where the respondents cope
most were on socioeconomic and spiritual aspect.

Conclusion
After consolidating the data gathered, the researchers
came to the conclusion that the respondents were effectively
coping with the effects of Diabetes Mellitus in terms of
socioeconomic
gathered

and

data,

spiritual

the

aspect.

researchers

Also,

concluded

based
that

on

the

Diabetic

patients are most prone to experience signs and symptoms of

hypoglycemia.
Recommendations
This research aims to assess the coping mechanisms to
the common effects of Diabetes Mellitus.
To the physician/ diabetologist of Lutheran clinic and
Divine Mercy Wellness Center, the researchers would like to
suggest to continuously evaluating the conditions of your
Diabetic

patients.

Furthermore,

the

researchers

would

recommend the utilization of the findings of this study as a

46

basis for formulation and implementation of interventions

for

the

maintenance

of

quality

life

of

the

patients.

Moreover, the researchers would further suggest conducting

similar studies.
To the respondents, the researchers would encourage to
improve their psychological coping mechanism to counteract
the stressful effects of the said disease.
To the succeeding researchers who would like to make
use of this study, the researchers would then suggest to
continue evaluating the condition of Diabetic patient on
other institutions aside from Lutheran clinic and Divine
Mercy Wellness Center.

REFERENCES:
Brunner & Suddarths (2010)

Textbook of Medical-Surgical

Nursing 12th edition

Barbara L. Bullock and Reet L. Henze
Richard M. Weil, MEd, CDE,
Wim JC de Grauw, Eloy H van de Lisdonk, Robert RA Behr,
Willem HEM van Gerwen, Henk JM van den Hoogen and Chris van
Weel (1999),
Mc Culloch (2001)

47

Birgitta Sandn-Eriksson, PhD (2000)

Diana Rodriguez (2011
http://www.medterms.com/script/main/art.asp?articlekey=2974
http://www.nhs.uk/news/2011/10October/Pages/males-morelikely-to-get-diabetes.aspx
http://www.mayoclinic.com/health/type-2-diabetes/DS00585
http://en.wikipedia.org/wiki/Diabetes_mellitus_type_2
http://www.staff.ncl.ac.uk/
http://www.medterms.com/script/
http://www.diabetes.co.uk/type2-diabetes.html
http://www.motleyhealth.com/lose-weight/the-puppy-fat-mythand-child-obesity
http://www.merckmanuals.com/home/hormonal_and_metabolic_dis
orders/diabetes_mellitus_dm/diabetes_mellitus.html
http://www.diabetes.co.uk/diabetes-life-expectancy.html
http://www.merckmanuals.com/home/hormonal_and_metabolic_dis
orders/diabetes_mellitus_dm/diabetes_mellitus.html
http://www.diabetes.org/living-withdiabetes/complications/stress.html

48

www.livestrong.com/article/94222-mental-social-effectsdiabetes/
http://www.chronicillness.org.au/downloads/Diabetesanddepre
ssion.pdf
http://www.uptodate.com/contents/patient-informationdiabetes-mellitus-type-2-overview-beyond-the-basics
Http://www.everydayhealth.com/type-2-diabetes/type-2diabetes-and-relationships.aspx
http://www.uptodate.com/contents/patient-informationdiabetes-mellitus-type-2-overview
http://www.diabetes.co.uk/type2-diabetes.html
http://www.hqlo.com/content/6/1/79
http://www.diabetesinitiative.org/documents/Coping_1025.pdf
http://www.diabetes.co.uk/type2-diabetes.html
http://www.diabetes.co.uk/type2-diabetes.html
2012)

on

March

8,

49

50

APPENDICES

Appendix A

St. Paul University Philippines

Tuguegarao City, Cagayan 3500
SCHOOL OF HEALTH SCIENCES
September 1, 2012
Dr. Joseph Richard Pagela Guzman, MD
Lutheran Clinic, Tuguegarao City
Dear Sir:
Christian Greetings!

51

As part of the curriculum requirement for Nursing students of

Saint Paul University Philippines, a research entitled Patients Coping
Mechanisms to the Common Effects of Diabetes Mellitus Type 2 will be
conducted.
The research involves mainly floating of questionnaires in who
are being diagnosed with Type 2 Diabetes Mellitus.
Believing that your institution is the most appropriate for this
purpose, the researchers would like to ask your permission for us to
administer and employ methodology related to the research work.
We hope that this request merits your approval.
Respectfully yours,
Iris Angela M. Deza

Jay-Anne B. Rapano

Monalisa E. Mabuti

Leizel B. Tumanguil

Noted by:

Approved by:

Mrs. Josephine Lorica, PhD

Mrs.

Ma.

Elizabeth

Baua, PhD
Clinical Instructor

Dean, School of Health Sciences

St. Paul University Philippines

Tuguegarao City, Cagayan 3500
SCHOOL OF HEALTH SCIENCES
September 22, 2012
Dr. Abigail Lejos-Cureg
Divine Mercy Wellness Center
Dear Sir:
Christian Greetings!

52

As part of the curriculum requirement for Nursing students of

Saint Paul University Philippines, a research entitled Patients Coping
Mechanisms to the Common Effects of Diabetes Mellitus Type 2 will be
conducted.
The research involves mainly floating of questionnaires in who
are being diagnosed with Type 2 Diabetes Mellitus.
Believing that your institution is the most appropriate for this
purpose, the researchers would like to ask your permission for us to
administer and employ methodology related to the research work.
We hope that this request merits your approval.
Respectfully yours,
Iris Angela M. Deza

Jay-Anne B. Rapano

Monalisa E. Mabuti

Leizel B. Tumanguil

Noted by:

Approved by:

Mrs. Josephine Lorica, PhD

Mrs.

Ma.

Elizabeth

Baua, PhD
Clinical Instructor

Dean, School of Health Sciences

APPENDIX B
PATIENTS COPING MECHANISMS TO THE COMMON EFFECTS OF
DIABETES MELLITUS TYPE 2
DIABETES ASSESSMENT FORM
ABOUT THIS SURVEY

53

Who is taking part in the survey?

Clients who are diagnosed with Type 2 diabetes mellitus for
at least one year are being asked with these questions.
Moreover, the client should be from 31 to 85 years old. Why?
We are interested to know the common effects of diabetes
mellitus type 2 that you were able to manifest and how the
disease process affects your coping mechanisms as an
individual.
Please put a check () in the box that corresponds to your
answer. Dont worry if you make a mistake - just cross out
the mistake and put a check in the correct box.
Your participation in this survey is voluntary.
Your answer will be treated in confidence.
Date: _________________
Name: ______________________________________ Age: ________
Date of Birth: _________________
Gender: _________________ Marital status: _________________
Address:
___________________________________________________________
Cellphone number: _________________
Educational Attainment: _________________
Year of diagnosis: _____Latest blood glucose level: _______
COMMON EFFECTS OR COMPLICATIONS OF TYPE 2 DIABETES MELLITUS
5
4
3
2
1

very strongly agree

strongly agree
agree
disagree
strongly disagree
Since I was diagnosed to have diabetes mellitus
Type 2
Effects of Type 2 Diabetes Mellitus
1 I usually feel hungry.
2 I always feel nervous.
3 I usually sweat.
4 My heart beat increases every time I work (tachycardia).
5 I usually experience shaking of my hands.
6 I usually experience sudden rapid heartbeat (palpitations).
7 I usually get sleepy.
8 My emotion usually is changing.
9 I always suffer from headache.
10 It is hard for me to concentrate.

54
11 I feel absent-minded all the time.
12 Most of the time, I am forgetful.
13 I
usually
experience
slurred
speech
(paputol-putol
pagsalita).
14 My breath odor smells like an acetone.
15 I usually feel like I want to vomit.
16 I always experience pain in my abdomen.
17 The amount of my urine increases when I had the disease.
18 I developed cataract.
19 I suffered from weight loss.
20 I usually get thirsty.
21 My stool is usually watery (diarrhea).
22 I experienced having blurry vision.

na

23 I started to experience chest pain.

24 I started to have a heart attack.
25 I felt tingling, burning sensation
(numbness).
26 My blood pressure increases.

in

my

feet

and

hands

27 My wound heals longer than the expected time.

28 I experienced having Urinary tract Infection.
29 I usually feel confused.
30 I always feel weak.
31 I always experience constipation.
32 (MEN ONLY) Have suffered or treated from impotence (difficulty
getting or sustaining an erection).
33 (BOTH MEN AND WOMEN) Increases sexual drive.
34 (WOMEN
ONLY)
Scanty
(little
amount)
of
blood
menstruation.
35 (WOMEN ONLY) Irregularity of menstruation period.

during

II. COPING MECHANISMS

4

always (have experienced it everyday)

sometimes (have experienced it at least weekly)

seldom (have experienced it at least once a month)

never (never experienced)

for the past 6 months

PSYCHOLOGICAL COPING MECHANISM
1
2

I feel good about my general health.

My level of stress is high.

55
3

I am trying to cope with the complications of diabetes.

I feel discouraged with my diabetes treatment plan.

5 My diabetes does not interfere with other aspects of my life.

6 I worry about the future and the possibility of serious
Complications.
7 I struggle with making changes in my life to care for
diabetes.
8 I have feelings of guilt on having the disease.
9

my

I am Confident in my ability to make dietary changes.

10 I cant accept my diabetes.

SPIRITUAL COPING MECHANISMS
1

I can still manage to attend spiritual activities such as rosary.

I was not able to attend mass regularly.

3
4
5
6

My faith increases.
I am not praying anymore.
I blame God for having the disease.
I can still join and support religious
activities of nuns and priests).
I consider my disease as a punishment of God.

groups

I have undergone an eye examination.

I was not able to fit physical activity into my daily routine

(e.g., I take elevators instead of stairs).
I start a low-carbohydrate diet (fruits and vegetables).

I feel tired and restless during work or while walking, climbing

up stairs.
I exercise continuously for at least 20 minutes.
I DID NOT practice oral care regularly (brushing teeth every
after meal, use of mouthwash).
(FOR SMOKER) I stop smoking.

I decrease the no. of sticks that I smoke.

I am not performing wound care when I have injury.

5
6

(missionary

8 I believe that God will help me to overcome this challenge.

9 I lost hope.
10 I still look myself as a beautiful creation of God.
PHYSICAL COPING MECHANISMS

10 I wash my feet, remembering to dry between my toes.

11 I am not taking my prescribed medications on regular basis and I
am not monitoring my blood glucose and cholesterol regularly.
12 I am eating 5 servings per day of fruits and vegetables.
13 (FOR ALCOHOLIC) I stop drinking alcoholic beverages.
14 I limit drinking alcoholic beverages.
SOCIO-ECONOMIC COPING MECHANISM

56
1
2

I have a wide family support system.

My familys income mostly goes to my treatment with the disease.

3
4
5

I still have a positive outlook about life.

I believed that my scheduled routine check-ups are burden to our
financial status.
I still find time to talk and communicate with my love ones.

I spend my time just staying in the house.

I still attend gatherings/parties like I used to do.

Seeking help from health professionals is costly.

My loved ones, friends, and even co-workers, understand that

diabetes does not hinder me from fulfilling my responsibilities
despite some precautions.

10 I cant afford to buy the prescribed diabetic medications.

......Thank You and God bless! J J J .......