Psychosocial factors that affect nursing care of older diabetic patients: A literature review

Abstract

Background: The functional status of elderly individuals with chronic conditions especially diabetes is a growing public health concern, particularly in developing countries such as Kenya. Understanding how these psychological and social dimensions have effect on functional capacity is essential for guiding patientcentered care, policy interventions, as well as resource allocation. The rising prevalence of diabetes among the elderly population presents not only a physiological challenge but also a significant psychosocial burden, particularly in low and middle-income settings such as sub-Saharan Africa and other developing countries across the world. Aim: This study examined the influence of psychosocial factors particularly depression, anxiety s well as social support on the functional status of elderly diabetic patients. Functional status, defined as the ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs), is a critical determinant of quality of life and independence in older adults. Method: Through a structured literature review guided by the PEO (Population, Exposure, Outcome) framework, 11 peer-reviewed empirical studies published between 2015 and 2024 were selected and then analysed. By using Krippendorff’s content analysis methodology, thematic categories were developed to identify recurring patterns linked to the emotional, cognitive and social dimensions of elderly diabetic care. Results: The findings showed that depression significantly impairs self-care behaviours, while anxiety contributes to functional decline by reducing physical activity and treatment adherence. On the contrary, social support, whether from family, peers or even from community health systems, was consistently linked to improved health behaviours and greater functional independence. The study highlights the critical need for integrated diabetes care models that comprise routine mental health screening, psychosocial support systems as well as patient-centered educational interventions. In resource-constrained situations, addressing these psychosocial variables might be vital in enhancing not only medical outcomes but also the dignity and autonomy of the aging populations. Conclusion: These findings therefore call for collaborative efforts among healthcare providers, families and policymakers to adopt holistic strategies that address both the medical and emotional needs of elderly patients living with diabetes.