Effects of Psycho-Spiritual Program on Hope, Resilience, and Diabetes Burnout Among Women with Type 2 Diabetes: A Randomized Controlled Trial

Abstract

Background: Type 2 diabetes mellitus (T2DM) is associated with substantial psychological challenges. Objectives: This study investigated whether a structured psycho-spiritual intervention could improve hope and resilience and reduce diabetes burnout among women with T2DM. Methods: In this randomized controlled trial, 83 women with T2DM were allocated to either an 8-session psycho-spiritual intervention plus routine care or to routine care only. Assessments were conducted at baseline, post-intervention, and at the 2-month follow-up. The primary outcome was hope, measured using the Herth Hope Index (HHI). Secondary outcomes were resilience, measured using the Connor-Davidson Resilience Scale (CD-RISC-25), and diabetes burnout, measured using the Diabetes Burnout Scale (DBS-12). Intention-to-treat data were analyzed using linear mixed-effects models with Bonferroni-corrected pairwise comparisons. Results: The intervention yielded a nonsignificant improvement in hope (group × time interaction: F(2, 160) = 1.92, P = 0.15; Cohen's d = 0.23). However, significant between-group differences over time were observed for resilience, which increased substantially in the intervention group (F(2, 160) = 18.67, P < 0.001; d = 0.83), and for diabetes burnout, which decreased markedly (F(2, 160) = 22.94, P < 0.001; d = 0.91). Improvements in the secondary outcomes were maintained at the 2-month follow-up, whereas the control group showed minimal changes across all measures. Conclusions: The psycho-spiritual intervention significantly enhanced resilience and reduced diabetes burnout in women with T2DM; however, improvement in the primary outcome, hope, did not reach statistical significance. These findings provide preliminary support for integrating psycho-spiritual approaches into comprehensive diabetes care, although further replication with longer follow-up is warranted.