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Woo J, Lehrer HM, Tabibi D, Cebulske L, Tanaka H, Steinhardt M. The Association of Multidimensional Sleep Health With HbA1c and Depressive Symptoms in African American Adults With Type 2 Diabetes. Psychosom Med 2024; 86:307-314. [PMID: 38724038 PMCID: PMC11090412 DOI: 10.1097/psy.0000000000001298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/15/2024]
Abstract
OBJECTIVE Sleep is important for diabetes-related health outcomes. Using a multidimensional sleep health framework, we examined the association of individual sleep health dimensions and a composite sleep health score with hemoglobin A1c (HbA1c) and depressive symptoms among African American adults with type 2 diabetes. METHODS Participants (N = 257; mean age = 62.5 years) were recruited through local churches. Wrist-worn actigraphy and sleep questionnaire data assessed multidimensional sleep health using the RuSATED framework (regularity, satisfaction, alertness, timing, efficiency, duration). Individual sleep dimensions were dichotomized into poor or good sleep health and summed into a composite score. HbA1c was assessed using the DCA Vantage™ Analyzer or A1CNow® Self Check. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Regression models examined the association of individual sleep dimensions and composite sleep health with HbA1c and depressive symptoms. RESULTS Higher composite sleep health scores were associated with a lower likelihood of having greater than minimal depressive symptoms (PHQ-9 ≥ 5) (odds ratio [OR] = 0.578, 95% confidence interval [CI] = 0.461-0.725). Several individual sleep dimensions, including irregularity (OR = 1.013, CI = 1.005-1.021), poor satisfaction (OR = 3.130, CI = 2.095-4.678), and lower alertness (OR = 1.866, CI = 1.230-2.833) were associated with a greater likelihood of having depressive symptoms. Neither composite sleep health scores nor individual sleep dimensions were associated with HbA1c. CONCLUSIONS Better multidimensional sleep health is associated with lower depressive symptoms among African American adults with type 2 diabetes. Longitudinal research is needed to determine the causal association between multidimensional sleep health and depressive symptoms in this population. TRIAL REGISTRY ClinicalTrials.gov identifier NCT04282395.
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Affiliation(s)
- Jihun Woo
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX
| | | | - Doonya Tabibi
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX
| | - Lauren Cebulske
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX
| | - Hirofumi Tanaka
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX
| | - Mary Steinhardt
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX
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Brooks BD, Kaniuka AR, Rabon JK, Sirois FM, Hirsch JK. Social Support and Subjective Health in Fibromyalgia: Self-Compassion as a Mediator. J Clin Psychol Med Settings 2022; 29:375-383. [PMID: 35001253 DOI: 10.1007/s10880-021-09832-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2021] [Indexed: 11/27/2022]
Abstract
Individuals with fibromyalgia report lower levels of health-related quality of life (HRQL) compared to other chronically ill populations and interpersonal factors (i.e., social support) may influence risk. What is less understood is how intrapersonal factors (i.e., self-compassion) may impact the social support-HRQL linkage. We examined the association between social support and HRQL in a sample of persons with fibromyalgia and tested the potential mediating role of self-compassion. Self-identified adults in the United States with fibromyalgia (N = 508) were recruited from state, regional, and national organizations and support groups and completed an online battery of self-report questionnaires including: Multidimensional Health Profile-Psychosocial Functioning Index, Short-Form 36 Health Survey, and Self-Compassion Scale-Short Form. Individuals with greater subjective social support reported higher levels of self-compassion and, in turn, higher mental HRQL. These findings provide greater information about psychosocial constructs and HRQL and extend our understanding of self-compassion among individuals living with fibromyalgia.
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Affiliation(s)
- Byron D Brooks
- Department of Psychology, Loyola University Chicago, 1032 West Sheridan Rd, Chicago, IL, 60660, USA. .,Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA.
| | - Andrea R Kaniuka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | | | - Fuschia M Sirois
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Jameson K Hirsch
- Department of Psychology, East Tennessee State University, Johnson City, TN, USA
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Vézina-Im LA, Morin CM, Desroches S. Sleep, Diet and Physical Activity Among Adults Living With Type 1 and Type 2 Diabetes. Can J Diabetes 2021; 45:659-665. [PMID: 33771447 DOI: 10.1016/j.jcjd.2021.01.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/21/2021] [Accepted: 01/23/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Our aim in this work was to document sleep/insomnia, fruit and vegetable (FV) consumption and physical activity (PA) according to diabetes presence and type and biologic sex, as these 3 lifestyle habits may influence glycemic control and prevention of diabetes-related complications. METHODS Adults between 18 and 64 years of age were invited to complete validated web-based self-reported questionnaires assessing sleep, insomnia, FV consumption and PA. Pregnant women and shift workers were excluded from the study. RESULTS A total of 151 adults (80.1% women), of whom 54 had diabetes (type 1 [T1D], n=30; type 2 [T2D], n=24), completed the questionnaires. Sleep quality scores were significantly higher, indicating poorer sleep quality, according to diabetes presence (diabetes, 7.2±3.5; no diabetes, 5.4±3.5; p=0.0024) and type (T1D, 6.1±2.9; T2D, 8.7±3.8; p=0.0072). Sleep duration was significantly shorter among adults living with diabetes (diabetes, 7.0±1.7 hours/night; no diabetes, 7.8±1.3 hours/night; p=0.0019), regardless of type. More adults living with diabetes had moderate to severe clinical insomnia (diabetes, 25.9%; no diabetes, 10.4%; p=0.0129), especially those with T2D (T1D, 13.3%; T2D, 41.7%; p=0.0182). FV consumption and PA did not vary significantly according to diabetes presence and type. Only PA differed by biologic sex, with lower PA among women. CONCLUSIONS The results suggest that adults living with diabetes, especially those with T2D, are at higher risk for short and poor sleep quality, and clinical insomnia. Adults living with diabetes, especially those with T2D, should have access to effective sleep interventions to prevent complications associated with elevated glucose levels.
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Affiliation(s)
- Lydi-Anne Vézina-Im
- School of Nutrition, Université Laval, Québec City, Québec, Canada; Centre Nutrition, santé et société, Institute of Nutrition and Functional Foods, Université Laval, Québec City, Québec, Canada; School of Psychology, Université Laval, Québec City, Québec, Canada; Centre d'étude des troubles du sommeil, Université Laval, Québec City, Québec, Canada.
| | - Charles M Morin
- School of Psychology, Université Laval, Québec City, Québec, Canada; Centre d'étude des troubles du sommeil, Université Laval, Québec City, Québec, Canada
| | - Sophie Desroches
- School of Nutrition, Université Laval, Québec City, Québec, Canada; Centre Nutrition, santé et société, Institute of Nutrition and Functional Foods, Université Laval, Québec City, Québec, Canada
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Ji M, Sereika SM, Dunbar-Jacob J, Erlen JA. Correlation of Symptom Distress, Self-Efficacy, and Social Support With Problem-Solving and Glycemic Control Among Patients With Type 2 Diabetes. Sci Diabetes Self Manag Care 2021; 47:85-93. [PMID: 34078204 DOI: 10.1177/0145721720983222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of the study was to examine the associations of self-efficacy, social support, and symptom distress with perceived problem-solving and glycemic control among patients with type 2 diabetes. METHOD Using baseline data from a parent study, which examined the effect of a problem-solving-focused intervention on medication adherence among patients with type 2 diabetes, this secondary analysis examined the relationships among self-efficacy, social support, symptom distress, problem-solving, and A1C. Of 358 patients enrolled at baseline, 304 (mean age = 64.1 years, 57.2% female) were included in the current analysis. Multiple linear regression was used to identify potential correlates of problem-solving and A1C. RESULTS The results showed that self-efficacy, social support, and symptom distress were independent predictors of problem-solving; they significantly improved the prediction of perceived problem-solving in diabetes management after controlling covariates. Adding problem-solving to the model did not improve the prediction for A1C. CONCLUSION The current study suggests that self-efficacy, social support, and symptom distress are essential factors associated with patients' perceived problem-solving in diabetes management. Researchers and clinicians should consider both personal factors and psychosocial factors such as self-efficacy, social support, and symptom distress when examining patients perceived problem-solving and developing tailored interventions to improve diabetes management. In addition, health care providers should consider these important aspects when providing tailored care to this patient population.
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Affiliation(s)
- Meihua Ji
- School of Nursing & Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Susan M Sereika
- Department of Health and Community Systems and Center for Research and Education, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Judith A Erlen
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
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Birhanu TT, Hassen Salih M, Abate HK. Sleep Quality and Associated Factors Among Diabetes Mellitus Patients in a Follow-Up Clinic at the University of Gondar Comprehensive Specialized Hospital in Gondar, Northwest Ethiopia: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2020; 13:4859-4868. [PMID: 33328747 PMCID: PMC7734063 DOI: 10.2147/dmso.s285080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 11/26/2020] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Diabetic mellitus has a negative impact on the quality of sleep. It is one of the leading public health conditions which can result in poor sleep quality. Poor sleep quality is an unreported and unrecognized problem which can affect the prognosis of diabetes patients. OBJECTIVE The aim of this study is to assess the prevalence of poor sleep quality and its associated factors among patients with diabetes mellitus attending follow-up clinics at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2019. METHODS An institution-based cross-sectional study was conducted among 430 diabetes mellitus patients at the University of Gondar Comprehensive Specialized Hospital from February 1, 2020 to March 28, 2020. A systematic random sampling method was used to reach the study subjects. An interviewer-administered questionnaire was used for data collection. Pittsburgh sleep quality index was used for assessing sleep quality. To explain study variables, frequency tables and percentages were used. A binary logistic regression was conducted to see the relation between dependent and independent variables. RESULTS A total of 430 diabetes mellitus patients participated in the study with a response rate of 100%. The overall prevalence of poor sleep quality was 47.2%. Drinking alcohol (AOR = 2.45, 95% CI: 1.28-4.69), smokers (AOR = 6.26, 95% CI: 2.04-19.21), comorbidity (AOR = 1.80, 95% CI: 1.10-2.96), BMI ≥ 30 (AOR = 4.87, 95% CI: 1.07-22.09), having type 2 diabetes mellitus (AOR = 2.16, 95% CI: 1.04-4.50), poor glycemic control (AOR = 2.61, 95% CI: 1.81-4.81) and having depression (AOR = 9.95, 95% CI: 4.85-20.38) were associated with poor sleep quality. CONCLUSION In this study, nearly half of the patients had poor sleep quality. Drinking alcohol, smoking, comorbidities, higher BMI, type 2 diabetes mellitus, poor glycemic control and having depression were factors in poor sleep quality. Creating awareness of the need for weight reduction, minimizing alcohol intake, cessation of smoking, and improving sleep hygiene for DM patients would be effective management for improving poor sleep quality.
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Affiliation(s)
| | - Mohamed Hassen Salih
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Hailemichael Kindie Abate
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Sleep Quality and Associated Factors among Diabetes, Hypertension, and Heart Failure Patients at Debre Markos Referral Hospital, Northwest Ethiopia. SLEEP DISORDERS 2020; 2020:6125845. [PMID: 32523782 PMCID: PMC7261322 DOI: 10.1155/2020/6125845] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/29/2020] [Accepted: 04/13/2020] [Indexed: 11/18/2022]
Abstract
Background Chronic illnesses have a negative impact on the quality of sleep; however, patients with chronic illness do not bring sleep issues while they are coming to a health institution for a follow-up. As a result, poor sleep quality among patients with chronic illness is often unrecognized and untreated, and it results to a negative impact on the prognosis of chronic illness. Methods An institutional-based cross-sectional study design was employed from February 22, 2018, to April 6, 2018. The total sample size was 396. The study employed a stratified random sampling technique, and study participants were selected by systematic sampling. The data were collected by a Pittsburgh Sleep Quality Index (PSQI) questionnaire which is a validated and standardized tool. The data were analyzed by SPSS version 25; text, tables, and figures were utilized for data presentation. By considering a 95% confidence level and P value of 0.05, binary logistic regression and Kruskal-Wallis test were enrolled. Results The prevalence of poor sleep quality among diabetes, hypertension, and heart failure patients was 36.5%. The odds of being a poor sleeper are increased when age increased. Patients who have poor perception towards the prognosis of their illness were four times more likely to be a poor sleeper compared to patients with good perception (AOR = 4.21, 95%CI = 1.94-9.13, P = 0.001). Patients who have anxiety were four times more likely to be a poor sleeper compared with patients without anxiety (AOR = 3.69, 95%CI = 2.19-6.20, P = 0.001). The educational level and residence were other factors associated with sleep quality. There was a statistically significant difference of sleep quality between patients with diabetes and hypertension, and diabetes and heart failure (F (2, 384) = 10.92, P = 0.004). Conclusion and Recommendations. In this study, over one-third of patients had poor sleep quality. Age, educational level, residence, perception towards prognosis of illness, and anxiety were factors associated with sleep quality. All health care providers should assess and provide advice about sleep hygiene and influencing factors. Assessment of sleep quality for every diabetes, hypertension, and heart failure patients in every visit should be incorporated in the care package.
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Alshehri MM, Alenazi AM, Hoover JC, Alothman SA, Phadnis MA, Rucker JL, Befort CA, Miles JM, Kluding PM, Siengsukon CF. Effect of Cognitive Behavioral Therapy for Insomnia on Insomnia Symptoms for Individuals With Type 2 Diabetes: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e14647. [PMID: 31855189 PMCID: PMC6940863 DOI: 10.2196/14647] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 09/24/2019] [Accepted: 09/24/2019] [Indexed: 12/17/2022] Open
Abstract
Background Insomnia symptoms are a common form of sleep difficulty among people with type 2 diabetes (T2D) affecting sleep quality and health outcomes. Several interventional approaches have been used to improve sleep outcomes in people with T2D. Nonpharmacological approaches, such as cognitive behavioral therapy for insomnia (CBT-I), show promising results regarding safety and sustainability of improvements, although CBT-I has not been examined in people with T2D. Promoting sleep for people with insomnia and T2D could improve insomnia severity and diabetes outcomes. Objective The objective of this study is to establish a protocol for a pilot randomized controlled trial (RCT) to examine the effect of 6 sessions of CBT-I on insomnia severity (primary outcome), sleep variability, and other health-related outcomes in individuals with T2D and insomnia symptoms. Methods This RCT will use random mixed block size randomization with stratification to assign 28 participants with T2D and insomnia symptoms to either a CBT-I group or a health education group. Outcomes including insomnia severity; sleep variability; diabetes self-care behavior (DSCB); glycemic control (A1c); glucose level; sleep quality; daytime sleepiness; and symptoms of depression, anxiety, and pain will be gathered before and after the 6-week intervention. Chi-square and independent t tests will be used to test for between-group differences at baseline. Independent t tests will be used to examine the effect of the CBT-I intervention on change score means for insomnia severity, sleep variability, DSCB, A1c, fatigue, sleep quality, daytime sleepiness, and severity of depression, anxiety, and pain. For all analyses, alpha level will be set at .05. Results This study recruitment began in February 2019 and was completed in September 2019. Conclusions The intervention, including 6 sessions of CBT-I, will provide insight about its effect in improving insomnia symptoms, sleep variability, fatigue, and diabetes-related health outcomes in people with T2D and those with insomnia symptoms when compared with control. Trial Registration ClinicalTrials.gov NCT03713996; https://clinicaltrials.gov/ct2/show/NCT03713996 International Registered Report Identifier (IRRID) DERR1-10.2196/14647
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Affiliation(s)
- Mohammed M Alshehri
- University of Kansas Medical Center, Lenexa, KS, United States.,Jazan University, Jazan, Saudi Arabia
| | - Aqeel M Alenazi
- University of Kansas Medical Center, Kansas City, KS, United States.,Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Jeffrey C Hoover
- University of Kansas Medical Center, Kansas City, KS, United States
| | | | - Milind A Phadnis
- University of Kansas Medical Center, Kansas City, KS, United States
| | - Jason L Rucker
- University of Kansas Medical Center, Kansas City, KS, United States
| | | | - John M Miles
- University of Kansas Medical Center, Kansas City, KS, United States
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Owens H. Sleep-an Essential Component of Obesity Screening and Counseling: A Policy Analysis of the Affordable Care Act. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2019; 56:46958019842001. [PMID: 31014152 PMCID: PMC6482644 DOI: 10.1177/0046958019842001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The Patient Protection and Affordable Care Act (PPACA) has provided access to health care for millions of people in the United States. One of the most beneficial aspects of the PPACA is the obesity screening and counseling provision. Currently, it is estimated that over 39% of US adults are obese. Research has linked sleep disturbances to obesity and obesity-related behaviors. The purpose of this article is to advocate for evidence-based care through the inclusion of sleep disturbance screening and management under the PPACA obesity screening and counseling provision. An in-depth policy analysis of the PPACA was conducted to examine the feasibility of adding sleep screenings to the obesity screening and counseling provision available under current law. Findings suggest that the adoption of this policy would require stakeholder advocacy and educational reform. Implementation of the policy would require additional economic investments, but the long-term savings could be significant. A campaign to raise awareness regarding the association between sleep disturbance and obesity among the public and health care professionals would be essential. Policy implementation would require interprofessional collaboration when performing sleep disordered screening and management. Preventative health care for individuals who have not previously accessed the health care system has the potential to socially and economically benefit society if policies provide for evidence-based care. Sleep screening and counseling is essential under the PPACA to adequately address the US obesity crisis.
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Li H, Ji M, Scott P, Dunbar-Jacob JM. The Effect of Symptom Clusters on Quality of Life Among Patients With Type 2 Diabetes. DIABETES EDUCATOR 2019; 45:287-294. [DOI: 10.1177/0145721719837902] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Purpose The purpose of this study was to examine the collective effect of a symptom cluster (depression, anxiety, fatigue, and impaired sleep quality) at baseline on the quality of life (QOL) of patients with type 2 diabetes (T2DM) over time. Methods This was a secondary data analysis of 302 patients with T2DM who presented with both hypertension and hyperlipidemia. All of the participants were enrolled in a randomized controlled intervention study testing strategies to improve medication adherence. The psychological symptoms and QOL were assessed at baseline, 6 months, and 12 months. Cluster analysis was used to identify subgroups of patients based on the severity of symptoms at baseline. Results Hierarchical cluster analysis identified 4 patient subgroups: all low severity, mild, moderate, and all high severity. There were significant differences in patients’ QOL overall among the 4 subgroups. Compared with the all-low-severity subgroup, subgroups with higher severity of the 4 symptoms had poorer QOL across all 3 time points. QOL was most impacted by trait anxiety across the 3 time points. Conclusion QOL was significantly impacted by psychological symptom clusters among patients with T2DM. Healthcare providers should not neglect psychological symptoms that patients experience. It is important to assess and manage these symptoms to improve QOL among patients with diabetes.
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Affiliation(s)
- Hongjin Li
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA (Ms Li)
| | - Meihua Ji
- School of Nursing, Capital Medical University, Beijing, China (Dr Ji)
| | - Paul Scott
- Department of Health & Community Systems, Center for Research & Evaluation, School of Nursing, University of Pittsburgh, Pittsburgh, PA (Dr Scott)
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Zargar A, Gooraji SA, Keshavarzi B, Haji Aghamohammadi AA. Effect of Irritable Bowel Syndrome on Sleep Quality and Quality of Life of Inflammatory Bowel Disease in Clinical Remission. Int J Prev Med 2019; 10:10. [PMID: 30774844 PMCID: PMC6360848 DOI: 10.4103/ijpvm.ijpvm_364_17] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 08/27/2018] [Indexed: 01/03/2023] Open
Abstract
Background: Inflammatory bowel disease (IBD) as a chronic and debilitating disease is affected by sleep disturbance which increases the risk of malignancy. Sleep disturbance is more common in irritable bowel syndrome (IBS) and few reported studies have assessed its role in IBD. We evaluated the effect of IBS on sleep quality and quality of life (QOL) of IBD patients in clinical remission. Methods: In a cross-sectional study, 115 IBD patients in clinical remission aged from 14 to 70 years referred to gastroenterology outpatient departments and private gastroenterology offices from 2007 to 2016. Patients considered in four groups (with/without IBS). The Revised “Rome III criteria” used for diagnosing IBS. Pittsburgh Sleep Quality Index questionnaire and the health-related QOL questionnaire used for evaluating sleep quality and QOL. Results: About 85 (73.9%) cases had ulcerative colitis (UC) and 30 (26.1%) cases had Crohn's disease (CD). Forty (34.8%) cases had IBD + IBS. Poor sleep quality in UC + IBS (OR: 0.018, P = 0.003) and UC (OR: 0.016, P = 0.002) was less than CD. Diseases extent in left side colitis (OR: 0.064, P = 0.016) were less than with pancolitis. Sleep quality affected by quality of life (IBDQ) (P = 0.048). Mean quality of life (IBDQ) in patients who had poor sleep was 11% less than those with good sleep. Conclusions: The syndrome of IBS affects the sleep quality of IBD in clinical remission, especially in CD. Its additive effect with IBD may worsen symptoms that correlated with sleep disturbance, such as pain, psychological and physical condition, and QOL.
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Affiliation(s)
- Ali Zargar
- Department of Internal Medicine, Velayat Hospital, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Somayeh Ahmadi Gooraji
- Velayat Clinical Research Development Unit, Velayat Hospital, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Bahareh Keshavarzi
- Velayat Clinical Research Development Unit, Velayat Hospital, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Ali Akbar Haji Aghamohammadi
- Department of Internal Medicine, Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
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Abstract
OBJECTIVE The study's objective is to examine differences in mental and physical health-related quality of life (HRQOL) in non-Hispanic White, non-Hispanic Black, and Hispanic adults with diabetes. DESIGN A secondary analysis of 2014 Behavioral Risk Factor Surveillance System (BRFSS) data was conducted. A total of 26 states participated in the 2014 BRFSS core and optional diabetes models (n = 17,923). HRQOL was measured by the number of mentally and physically unhealthy days during the past month, respectively. A series of regression models were developed to assess differences in HRQOL without and with inclusion of demographic (age, marital status, income, gender, and education) and diabetes-related (depression, sleep time, insulin use, complications, age of diabetes diagnosis, BMI, smoking, and exercise) factors. RESULTS In the fully adjusted models (inclusion of demographic and diabetes-related factors), non-Hispanic Whites had more mentally (β = 0.88, p = 0.03) and physically (β = 1.35, p = 0.01) unhealthy days per month compared to Hispanics. Non-Hispanic Blacks (β = 1.42, p < 0.01) also had more mentally unhealthy days per month in relation to Hispanics when adjusting for demographic and diabetes-related factors. Depression emerged as a potent predictor of mentally (β = 8.60; p < 0.0001) and physically (β = 4.43; p < 0.0001) unhealthy days in the multivariate models. CONCLUSION Non-Hispanic Black and White adults with diabetes may be more vulnerable to poor HRQOL compared to their Hispanic counterparts. Increased, widened application of diabetes interventions targeting depression appears warranted to improve HRQOL outcomes.
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Bani-issa W, Al-Shujairi AM, Patrick L. Association between quality of sleep and health-related quality of life in persons with diabetes mellitus type 2. J Clin Nurs 2018; 27:1653-1661. [DOI: 10.1111/jocn.14221] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Wegdan Bani-issa
- Department of Nursing; College of Health Sciences; University of Sharjah; Sharjah United Arab Emirates
| | - Arwa M Al-Shujairi
- Research Institute of Medical and Health Sciences; University of Sharjah; Sharjah United Arab Emirates
| | - Linda Patrick
- Faculty of Nursing; University of Windsor; Windsor ON USA
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13
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Darraj A, Mahfouz MS, Alsabaani A, Sani M, Alameer A. Assessment of sleep quality and its predictors among patients with diabetes in Jazan, Saudi Arabia. Diabetes Metab Syndr Obes 2018; 11:523-531. [PMID: 30288072 PMCID: PMC6163002 DOI: 10.2147/dmso.s178674] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Poor sleep quality is common among patients with diabetes. It is associated with negative physical, psychological, and functional consequences. However, the implicated risk factors of poor sleep quality remain uncertain. OBJECTIVES This study aimed to determine the prevalence of poor sleep quality among patients with diabetes and to investigate the factors associated with the poor sleep quality. PATIENTS AND METHODS An analytical cross-sectional study of 307 diabetic patients in Jazan, Saudi Arabia was conducted in 2018. A multistage cluster random sampling was used to select the study participants. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Data on patient's characteristics were gathered via patients' interviews, and medical data were collected based on the patients' files. Logistic regression analysis was used to identify the predictors of poor sleep quality. RESULTS The mean score of PSQI was 5.29±2.73. The prevalence of poor sleep quality was 55.4% (95% CI 49.7-60.8). Sociodemographic and clinical factors were significantly associated with poor sleep quality, such as being elderly, female, illiterate, smoker, complications of diabetes, comorbidity, or psychological symptoms. However, female gender was the strongest predictor of reporting poor quality of sleep, OR= 3.69, 95% CI 1.65-8.28 (P<0.001). CONCLUSION Poor sleep quality among diabetic patients is a prevalent health problem. Many factors can affect sleep quality. Health care providers may consider routine screening for and address sleep problems among diabetic patients.
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Affiliation(s)
| | - Mohamed Salih Mahfouz
- Family and Community Medicine Department, College of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Abdullah Alsabaani
- Family and Community Medicine Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Mubarack Sani
- Family and Community Medicine Department, College of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Anwar Alameer
- Jazan Health Affairs, Ministry of Health, Jazan, Saudi Arabia,
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Testing whether patients with diabetes and healthy people perceive the meaning of the items in the Persian version of the SF-36 questionnaire similarly: a differential item functioning analysis. Qual Life Res 2016; 26:835-845. [PMID: 27699556 DOI: 10.1007/s11136-016-1419-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2016] [Indexed: 01/04/2023]
Abstract
PURPOSE It has been rarely studied whether observed disparity in health-related quality-of-life (HRQoL) scores between patients with diabetes and healthy individuals is due to differential item functioning (DIF) or a true difference in the underlying construct. This study aimed to examine DIF in the SF-36 questionnaire and its effect on comparing HRQoL scores between patients with diabetes and healthy people. METHODS The sample consisted of 230 patients with type 2 diabetes and 642 healthy individuals who filled out the Persian version of the SF-36 questionnaire. To detect DIF across patients with diabetes and healthy individuals, multiple-group multiple-indicator multiple-causes model was used. In addition, item calibration strategy was used to determine whether the effect of item-level DIF was transferred to the scale level. RESULTS Nine out of thirty-six (25 %) items were detected as DIF, of which one item (11 %) was flagged as uniform and eight items (89 %) as non-uniform DIF. Most of the DIF items were detected in the mental health component which includes vitality, perceived mental health and social functioning subscales rather than in physical health component. Moreover, nonsignificant latent mean differences for general health perception and social functioning subscales became significant after DIF calibration. CONCLUSION The findings of the present study show that patients with diabetes and healthy individuals perceived some items in the SF-36 questionnaire differently. More importantly, in some subscales, the effect of item-level DIF was transferred to the scale level. Consequently, considerable caution should be taken in comparing HRQoL scores between patients with diabetes and healthy individuals.
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15
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Tsai SY, Shun SC, Lee PL, Lee CN, Weaver TE. Validation of the Chinese Version of the Functional Outcomes of Sleep Questionnaire-10 in Pregnant Women. Res Nurs Health 2016; 39:463-471. [PMID: 27545720 DOI: 10.1002/nur.21750] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2016] [Indexed: 12/25/2022]
Abstract
We evaluated the psychometric properties of a Mandarin Chinese version of the Functional Outcomes of Sleep Questionnaire-10 (FOSQ-10) in pregnant women. A total of 228 first-trimester pregnant women participated in the study, which was conducted in an outpatient obstetric clinic at a medical center in Taipei, Taiwan. The Chinese version of the FOSQ-10 demonstrated satisfactory internal consistency (Cronbach alpha = .85), adequate corrected item-total correlations (from .40 to .67), and acceptable test-retest reliability over 7 days (ICC = .73). Construct validity was supported by exploratory factor analysis showing a one-factor structure with item loadings between .49 and .77. Significant associations with the Medical Outcomes Study Short-Form Health Survey 12 version 2 and Pittsburgh Sleep Quality Index supported criterion-related and convergent validity. Significant differences in the Chinese version of the FOSQ-10 total scores were found between women with clinically significant daytime sleepiness and those without, suggesting adequate discriminant validity. Ceiling effects were observed for all items, but no floor or ceiling effects were found for total scores. Findings suggest that the Chinese version of the FOSQ-10 is a valid and reliable instrument to identify important effects of sleep-related impairment in Chinese women during pregnancy. Further testing is needed in more diverse pregnant women, such as women with complicated pregnancies and those with sleep disorders. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Shao-Yu Tsai
- Associate Professor, School of Nursing, National Taiwan University, No. 1, Sec. 1, Jen-Ai Rd., Taipei, Taiwan, 10051
| | - Shiow-Ching Shun
- Associate Professor, School of Nursing, National Taiwan University, Taipei, Taiwan
| | - Pei-Lin Lee
- Assistant Professor, Department of Internal Medicine, National Taiwan University, Director, Center of Sleep Disorder, Attending Physician, Division of Pulmonary and Critical Care Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Nan Lee
- Professor, Department of Obstetrics and Gynecology, National Taiwan University, Taipei, Taiwan
| | - Terri E Weaver
- Dean and Professor, College of Nursing, University of Illinois at Chicago, Chicago, IL
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16
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Zhang P, Lou P, Chang G, Chen P, Zhang L, Li T, Qiao C. Combined effects of sleep quality and depression on quality of life in patients with type 2 diabetes. BMC FAMILY PRACTICE 2016; 17:40. [PMID: 27044393 PMCID: PMC4820902 DOI: 10.1186/s12875-016-0435-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 03/22/2016] [Indexed: 12/21/2022]
Abstract
Background Poor sleep quality and depression negatively impact the health-related quality of life of patients with type 2 diabetes, but the combined effect of the two factors is unknown. This study aimed to assess the interactive effects of poor sleep quality and depression on the quality of life in patients with type 2 diabetes. Methods Patients with type 2 diabetes (n = 944) completed the Diabetes Specificity Quality of Life scale (DSQL) and questionnaires on sleep quality and depression. The products of poor sleep quality and depression were added to the logistic regression model to evaluate their multiplicative interactions, which were expressed as the relative excess risk of interaction (RERI), the attributable proportion (AP) of interaction, and the synergy index (S). Results Poor sleep quality and depressive symptoms both increased DSQL scores. The co-presence of poor sleep quality and depressive symptoms significantly reduced DSQL scores by a factor of 3.96 on biological interaction measures. The relative excess risk of interaction was 1.08. The combined effect of poor sleep quality and depressive symptoms was observed only in women. Conclusions Patients with both depressive symptoms and poor sleep quality are at an increased risk of reduction in diabetes-related quality of life, and this risk is particularly high for women due to the interaction effect. Clinicians should screen for and treat sleep difficulties and depressive symptoms in patients with type 2 diabetes.
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Affiliation(s)
- Pan Zhang
- School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Peian Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, School of Public Health, Xuzhou Medical University, 42 West Erhuan Road, Xuzhou, Jiangsu, China.
| | - Guiqiu Chang
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Peipei Chen
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Lei Zhang
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Ting Li
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Cheng Qiao
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China
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Chasens ER, Luyster FS. Effect of Sleep Disturbances on Quality of Life, Diabetes Self-Care Behavior, and Patient-Reported Outcomes. Diabetes Spectr 2016; 29:20-3. [PMID: 26912961 PMCID: PMC4755460 DOI: 10.2337/diaspect.29.1.20] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
IN BRIEF Poor sleep quality and sleep disorders, particularly insomnia, obstructive sleep apnea, and restless legs syndrome, are prevalent among people with type 2 diabetes. Evidence suggests that coexisting diabetes and sleep disturbances are associated with decreases in quality of life, diabetes self-care behaviors, and patient-reported outcomes. Additional research is required to determine the effect of treatment of sleep disorders on patient-centered outcomes in people with type 2 diabetes.
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18
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Chasens ER, Morris JL, Strollo PJ, Sereika SM, Burke LE, Korytkowski M. Gender Differences in the Response to Impaired Sleep in Adults with Diabetes. Behav Sleep Med 2016; 14:457-66. [PMID: 26406786 PMCID: PMC4808489 DOI: 10.1080/15402002.2015.1017100] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study analyzed cross-sectional data to examine gender differences in the association of sleep quality and daytime sleepiness with mood and functional outcomes in adults with type 2 diabetes (T2DM). Measures included demographic and clinical data as well as scales that measured subjective daytime sleepiness, sleep quality, mood disturbances, and functional outcomes. The majority of the sample (N = 116) had poor sleep quality and was subjectively sleepy. We observed in males and females significantly different associative patterns between the predictor variables of daytime sleepiness and sleep quality and the outcome variables of mood and functional outcome. There was no significant difference in daytime sleepiness or impaired sleep quality between men and women with T2DM; however, there was a difference in the expression of impaired sleep on mood and functional outcomes between genders.
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Affiliation(s)
- Eileen R. Chasens
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jonna L. Morris
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Susan M. Sereika
- School of Nursing and Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lora E. Burke
- School of Nursing and Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mary Korytkowski
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Manjunath K, Christopher P, Gopichandran V, Rakesh PS, George K, Prasad JH. Quality of life of a patient with type 2 diabetes: a cross-sectional study in rural South India. J Family Med Prim Care 2015; 3:396-9. [PMID: 25657951 PMCID: PMC4311350 DOI: 10.4103/2249-4863.148124] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND With a high prevalence of diabetes in India, there is a need to study the impact of this disease on the quality of life (QoL) of the patients. MATERIALS AND METHODS This facility-based cross-sectional study assessed the QoL of patients attending the diabetic clinic using the World Health Organization (WHO) QoL BREF instrument in Tamil Nadu. The QoL was analyzed domain-wise and various socio-demographic factors affecting the QoL were studied. RESULTS The mean total score of the QoL scale was 58.05 (95% CI, 22.18-93.88). Domain-wise, 63% had good physical, 69% had good psychological, 27% had good social and 85% had good environmental QoL scores. Males, currently married and those with BMI more than 25 had a statistically significantly better QoL compared to their counterparts. CONCLUSIONS Diabetes does impair the QoL of patients but not to a great extent. There is a need to specifically target and improve the QoL of women, widowed and separated, and non-obese diabetics who are at risk of a poor QoL. QoL assessment should be routinely practiced in diabetic clinics.
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Affiliation(s)
- K Manjunath
- Department of Family Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Prince Christopher
- Department of Family Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - P S Rakesh
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Kuryan George
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Jasmin Helan Prasad
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
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