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Neves NWT, Breder JSC, Oliveira BA, Zanchetta FC, Barreto J, Sposito AC, Lima MHM. Diabetes-related distress and quality of life among people with type 2 diabetes at primary care level in Brazil. Acta Diabetol 2024; 61:461-471. [PMID: 38095701 DOI: 10.1007/s00592-023-02216-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/17/2023] [Indexed: 03/27/2024]
Abstract
PURPOSE Living with diabetes can be challenging, particularly when it comes to dealing with psychological distress and requiring self-care directives. Patients may feel frustrated, angry, overwhelmed, and discouraged. This study aimed to investigate the diabetes-related distress and quality of life among people with type 2 diabetes mellitus (T2DM). METHODS A cross-sectional study carried out at the Clinical Research Centre at the University of Campinas, Brazil, between September 2020 and April 2021. Patients answered data regarding demographic and clinical variables, the Brazilian version of the Diabetes Distress Scale and the Diabetes Quality of Life (QOL) Measure by telephone contact. The data were managed using the RedCap System. For statistical analysis of the data, the Mann-Whitney and Kruskal-Wallis tests were applied for comparisons, and the Chi-square test for associations. The correlations were evaluated using the Spearman correlation coefficient. RESULTS Out of the 302 participants we recruited, 50.33% exhibited significant diabetes-related distress. Those with elevated diabetes-related distress scores had shorter education levels (p < 0.05), lower HbA1c levels (p < 0.05), and lower total scores in Diabetes QOL Measure (p < 0.0001), particularly in the QOL impact (p < 0.0001), social/vocational worry (p < 0.05), and diabetes worry (p < 0.0001) subscales compared to the group with the lowest diabetes-related distress. CONCLUSION Elevated diabetes-related stress scores significantly affect patients' QOL. Therefore, early screening of individuals at risk for this condition, using well-coordinated protocols, could mitigate adverse QOL effects and enhance their overall experience during disease management.
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Affiliation(s)
| | | | | | | | - Joaquim Barreto
- Department of Clinical Medicine, School of Medical Sciences, Universidade Estadual de Campinas, São Paulo, Brazil
| | - Andrei C Sposito
- Department of Clinical Medicine, School of Medical Sciences, Universidade Estadual de Campinas, São Paulo, Brazil
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Adugnew M, Fetene D, Assefa T, Kedir S, Asmamaw K, Feleke Z, Gomora D, Mamo H. Diabetes-related distress and its associated factors among people with type 2 diabetes in Southeast Ethiopia: a cross-sectional study. BMJ Open 2024; 14:e077693. [PMID: 38176868 PMCID: PMC10773350 DOI: 10.1136/bmjopen-2023-077693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Diabetes-related distress lowers the motivation for self-care, often leading to lowered physical and emotional well-being, poor diabetes control, poor medication adherence and increased mortality among individuals with diabetes. OBJECTIVE To assess factors associated with diabetes-related distress among people living with type 2 diabetes in Southeast Ethiopia. DESIGN Institution-based cross-sectional study was conducted. SETTING Six diabetic follow-up care units at public hospitals in Southeast Ethiopia. PARTICIPANTS All adult people living with type 2 diabetes from the diabetic follow-up clinic. THE MAIN OUTCOME MEASURES Diabetes Distress Scale-17 questionnaire was used to assess diabetes-related distress. RESULTS Out of the total 871 study participants intended, 856 participated in the study with a response rate of 98.3%. The findings showed that about 53.9% (95% CI 50.4% to 57.2%) of the patients have diabetes-related distress. Physical activity (adjusted OR, AOR 2.22; 95% CI 1.36 to 3.63), social support (AOR 4.41; 95% CI 1.62 to 12.03), glycaemic control (AOR 2.36; 95% CI 1.35 to 4.12) and other comorbidities (AOR 3.94; 95% CI 2.01 to 7.73) were factors that significantly associated with diabetes-related distress at p<0.05. CONCLUSION This study demonstrated that more than half of the participants had diabetes-related distress. Therefore, the identified factors of diabetes-related distress need to be a concern for health institutions and clinicians in the management of people living with type 2 diabetes.
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Affiliation(s)
| | | | | | - Sana'a Kedir
- Nursing, Madda Walabu University, Goba, Ethiopia
| | | | | | | | - Hailye Mamo
- Nursing, Madda Walabu University, Goba, Ethiopia
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Rias YA, Tsai HT, Thato R, Apriyanto BS, Chou KR, Ho SC, Sun CH. Synergistic Interactions of Insufficient Physical Activity and a High Systemic Immune-Inflammation Index on Psychological Problems in Indonesians With Type 2 Diabetes Mellitus. Biol Res Nurs 2023; 25:516-526. [PMID: 36891960 DOI: 10.1177/10998004231162050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
BACKGROUND High-grade inflammation represents a critical contribution to the onset of depression and might be manageable by physical activity (PA). Nevertheless, no study has examined synergistic interactions of insufficient PA and high values of the systemic immune-inflammation index (SII) on psychological problems. OBJECTIVE We investigated independent and synergistic interactions of insufficient PA and high SII levels on stress, anxiety, and depression in T2DM patients. METHODS A cross-sectional research design with 294 T2DM patients was conducted. An XP-100 automated hematology analyzer was used to evaluate inflammatory biomarkers. Depression, Anxiety, and Stress Scale-21 items and a standardized questionnaire about PA were respectively used to measure psychological problems and metabolic equivalent of task (MET)-h/week. RESULTS A multiple linear regression demonstrated that patients with insufficient PA were significantly more likely to have higher stress (β = 1.84, 95% confidence interval (CI) = 1.03-2.65), anxiety (β = 1.88, 95% CI = 1.81-2.96), and depression (β = 2.53, 95% CI = 0.82-4.24) than those with active PA. A high SII level was a key predictor and was most strongly associated with stress (β = 2.61, 95% CI = 2.02-3.20), anxiety (β = 3.16, 95% CI = 2.37-3.94), and depression (β = 3.72, 95% CI = 2.49-4.96) compared to those who had low SII levels. Notably, additive interaction results showed that combining insufficient PA and a high SII level had a significantly escalated 1.71-fold risk of stress, 1.82-fold risk of anxiety, and 2.69-fold risk of depression. CONCLUSIONS Active PA and a low SII had a positive synergistic effect of decreasing psychological problems.
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Affiliation(s)
- Yohanes Andy Rias
- Faculty of Health and Medicine, College of Nursing, Institut Ilmu Kesehatan Bhakti Wiyata, Kediri, Indonesia
- Graduate School of Chulalongkorn University, Bangkok, Thailand
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC
| | - Hsiu Ting Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC
| | - Ratsiri Thato
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | - Bagus Sholeh Apriyanto
- Faculty of Health and Medicine, College of Nursing, Institut Ilmu Kesehatan Bhakti Wiyata, Kediri, Indonesia
| | - Kuei Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC
| | - Shu Chuan Ho
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC
| | - Chia Hsuan Sun
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC
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Alwani AA, Singh U, Sankhyan S, Chandra A, Rai SK, Nongkynrih B. Hypertension-related distress and its associated factors: findings from an urban primary health centre of South Delhi, India. J Family Med Prim Care 2023; 12:1885-1892. [PMID: 38024890 PMCID: PMC10657111 DOI: 10.4103/jfmpc.jfmpc_1909_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 04/11/2023] [Accepted: 04/17/2023] [Indexed: 12/01/2023] Open
Abstract
Background Living with hypertension (HTN) has been found to cause distress, which adversely affects one's self-care and may lead to elevated blood pressure. There is a paucity of data regarding the prevalence of HTN-related distress. This study was conducted to estimate the prevalence of HTN-related distress among adults with HTN attending an outpatient department in an urban primary health centre and to determine the factors associated with distress. Methods This was a cross-sectional study conducted at the outpatient department of an urban primary health centre in Delhi, India. The enrolled participants were administered a questionnaire, which included a Distress Scale for patients with diabetes mellitus and/or hypertension (DSDH17 M) (to assess for HTN-related distress) and Health-Related Quality of Life, Healthy Days Measure. A descriptive analysis was performed. Factors associated with HTN-related distress were tested using logistic regression. Results One hundred forty-one participants were enrolled in this study. Most were women (73.76%) with a mean age of 60.15 years (standard deviation [SD]: 0.78). The prevalence of HTN-related distress (average DSDH17 M score ≥3) was 14% (95% confidence interval [CI]: 9.30-21.03). Patients with HTN-related distress had significantly poor health and reported a greater number of days where they were physically or mentally unhealthy. Patients with uncontrolled blood pressure had six times the odds (95% CI: 1.69-21.77, P value = 0.006) of HTN-related distress compared to those with controlled blood pressure. Conclusions Hypertension-related distress was present in 14% of adults with HTN. Patients with uncontrolled blood pressure had six times the odds of HTN-related distress.
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Affiliation(s)
- Anam A. Alwani
- Centre for Community Medicine (CCM), All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Udita Singh
- Centre for Community Medicine (CCM), All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sujata Sankhyan
- Department of Paediatrics, Indira Gandhi Medical College (IGMC), Shimla, Himachal Pradesh, India
| | - Ankit Chandra
- Centre for Community Medicine (CCM), All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sanjay K. Rai
- Centre for Community Medicine (CCM), All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Baridalyne Nongkynrih
- Centre for Community Medicine (CCM), All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Misra R, Adelman MM, Kirk B, Sambamoorthi U. Relationship Among Diabetes Distress, Health Literacy, Diabetes Education, Patient-Provider Communication and Diabetes Self-Care. Am J Health Behav 2022; 46:528-540. [PMID: 36333828 DOI: 10.5993/ajhb.46.5.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Mechanisms underlying relationships among patients' health literacy, diabetes distress, diabetes education, and provider counseling for self-care of chronic conditions are unclear. This study tested these relationships using SEM with adult patients with comorbid diabetes and hypertension in rural WV. METHODS Ninety-one participants of a 12-week self-management program reported on diabetes self-care (diet, exercise, blood glucose (BG) monitoring) and related provider counseling. RESULTS Based on patient report, providers' recommendations included following a low-fat diet, eating fruits/ vegetables, limiting sweets, a daily low-level of exercise and/or exercise ≥20 minutes three times/week, and BG monitoring. Provider recommendations were shown to be associated with patients' self-care behaviors (r=0.22, p<0.05). Multiple factors directly influenced provider recommendations: diabetes distress, health literacy, and family history of diabetes. A positive association was also noted between prior diabetes education and provider recommendations and diabetes self-care (r=0.44, p<0.001). A negative association was noted between diabetes distress and self-care, but a positive effect on provider recommendations was found. The model demonstrated good fit [CFI=0.94, and Root Mean Square Error of Approximation (RMSEA) =0.05]. CONCLUSIONS To enhance diabetes self-care, providers should consistently provide education on self-care behaviors as well as partner with them to address diabetes distress.
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Affiliation(s)
- Ranjita Misra
- Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV
| | - Megan M Adelman
- Cleveland Clinic Akron General - Center for Family Medicine, Akron, OH
| | - Brenna Kirk
- Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV
| | - Usha Sambamoorthi
- College of Pharmacy, University of North Texas Health Science Center, Fort Worth, TX
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Factors Associated with Diabetes-Related Distress in Patients with Type 2 Diabetes Mellitus. JOURNAL OF INTERDISCIPLINARY MEDICINE 2021. [DOI: 10.2478/jim-2021-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction: The aim of this study was to identify factors associated with diabetes-related distress (DRD) in adult patients with type 2 diabetes mellitus (T2DM).
Material and Methods: This was an analysis of data previously obtained from two cross-sectional studies, in which medical charts review and direct interviews were employed to obtain medical and demographic data. Vital status assessment and anthropometric measurements were performed. The patients filled out specific questionnaires for DRD (DDS-17), symptoms of depression (PHQ-9), and of anxiety (GAD-7). A clinical meaningful threshold for DRD was set at ≥2.0 points. Symptoms of depression and anxiety, number of chronic complications, therapy for T2DM, anthropometric and cardio-metabolic parameters, as well as demographic, socio-economic data, and lifestyle habits were evaluated as factors possibly associated with DRD by univariate and multiple regression analyses.
Results: A total of 271 patients with T2DM were included in this analysis, of whom 25.1% presented a DDS-17 score ≥2 points (and 9.96% a DDS-17 score ≥3). Subjects with a DDS-17 score ≥2 had higher HbA1c levels (p = 0.018), PHQ-9 and GAD-7 scores (p <0.0001 for both). The multiple regression model indicated that anxiety (p = 0.026), depression (p = 0.001), and ethnicity (p = 0.002) were significantly correlated with DRD (p <0.0001). With regards to subscales, the HbA1c (p = 0.005) and PHQ-9 score (p <0.0001) were significantly associated with emotional burden, ethnicity (p = 0.001) and depression (p = 0.004) with regimen-related distress, whereas ethnicity (p = 0.010) and GAD-7 score (p = 0.012) with interpersonal distress.
Conclusions: Psychosocial factors like depression, anxiety, or ethnicity significantly contribute to DRD in patients with T2DM, and worse glycemic control is associated with emotional burden.
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Alzubaidi H, Sulieman H, Mc Namara K, Samorinha C, Browning C. The relationship between diabetes distress, medication taking, glycaemic control and self-management. Int J Clin Pharm 2021; 44:127-137. [PMID: 34586556 DOI: 10.1007/s11096-021-01322-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/20/2021] [Indexed: 11/30/2022]
Abstract
Background Diabetes distress (DD) has broad-ranging effects on type 2 diabetes (T2DM) management and outcomes. DD research is scarce among ethnic minority groups, particularly Arabic-speaking immigrant communities. To improve outcomes for these vulnerable groups, healthcare providers, including pharmacists, need to understand modifiable predictors of DD. Aim To assess and compare DD and its association with medication-taking behaviours, glycaemic control, self-management, and psychosocial factors among first-generation Arabic-speaking immigrants and English-speaking patients of Anglo-Celtic background with diabetes, and determine DD predictors. Setting Various healthcare settings in Australia. Method A multicentre cross-sectional study was conducted. Adults with T2DM completed a survey comprised of validated tools. Glycated haemoglobin, blood pressure, and lipid profile were gathered from medical records. Multiple linear regression models were computed to assess the DD predictors. Main outcome measure Diabetes distress level. Results Data was analysed for 696 participants: 56.3% Arabic-speaking immigrants and 43.7% English-speaking patients. Compared with English-speaking patients, Arabic-speaking immigrants had higher DD, lower medication adherence, worse self-management and glycaemic control, and poorer health and clinical profile. The regression analysis demonstrated that higher DD in Arabic-speaking immigrants was associated with cost-related medication underuse and lower adherence to exercise, younger age, lower education level, unemployment, lower self-efficacy, and inadequate glycaemic control. Whereas among English-speaking patients, higher DD was associated with both cost- and non-cost-related underuse of medication and lower dietary adherence. Conclusion Results provided new insights to guide healthcare providers on reducing the apparent excess burden of DD among Arabic-speaking immigrants and potentially improve medication adherence, glycaemic control, and self-management.
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Affiliation(s)
- Hamzah Alzubaidi
- Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates. .,Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates.
| | - Hana Sulieman
- Department of Mathematics and Statistics, American University of Sharjah, Sharjah, United Arab Emirates
| | - Kevin Mc Namara
- School of Medicine, Deakin University, Victoria, Australia.,Centre for Population Health Research, Deakin University, Burwood, VIC, Australia
| | - Catarina Samorinha
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Colette Browning
- School of Nursing and Healthcare Professions, Federation University, Ballarat, VIC, Australia.,Australian National University, Australian Capital Territory, Canberra, Australia
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