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Jafari A, Naddafi F, Gholian-Aval M, Tehrani H. Relationship between diabetes health literacy, distress, burnout, social support, complications, self-care behaviors, and quality of life among patients with type 2 diabetes: a path analysis study. Diabetol Metab Syndr 2024; 16:150. [PMID: 38970113 PMCID: PMC11225537 DOI: 10.1186/s13098-024-01391-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 06/26/2024] [Indexed: 07/07/2024] Open
Abstract
INTRODUCTION Improving the quality of life (QOL) is the most important goal of early diagnosis and treatment in patients with type 2 diabetes (T2D). Numerous studies have indicated the positive effects of health literacy, social support and self-care behaviors and the negative effects of diabetes distress and burnout on the QOL of patients with T2D. Understanding these factors is crucial for people with diabetes. However, no study has investigated the simultaneous effects of these variables on QOL. In this study, our goals were to find out how these variables are related to each other, in addition, which variables play the role of mediating variables, and finally, what is the cumulative effect of these variables in predicting the QOL of patients with T2D. So, this study aimed to examine the relationship between diabetes health literacy (DHL), distress, burnout, social support, complications of diabetes, self-care behaviors, and QOL among patients with T2D by application Path analysis method. METHODS In this study 929 participants were entered to study by cluster sampling method and finally, data were analyzed among 820 participants. Data were gathered by self-report and with seven tools of Demographic section, DHL Scale, Diabetes distress scale, Diabetes Burnout scale, Diabetes Self-Management Questionnaire (DSMQ), Perceived social support, Diabetes Quality of Life (DQOL) Questionnaire. The software's of SPSS version 24 and AMOS version 24 were used for analysis. RESULTS The variables of DHL, social support, diabetes distress, and complications of diabetes predicted 38% variance in diabetes burnout (R2 = 0.38). Greatest impact on diabetes burnout was related to diabetes distress (estimate total effect = 0.539). The variables of DHL, social support, diabetes distress, complications of diabetes, and diabetes burnout predicted 24% variance in self- care behaviors (R2 = 0.24). Greatest impact on self- care behaviors was related to DHL (estimate total effect = 0.354). The variables of DHL, social support, diabetes distress, diabetes burnout, complications of diabetes, and self- care behaviors predicted 49% variance in DQOL (R2 = 0.49). Greatest impact on DQOL was related to variables of diabetes distress (estimate total effect = -0.613), DHL (estimate total effect = 0.225), diabetes burnout (estimate total effect = -0.202), complications of diabetes (estimate total effect = - 0.173), social support (estimate total effect = 0.149), and self -care (estimate total effect = 0.149), respectively. CONCLUSION To improve QOL in patients with T2D, health care providers must develop interventions that increase DHL of diabetic. Because DHL can decrease distress and burnout, enhance self -care skills, create supportive networks, and ultimately improve QOL in patients with type 2 diabetes.
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Affiliation(s)
- Alireza Jafari
- Department of Health Education and Health Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Fatemehzahra Naddafi
- Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mahdi Gholian-Aval
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Tehrani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
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Qiu J, Bi Y, Pang J, Zhang N, Sun F, He Y, Zou Y, Wan X, Liu L, Zhang Y. Relationship between family function, self-perceived burden and loneliness in patients with type 2 diabetes mellitus: a cross-lagged analysis. Acta Diabetol 2024; 61:381-388. [PMID: 37991562 DOI: 10.1007/s00592-023-02207-8] [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] [Received: 08/10/2023] [Accepted: 10/30/2023] [Indexed: 11/23/2023]
Abstract
AIMS To explore the inter-predictive role and causal relationship between family functioning, self-perceived burden and loneliness in people with type 2 diabetes. METHODS In this study, patients with type 2 diabetes admitted to two tertiary care hospitals in China were selected for an 8-month follow-up, and the patients' scores on the Family Functioning, Self-perceived Burden, and Loneliness scales were measured repeatedly at three time periods: during hospitalisation (T1), 1 month after discharge (T2), and 3 months after discharge (T3). RESULTS The results showed that family function at the T1 time point had a negative predictive effect on self-perceived burden at the T2 time point, β = - 0.43, P = 0.005. Loneliness at the T1 time point had a positive predictive effect on self-perceived burden at the T2 time point, β = 0.08, P = 0.021. Unlike the pathway at time point T1, family functioning at time point T2 negatively predicted loneliness at time point T3, β = - 0.32, P = 0.013. Loneliness at time point T2 positively predicted family functioning at time point T3, β = 0.025, P = 0.013. Loneliness at time point T2 negatively predicted self-perceived burden at time point T3 (P = 0.011). CONCLUSIONS The results of the cross-lagged analysis show that there is a mutually predictive and moderating relationship between family functioning and loneliness in patients with type 2 diabetes. Loneliness can predict the level of self-perceived burden at the next time point.
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Affiliation(s)
- Jiahui Qiu
- School of Nursing, Yangzhou University, 136 Jiangyang Road, Yangzhou, Jiangsu Province, China
| | - Yaxin Bi
- School of Nursing, Yangzhou University, 136 Jiangyang Road, Yangzhou, Jiangsu Province, China
| | - Juan Pang
- School of Nursing, Yangzhou University, 136 Jiangyang Road, Yangzhou, Jiangsu Province, China
| | - Ning Zhang
- School of Nursing, Yangzhou University, 136 Jiangyang Road, Yangzhou, Jiangsu Province, China
| | - Fenfen Sun
- School of Nursing, Yangzhou University, 136 Jiangyang Road, Yangzhou, Jiangsu Province, China
| | - Yuyin He
- School of Nursing, Yangzhou University, 136 Jiangyang Road, Yangzhou, Jiangsu Province, China
| | - Yan Zou
- School of Nursing, Yangzhou University, 136 Jiangyang Road, Yangzhou, Jiangsu Province, China
| | - Xiaojuan Wan
- School of Nursing, Yangzhou University, 136 Jiangyang Road, Yangzhou, Jiangsu Province, China
| | - Lin Liu
- School of Nursing, Yangzhou University, 136 Jiangyang Road, Yangzhou, Jiangsu Province, China
| | - Yu Zhang
- School of Nursing, Yangzhou University, 136 Jiangyang Road, Yangzhou, Jiangsu Province, China.
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, China.
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Verdecias N, McQueen A, Von Nordheim DA, Broussard DJ, Smith RE, Kreuter MW. Diabetes distress in a Medicaid sample: The role of psychosocial and health-related factors. J Diabetes Complications 2023; 37:108495. [PMID: 37156052 PMCID: PMC10330688 DOI: 10.1016/j.jdiacomp.2023.108495] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/13/2023] [Accepted: 05/01/2023] [Indexed: 05/10/2023]
Abstract
AIMS Diabetes-related distress can negatively affect disease management leading to worse complications, especially among marginalized populations. Prior studies mostly focus on distress' impact on diabetes outcomes, with few examining distress predictors. The current study examined the impact of social needs on distress on its own and after controlling for other socio-demographic, psychosocial, and health factors. METHODS Adult Medicaid beneficiaries with type 2 diabetes and a recent HbA1c test documented in claims data (<120 days) were recruited for a 12-month social needs intervention trial. Baseline survey data assessed diabetes distress, social needs, psychosocial factors and health factors. Descriptive statistics were obtained, and bivariate and multivariable logistic regression analyses were used to identify predictors of moderate to severe distress. RESULTS Bivariate analyses revealed social needs, stress, depression, comorbidity and comorbidity burden, poor self-rated health, insulin use, a self-reported HbA1c ≥ 9.0, and difficulty remembering to take diabetes medications were all positively associated with greater odds of diabetes distress; greater social support, diabetes self-efficacy, and age were negatively associated. Four variables remained significant in the multivariate model: depression, diabetes self-efficacy, self-reported HbA1c ≥ 9.0, and younger age. CONCLUSIONS Targeted distress screening efforts might prioritize people with HbA1c values >9.0, greater depression, and worse diabetes self-efficacy.
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Affiliation(s)
- Niko Verdecias
- Arizona State University, College of Health Solutions, Phoenix, AZ, United States of America; Health Communication Research Laboratory, The Brown School of Social Work, Washington University in St. Louis, MO, United States of America.
| | - Amy McQueen
- Health Communication Research Laboratory, The Brown School of Social Work, Washington University in St. Louis, MO, United States of America; School of Medicine, Washington University in St. Louis, MO, United States of America
| | - David A Von Nordheim
- Health Communication Research Laboratory, The Brown School of Social Work, Washington University in St. Louis, MO, United States of America
| | | | - Rachel E Smith
- Louisiana Healthcare Connections, Baton Rouge, LA, United States of America
| | - Matthew W Kreuter
- Health Communication Research Laboratory, The Brown School of Social Work, Washington University in St. Louis, MO, United States of America
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Prevalence and predictors of diabetes-related distress in adults with type 1 diabetes. Sci Rep 2022; 12:15758. [PMID: 36130979 PMCID: PMC9492762 DOI: 10.1038/s41598-022-19961-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 09/07/2022] [Indexed: 11/20/2022] Open
Abstract
Type 1 diabetes (T1DM) is a chronic disease requiring lifelong insulin therapy and rigorous self-management. As it negatively impacts the affected individuals’ quality of life, it may eventually lead to diabetes-related distress. This study evaluated the prevalence and identified the predictors of diabetes-related distress in a representative sample of adults with T1DM treated at secondary and tertiary levels in Croatia. A multicenter, cross-sectional study was conducted in adults with T1DM in Croatia (N = 100). Data were collected between January 2018 and December 2018 from medical records and interviews during a single clinical visit, when participants completed a 20-item Problem Area in Diabetes (PAID) Questionnaire. The proportion of participants with a total PAID score ≥ 40 indicating high diabetes-related distress was calculated, and binary logistic regression was run to determine predictors. High diabetes-related distress was found in 36% of participants, with a mean PAID total score of 31.9 (21.1). The predictors of diabetes-related distress were higher HbA1c level (OR = 1.491, p = 0.037, CI = 1.025–2.169) and the presence of microvascular complications (OR = 4.611, p = 0.005; 95%CI 1.546–13.754). Worrying about the future and chronic complications and feeling guilty when off-track with diabetes management were identified as items that contribute the most to distress. Diabetes-related distress is a frequent condition in adults with T1DM in Croatia. Special attention should be given to patients with suboptimal glycemic control and microvascular complications. Given the high prevalence and impact of psychosocial problems in diabetes, psychological care should be integrated into routine care for adults with type 1 diabetes.
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Martin-Delgado J, Guilabert M, Mira-Solves J. Patient-Reported Experience and Outcome Measures in People Living with Diabetes: A Scoping Review of Instruments. THE PATIENT 2021; 14:759-773. [PMID: 34043215 PMCID: PMC8563512 DOI: 10.1007/s40271-021-00526-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/16/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Diabetes mellitus is a global public health concern, with over 463 million people living with this chronic disease. Pathology complexity, management difficulty, and limited participation in care has resulted in healthcare systems seeking new strategies to engage people living with diabetes. Patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs) were developed to address the gap between the healthcare system expectation and patient preference. OBJECTIVE This study aimed to review the existing literature on PREMs and PROMs specific to type 1 and 2 diabetes, and report the dimensions report the dimensions they have measured. METHODS A scoping review was conducted from January 1985 to March 2020 of six databases, MEDLINE, EMBASE, PsycINFO, CINHAL, Scopus, and BiblioPro, to identify PREM and PROM instruments specific for type 1 and 2 diabetes. RESULTS Overall, 34 instruments were identified, 32 PROMs and two PREMs. The most common instrument included outcomes related to quality of life at 44% (n = 15), followed by satisfaction (whether with treatment, device, and healthy habits) at 26% (n = 9). Furthermore, instruments regarding personal well-being accounted for 15% (n = 5). For instruments that measure experiences of persons with diabetes, there were two scales of symptoms, and one related to the attitude patients have toward the disease. CONCLUSIONS Diabetes-specific validated instruments mainly focus on quality of life, education, and treatment, and sometimes overlap each other, in their subscales and assessment dimensions. Constructs such as cultural and religious beliefs, leisure, and work life may need more attention. There appears to be a gap in instruments to measure experiences of individuals who "live with diabetes" and seek to lead a "normal life."
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Affiliation(s)
- Jimmy Martin-Delgado
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, Health District Alicante-Sant Joan, Carretera Nacional 332, Av. de Benidorm, Sant Joan d´Alacant, 03550, Alicante, Spain.
- Health Services and Policy Research Group, University of Exeter Medical School, Exeter, UK.
- Department of Public Health, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.
| | - Mercedes Guilabert
- Department of Health Psychology, Miguel Hernández University, Elche, Spain
| | - José Mira-Solves
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, Health District Alicante-Sant Joan, Carretera Nacional 332, Av. de Benidorm, Sant Joan d´Alacant, 03550, Alicante, Spain
- Department of Health Psychology, Miguel Hernández University, Elche, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), Alicante, Spain
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Amankwah‐Poku M, Akpalu J, Sefa‐Dedeh A, Amoah AGB. Psychosocial barriers to well‐being and quality of life among type 2 diabetes patients in Ghana. LIFESTYLE MEDICINE 2021. [DOI: 10.1002/lim2.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Margaret Amankwah‐Poku
- Department of Psychology, School of Social Sciences, College of Humanities University of Ghana Accra Ghana
| | - Josephine Akpalu
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences University of Ghana Accra Ghana
| | - Araba Sefa‐Dedeh
- Department of Psychiatry, University of Ghana Medical School, College of Health Sciences University of Ghana Accra Ghana
| | - Albert G. B. Amoah
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences University of Ghana Accra Ghana
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Dong Q, Huang J, Liu S, Yang L, Li J, Li B, Zhao X, Li Z, Wu L. A survey on glycemic control rate of type 2 diabetes mellitus with different therapies and patients' satisfaction in China. Patient Prefer Adherence 2019; 13:1303-1310. [PMID: 31534317 PMCID: PMC6682321 DOI: 10.2147/ppa.s198908] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 06/19/2019] [Indexed: 12/13/2022] Open
Abstract
AIM To compare the blood glucose control of patients with type 2 diabetes mellitus (T2DM) with different treatment methods, oral hypoglycemic agents (OHA) monotherapy, insulin injection and combined therapy (OHA + insulin injection) and evaluate their satisfaction with the medical care. METHODS A total of 1512 T2DM patients were assessed, to compare the effects of different treatment methods on glycemic control in T2DM patients, the influencing factors of patients' satisfaction with medical care measures and their relationship with glycemic control. Fasting plasma glucose (FPG), 2 hrs postprandial plasma glucose (2hPG) and HbA1c were measured as the standard of the glycemic control. Satisfaction was defined using the simplified version of DAWN of chronic disease care patient scale (PACIC - DSF). RESULTS In this study, the FPG compliance rate, 2hPG compliance rate and HbA1c compliance rate were 25.5%, 22.7% and 19.5%, respectively. The differences in the glycemic control compliance rates of different treatment methods were not statistically significant. The total score of PACIC - DSF was 34.54±11.65(p>0.05), and the influencing factors included fast blood glucose (FBG) and 2hPG, 2hPG and PACIC - DSF were negatively correlated. CONCLUSIONS The T2DM glycemic control rate in China is currently low. From the score of the PACIC - DSF, there is no significant difference in general satisfaction with medical care measures in different treatments. What is more, education level, occupation and exercise of patients with type 2 diabetes had influence on PACIC - DSF score. Different treatment methods have no influence on the glycemic control of patients with T2DM. FPG value and the 2hPG value are negative correlation with the satisfaction of patients in medical care measures.
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Affiliation(s)
- Qiaoliang Dong
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province410011, People’s Republic of China
| | - Jin Huang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province410011, People’s Republic of China
| | - Shunying Liu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province410011, People’s Republic of China
| | - Lingfeng Yang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province410011, People’s Republic of China
| | - Juan Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province410011, People’s Republic of China
| | - Bei Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province410011, People’s Republic of China
| | - Xue Zhao
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province410011, People’s Republic of China
| | - Zaizhao Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province410011, People’s Republic of China
| | - Liaofang Wu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province410011, People’s Republic of China
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