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Pei JH, Wei YT, Tao HX, Yang QX, Zhang GL, Guo XJ, Guo JL, Yan FH, HanPhD L. The prevalence and characteristics of alexithymia in patients with type 2 diabetes mellitus: A systematic review and meta-analysis. J Psychosom Res 2022; 162:111018. [PMID: 36088789 DOI: 10.1016/j.jpsychores.2022.111018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/17/2022] [Accepted: 08/20/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Alexithymia is common in patients with type 2 diabetes mellitus (T2DM). Although the estimated prevalence of alexithymia in patients with T2DM is widely reported, these results have not been synthesized. AIM To systematically assess the prevalence and characteristics of alexithymia in patients with T2DM. METHODS We searched for relevant publications in PubMed, Embase, Web of Science, China Knowledge Resource Integrated Database, Wanfang Database, Chinese Biomedical Database, and Weipu Database. The prevalence of alexithymia, the mean scores, and standard deviations of the total scale of the 20-item Toronto Alexithymia Scale (TAS-20) were pooled using random effects meta-analysis in Stata 13.0, with studies stratified by study location in this meta-analysis. RESULTS This meta-analysis included thirteen articles. Pooled prevalence of alexithymia (TAS-20 total scores ≥61) were 43.0% (95%CI 35.0-51.0%), and the prevalence of alexithymia was higher in China (45.0%, 95%CI 36.0-54.0%) compared with non-China (41.0%, 95%CI 29.0-54.0%). The pooled mean score for the TAS-20 total scale was 57.70 (95% CI 55.25-60.15). Leave-one-out analysis showed that none of the studies significantly impacted the overall pooled results. CONCLUSIONS This meta-analysis indicated a high prevalence of alexithymia in patients with T2DM. Thus, clinicians need to be aware of and assess appropriately for alexithymia in patients with T2DM.
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Affiliation(s)
- Ju-Hong Pei
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Yu-Ting Wei
- Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Hong-Xia Tao
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Qiu-Xia Yang
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Guo-Li Zhang
- Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Xiao-Jing Guo
- Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Jia-Li Guo
- Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Fang-Hong Yan
- Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Lin HanPhD
- Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, Gansu, China; Department of Nursing, Gansu Provincial Hospital, Lanzhou, Gansu, China.
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Nutrition quality of life associated with affective functioning among Omani patients with type 2 diabetes from primary health care. J Nutr Sci 2021; 10:e6. [PMID: 33889389 PMCID: PMC8057477 DOI: 10.1017/jns.2020.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/15/2020] [Indexed: 11/08/2022] Open
Abstract
Diabetes requires challenging lifelong dietary management, affects quality of life and heightens the impact of affective functioning. The aim of this study was to investigate the relationship between Nutrition Quality of Life (NQOL) and affective functioning in a sample of Omani patients with type 2 diabetes. A sample of 149 adults with type 2 diabetes was conveniently recruited from seven Primary Health Centers (PHCs) during follow-up visits. Data were gathered via face-to-face interviews. Pearson correlation and χ2 test of independence were applied to examine associations at P < 0⋅05. Most patients had poor glycemic control (71⋅1 %), BMI ≥ 25 kg/m2 (85⋅2 %) and central obesity (75⋅8 %), and moderate (54⋅4 %) and poor (32⋅9 %) level of NQOL. Based on the Hospital Anxiety and Depression Scale (HADS), 16⋅1 and 23⋅5 % of the sample endorsed the presence of anxiety and depression, respectively. A significant negative correlation was found between NQOL and HADS (r −0⋅590, P = 0⋅000), anxiety (r −0⋅597, P = 0⋅000) and depression (r −0⋅435, P = 0⋅000). There was a significant association between NQOL and HADS, χ2 (2) = 38⋅21, P < 0⋅01 that was large, Cramer's V = 0⋅51. Also, there were significant associations (P < 0⋅01) between NQOL and HADS when controlling for HbA1c, BMI, waist circumference and HMNT that were moderately to largely strong, Cramer's V = 0⋅43–0⋅55. There is an evident association between NQOL and affective functioning in adults with type 2 diabetes. Further research is recommended to confirm these relationships and to guide intervention programmes at PHCs to help improve the general quality of life of such patients.
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Martino G, Caputo A, Vicario CM, Catalano A, Schwarz P, Quattropani MC. The Relationship Between Alexithymia and Type 2 Diabetes: A Systematic Review. Front Psychol 2020; 11:2026. [PMID: 32982843 PMCID: PMC7484475 DOI: 10.3389/fpsyg.2020.02026] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/21/2020] [Indexed: 12/14/2022] Open
Abstract
Background: This systematic review analyzed the relationship between alexithymia, considered as the inability to recognize and express thoughts and emotions, and type 2 diabetes mellitus (T2DM), one of the most common chronic illness, characterized by a metabolic disorder burdened by high morbidity and mortality worldwide due to its outcomes. Methods: PRISMA guidelines were followed throughout this systematic review of the recent literature indexed in the databases PubMed, PsycInfo, Scopus, and Web of Science. Search terms for eligible studies were: "Type 2 diabetes" OR "T2DM" AND "Toronto Alexithymia Scale" OR "TAS-20"[All Fields]. Results: The initial search identified 61 indexed scientific publications. After screening we found that seven publications met the established scientific inclusion and exclusion criteria. It emerged that alexithymic patients ranged from 25 to 50% across the examined publications and it appeared that patients with T2DM generally reflected greater values of alexithymia, revealing particular differences among TAS domains. Moreover, emlpoyed participants were alexithymic to a greater extent compared to non-working participants (77.8 vs. 35.4%) and alexithymia was 2.63 times more severe among working participants when examining predictors of alexithymia. When evaluating the correlations between alexithymia and HbA1c or fasting blood glucose levels we found strong associations equal to 0.75 and 0.77 for TAS-20 total scores, respectively. While alexithymic participants showed significantly higher levels of HbA1c and blood glucose when compared to the non-alexithymic participants. Conclusions: The results of this systematic review of the current literature highlight the need of alexithymia evaluation in patients with T2DM. The high prevalence in T2DM and strong associations with poorly regulated diabetes and psychological distress, indicate a significant relationship between poor glycemic control and psychological distress, such as anxiety and depression, and quality of life. Further studies are needed focusing on age and gender differences in order to be able to improve clinical psychological care and prevention.
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Affiliation(s)
- Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Andrea Caputo
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Carmelo M. Vicario
- Department of Cognitive Sciences, Psychology, Education and Cultural Studies, University of Messina, Messina, Italy
| | - Antonino Catalano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Peter Schwarz
- Department of Medical Endocrinology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Maria C. Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Upadhyay D, Mohamed Ibrahim M, Mishra P, Alurkar V. Impact assessment of pharmacist-supervised intervention on health-related quality of life of newly diagnosed diabetics: A pre-post design. J Pharm Bioallied Sci 2020; 12:234-245. [PMID: 33100782 PMCID: PMC7574756 DOI: 10.4103/jpbs.jpbs_6_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 02/16/2020] [Accepted: 04/03/2020] [Indexed: 11/09/2022] Open
Abstract
Introduction: Diabetics face a series of challenges that affect all aspects of their daily life. Diabetes related complications adversely affect patient’s health-related quality of life (HRQoL). Knowledge and self-care skills of diabetics are corner stones to improve their HRQoL. Objective: To assess the impact of pharmacist-supervised intervention on HRQoL of newly diagnosed diabetics using an Audit of Diabetes-Dependent Quality of Life (ADDQoL) questionnaire. Materials and Methods: A pre-post comparison study was conducted among the control group (CG), test 1 group (T1G) and test 2 group (T2G) patients with three treatment arms to explore the impact of pharmacist-supervised intervention on HRQoL of newly diagnosed diabetics for 18 months. Patients’ HRQoL scores were determined using ADDQoL questionnaire at baseline, 3, 6, 9 and 12-months. T1G patients received pharmacist’s intervention whereas T2G patients received diabetic kit demonstration in addition to pharmacist’s intervention. CG patients were deprived of pharmacist intervention and diabetic kit demonstration, and only received care from attending physician/nurses. Non-parametric tests were used to find the differences in an average weighted impact scores (AWIS) among the groups before and after the intervention at P ≤ 0.05. Results: Friedman test identified significant (P < 0.001) improvement in AWIS among the test groups’ patients. Differences in scores were significant between T1G and T2G at 6-months (P = 0.033), 9-months (P < 0.001) and 12-months (P < 0.001); between CG and T1G at 12-months (P < 0.001) and between CG and T2G at 9-months (P < 0.001) and 12-months (P < 0.0010) on Mann.Whitney U test. Conclusion: Pharmacist’s intervention improved AWIS of test groups’ diabetics. Diabetic kit demonstration strengthened the disease understanding and selfcare skills of T2G patients. Disease and self-care awareness among diabetics should be increased in Nepali healthcare system by involving pharmacists for better patient’s related outcomes.
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Jannoo Z, Yap BW, Khan NM, Farcomeni A. Assessing Diabetes Distress Among Type 2 Diabetes Mellitus in Malaysia Using the Problem Areas in Diabetes Scale. Value Health Reg Issues 2019; 18:159-164. [PMID: 31082796 DOI: 10.1016/j.vhri.2019.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 01/22/2019] [Accepted: 03/26/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To validate, from a psychometric perspective, the Problem Areas in Diabetes (PAID) questionnaire in patients with type 2 diabetes mellitus from Malaysia. METHODS A total of 497 patients with type 2 diabetes mellitus were recruited from public hospitals in the state of Selangor through convenience sampling. Construct validity was evaluated through confirmatory factor analysis. Internal consistency of the instrument was tested by Cronbach α. Criterion validity and discriminant validity were also used. RESULTS The PAID instrument consisted of 3 factors: social support problem, food-related problem, and emotional distress problem. The Cronbach α values of the 3 factors showed adequate internal consistency with α values greater than 0.90. The present confirmatory factor analysis model achieved a good fit with a comparative fit index value of 0.923. Satisfactory criterion validity was also demonstrated because there existed positive significant association between glycated hemoglobin A1c and diabetes duration. CONCLUSIONS The PAID questionnaire in Malaysia was found to be a reliable and valid instrument exhibiting good psychometric properties.
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Affiliation(s)
- Zeinab Jannoo
- Department of Economics and Statistics, University of Mauritius, Réduit, Mauritius.
| | - Bee Wah Yap
- Faculty of Computer and Mathematical Sciences, Centre of Statistical and Decision Science Studies, Universiti Teknologi MARA, Shah Alam, Selangor, Malaysia
| | - Naushad Mamode Khan
- Department of Economics and Statistics, University of Mauritius, Réduit, Mauritius
| | - Alessio Farcomeni
- Department of Public Health and Infectious Diseases, Sapienza-University of Rome, Rome, Italy
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Sionti V, Papageorgiou G, Peschos D, Charalambous G, Kotrotsiou E, Christodoulides P, Zakopoulou V, Gouva M. Quality of life in patients with type 2 diabetes mellitus: a cross-sectional study. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2019. [DOI: 10.1108/ijphm-02-2018-0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to investigate certain social and psychological parameters and to compare them with basic demographic information, such as the gender and the education, of patients suffering from Type 2 diabetes mellitus (T2DM).
Design/methodology/approach
A cross-sectional study of Type 2 diabetic patients was conducted. In total, 200 patients with T2DM were enrolled in the study. Psychological factors were assessed with questionnaires, including the Symptom Checklist 90-R (SCL-90-R), the Short-Form Health Survey (SF-36), the Life Orientation Test-Revised (LOT-R) and the Cardiac Anxiety Questionnaire (CAQ). The associations of psychological with socio-demographic factors were assessed through logistic regression analyses.
Findings
Women patients had higher levels of heart-focused anxiety psychopathology than men, and therefore, women tend to avoid activities that burden the heart. Men patients had a significantly higher index of physical functionality than women. No differences were recorded by the SCL-90R questionnaire between men and women. For the patients with elementary education, lower levels of mental health (SF-36-MCS) were observed.
Originality/value
The chronicity of the disease aggravates the psychopathology of the patients thereby creating adverse impact not only on health but also on efforts for compliance. A personalized approach by the health professionals could contribute in addressing the psychological factors that accompany T2DM.
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Carpenter R, DiChiacchio T, Barker K. Interventions for self-management of type 2 diabetes: An integrative review. Int J Nurs Sci 2019; 6:70-91. [PMID: 31406872 PMCID: PMC6608673 DOI: 10.1016/j.ijnss.2018.12.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 09/17/2018] [Accepted: 12/14/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus has been identified as one of the most challenging chronic illnesses to manage. Since the management of diabetes is mainly accomplished by patients and families, self-management has become the mainstay of diabetes care. However, a significant proportion of patients fail to engage in adequate self-management. A priority research question is how do interventions affect the self-management behaviors of persons with Type 2 diabetes? PURPOSE/OBJECTIVES The purpose of this integrative review is to provide a summary and critique of interventions that support diabetes self-management in the patient with Type II diabetes mellitus. DESIGN An integrative review design, with a comprehensive methodological approach of reviews, allowing inclusion of experimental and non-experimental studies. PROCEDURES A comprehensive search was conducted via Ebscohost using databases of Academic Search Complete, CINAHL, Health Source: Nursing/Academic Edition, MEDLINE, PsycArtiCLES, and PsycInfo. The final number of papers used for this review were: motivational interviewing (6), peer support/coaching (10), problem solving therapy (3), technology-based interventions (30), lifestyle modification programs (7), patient education (11), mindfulness (3), and cognitive behavioral therapy (5). RESULTS Studies were examined from seventeen countries including a broad range of cultures and ethnicities. While interventions have shown mixed results in all interventional categories, many studies do support small to modest improvements in physiologic, behavioral, and psychological outcome measures. Considerable heterogeneity of interventions exists. The most commonly reported physiologic measure was HbA1c level. Outcome measures were collected mostly at 6 and 12 months. Duration of most research was limited to one year. CONCLUSIONS Research exploring the impact of interventions for self-management has made major contributions to the care of persons with type 2 diabetes, from offering suggestions for improving care, to stimulating new questions for research. However, implications for clinical practice remain inconclusive, and limitations in existing research suggest caution in interpreting results of studies.
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Affiliation(s)
- Roger Carpenter
- West Virginia University School of Nursing, Morgantown, WV, 26506, USA
| | - Toni DiChiacchio
- Faculty Practice & Community Engagement, West Virginia University, Morgantown, WV, 26506, USA
| | - Kendra Barker
- West Virginia University School of Nursing, Morgantown, WV, 26506, USA
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Odajima Y, Sumi N. Factors related to sense of coherence in adult patients with Type 2 diabetes. NAGOYA JOURNAL OF MEDICAL SCIENCE 2018; 80:61-71. [PMID: 29581615 PMCID: PMC5857502 DOI: 10.18999/nagjms.80.1.61] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The influence of a diabetic person's sense of burden and blood sugar control through sense of coherence (SOC) on self-management has yet to be sufficiently clarified. The purpose of this study was to examine the utility of salutogenesis, which has sense of coherence at its core, for the self-management of patients with type 2 diabetes. A total of 258 questionnaires were distributed to patients who were seen at one of three hospitals in an urban area in Japan, after obtaining consent from the patient. They were between 20 and 75 years old and regularly received care. Of the 185 responses, 177 were valid. The responses were analyzed by referring to the framework of salutogenesis, and the relationship between patient characteristics, SOC, the Problem Areas In Diabetes survey (PAID), and glycosylated hemoglobin (HbA1c) were studied with structural equation modeling (SEM). SOC had a main effect on PAID scores and an indirect effect on HbA1c. Moreover, age influenced SOC positively. The SOC of patients with type 2 diabetes in the present study was comparatively high. These observations suggest a direct effect of SOC on reducing the sense of burden from having diabetes and an indirect effect on decreasing HbA1c. This research suggested the possibility that diabetes can be controlled by improving SOC.
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Affiliation(s)
- Yuki Odajima
- School of Nursing, Nagoya City University, Nagoya, Japan
| | - Naomi Sumi
- Department of Fundamental Nursing, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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Zuniga JA, Bose E, Park J, Lapiz-Bluhm MD, García AA. Diabetes Changes Symptoms Cluster Patterns in Persons Living With HIV. J Assoc Nurses AIDS Care 2017; 28:888-896. [PMID: 28765048 DOI: 10.1016/j.jana.2017.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 07/08/2017] [Indexed: 11/30/2022]
Abstract
Approximately 10-15% of persons living with HIV (PLWH) have a comorbid diagnosis of diabetes mellitus (DM). Both of these long-term chronic conditions are associated with high rates of symptom burden. The purpose of our study was to describe symptom patterns for PLWH with DM (PLWH+DM) using a large secondary dataset. The prevalence, burden, and bothersomeness of symptoms reported by patients in routine clinic visits during 2015 were assessed using the 20-item HIV Symptom Index. Principal component analysis was used to identify symptom clusters. Three main clusters were identified: (a) neurological/psychological, (b) gastrointestinal/flu-like, and (c) physical changes. The most prevalent symptoms were fatigue, poor sleep, aches, neuropathy, and sadness. When compared to a previous symptom study with PLWH, symptoms clustered differently in our sample of patients with dual diagnoses of HIV and diabetes. Clinicians should appropriately assess symptoms for their patients' comorbid conditions.
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Paula JS, Braga LD, Moreira RO, Kupfer R. Correlation between parameters of self-monitoring of blood glucose and the perception of health-related quality of life in patients with type 1 diabetes mellitus. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2016; 61:343-347. [PMID: 27901179 PMCID: PMC10118933 DOI: 10.1590/2359-3997000000222] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 08/10/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate how different parameters of short-term glycemic control would correlate with the perception of health-related quality of life (HRQoL) in patients with type 1 diabetes mellitus (T1D). SUBJECTS AND METHODS A total of 50 T1D patients aged 18 to 50 years were evaluated with the questionnaires Problem Areas in Diabetes (PAID) scale and Diabetes Quality of Life (DQOL) measure after 30 days of self-monitoring of blood glucose (SMBG). Glycemic control was evaluated using glycated hemoglobin (HbA1c), mean glucose levels (MGL) in the prior month's data from SMBG (Accu-Check 360o), number of hypoglycemic episodes (< 70 mg/dL and < 50 mg/dL), and glycemic variability (GV). RESULTS PAID correlated positively with MGL (r = 0.52; p < 0.001) and HbA1c (r = 0.36; p < 0.0097), but not with GV (r = 0.17; p = 0.23) or number of hypoglycemic episodes (r = 0.15; p = 0.17 for glucose < 70 mg/dL and r = 0.02; p = 0.85 for glucose < 50 mg/dL). After multiple linear regression, only MGL remained independently related to PAID scores. DQOL scores had a positive correlation with MGL (r = 0.45; p = 0.001), but not with HbA1c (r = 0.23; p = 0.09), GV (r = 0.20; p = 0.16), or number of hypoglycemic episodes (r = 0.06 p = 0.68). CONCLUSION In T1D patients, MGL, but not HbA1c or number hypoglycemic episodes, was the glycemic control parameter that best correlated with short-term perception of HRQoL.
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Affiliation(s)
- Juliana Santos Paula
- Serviço de Diabetes, Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione (IEDE), Rio de Janeiro, RJ, Brasil
| | - Letícia Dinis Braga
- Serviço de Diabetes, Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione (IEDE), Rio de Janeiro, RJ, Brasil
| | - Rodrigo Oliveira Moreira
- Serviço de Diabetes, Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione (IEDE), Rio de Janeiro, RJ, Brasil
| | - Rosane Kupfer
- Serviço de Diabetes, Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione (IEDE), Rio de Janeiro, RJ, Brasil
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Zhu Y, Fish AF, Li F, Liu L, Lou Q. Psychosocial factors not metabolic control impact the quality of life among patients with type 2 diabetes in China. Acta Diabetol 2016; 53:535-41. [PMID: 26754324 DOI: 10.1007/s00592-015-0832-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 12/18/2015] [Indexed: 12/16/2022]
Abstract
AIMS Quality of life is a major focus of health care today. In published studies on patients with type 2 diabetes, findings on quality of life are mixed. Those with diabetes have chronic illness and must adhere to a complicated care regimen daily, which for many patients is challenging. This study analyzed psychosocial factors and metabolic control as potential predictors of quality of life among these patients. METHODS A cross-sectional study of 397 patients with type 2 diabetes was conducted in a hospital in Nanjing, China. Demographic information and clinical characteristics were collected from the medical record. The World Health Organization Quality of Life-BREF, General Self-Efficacy Scale, Diabetes Distress Scale, and Diabetes Empowerment Scale-Short Form were administered. RESULTS The mean score of quality of life was 67.80 ± 13.44 on a 100-point scale. General self-efficacy (β = 0.340, P < 0.001), diabetes distress (β = -0.266, P < 0.001), and diabetes empowerment ability (β = 0.207, P < 0.001) were predictors of quality of life. In contrast, other factors including HbA1c, diabetes complications, and the duration of diabetes were not associated with quality of life (P > 0.05). CONCLUSIONS Our study indicated that psychosocial factors such as self-efficacy, diabetes distress, and diabetes empowerment ability are related to quality of life. Assessment and interventions aimed at reducing psychosocial problems should be applied in diabetes care.
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Affiliation(s)
- Yuanyuan Zhu
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu Province, China
- Nursing College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Anne F Fish
- College of Nursing, University of Missouri-St. Louis, Affiliated with the ISP Fellowship Support Program, St. Louis, MO, USA
| | - Fan Li
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Lin Liu
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Qingqing Lou
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China.
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu Province, China.
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Avci D, Kelleci M. Alexithymia in patients with type 2 diabetes mellitus: the role of anxiety, depression, and glycemic control. Patient Prefer Adherence 2016; 10:1271-7. [PMID: 27499615 PMCID: PMC4959761 DOI: 10.2147/ppa.s110903] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE This study was aimed at determining the prevalence of alexithymia in patients with type 2 DM and the factors affecting it. METHODS This cross-sectional study was conducted with 326 patients with type 2 DM. Study data were collected with the Personal Information Form, Toronto Alexithymia Scale, and Hospital Anxiety and Depression Scale. Glycemic control was assessed by glycated haemoglobin (HbA1c) results. The analysis was performed using descriptive statistics, chi-square test, Pear-son's correlation, and logistic regression analysis. RESULTS Of the patients, 37.7% were determined to have alexithymia. A significant relationship was determined between alexithymia and HbA1c, depression, and anxiety. According to binary logistic regression analyses, alexithymia was 2.63 times higher among those who were in a paid employment than those who were not, 2.09 times higher among those whose HbA1c levels were ≥7.0% than those whose HbA1c levels were <7.0%, 3.77 times higher among those whose anxiety subscale scores were ≥11 than those whose anxiety subscale scores were ≤10, and 2.57 times higher among those whose depression subscale scores were ≥8 than those whose depression subscale scores were ≤7. CONCLUSION In this study, it was determined that two out of every five patients with DM had alexithymia. Therefore, their treatment should be arranged to include mental health care services.
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Affiliation(s)
- Dilek Avci
- Department of Nursing, Faculty of Health Sciences, Bandirma Onyedi Eylul University, Balikesir
| | - Meral Kelleci
- Department of Nursing, Faculty of Health Sciences, Cumhuriyet University, Sivas, Turkey
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13
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Pilates-Based Mat Exercises and Parameters of Quality of Life in Women With Type 2 Diabetes. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016. [DOI: 10.5812/ircmj.21919] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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14
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Harm/Loss, Threat, and Challenge of Living With Diabetes for Persons From Rural Appalachia: A Qualitative Study. Holist Nurs Pract 2015; 29:323-9. [PMID: 26263292 DOI: 10.1097/hnp.0000000000000103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Living with the stress of diabetes involves suffering with pain, being frightened of the unknown, worrying about threats to family, trying to manage restrictions, taking on activities of living the everyday, and moving forward with confidence. The appraisal of the stress of diabetes indicates a need for development of person-centered interventions.
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Hershey DS, Given B, Given C, Corser W, von Eye A. Predictors of diabetes self-management in older adults receiving chemotherapy. Cancer Nurs 2015; 37:97-105. [PMID: 23519039 DOI: 10.1097/ncc.0b013e3182888b14] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cancer patients with diabetes have higher mortality rates and are more likely to develop infections, and be hospitalized during treatment. Hyperglycemia has been hypothesized as one of the factors associated with this increased risk. Diabetes self-management is one of the essential elements used by patients to maintain glucose levels. OBJECTIVE This exploratory study seeks to develop an understanding of the impact cancer treatment can have on overall diabetes self-management and how individual, clinical, and behavioral characteristics may influence or predict the level of diabetes self-management in adults who are undergoing chemotherapy for a solid tumor cancer. METHODS This study was conducted at 8 community-based cancer centers in Michigan and Ohio and used a written, self-administered survey at baseline and a phone survey 8 weeks later. RESULTS Diabetes self-management significantly decreased (P < .001), and the level of symptom severity significantly increased (P < .001) after patients were on chemotherapy for a minimum of 8 weeks. The level of symptom severity and diabetes self-efficacy were significantly predictive of the performance of diabetes self-management activities. CONCLUSIONS Chemotherapy and associated symptoms can have a negative impact on the performance of diabetes self-management activities in adults with both diabetes and cancer, increasing the risk for hyperglycemia and development of complications. IMPLICATIONS FOR PRACTICE Oncology nurses need to be aware of the impact cancer treatment can have on the performance of diabetes self-management activities in adults. Future research needs to test interventions that may assist patients with diabetes and cancer in managing both diseases.
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Affiliation(s)
- Denise Soltow Hershey
- Author Affiliations: College of Nursing (Drs Hershey and B. Given); Department of Family Medicine (Dr C. Given) and Institute for Health Care Studies (Dr. Corser), College of Human Medicine; and Department of Psychology (Dr von Eye), Michigan State University, East Lansing
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Sun JC, Xu M, Lu JL, Bi YF, Mu YM, Zhao JJ, Liu C, Chen LL, Shi LX, Li Q, Yang T, Yan L, Wan Q, Wu SL, Liu Y, Wang GX, Luo ZJ, Tang XL, Chen G, Huo YN, Gao ZN, Su Q, Ye Z, Wang YM, Qin GJ, Deng HC, Yu XF, Shen FX, Chen L, Zhao LB, Wang TG, Lai SH, Li DH, Wang WQ, Ning G. Associations of depression with impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes in Chinese adults. Diabet Med 2015; 32:935-43. [PMID: 25439630 DOI: 10.1111/dme.12649] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2014] [Indexed: 12/29/2022]
Abstract
AIM To examine the association between depression and impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes in middle-aged and elderly Chinese people, and whether depression was associated with different treatment regimens or durations of diabetes. METHODS A cross-sectional study was performed among 229,047 adults living in the community aged ≥ 40 years from 25 centres in China. The self-reported depression rating scale Patient Health Questionnaire 9 (PHQ-9) was used to diagnose probable and sub-threshold depression. Glucose metabolism status was determined according to World Health Organization 1999 diagnostic criteria. RESULTS The numbers of participants with normal glucose regulation, impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes were 120,458, 59,512, 24,826 and 24,251, respectively. The prevalence of sub-threshold depression in the total sample of participants was 4.8% (4.8%, 4.8%, 4.4% and 5.6% from normal glucose regulation to previously diagnosed diabetes, respectively), and the prevalence of probable depression was 1.1% (1.1%, 1.0%, 0.9% and 1.8% from normal glucose regulation to previously diagnosed diabetes, respectively). Compared with participants with normal glucose regulation, those with previously diagnosed diabetes had increased odds of probable depression [odds ratio (OR) = 1.61, 95% confidence interval (CI) 1.39-1.87] and sub-threshold depression (OR = 1.14, 95% CI 1.06-1.24), after adjustment for multiple confounding factors. Newly diagnosed diabetes or impaired glucose regulation was not associated with depression. Among those with previously diagnosed diabetes, insulin treatment was associated with greater odds of depression compared with no treatment or oral anti-diabetic medicine. CONCLUSION Previously diagnosed diabetes, but not newly diagnosed diabetes or impaired glucose regulation, was associated with a higher prevalence of depression. Patients receiving insulin were more likely to have depression than those not receiving treatment or being treated with oral anti-diabetic medicine.
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Affiliation(s)
- J C Sun
- Laboratory of Endocrine and Metabolic Diseases, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, and Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - M Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - J L Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Y F Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Y M Mu
- People's Liberation Army General Hospital, Beijing, China
| | - J J Zhao
- Shandong Provincial Hospital, Jinan, China
| | - C Liu
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China
| | - L L Chen
- Wuhan Xiehe Hospital, Huazhong University of Science and Technology School of Medicine, Wuhan, China
| | - L X Shi
- Affiliated Hospital of Guiyang Medical College, Guiyang, China
| | - Q Li
- The Second Affilliated Hospital of Haerbin Medical University, Haerbin, China
| | - T Yang
- The First Affiliated Hospital with Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - L Yan
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Q Wan
- The Affiliated Hospital of Luzhou Medical College, Luzhou, China
| | - S L Wu
- Xinjiang Kelamayi Peoples Hospital, Kelamayi, China
| | - Y Liu
- The First Hospital of Jilin University, Changchun, China
| | - G X Wang
- The First Hospital of Jilin University, Changchun, China
| | - Z J Luo
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - X L Tang
- The First Hospital of Lanzhou University, Lanzhou, China
| | - G Chen
- Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Y N Huo
- Jiangxi Peoples Hospital, Nanchang, China
| | - Z N Gao
- Dalian Municipal Central Hospital, Dalian, China
| | - Q Su
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Z Ye
- Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - Y M Wang
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - G J Qin
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - H C Deng
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - X F Yu
- Wuhan Tongji Hospital, Huazhong University of Science and Technology School of Medicine, Wuhan, China
| | - F X Shen
- The First Affiliated Hospital of Wenzhou Medical University, The First Provincial Wenzhou Hospital of Zhejiang, Wenzhou, China
| | - L Chen
- Qilu Hospital, University of Shandong School of Medicine, Jinan, China
| | - L B Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - T G Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - S H Lai
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - D H Li
- Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, >TX, USA
| | - W Q Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - G Ning
- Laboratory of Endocrine and Metabolic Diseases, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, and Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Akena D, Kadama P, Ashaba S, Akello C, Kwesiga B, Rejani L, Okello J, Mwesiga EK, Obuku EA. The association between depression, quality of life, and the health care expenditure of patients with diabetes mellitus in Uganda. J Affect Disord 2015; 174:7-12. [PMID: 25479048 PMCID: PMC4549461 DOI: 10.1016/j.jad.2014.11.019] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 11/10/2014] [Accepted: 11/13/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND Depression is one of the commonest neuropsychiatric disorders in patients with diabetes mellitus (DM) and is associated with poor glycaemic control, vascular complications, a low quality of life and increased health care expenditure. Co-morbid DM and depression remains poorly identified and inadequately treated in sub-Saharan Africa. METHODS We conducted a cross-sectional survey of 437 patients with DM at 3 DM clinics in Uganda. Participants were assessed for depression, blood sugar levels, diabetic neuropathy, quality of life, and health care expenditures. RESULTS The prevalence of depression was 34.8%. Depressed participants were more likely to be suicidal [OR=3.81, (CI 2.87-5.04)], younger [OR=3.98 CI (1.20-13.23)], un-employed [OR=1.99(CI 1.04-3.81)], and having lost a spouse [OR=2.36 (CI 1.29-4.31)]. Overall quality of life was poor [OR=0.67 (CI 0.47-0.96)], they scored poorer in the physical [OR=0.97, (CI 0.95-0.99)], psychological [OR=1.05 (CI 1.03-1.07)], and environmental [OR=0.97, (CI 0.95-0.99)] domains. They had an increased likelihood of incurring direct out-of-pocket payments for health care services [OR=1.56 (CI 1.03-2.36)], and were more likely to be impoverished [OR=1.52 (CI 1.01-2.28)]. LIMITATION The cross sectional nature of this study makes it difficult to examine causation. More studies are required in order to better understand the associations and impact of the factors examined above on patient outcomes. CONCLUSIONS Depression is highly prevalent among patients with DM in Uganda, and is associated with a number of adverse outcomes. A holistic approach that focuses on the depression management among patients with diabetes is recommended.
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Affiliation(s)
- Dickens Akena
- Makerere University College of Health Sciences, Kampala, Uganda,Corresponding author at: Department of Psychiatry, Makerere University College of Health Sciences
| | - Philippa Kadama
- Infectious Diseases Institute, Makerere University, Kampala, Uganda
| | - Scholastic Ashaba
- Department of Psychiatry, Mbarara University of Science & Technology, Mbarara, Uganda
| | - Carolyne Akello
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Brendan Kwesiga
- Makerere University College of Health Sciences, Kampala, Uganda,Infectious Diseases Institute, Makerere University, Kampala, Uganda,Department of Psychiatry, Mbarara University of Science & Technology, Mbarara, Uganda,Department of Psychiatry, Gulu University, Gulu, Uganda,Clinical Epidemiology Unit, Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, PO Box 7072, Kampala, Uganda,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, WC1E 7HT London, UK
| | - Lalitha Rejani
- Makerere University College of Health Sciences, Kampala, Uganda
| | - James Okello
- Department of Psychiatry, Gulu University, Gulu, Uganda
| | | | - Ekwaro. A. Obuku
- Clinical Epidemiology Unit, Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, PO Box 7072, Kampala, Uganda
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Challenges and movement to resolution for persons living with diabetes. Arch Psychiatr Nurs 2014; 28:352-3. [PMID: 25439978 DOI: 10.1016/j.apnu.2014.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 06/27/2014] [Indexed: 11/22/2022]
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Yang CJ, Hsu HY, Lu CH, Chao YL, Chiu HY, Kuo LC. The associations among hand dexterity, functional performance, and quality of life in diabetic patients with neuropathic hand from objective- and patient-perceived measurements. Qual Life Res 2014; 24:213-21. [PMID: 25017499 DOI: 10.1007/s11136-014-0748-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2014] [Indexed: 11/24/2022]
Abstract
PURPOSE To comprehend the associations among the dexterity and functional performance of the hands and quality of life in diabetic patients with neuropathic hands, via objective- and patient-perceived measurements. METHODS The study participants were 144 diabetes patients who received objective evaluations, including the Purdue pegboard test, electrophysiological testing in sensory amplitude of the median nerve, and self-administrated measurements, including the Michigan Hand Outcomes Questionnaire (MHQ) and Diabetes-39 (D-39). Pearson's and Spearman's correlation tests were conducted to assess the relationships among hand neuropathy, hand dexterity and functions, and quality of life. RESULTS The results show that the amplitude of the sensory nerve action potential of the median nerve was positively correlated with hand dexterity (r = 0.28-0.43; p < 0.01) and the total score of MHQ (r = 0.24-0.33; p < 0.01). Objective hand dexterity had mild to moderate relationships with most of the MHQ results, but only weak associations with some dimensions of the D-39 results. The MHQ results were negatively correlated with the D-39 scores, with mild to moderate relationships in the domains of energy/mobility and anxiety. CONCLUSIONS In comparison with diabetic feet, neuropathic diabetic hands are an easily neglected problem, with insufficient empirical evidence in the literature to indicate its impact on functional performance and quality of life. This study showed that lesions related to neural functioning in the diabetic hand may negatively influence dexterity and functional hand performance and thus also affect the quality of life.
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Affiliation(s)
- Chien-Ju Yang
- Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan
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20
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The relationship between diabetes-related distress and clinical variables and perceived support among adults with type 2 diabetes: A prospective study. Int J Nurs Stud 2014; 51:438-47. [DOI: 10.1016/j.ijnurstu.2013.06.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 06/25/2013] [Accepted: 06/27/2013] [Indexed: 11/22/2022]
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Kendzor DE, Chen M, Reininger BM, Businelle MS, Stewart DW, Fisher-Hoch SP, Rentfro AR, Wetter DW, McCormick JB. The association of depression and anxiety with glycemic control among Mexican Americans with diabetes living near the U.S.-Mexico border. BMC Public Health 2014; 14:176. [PMID: 24548487 PMCID: PMC3929559 DOI: 10.1186/1471-2458-14-176] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 02/12/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The prevalence of diabetes is alarmingly high among Mexican American adults residing near the U.S.-Mexico border. Depression is also common among Mexican Americans with diabetes, and may have a negative influence on diabetes management. Thus, the purpose of the current study was to evaluate the associations of depression and anxiety with the behavioral management of diabetes and glycemic control among Mexican American adults living near the border. METHODS The characteristics of Mexican Americans with diabetes living in Brownsville, TX (N = 492) were compared by depression/anxiety status. Linear regression models were conducted to evaluate the associations of depression and anxiety with BMI, waist circumference, physical activity, fasting glucose, and glycated hemoglobin (HbA1c). RESULTS Participants with clinically significant depression and/or anxiety were of greater age, predominantly female, less educated, more likely to have been diagnosed with diabetes, and more likely to be taking diabetes medications than those without depression or anxiety. In addition, anxious participants were more likely than those without anxiety to have been born in Mexico and to prefer study assessments in Spanish rather than English. Greater depression and anxiety were associated with poorer behavioral management of diabetes (i.e., greater BMI and waist circumference; engaging in less physical activity) and poorer glycemic control (i.e., higher fasting glucose, HbA1c). CONCLUSIONS Overall, depression and anxiety appear to be linked with poorer behavioral management of diabetes and glycemic control. Findings highlight the need for comprehensive interventions along the border which target depression and anxiety in conjunction with diabetes management.
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Affiliation(s)
- Darla E Kendzor
- School of Public Health, The University of Texas Health Science Center, Dallas, TX, USA
- Population Science and Cancer Control Program, UT Southwestern Harold C. Simmons Cancer Center, Dallas, TX, USA
| | - Minxing Chen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Belinda M Reininger
- School of Public Health, The University of Texas Health Science Center, Brownsville, TX, USA
| | - Michael S Businelle
- School of Public Health, The University of Texas Health Science Center, Dallas, TX, USA
- Population Science and Cancer Control Program, UT Southwestern Harold C. Simmons Cancer Center, Dallas, TX, USA
| | - Diana W Stewart
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Susan P Fisher-Hoch
- School of Public Health, The University of Texas Health Science Center, Brownsville, TX, USA
| | - Anne R Rentfro
- College of Nursing, The University of Texas at Brownsville, Brownsville, TX, USA
| | - David W Wetter
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Joseph B McCormick
- School of Public Health, The University of Texas Health Science Center, Brownsville, TX, USA
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22
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Rotella F, Dicembrini I, Lazzeretti L, Bigiarini M, Ricca V, Rotella CM, Mannucci E. Is there a practical way of predicting therapeutic success in type 2 diabetes on the basis of psychological features? Development and validation of the Psychological Predictors of Therapeutic success in Diabetes (PPTD) questionnaire. Acta Diabetol 2014; 51:133-40. [PMID: 24413892 DOI: 10.1007/s00592-013-0552-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 12/29/2013] [Indexed: 11/24/2022]
Abstract
Many psychiatric disorders and symptoms have been associated with impaired metabolic control in type 2 diabetes; several studies focused on non-pathological psychological features. Aims of this observational, longitudinal study are: the assessment of the impact of a wide range of psychological factors on metabolic control in type 2 diabetes; and the development and validation of a simple questionnaire to assess the impact of psychological factors on therapeutic success. To identify psychological factors interfering with attainment of glycemic targets, a prospective 1-year study was performed on a sample of 250 patients with type 2 diabetes. The impact of identified factors on therapeutic outcome was then subsequently verified on a further, independent sample of 200 patients. The first phase of the study allowed the development of a 19-items questionnaire, the Psychological Predictors of Therapeutic success in Diabetes (PPTD) questionnaire. Validation analyses showed that the questionnaire was able to predict therapeutic success. Patients with HbA1c ≤7% (53 mmol/mol) at follow-up showed higher test scores than those with HbA1c >7% [31.0 (26.2; 35.0) vs 28.0 (23.0; 32.0); p = 0.016]. The attainment and maintenance of therapeutic goals in patients with type 2 diabetes depend on a wide range of factors. The PPTD is an attempt at condensing the complexity of psychological factors affecting glycemic control in a simple and easy-to-use self-reported questionnaire, which can be used in wide-scale research.
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Affiliation(s)
- Francesco Rotella
- Diabetes Agency, Azienda Ospedaliero-Universitaria Careggi, Careggi Teaching Hospital, University of Florence, Via delle Oblate 4, 50141, Florence, Italy,
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Donald M, Dower J, Coll JR, Baker P, Mukandi B, Doi SAR. Mental health issues decrease diabetes-specific quality of life independent of glycaemic control and complications: findings from Australia's living with diabetes cohort study. Health Qual Life Outcomes 2013; 11:170. [PMID: 24131673 PMCID: PMC3853250 DOI: 10.1186/1477-7525-11-170] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 10/11/2013] [Indexed: 11/29/2022] Open
Abstract
Background While factors associated with health-related quality of life for people with chronic diseases including diabetes are well researched, far fewer studies have investigated measures of disease-specific quality of life. The purpose of this study is to assess the impact of complications and comorbidities on diabetes-specific quality of life in a large population-based cohort of type 2 diabetic patients. Methods The Living with Diabetes Study recruited participants from the National Diabetes Services Scheme in Australia. Data were collected via a mailed self-report questionnaire. Diabetes-specific quality of life was measured using the Audit of Diabetes-Dependent Quality of Life (ADDQoL) questionnaire. The analyses are for 3609 patients with type 2 diabetes. Regression models with adjustment for control variables investigated the association of complications and comorbidities with diabetes-specific quality of life. Next, the most parsimonious model for diabetes-specific quality of life after controlling for important covariates was examined. Results The expected associations with better diabetes-specific quality of life were evident, such as increased income, not on insulin, better glycaemic control and older age. However, being single and having been diagnosed with cancer were also associated with better ADDQoL. Additionally, poorer diabetes-specific quality of life was strongly sensitive to the presence of diabetes complications and mental health conditions such as depression, anxiety and schizophrenia. These relationships persisted after adjustment for gender, age, duration of diabetes, treatment regimen, sampling region and other treatment and socio-demographic variables. Conclusions A greater appreciation of the complexities of diabetes-specific quality of life can help tailor disease management and self-care messages given to patients. Attention to mental health issues may be as important as focusing on glycaemic control and complications. Therefore clinicians’ ability to identify and mange mental health issues and/or refer patients is critical to improving patients’ diabetes-specific quality of life.
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Affiliation(s)
- Maria Donald
- School of Population Health, University of Queensland, Herston Campus, Brisbane, Queensland, Australia.
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de Figueiredo RC, Snoek FJ, Barreto SM. Do patients and physicians agree on diabetes management? A study conducted in public healthcare centres in Brazil. PATIENT EDUCATION AND COUNSELING 2013; 92:107-113. [PMID: 23478448 DOI: 10.1016/j.pec.2013.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 01/21/2013] [Accepted: 01/25/2013] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To explore to what extent patients with diabetes agree with their physicians on diabetes management and whether the agreement varies according to patients' socio-demographic characteristics. METHODS A cross-sectional study was conducted among patients with diabetes and their Family Health physicians in 108 healthcare centres in Belo Horizonte, Brazil. Patients and physicians were interviewed face-to-face using standard questionnaires. Physicians were unaware of which of their patients would be interviewed. Their responses were compared using descriptive statistics and Cohen's weighted kappa. RESULTS 282 patient-physician pairs were included. Kappa coefficients were often low, the highest was found for presence of diabetic foot and the lowest for kidney disease. Physicians tended to overestimate patients' risk of diabetes complications and underestimate patients' adherence to all diabetes self-management activities as well as diabetes control. Moreover, the agreement rate regarding adherence to diet, foot care and medicine prescriptions was significantly higher among male, younger and higher educated patients. CONCLUSION Results indicate that physicians' recommendations are generally poorly apprehended by their patients, especially by the lower educated, compromising the goal of patient-centred care. PRACTICE IMPLICATIONS Educational programmes need to incorporate strategies to improve the comprehension and effectiveness of physician-patient communication, especially with the most socially vulnerable groups.
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Nandipati S, Luo X, Schimming C, Grossman HT, Sano M. Cognition in non-demented diabetic older adults. Curr Aging Sci 2013; 5:131-5. [PMID: 22023096 DOI: 10.2174/1874609811205020131] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 08/02/2010] [Accepted: 07/25/2011] [Indexed: 01/21/2023]
Abstract
Evidence links diabetes mellitus to cognitive impairment and increased risk of Alzheimer's disease (AD) and suggests that insulin therapy improves cognition. With an increasing percentage of the US elderly population at high risk for diabetes and AD, the evidence of an association between diabetes and poor cognition in non-demented elderly may have implications for diagnosis, prevention and treatment of cognitive decline including AD. In our study, we hypothesized that diabetic elders with normal cognition would demonstrate poorer cognitive outcomes than non-diabetic elders and that diabetic elders receiving diabetes treatment would demonstrate better outcomes than those not receiving treatment. Data were evaluated from the National Alzheimer's Coordinating Center's Uniform Data Set (UDS). The UDS consists of clinical and neuropsychological assessments of a sample of elderly research subjects recruited from thirty-one Alzheimer's Disease Centers nationwide. The UDS provides a unique opportunity to study cognition in a nationally recruited sample with structured neuropsychological tests. We examined the impact of diabetes and diabetes treatment on cognitive measures in 3421 elderly research subjects from 2005-2007 with normal cognition. We performed linear regression analyses to compare cognitive scores between diabetic subjects and non-diabetic subjects. Diabetic subjects had lower scores than non-diabetic subjects including attention, psychomotor function and executive function, but no differences in memory or semantic memory language. There was no association between diabetes treatment and cognitive scores. These subtle but significant cognitive deficits in diabetic subjects compared to non-diabetic subjects may contribute to difficulty with compliance with complex diabetes medication regimens. A specific role of diabetes as a risk for cognitive impairment will require longitudinal study.
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Affiliation(s)
- Sirisha Nandipati
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA
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Rotella F, Cresci B, Monami M, Aletti V, Andreoli V, Ambrosio ML, Ricca V, Dicembrini I, Mannucci E. Are psychopathological features relevant predictors of glucose control in patients with type 2 diabetes? A prospective study. Acta Diabetol 2012; 49 Suppl 1:S179-84. [PMID: 22644473 DOI: 10.1007/s00592-012-0403-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 05/08/2012] [Indexed: 12/22/2022]
Abstract
Type 2 diabetes has been associated with an increased prevalence of psychopathology, in comparison with matched non-diabetic controls. However, the cross-sectional design of most studies does not allow causal inferences. The aim of the present study is the exploration of this possible association in patients with type 2 diabetes, in a longitudinal fashion. This prospective observational study was conducted on a consecutive series of 250 type 2 diabetic outpatients and a 1-year follow-up period was performed. At enrollment, a complete medical history was collected and hemoglobin A1c was measured. General psychopathology was assessed using the Symptom Checklist 90-revised and the Eating Disorder Examination Questionnaire. Among the 187 patients available at follow-up, factors associated with unsatisfactory glycemic control at follow-up were baseline hemoglobin A1c, insulin therapy, a longer duration of diabetes, higher scores on the Eating behavior, and Somatization scales. At multivariate analysis, the attainment of hemoglobin A1c ≤ 7 % was associated with baseline hemoglobin A1c (p = 0.01), insulin therapy (p = 0.016), and Eating behavior (p = 0.02), whereas duration of diabetes and Somatization were no longer significant after adjusting for confounders. The results of the present study suggest that clinical features have a much greater impact on attainment of therapeutic goals than psychopathology. However, there are several aspects, such as temperament, motivation, self-efficacy, and well-being, not assessed in the present study, which could be crucial. These areas should be adequately explored for obtaining an overall picture of the psychological determinants of appropriate metabolic control in diabetes.
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Affiliation(s)
- Francesco Rotella
- Diabetes Agency, Careggi Teaching Hospital and University of Florence, Largo Brambilla 3, 50134 Florence, Italy.
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Chan HL, Lin CK, Chau YL, Chang CM. The impact of depression on self-care activities and health care utilization among people with diabetes in Taiwan. Diabetes Res Clin Pract 2012; 98:e4-7. [PMID: 22749685 DOI: 10.1016/j.diabres.2012.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Revised: 11/24/2011] [Accepted: 06/12/2012] [Indexed: 11/30/2022]
Abstract
Using cross-sectional analyses of a nationally representative community sample (n=1260), we found that in people with diabetes, depression was associated with lower rates of reducing or quitting smoking and alcohol, less exercise, less regular lifestyle, but more health care utilization and a higher rate of foot care.
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Affiliation(s)
- Hsiang-Lin Chan
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, and Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC
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Rogvi S, Tapager I, Almdal TP, Schiøtz ML, Willaing I. Patient factors and glycaemic control--associations and explanatory power. Diabet Med 2012; 29:e382-9. [PMID: 22540962 DOI: 10.1111/j.1464-5491.2012.03703.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To investigate the association between glycaemic control and patient socio-demographics, activation level, diabetes-related distress, assessment of care, knowledge of target HbA(1c), and self-management behaviours, and to determine to what extent these factors explain the variance in HbA(1c) in a large Danish population of patients with Type 2 diabetes. METHODS Cross-sectional survey and record review of 2045 patients from a specialist diabetes clinic. Validated scales measured patient activation, self-management behaviours, diabetes-related emotional distress, and perceived care. The electronic patient record provided information about HbA(1c), medication, body mass index, and duration of diabetes. Data were analysed using multiple linear regression models with stepwise addition of covariates. RESULTS The response rate was 54% (n = 1081). Good glycaemic control was significantly associated with older age, higher education, higher patient activation, lower diabetes-related emotional distress, better diet and exercise behaviours, lower body mass index, shorter duration of disease and knowledge of HbA(1c) targets (P < 0.05 for all). Patient socio-demographics, behaviour; perceptions of care and diabetes distress accounted for 14% of the total variance in HbA(1c) levels (P = 0.0134), but the variance explained was higher for respondents treated with medications other than insulin. CONCLUSIONS Our study emphasizes the complex relationships between patient activation, distress and behaviour, specific treatment modalities and glycaemic control. Knowledge of treatment goals, achieving patient activation in coping with diabetes, and lowering disease-related emotional stress are important patient education goals. However, the large unexplained component of HbA(1c) variance highlights the need for more research to understand the mechanisms of glycaemic control.
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Affiliation(s)
- S Rogvi
- Steno Health Promotion Centre, Steno Diabetes Centre, Gentofte, Denmark
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Brasil F, Pontarolo R, Correr CJ. Patient Reported Outcomes Measures (PROMs) in diabetes: why are they still rarely used in clinical routine? Diabetes Res Clin Pract 2012; 97:e4-5. [PMID: 22336635 DOI: 10.1016/j.diabres.2012.01.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2011] [Accepted: 01/23/2012] [Indexed: 11/22/2022]
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Graco M, Hutchinson A, Barker A, Lawlor V, Wong R, Fourlanos S. Glycemic Outcome Not Predicted by Baseline Psychological Measures in a Diabetes Management Program. Popul Health Manag 2012; 15:163-7. [DOI: 10.1089/pop.2011.0043] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- Marnie Graco
- Northern Clinical Research Centre, Northern Health and The University of Melbourne Dept of Medicine, Melbourne, Australia
| | - Anastasia Hutchinson
- Northern Clinical Research Centre, Northern Health and The University of Melbourne Dept of Medicine, Melbourne, Australia
| | - Anna Barker
- Northern Clinical Research Centre, Northern Health and The University of Melbourne Dept of Medicine, Melbourne, Australia
- Centre for Research Excellence in Patient Safety (CREPS), School of Public Health and Preventative Medicine, Monash University, Victoria, Australia
| | - Vicki Lawlor
- Northern Clinical Research Centre, Northern Health and The University of Melbourne Dept of Medicine, Melbourne, Australia
| | - Rita Wong
- Northern Clinical Research Centre, Northern Health and The University of Melbourne Dept of Medicine, Melbourne, Australia
| | - Spiros Fourlanos
- Northern Health Endocrinology Unit, Northern Alliance HARP Diabetes, Northern Health and The University of Melbourne Dept of Medicine, Melbourne, Australia
- Department of Diabetes & Endocrinology, Royal Melbourne Hospital, Victoria, Australia
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Berben L, Sereika SM, Engberg S. Effect size estimation: methods and examples. Int J Nurs Stud 2012; 49:1039-47. [PMID: 22377339 DOI: 10.1016/j.ijnurstu.2012.01.015] [Citation(s) in RCA: 139] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 11/25/2011] [Accepted: 01/26/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND While the p-value will tell the reader a study's results are statistically significant, it does not provide any information about the practical or clinical importance of the findings. Furthermore, p-values are influenced by sample size. They are more likely to be significant when sample size is large and less likely if the sample is small. Effect size estimates, on the other hand, are not sensitive to sample size and provide information about the direction and strength of the relationship between variables (e.g., a treatment and an outcome). In addition to providing valuable clinical information about study findings, effect size estimates can provide a common metric to compare results across studies. Despite their usefulness, effect size estimates are often not reported as part of the research results. Consequently, effect sizes often have to be calculated based on summary and test statistics reported in research articles. RESULTS This article provides the formulas utilized to directly calculate common effective size estimates using summary statistics reported in research studies, as well as methods to more indirectly estimate these effect sizes when basis summary statistics are not reported. In addition we present formulas to compute the corresponding confidence interval for each effect size.
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Affiliation(s)
- Lut Berben
- Institute of Nursing Science, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland
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Rasekaba TM, Graco M, Risteski C, Jasper A, Berlowitz DJ, Hawthorne G, Hutchinson A. Impact of a Diabetes Disease Management Program on Diabetes Control and Patient Quality of Life. Popul Health Manag 2012; 15:12-9. [DOI: 10.1089/pop.2011.0002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Tshepo Mokuedi Rasekaba
- Northern Clinical Research Centre, Northern Health & The University of Melbourne Department of Medicine, Melbourne, Australia
| | - Marnie Graco
- Northern Clinical Research Centre, Northern Health & The University of Melbourne Department of Medicine, Melbourne, Australia
| | - Chrissie Risteski
- Northern Clinical Research Centre, Northern Health & The University of Melbourne Department of Medicine, Melbourne, Australia
| | - Andrea Jasper
- Northern Clinical Research Centre, Northern Health & The University of Melbourne Department of Medicine, Melbourne, Australia
| | - David J. Berlowitz
- Northern Clinical Research Centre, Northern Health & The University of Melbourne Department of Medicine, Melbourne, Australia
- Department of Psychiatry, University of Melbourne, Australia
| | | | - Anastasia Hutchinson
- Northern Clinical Research Centre, Northern Health & The University of Melbourne Department of Medicine, Melbourne, Australia
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Abstract
BACKGROUND The aim of the present study was to evaluate possible clinical and psychosocial variables that influence diabetes self-care management in patients with type 2 diabetes mellitus (T2DM). METHODS A total of 150 individuals with T2DM who had had diabetes for at least 6 months were recruited to this cross-sectional study. Levels of self-care and psychosocial status were determined using the Self-Care Inventory (SCI) and Problem Areas in Diabetes (PAID) scale. The PAID scores were calculated using a five-point Likert scale with options ranging from 0 (not a problem) to 4 (serious problem). Data were evaluated using non-parametric and parametric tests as appropriate. RESULTS The mean age of the study participants was 69.97 ± 8.68 years. Cronbach's α for SCI and PAID scores was 0.85 and 0.98, respectively. People with poor glycemic control had significantly higher mean (±SD) total PAID scores than individuals with good glycemic control (29.5 ± 30.9 vs 16.7 ± 26.9, respectively; P = 0.012). There was a significant relationship between PAID scores and glycemic control (r = 0.2; P = 0.012). CONCLUSIONS The present study demonstrates that psychosocial factors directly influence glycemic control and diabetes self-care habits. In addition, diabetes-specific distress in study population was unrelated to the duration of diabetes, the age of the patients and anthropometric indices.
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Affiliation(s)
- Anthonia Ogbera
- Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria.
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Horvath Z, de Lijster J, Kupper N. The association between quality of life, depressive symptoms and glycemic control in a group of type 2 diabetes patients: comment on Papelbaum et al. Diabetes Res Clin Pract 2011; 93:e5-6. [PMID: 21440947 DOI: 10.1016/j.diabres.2011.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 03/01/2011] [Indexed: 10/18/2022]
Abstract
This comment on the article: "The association between quality of life, depressive symptoms and glycemic control in a group of type 2 diabetes patients" by Papelbaum et al. was aimed to provide some critical remarks concerning the focus of the results section which showed significant discrepancies compared to the introduction and the research question. In addition, we would like to exhort the authors for a more comprehensive approach and for a more complete and congruent description of their results, in order to avoid misunderstanding.
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Karlsen B, Oftedal B, Bru E. The relationship between clinical indicators, coping styles, perceived support and diabetes-related distress among adults with type 2 diabetes. J Adv Nurs 2011; 68:391-401. [PMID: 21707728 DOI: 10.1111/j.1365-2648.2011.05751.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM This article is a report of a cross-sectional study examining the degree to which clinical indicators, coping styles and perceived support from healthcare professionals and family are related to diabetes-related distress. BACKGROUND Many people with type 2 diabetes experience high levels of distress stemming from concerns and worries associated with their disease. Diabetes-related distress has predominantly been studied in relation to diabetes management and metabolic control, and to some extent in relation to coping styles and perceived social support. To date, little is known about the relative contribution of clinical indicators, coping styles and perceptions of social support to perceived distress among people with type 2 diabetes. METHODS A sample comprising 425 Norwegian adults, aged 30-70, with type 2 diabetes, completed questionnaires assessing coping styles, perceived social support from health professionals and family and diabetes-related distress assessed by the Problem Areas in Diabetes Scale. Demographical and clinical data were collected by self-report. Data were collected in October 2008. FINDINGS Results from the regression analyses showed a greater variance in emotional distress accounted for by coping styles (21·3%) and perceived support (19·7%) than by clinical indicators (5·8%). CONCLUSION FINDINGS may indicate that healthcare providers should pay more attention to non-clinical factors such as coping styles and social support, when addressing diabetes-related distress. They should also be aware that interventions based on psychosocial approaches may primarily influence distress, and not necessarily metabolic control.
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Affiliation(s)
- Bjørg Karlsen
- Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Norway.
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