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Theofilou P. Is there a Relation between Depression and Anxiety to Clinical Characteristics among Patients with T2D in Greece? Curr Diabetes Rev 2024; 20:e060723218470. [PMID: 37415370 DOI: 10.2174/1573399820666230706124718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/27/2023] [Accepted: 06/14/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Diabetes is a chronic disease that may be related to various periods of an individual's life. AIM The aim of the present study is the investigation of the existence of depression and anxiety among patients suffering from type 2 diabetes as well as the factors that influence these variables (depression and anxiety). MATERIALS AND METHODS The Hospital Anxiety and Depression Scale (HADS) for mental health assessment was used in the context of the collection of the research data. The study involved 100 patients (42 men and 58 women) with an average age of 63.72 ± 9.84 years of life. RESULT The results showed that there was a positive correlation between HbA1c value and anxiety as well as HADS questionnaire total score, and a positive correlation between blood glucose value and anxiety as well as HADS questionnaire total score. CONCLUSION Both depression and anxiety of these patients are influenced by different clinical factors.
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Abuhegazy H, Mujairi A, Banah F, Agdi Y, Elkeshishi H, Kamel A, Abdullah A, Elsheikh M. Depression and Associated Risk Factors Among Type 2 Diabetic Patients: A Cross Sectional Study on a Convenience Sample from the Diabetic Center, Khamis Mushait; Saudi Arabia. Neuropsychiatr Dis Treat 2022; 18:1975-1984. [PMID: 36072678 PMCID: PMC9442912 DOI: 10.2147/ndt.s374752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 08/20/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Studies had confirmed that diabetic patients have a greater risk for developing depression. Our objectives were to estimate the prevalence and predictors of depression among type 2 diabetic patients. METHODS A cross-sectional study at the Diabetic Center, Armed Forces Hospital-Southern Region (AFHSR), Khamis Mushait was conducted in the period from March to June 2017. The study includes a convenience sample of type 2 diabetic patients. Self-administered questionnaires were utilized. It consists of personal characteristics, diabetes-related information's, and the Arabic version of the Patient Health Questionnaire (PHQ-9). Proper statistical analyses were done to assess the significance of the correlates with p ≤ 0.05 considered significant. RESULTS The study included 350 diabetic patients out of 410 with a response rate of 85.4%. Their age ranged between 28 and 100 years with a mean ±SD of 61.4±13 years. The prevalence of depression among them was 36.6%. Logistic regression revealed that patients older than 50 years were at lower risk for developing depression as compared to those aged between 28 and 40 years OR and 95% CI were 0.21 (0.08-0.57), 0.30 (0.12-0.78) and 0.33 (0.12-0.91) for patients in the age groups 51-60, 61-70 and > 70 years, respectively. Diabetic patients with thyroid dysfunction, neuropathy, those treated with insulin, and noncompliant patients were at double risk for developing depression compared to their counterparts (OR = 2.26, 95% CI = 1.20-4.27, p = 0.012); (OR = 2.35, 95% CI = 1.22-4.53, p = 0.011); (OR = 1.92, 95% CI = 1.08-3.40, p = 0.026); (AOR = 2.14, 95% CI = 1.01-4.53, p = 0.047) respectively. CONCLUSION Almost one third of type 2 diabetic patients were depressed. Younger patients, having comorbid thyroid disorders or neuropathy, those treated with insulin and noncompliant patients were at higher risk for developing depression. Proper screening and treatment of depression is a crucial part of the health care management of diabetic people.
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Affiliation(s)
- Hesham Abuhegazy
- Department of Psychiatry, faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahoud Mujairi
- Department of Family Medicine, Ministry of Health, Jazan, Saudi Arabia
| | - Faisal Banah
- Department of Family Medicine, Armed Forces Hospital, Khamis mushait, Saudi Arabia
| | - Yasir Agdi
- Department of Family Medicine, Ministry of Health, Jazan, Saudi Arabia
| | - Heba Elkeshishi
- Department of Psychology, faculty of Arts, El-menia University, Elmenia, Egypt
| | - Ahmed Kamel
- Department of Psychiatry, faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Abdullah
- Department of Psychiatry, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed Elsheikh
- Department of Psychiatry, faculty of Medicine, Al-Azhar University, Cairo, Egypt
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Worsa KT, Zinab B, Teshome MS. Dietary Practice among Type 2 Diabetic Ppatients in Southern Ethiopia. Int J Endocrinol 2021; 2021:1359792. [PMID: 34987574 PMCID: PMC8723874 DOI: 10.1155/2021/1359792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/05/2021] [Accepted: 12/13/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Diabetic patients' dietary practice is critical to improve glycemic, lipid, and blood pressure control. However, a significant number of patients had poor dietary practice. In Ethiopia, more than half of diabetic patients were not practicing a healthy dietary approach. Therefore, this study assessed variables that were hardly addressed in previous studies. The aim of this study was to assess dietary practice and associated factors among patients with type 2 diabetes. METHODS A facility-based cross-sectional study was performed among patients with type 2 diabetes in Arba Minch General Hospital from April 21 to May 20, 2020. A systematic sampling technique was used to select 352 patients. The data were entered into EpiData version 3.1 and exported to SPSS version 21 for cleaning and analysis. Descriptive statistics were performed. All variables in bivariate analysis with p-value <0.25 were entered into a multivariable logistic regression model, and statistical significance was declared at a p-value of less than 0.05. RESULTS The prevalence of poor dietary practice was found to be 40.6% (95%CI (35.7-46.0)). After adjusting for other variables in multivariable analysis, not attending formal education (AOR = 3.0; 95%CI (1.6-5.5)), being at primary education level (AOR = 2.2; 95%CI (1.1-4.4)), being moderately food insecure (AOR = 5.3; 95%CI (2.8-9.9)), having depression (AOR = 5.9; 95%CI (3.0-11.4)), and not having nutrition education (AOR = 2.2; 95% (1.1-4.6)) were factors associated with poor dietary practice. CONCLUSIONS A significant proportion of patients had poor dietary practice. The poor dietary practice was significantly higher among those with no formal education, at the primary education level, from the moderately food-insecure household, having depression, and not having nutrition education. The results imply the need for strengthening health information dissemination concerning healthy dietary practice in the form of a package.
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Affiliation(s)
- Kidus Temesgen Worsa
- School of Public Health, College of Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Beakal Zinab
- Department of Nutrition and Dietetics, Faculty of Public Health, Health Institute, Jimma University, Jimma, Ethiopia
| | - Melese Sinaga Teshome
- Department of Nutrition and Dietetics, Faculty of Public Health, Health Institute, Jimma University, Jimma, Ethiopia
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Lunghi C, Zongo A, Tardif I, Demers É, Diendéré JDR, Guénette L. Depression but not non-persistence to antidiabetic drugs is associated with mortality in type 2 diabetes: A nested case-control study. Diabetes Res Clin Pract 2021; 171:108566. [PMID: 33271227 DOI: 10.1016/j.diabres.2020.108566] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/09/2020] [Accepted: 11/16/2020] [Indexed: 01/06/2023]
Abstract
AIMS To measure the effect of depression on mortality of individuals newly treated with antidiabetic drugs, accounting for non-persistence to treatment. METHODS We conducted a nested case-control study within a cohort of newly treated individuals with diabetes. Using Quebec administrative data, we identified all-cause, diabetes-related, cardiovascular-related and major cardiovascular event deaths during a maximum follow-up of eight years. Each case was matched with up to 10 controls by age, sex, follow-up, and comorbidity index. We used conditional logistic regressions to estimate the effect of depression on mortality, adjusting for non-persistence to antidiabetic drug treatment, and other variables. RESULTS We retrieved 13,558 deaths, of which 3,652 were related to cardiovascular diseases, 2,112 to major cardiovascular events, and 311 to diabetes. Depression was associated with an increased risk of all-cause and cardiovascular-related deaths, with adjusted odds ratios (ORs) ranging from 1.32 (95% CI: 1.21-1.45) to 1.72 (95% CI: 1.57-1.88) depending on the model, but not with diabetes-related mortality. CONCLUSION Depression is independently associated with all-cause and cardiovascular-related mortality in individuals with type 2 diabetes, even when adjusting for non-persistence to antidiabetic drug treatment. Identifying risk factors for depression and implementing a screening and proper treatment for depression may help reducing mortality.
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Affiliation(s)
- Carlotta Lunghi
- Department of Health Sciences, Université du Québec à Rimouski, 1595 boulevard Alphonse-Desjardins, Lévis (QC), Canada; Axe Santé des Populations et Pratiques Optimales en Santé (SP-POS), Centre de recherche du CHU de Quebec, 1050 chemin Ste-Foy, Quebec City (QC) Canada; Faculty of Pharmacy, 1050 avenue de la Médecine, Université Laval, Quebec City (QC) Canada.
| | - Arsène Zongo
- Axe Santé des Populations et Pratiques Optimales en Santé (SP-POS), Centre de recherche du CHU de Quebec, 1050 chemin Ste-Foy, Quebec City (QC) Canada; Faculty of Pharmacy, 1050 avenue de la Médecine, Université Laval, Quebec City (QC) Canada
| | - Isabelle Tardif
- Faculty of Medicine, 1050 avenue de la Médecine, Université Laval, Quebec City (QC) Canada
| | - Éric Demers
- Axe Santé des Populations et Pratiques Optimales en Santé (SP-POS), Centre de recherche du CHU de Quebec, 1050 chemin Ste-Foy, Quebec City (QC) Canada
| | - Joël Désiré Relwende Diendéré
- Axe Santé des Populations et Pratiques Optimales en Santé (SP-POS), Centre de recherche du CHU de Quebec, 1050 chemin Ste-Foy, Quebec City (QC) Canada; Faculty of Pharmacy, 1050 avenue de la Médecine, Université Laval, Quebec City (QC) Canada
| | - Line Guénette
- Axe Santé des Populations et Pratiques Optimales en Santé (SP-POS), Centre de recherche du CHU de Quebec, 1050 chemin Ste-Foy, Quebec City (QC) Canada; Faculty of Pharmacy, 1050 avenue de la Médecine, Université Laval, Quebec City (QC) Canada
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Sadeghpour F, Heidarzadeh M, Kohi F, Asadi R, Aghamohammadi-Kalkhoran M, Abbasi F. The Relationship between "Self-Care Ability" and Psychological Changes among Hemodialysis Patients. Indian J Palliat Care 2020; 26:276-280. [PMID: 33311866 PMCID: PMC7725168 DOI: 10.4103/ijpc.ijpc_129_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 11/02/2019] [Accepted: 12/31/2019] [Indexed: 11/15/2022] Open
Abstract
Aim: The study investigates and analyzes the relationship among the concepts of demoralization, posttraumatic growth, and self-care ability in patients undergoing hemodialysis. Methods: The cross-sectional descriptive correlational study was conducted in 2017 on 150 hemodialysis patients selected through census in Buali Hospital, Ardabil, Iran. Demoralization scale, the posttraumatic growth inventory, and self-care questionnaire were used for cross-sectional data collection. Data were analyzed using descriptive statistics, Pearson and Spearman correlation coefficient. Results: The mean and standard deviation of demoralization, posttraumatic growth, and self-care were 36.25 ± 18.84, 63.17 ± 17.71, and 33.89 ± 6.40, respectively. Self-care ability was positively associated with posttraumatic growth (r = 0.287) and negatively related to demoralization (r = −0.168). Self-care ability was also found to be desirable in 84.7% of the patients. Conclusions: Hemodialysis patients can experience both positive and negative psychological changes. Self-care ability is associated with reductions in negative psychological problems and increases in positive psychological changes. Health-care providers can, therefore, help hemodialysis patients to improve their psychological conditions by making plans for improving self-care abilities.
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Affiliation(s)
- Fatemeh Sadeghpour
- Student Research Committee, Nursing and Midwifery School, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mehdi Heidarzadeh
- Department of Medical-Surgical Nursing, Nursing and Midwifery School, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Farzad Kohi
- Student Research Committee, Nursing and Midwifery School, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Reza Asadi
- Student Research Committee, Nursing and Midwifery School, Ardabil University of Medical Sciences, Ardabil, Iran
| | | | - Faeze Abbasi
- Student Research Committee, Nursing and Midwifery School, Ardabil University of Medical Sciences, Ardabil, Iran
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Oluma A, Mosisa G, Abadiga M, Tsegaye R, Habte A, Abdissa E. Predictors of Adherence to Self-Care Behavior Among Patients with Diabetes at Public Hospitals in West Ethiopia. Diabetes Metab Syndr Obes 2020; 13:3277-3288. [PMID: 33061490 PMCID: PMC7520154 DOI: 10.2147/dmso.s266589] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/20/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Diabetes is a typical chronic disease that needs integrated and multifaceted approaches. Self-care practices are fundamental to achieve good blood glucose control and prevent long-term complications. Therefore, the aim of the study was to determine the level and predictors of adherence to self-care behavior among patients with diabetes on follow-up at public hospitals of western Ethiopia. PATIENTS AND METHODS The cross-sectional study design was employed on a sample of 423 diabetic patients on follow-up at public hospitals of western Ethiopia. A systematic random sampling method was employed. The data were entered into Epi data version 3.1 and exported into Statistical Package for the Social Sciences window version 24 for analysis. All variables significant at p-value <0.05 in the bivariable were entered in multivariate regression analysis. Backward stepwise goodness of fit was used to ascertain the suitable variables in multiple linear regression analysis. Finally, multivariate linear regression analysis with adjusted B, CI at 95%, and the significance level was set at p <0.05. All predictive variables were reported in terms of adjusted R2. RESULTS The overall mean and standard deviation of adherence to self-care behavior was 23.09 ±6.55. Among the study participants, 42.70% had good self-care behavior. Self-efficacy (B=0.106, p<0.001), home blood glucose test (B=0.075, p<0.001), exercise per week (0.035, P<0.002), meal planning (B=0.039, P<0.001), dietary restriction (B=0.077, P<0.001), duration of diabetes<4 years (B=0.030, P<0.013), non-pharmacological intervention (B=0.055, P<0.011), and good appetite (B=0.039, P<0.045) were significant variables associated with adherence to self-care behaviors. CONCLUSION The overall level of adherence to self-care behavior was low. Therefore, we recommended that it is better if the national health policymaker focused on dietary management modality that engages patients' behavior change to develop self-care practices and closely monitoring of glucose level. Also, we recommended an additional longitudinal study incorporating a qualitative study that focused on behavioral changes.
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Affiliation(s)
- Adugna Oluma
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Getu Mosisa
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Muktar Abadiga
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Reta Tsegaye
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Ashenafi Habte
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Eba Abdissa
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
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Abstract
BACKGROUND Electronic health records often include a portal for secure patient-clinician communication. There is evidence that use of electronic portals increases satisfaction, treatment adherence, safety, and clinical outcomes. We want everyone to enjoy these benefits and we noticed low and uneven portal use. We studied factors that we can address to improve portal use. QUESTIONS/PURPOSES After controlling for differences in patient characteristics, what psychological and demographic factors are associated with an increased likelihood of registering for an electronic health record portal among people seeking musculoskeletal specialty care? METHODS We reviewed data on 5672 adult English or Spanish-speaking patients seen in a musculoskeletal specialty office between October 2017 and December 2019. Eighteen percent (996 patients) had missing measures of symptoms of depression and anxiety due to intermittent problems with survey technology, leaving 4676 for analysis, 42% (1970 of 4676) men and 58% (2706 of 4676) women with a mean age of 51±15, 76% (3569 of 4676) of patients were English speaking, 22% (1015 of 4676) were Spanish speaking, and 2% (92 of 4676) spoke another language. Seventy-seven percent (3620 of 4676) of patients were residents of Austin, Texas, USA, 4% (159) were from Pflugerville, Texas, USA, 3% (143) were from Del Valle, Texas, USA, and 16% (754 of 4676) were from other areas of Texas. Ninety nine percent of patients were residents of Texas (4645 of 4676). Twenty-three percent of patients visited the upper extremity team (1077 of 4676), 37% the lower extremity team (1721 of 4676), 21% the back and neck team (1002 of 4676), and 19% the sport medicine team (876 of 4676). Seventy eight percent of patients (3654 of 4676) registered in portal and 22% (1022 of 4676) did not. The omitted population were not different from our study population in terms of age, gender, language, residence, and region of symptoms. We used a two-question measure of symptoms of depression (Patient Health Quality-2 [PHQ-2]) and a two-question measure of symptoms of anxiety (General Anxiety Disorder-2 [GAD-2]). The primary outcome was portal registration. To account for potential confounding, a multivariable logistic regressions model was used to determine the influence of age, spoken language, city and state of residence, care team, number of completed visits and GAD and PHQ scores on portal registration. RESULTS After controlling for potentially confounding variables such as state of residence, we found younger age (odds ratio 0.98 [95% CI 0.97 to 0.99]; p < 0.01), speaking English (OR 1.85 [95% CI 1.14 to 3.02]; p = 0.01) rather than Spanish (OR 0.27 [95% CI 0.17 to 0.45]; p < 0.01), seeking care for back or neck symptoms, (OR 3.84 [95% CI 2.60 to 5.66]; p < 0.01) and higher number of completed visits (OR 1.03 [95% CI 1.01 to 1.05]; p < 0.01) were associated with an increased likelihood of portal registration while living in Austin, Texas, USA (OR 0.68 [95% CI 0.53 to 0.87]; p < 0.01) and Del Valle, Texas, USA (OR 0.47 [95% CI 0.30 to 0.74]; p < 0.01) compared with Pflugerville, Texas, USA, or other cities, seeking care for upper extremity (OR 0.74 [95% CI 0.58 to 0.94]; p = 0.01) or lower extremity symptoms (OR 0.68 [95% CI 0.53 to 0.86]; p < 0.01), and greater symptoms of anxiety (GAD score) (OR 0.97 [95% CI 0.95 to 0.99]; p < 0.01) or depression (PHQ score) (OR 0.97 [95% CI 0.95 to 0.98]; p < 0.01) were associated with lower likelihood of registering for the portal. English language, city of residence, and seeking care for back or neck symptoms (due to insurance contracts) were all associated with higher socioeconomic status in our setting. CONCLUSIONS The association of better mental and social health (financial, employment, housing and food security; connectedness) with registration in a communication portal directs us to be more intentional about efforts to specifically welcome disadvantaged people to participate in the portal and to study the impact and effectiveness of such efforts. LEVEL OF EVIDENCE Level III, therapeutic study.
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Xie Z, Liu K, Or C, Chen J, Yan M, Wang H. An examination of the socio-demographic correlates of patient adherence to self-management behaviors and the mediating roles of health attitudes and self-efficacy among patients with coexisting type 2 diabetes and hypertension. BMC Public Health 2020; 20:1227. [PMID: 32787809 PMCID: PMC7424981 DOI: 10.1186/s12889-020-09274-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 07/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients with coexisting type 2 diabetes and hypertension generally exhibit poor adherence to self-management, which adversely affects their disease control. Therefore, identification of the factors related to patient adherence is warranted. In this study, we aimed to examine (i) the socio-demographic correlates of patient adherence to a set of self-management behaviors relevant to type 2 diabetes and hypertension, namely, medication therapy, diet therapy, exercise, tobacco and alcohol avoidance, stress reduction, and self-monitoring/self-care, and (ii) whether health attitudes and self-efficacy in performing self-management mediated the associations between socio-demographic characteristics and adherence. METHODS We performed a secondary analysis of data collected in a randomized controlled trial. The sample comprised 148 patients with coexisting type 2 diabetes mellitus and hypertension. Data were collected by a questionnaire and analyzed using logistic regression. RESULTS Female patients were found to be less likely to exercise regularly (odds ratio [OR] = 0.49, P = 0.03) and more likely to avoid tobacco and alcohol (OR = 9.87, P < 0.001) than male patients. Older patients were found to be more likely to adhere to diet therapy (OR = 2.21, P = 0.01) and self-monitoring/self-care (OR = 2.17, P = 0.02). Patients living with family or others (e.g., caregivers) were found to be more likely to exercise regularly (OR = 3.44, P = 0.02) and less likely to avoid tobacco and alcohol (OR = 0.10, P = 0.04) than those living alone. Patients with better perceived health status were found to be more likely to adhere to medication therapy (OR = 2.02, P = 0.03). Patients with longer diabetes duration (OR = 2.33, P = 0.01) were found to be more likely to adhere to self-monitoring/self-care. Self-efficacy was found to mediate the association between older age and better adherence to diet therapy, while no significant mediating effects were found for health attitudes. CONCLUSIONS Adherence to self-management was found to be associated with socio-demographic characteristics (sex, age, living status, perceived health status, and diabetes duration). Self-efficacy was an important mediator in some of these associations, suggesting that patient adherence may be improved by increasing patients' self-management efficacy, such as by patient empowerment, collaborative care, or enhanced patient-physician interactions.
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Affiliation(s)
- Zhenzhen Xie
- Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Hong Kong, China
| | - Kaifeng Liu
- Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Hong Kong, China
| | - Calvin Or
- Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Hong Kong, China.
| | - Jiayin Chen
- Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Hong Kong, China
| | - Mian Yan
- School of Intelligent Systems Science and Engineering, Jinan University, Zhuhai, China
| | - Hailiang Wang
- Department of Systems Engineering and Engineering Management, City University of Hong Kong, Hong Kong, China
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Shrestha M, Ng AH, Gray RJ. Association between subthreshold depression and self-care behaviours in adults with type 2 diabetes: A protocol for a cross-sectional study. J Clin Nurs 2020; 30:2453-2461. [PMID: 32415880 DOI: 10.1111/jocn.15250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/05/2020] [Accepted: 03/14/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To examine the association between subthreshold depression and self-care behaviours in adults with type 2 diabetes (T2D) attending a tertiary healthcare service. BACKGROUND Diabetes is a global public health problem. Self-care behaviours are a fundamental element in managing diabetes as adherence to self-care activities is associated with improved glycaemic control. Depression in T2D is associated with decreased adherence to self-care behaviours. Adults with subthreshold depression in diabetes may have difficulties in achieving metabolic control. Further, people with subthreshold depression have an increased risk of developing major depression. Few studies have examined the association between subthreshold depression and self-care behaviours. DESIGN A cross-sectional study. METHODS The study will be conducted among 384 adults diagnosed with T2D for at least a year attending their routine outpatient appointment at Tribhuvan University Teaching Hospital in Nepal. Convenience sampling will be used to recruit study participants. Data will be collected via face-to-face interviews and a medical record review. Self-care behaviours will be assessed using the Summary of Diabetes Self-care activities and subthreshold depression will be determined using the Patient Health Questionnaire- 9. Covariates in the study include sociodemographic and clinical factors, diabetes knowledge, perceived social support and self-efficacy. This paper complies with the STROBE reporting guideline for cross-sectional studies. RESULTS We will use multiple linear regression to examine the association between subthreshold depression and each self-care behaviours (i.e. diet, physical activity, foot care, blood glucose testing and medication) and total self-care behaviour. CONCLUSIONS Effective management of diabetes requires adherence to self-care behaviours. The findings of the study will help in identifying an effective way to improve diabetes self-care. RELEVANCE TO CLINICAL PRACTICE Our observations will inform nursing research and practice by providing evidence about how subthreshold depression may influence self-care behaviours.
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Affiliation(s)
- Monika Shrestha
- School of Nursing and Midwifery, La Trobe University, Bundoora, Australia
| | - Ashley H Ng
- Department of Dietetics, Human Nutrition and Sport, La Trobe University, Bundoora, Australia
| | - Richard J Gray
- School of Nursing and Midwifery, La Trobe University, Bundoora, Australia
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Lee J, Callaghan T, Ory M, Zhao H, Foster M, Bolin JN. Effect of Study Design and Survey Instrument to Identify the Association Between Depressive Symptoms and Physical Activity in Type 2 Diabetes, 2000-2018: A Systematic Review. DIABETES EDUCATOR 2019; 46:28-45. [DOI: 10.1177/0145721719893359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Previous studies have used a variety of survey measurement options for evaluating the association between physical activity (PA) and depressive symptoms, raising questions about the types of instruments and their effect on the association. This study aimed to identify measures of PA and depressive symptoms and findings of their association given diverse instruments and study characteristics in type 2 diabetes (T2DM). Methods Online databases, Medline, Embase, CINAHL, and PsycINFO were searched on July 20, 2018, and January 8, 2019. Our systematic review included observational studies from 2000 to 2018 that investigated the association between PA and depressive symptoms in T2DM. Results Of 2294 retrieved articles, 28 studies were retained in a focused examination and comparison of the instruments used. There were a range of standard measures, 10 for depressive symptoms and 7 for PA, respectively. Patient Health Questionnaire (PHQ) for depressive symptoms and study-specific methods for PA were the most popular. Overall, 71.9% found a significant association between PA and depressive symptoms. Among studies classified as high quality or reliability, the figure was 81.8%. Conclusion A majority of the sample found an association between depressive symptoms and PA, which is fairly consistent across study characteristics. The findings provide the evidence for the health benefits of PA on reducing depressive symptoms in persons with T2DM, suggesting active engagement in PA for effective diabetes management. However, guidelines for objective measurements and well-designed prospective studies are needed to strengthen the evidence base and rigor for the association and its directionality.
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Affiliation(s)
- Jusung Lee
- Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, Texas
| | - Timothy Callaghan
- Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, Texas
| | - Marcia Ory
- Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, Texas
| | - Hongwei Zhao
- Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, Texas
| | - Margaret Foster
- Medical Sciences Library, Texas A&M University, College Station, Texas
| | - Jane N. Bolin
- Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, Texas
- School of Nursing, Texas A&M University, College Station, Texas
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Shrestha M, Al-Ghareeb A, Alenazi F, Gray R. Association between subthreshold depression and self-care behaviour in people with type 2 diabetes: a protocol for systematic review of observational studies. Syst Rev 2019; 8:167. [PMID: 31300045 PMCID: PMC6624905 DOI: 10.1186/s13643-019-1084-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 07/02/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression is a common comorbidity in type 2 diabetes. Studies have consistently shown that major depression is associated with decreased diabetic self-care behaviour. People with subthreshold depression experience greater functional impairment, have a poorer quality of life and use health services more than those without depressive symptoms. Although subthreshold depression impacts self-care behaviour, the relationship between subthreshold depression and diabetes self-care behaviour has not been systematically reviewed. The objective of this systematic review is to determine the association between subthreshold depression and self-care behaviour in adults with type 2 diabetes. METHODS This protocol will follow the guideline of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 (PRISMA-P-2015). A systematic search of literature will be conducted for observational studies reporting the association between subthreshold depression and self-care behaviour in adults aged 18 years or over and diagnosed with type 2 diabetes. Electronic databases including MEDLINE, EMBASE, PsycINFO, Emcare and CINAHL will be searched using predefined search terms. Title and abstract, full-text screening and data extraction of identified articles will be done by two reviewers independently. Discrepancies will be resolved by a third author. The methodological quality of the included studies will be assessed using The Joanna Briggs Institute (JBI) risk of bias tools. The review results will be presented in the form of narrative synthesis, and if sufficient studies are available and variability among the studies is low, a random effects meta-analysis will be done to quantify the result. DISCUSSION This review will synthesise evidence on the association between subthreshold depression and self-care behaviour in type 2 diabetic adults. The findings will be useful to researchers and policymakers to determine the most effective approach to overall diabetes management. The review will also identify research gaps in the current literature and provide direction for future research in this area of study. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018116373.
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Affiliation(s)
- Monika Shrestha
- School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
- Nepal Diabetic Society, Kathmandu, Nepal
| | - Amal Al-Ghareeb
- School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
| | - Fatimah Alenazi
- School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
- Qassim University, Buraydah, Kingdom of Saudi Arabia
| | - Richard Gray
- School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
- University of South Australia, Adelaide, Australia
- University of Essex, Colchester, Essex, UK
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Jaworski M, Panczyk M, Śliwczyński A, Brzozowska M, Janaszek K, Małkowski P, Gotlib J. Severe Depressive Episode with Psychotic Symptoms and Type 2 Diabetes: A 2010-2017 Longitudinal Study. Med Sci Monit 2019; 25:1760-1768. [PMID: 30846676 PMCID: PMC6419531 DOI: 10.12659/msm.913356] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND There have been few studies published on the prevalence of severe depressive episode in people with type 2 diabetes (T2DM) or its role in adherence to dietary recommendations. We examined the Polish National Health Fund (NFZ) database estimates of all medical visits from 2010 to 2017 to determine the trend and the epidemiology of severe depressive episode in T2DM. MATERIAL AND METHODS The NFZ database was used. We defined the T2DM group diagnosed with both T2DM and severe depressive episode according to the ICD-10 codes. The annual prevalence of severe depressive episode was estimated according to the T2DM diagnosis status, and the age groups were stratified into 8 groups. RESULTS Relative risk for depression (regardless of severity of symptoms) in T2DM is 1.347 [95%CI: 1.342-1.353]. The frequency trend of severe depressive episode with or without psychotic symptoms remains relatively stable. In the case of mild and moderate depressive episode, a downward trend was noted, but they are still the most frequent mood disorders diagnosed. Patients with T2DM aged 20 to 40, for whom the peak of coexistence of these illnesses was noted, are the group particularly vulnerable to depression. Depression also remains on a relatively high but stable level for patients over 60 years of age. CONCLUSIONS The coexistence of depressive episodes in T2DM is a key challenge for medicine and public health. Measures aimed at early identification of patients with T2DM prone to depression need to be taken. Creating multidisciplinary care teams in diabetes management is also necessary.
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Affiliation(s)
- Mariusz Jaworski
- Division of Teaching and Outcomes of Education, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Mariusz Panczyk
- Division of Teaching and Outcomes of Education, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Śliwczyński
- Department of Analysis and Strategy, The National Health Fund, Warsaw, Poland
| | - Melania Brzozowska
- Department of Analysis and Strategy, The National Health Fund, Warsaw, Poland
| | - Katarzyna Janaszek
- Department of Analysis and Strategy, The National Health Fund, Warsaw, Poland
| | - Piotr Małkowski
- Department of Surgical and Transplant Nursing and Extracorporeal Treatment, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Gotlib
- Division of Teaching and Outcomes of Education, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
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The Burden of Poor Mental Well-being Among Patients With Type 2 Diabetes Mellitus: Examining Health Care Resource Use and Work Productivity Loss. J Occup Environ Med 2018; 58:1121-1126. [PMID: 27820762 PMCID: PMC5084642 DOI: 10.1097/jom.0000000000000874] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objective: The aim of this study was to evaluate the association of mental well-being with outcomes among patients with type 2 diabetes mellitus (T2DM). Methods: Seven thousand eight hundred fifty-two adults with T2DM were identified from a national, Internet-based study. Mental well-being [SF-36v2 mental component summary (MCS)] was categorized as good (MCS ≥ 50), poor (40 ≤ MCS < 50), and very poor (MCS < 40). Outcomes included past 6 months of health care resource use and lost productivity (Work Productivity and Activity Impairment questionnaire). Results: Respondents with very poor/poor versus good mental well-being were more likely to visit the emergency room (27%/18% vs 11%, P < 0.001) or be hospitalized (19%/14% vs 9%, P < 0.001). Among labor force participants, those with very poor/poor versus good mental well-being experienced greater overall work impairment (43.7/26.0 vs 10.7, P < 0.001). Conclusions: Greater resource use and work productivity impairment associated with poorer mental well-being among patients with T2DM has cost implications.
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Sopjani I, Vehapi S, Gorani D, Imeri M, Vitoja S, Tahiri S. The Relation Between Depressive Symptoms and Self-Care in Patients with Diabetes Mellitus Type 2 in Kosovo. Med Arch 2018; 70:425-428. [PMID: 28210013 PMCID: PMC5292218 DOI: 10.5455/medarh.2016.70.425-428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: The depression is a significant problem in patients with diabetes. This research is the first of it’s kind conducted in the Republic of Kosovo to determine the prevalence of depression diagnosed in people with diabetes mellitus type 2 (DMT2) and interrelation between depressive symptoms and behavior of diabetes self-care (glucose monitoring, exercise, diet, and self- health care). Methods: Research was conducted in the University Clinical Center of Kosovo (UCCK), in Pristine. The sample consisted of 200 individuals. Data collection was done through structured questionnaires. HANDS (Harvard Department of Psychiatry / National Depression Screening Day Scale) questionnaire was used to assess depressive symptoms and DSMQ (The Diabetes Self-Management Questionnaire) was used to assess self-care behavior. Data analysis was run through SSPS program, version 21. Results: The results showed that the prevalence of depression in diabetic patients was 66.5% in Kosovo. Being a woman, a resident of rural areas or with low level of education, there were significant predictors and were associated with increased chance of developing the symptoms of major depression. Significant relations were found between major depression and physical activity (p<0.05). While between major depression and management of blood glucose level, dietary control and self health care, no significant correlation was found. Conclusion: This paper concluded the involvement of psychological aspect in health care plan for diabetics, in order to reduce the number of individuals affected by depression, to diagnose and to treat these individuals for a better quality of life.
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Affiliation(s)
| | | | - Daut Gorani
- Nursing Faculty, AAB College, Pristine, Kosovo
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Ausili D, Bulgheroni M, Ballatore P, Specchia C, Ajdini A, Bezze S, Di Mauro S, Genovese S. Self-care, quality of life and clinical outcomes of type 2 diabetes patients: an observational cross-sectional study. Acta Diabetol 2017; 54:1001-1008. [PMID: 28852863 DOI: 10.1007/s00592-017-1035-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 07/31/2017] [Indexed: 01/03/2023]
Abstract
AIMS To describe self-care of T2DM patients and to evaluate outcomes associated with self-care in T2DM patients. METHODS A multicentre cross-sectional study was conducted on a sample of 302 randomly selected T2DM patients. Clinical and socio-demographic data were collected by medical records. The Summary of Diabetes Self-care Activities was used to measure self-care about diet, blood testing, exercise and foot care. The EQ-5D was used to measure perceived quality of life. Multiple regression models were used to evaluate the associations between self-care and body mass index (BMI), glycated haemoglobin (HbA1c), presence of diabetes complications and quality of life (QoL). RESULTS Self-care was lower about exercise (median = 2.0) and foot care (median = 3.5) than about diet (median = 5.2) and blood testing (median = 4.5). HbA1c was associated with diet (p = 0.025), exercise (p = 0.017) and blood testing (p = 0.034). BMI was associated with exercise (p = 0.0071). Diabetes complications were associated with exercise (p = 0.031) and blood testing (p < 0.009). QoL was associated with exercise (p < 0.0001), blood testing (p = 0.032) and foot care (p = 0.013). CONCLUSIONS Self-care influences both clinical outcomes and quality of life of T2DM patients. Although exercise is more frequently associated with positive outcomes, it is particularly poor in T2DM population. Blood testing and foot care should be performed to prevent complications and not only when a health problem is already occurred. Interventions aimed to improve exercise are recommended. Further research is needed to explore barriers to exercise.
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Affiliation(s)
- Davide Ausili
- Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, 20900, Monza, Italy.
| | - Monica Bulgheroni
- Unit of Endocrinology, Diabetology and Metabolic Diseases, IRCCS MultiMedica, Sesto San Giovanni, Italy
| | | | - Claudia Specchia
- IRCCS MultiMedica Sesto San Giovanni, University of Brescia, Brescia, Italy
| | - Ajtena Ajdini
- Medical Department, Hospital ASST Sette Laghi, Varese, Italy
| | - Sabrina Bezze
- IRCCS MultiMedica, University of Milan-Bicocca, Sesto San Giovanni, Italy
| | - Stefania Di Mauro
- Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, 20900, Monza, Italy
| | - Stefano Genovese
- Unit of Endocrinology, Diabetology and Metabolic Diseases, IRCCS MultiMedica, Sesto San Giovanni, Italy
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Bazarganipour F, Taghavi SA, Allan H, Hosseini N. Facilitating and inhibiting factors related to treatment adherence in women with polycystic ovary syndrome: A qualitative study. Int J Reprod Biomed 2017. [DOI: 10.29252/ijrm.15.9.553] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Lunghi C, Zongo A, Moisan J, Grégoire JP, Guénette L. The impact of incident depression on medication adherence in patients with type 2 diabetes. DIABETES & METABOLISM 2017; 43:521-528. [PMID: 28822618 DOI: 10.1016/j.diabet.2017.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 06/09/2017] [Accepted: 07/14/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Depression has been correlated with suboptimal adherence to antidiabetic drugs (ADs). Most studies on this topic were cross-sectional; thus, the directionality of this relationship could not be established. The objective of this study was to measure the association between incident depression and AD nonadherence among newly treated patients with diabetes. METHODS We performed a population-based cohort study among new AD users using the Quebec public health insurance data. To avoid immortal time bias, we carried out depression diagnosis-time distribution matching by assigning a date of depression diagnosis to individuals without depression. Nonadherence (i.e.,<90% of days covered by≥1 AD) during the year following depression diagnosis (real or assigned date) was the outcome. Multivariate logistic regression analyses that adjusted for baseline adherence and other confounders were used to estimate the adjusted effect of depression on AD nonadherence. RESULTS Between 2000 and 2006, we identified 3,106 new AD users with a subsequent diagnosis of depression and 70,633 without depression, of which 52% and 49% became non-adherent to AD treatment, respectively. Among patients with depression, 52.0% were considered AD non-adherent in the year after depression diagnosis compared with 49.0% of matched patients without depression. Depression was associated with AD nonadherence after accounting for baseline adherence and other confounders with an adjusted odds ratio of 1.24 (95% confidence interval: 1.13-1.37). CONCLUSIONS The results suggest that depression is an independent risk factor for AD nonadherence. Patients with type 2 diabetes and depression might benefit from adherence-enhancing interventions.
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Affiliation(s)
- C Lunghi
- Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Center, Université Laval, Québec, QC, Canada
| | - A Zongo
- Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Center, Université Laval, Québec, QC, Canada
| | - J Moisan
- Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Center, Université Laval, Québec, QC, Canada
| | - J-P Grégoire
- Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Center, Université Laval, Québec, QC, Canada
| | - L Guénette
- Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Center, Université Laval, Québec, QC, Canada.
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Sex-Specific Differences in the Association Between Childhood Adversity and Cardiovascular Disease in Adulthood: Evidence From a National Cohort Study. Can J Cardiol 2017; 33:1013-1019. [DOI: 10.1016/j.cjca.2017.05.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 05/12/2017] [Accepted: 05/12/2017] [Indexed: 11/18/2022] Open
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Goudarzian AH, Bagheri Nesami M, Zamani F, Nasiri A, Beik S. Relationship between Depression and Self-care in Iranian Patients with Cancer. Asian Pac J Cancer Prev 2017; 18:101-106. [PMID: 28240016 PMCID: PMC5563084 DOI: 10.22034/apjcp.2017.18.1.101] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background: The current cross-sectional study was carried out to determine relationships between self-care and depression in patients with cancer. Materials and Methods: From October to December, 2015, 380 patients with cancer admitted to the associated university’s medical sciences hospitals (Sari, Iran), were entered into the study using non random sampling (accessible sampling). Data were collected by demographic questionnaire, Center for Epidemiological Studies Depression Scale (CES-D) and a Self-care Questionnaire. Results: Males (48.4±13±39; CI95: 46.4-50.4) were older than females (45.3±18.4; CI95:42.8-47.9). Spearman correlation analysis results showed that there was a significant negative correlation between self-care and depression (r= -0.134, P<0.05) and also a significant inverse relationship between physical (r= -0.166, P=0.001), psychological (r= -0.207, P<0.001) and emotional self-care (r= -0.179, P<0.001) with depression. Conclusions: It appears that self-care measures such as training of physical exercises, promotion of physical self-care, holding counseling sessions and psychotherapy can reduce depression levels.
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Vijayalakshmi UB, Bodi AV, Sudagani J. Biochemical and Clinical Profile in Type 2 Diabetics with Depression. J Clin Diagn Res 2016; 10:BC19-23. [PMID: 27656433 DOI: 10.7860/jcdr/2016/21624.8381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 07/13/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION There were 72 million adults with Diabetes Mellitus (DM) in 2013 in the South East Asian region of which India is a part. This figure is expected to rise to more than 123 million by 2035. Some studies have also shown that there is an increased risk of depression in subjects with Type 2 Diabetes Mellitus (T2DM). The present study is an attempt to decipher whether there is any difference in the metabolic and clinical profile between patients having T2DM with depression and without depression. AIM To study the clinical and biochemical profile of subjects with T2DM and depression and compare a non-depressed diabetic cohort on the same parameters. MATERIALS AND METHODS The cross-sectional study was conducted at a tertiary care teaching hospital in rural Andhra Pradesh. Patients with T2DM who fulfilled the inclusion and exclusion criteria and attending the outpatient clinic of the General Medicine department were the subjects of this study. The subjects with T2DM were categorized as depressed or non-depressed after administering the Patient Health Questionnare-9. Out of them 30 subjects with depression and 30 without depression were selected. Samples for blood were collected and analysed for glucose, urea, creatinine, lipid profile and glycated haemoglobin. Urine micro protein was estimated. Anthropometric measurements, blood pressure and chronic complications were recorded. RESULTS The two groups were similar on most of the socio-demographic parameters, biochemical and many of the clinical parameters like age, waist circumference, glycated haemoglobin, lipid profile and insulin use. The Chi-square test for association between the categorical variables like use of insulin, gender predilection, exercise and complications with depression were not significant. CONCLUSION The study did not show any significant difference between the two groups in terms of the biochemical and clinical profile.
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Affiliation(s)
- Udipi Badikillaya Vijayalakshmi
- Associate Professor, Department of Biochemistry, Dr Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation , Chinoutapalli, Krishna, A.P., India
| | - Akhil Venkata Bodi
- Undergraduate Medical Student, Dr Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation , Chinoutapalli, Krishna, A.P., India
| | - Jaidev Sudagani
- Consultant Endocrinologist, Santhi Endocrine and Diabetes Hospital , Vijayawada, India
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A collaborative care program for management of common mental disorders among diabetic patients in a primary healthcare setting. J Public Health (Oxf) 2016. [DOI: 10.1007/s10389-016-0722-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Islam SMS, Ferrari U, Seissler J, Niessen L, Lechner A. Association between depression and diabetes amongst adults in Bangladesh: a hospital based case-control study. J Glob Health 2016; 5:020406. [PMID: 26649173 PMCID: PMC4672835 DOI: 10.7189/jogh.05.020406] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Methods A matched case–control study was conducted among 591 consecutive patients with diabetes attending a tertiary hospital in Dhaka and 591 controls matched for age, sex and area of residence without diabetes not related with the index–case. Depression was measured using the Patient Health Questionnaire–9. Multivariate logistic regression was performed to examine the association between depression and diabetes. Results The mean age (±standard deviation) of the participants was 50.4 ± 11.4 years, with a male to female ratio of 43:57. The prevalence of depression was 45.2% and 19.8% among cases and controls, respectively. In the multivariate analysis, mild as well as moderate to severe depression were significantly associated with diabetes and independent of sociodemographic factors and co–morbidity (adjusted odds ratio (OR) = 2.0, 95% confidence interval (CI) = 1.4–2.9 and adjusted OR = 6.4, 95% CI = 3.4–12.3; P < 0.001 for both). Conclusion The high prevalence and strong association of depression in individuals with diabetes in Bangladesh suggests that depression should be routinely screened for patients with diabetes at the clinics and that management strategies adequate for resource–poor settings need to be developed. Further research to determine the pathophysiological role of depression in the development of diabetes is merited.
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Affiliation(s)
- Sheikh Mohammed Shariful Islam
- Center for Control of Chronic Diseases (CCCD), International Center for Diarrhoeal Diseases Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh ; Center for International Health (CIH), Ludwig-Maximilians Universität, Munich, Germany ; Cardiovascular Division, the George Institute for Global Health, Sydney, Australia
| | - Uta Ferrari
- Diabetes Research Group, Medical Department 4, Ludwig-Maximilians Universität, Munich, Germany
| | - Jochen Seissler
- Diabetes Research Group, Medical Department 4, Ludwig-Maximilians Universität, Munich, Germany
| | - Louis Niessen
- Centre for Applied Health Research and Delivery, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Andreas Lechner
- Diabetes Research Group, Medical Department 4, Ludwig-Maximilians Universität, Munich, Germany ; Clinical Cooperation Group Type 2 Diabetes, German Research Center for Environmental Health, Neuherberg, Germany ; Diabetes Research Group, German Center for Diabetes Research, Munich, Germany
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Pereira MG, Costa V, Oliveira D, Ferreira G, Pedras S, Sousa MR, Machado JC. Patients' and Spouses' Contribution Toward Adherence to Self-Care Behaviors in Type 2 Diabetes. Res Theory Nurs Pract 2016; 29:276-96. [PMID: 26714355 DOI: 10.1891/1541-6577.29.4.276] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This article focuses on patients' and partners' variables regarding adherence to self-care, in recently diagnosed patients with Type 2 diabetes. One hundred four patients and partners were included. Instruments answered were Family Inventory of Life Events and Changes (family stress), Family Crisis Oriented Personal Evaluation Scales (family coping), Revised Dyadic Adjustment Scale (dyadic adjustment), Multidimensional Diabetes Questionnaire (partner support) and Hospital Anxiety and Depression Scale (psychological morbidity). Results showed adherence to diet to be positively predicted by patient dyadic adjustment and patient positive support and negatively by partner depression and partner negative support. Adherence to exercise was predicted by patient's family stress and negatively by partner anxiety. Adherence to glucose monitoring was predicted by partner positive support. Psychological variables were not associated with adherence to foot care. Finally, positive partner support moderated the relationship between family stress and dyadic adjustment in patients. The results emphasize the need to treat the patient in the context of the dyad. Future research should focus on partners' specific instrumental behaviors that promote patients' self-care behaviors.
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Kim CJ, Schlenk EA, Kim DJ, Kim M, Erlen JA, Kim SE. The role of social support on the relationship of depressive symptoms to medication adherence and self-care activities in adults with type 2 diabetes. J Adv Nurs 2015; 71:2164-75. [PMID: 25976591 DOI: 10.1111/jan.12682] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2015] [Indexed: 12/22/2022]
Abstract
AIM To examine the mediating role of social support on the relationship of depressive symptoms to medication adherence and self-care activities in Korean adults. BACKGROUND Recent evidence suggests that higher levels of social support are associated with improved medication adherence and self-care activities; however, the role of social support on the relationship of depressive symptoms to medication adherence and self-care activities is less well understood. DESIGN A cross-sectional survey. METHODS The data were collected from 311 Korean adults with type 2 diabetes who were taking hypoglycaemic agents in the period 2012-2013. Depressive symptoms, social support, medication adherence and self-care activities were assessed using structured questionnaires. Multiple regression analysis with adjustment for covariates and the Sobel test were used to examine the mediating effect of social support on the relationship of depressive symptoms to medication adherence and self-care activities. RESULTS There were statistically significant differences by subgroups with and without depressive symptoms in social support, medication adherence and self-care activities of diet, physical activity and stress management. The Sobel test confirmed that social support mediated the effect of depressive symptoms on medication adherence and self-care activities of diet, physical activity and stress management. CONCLUSION The evidence from this study suggests that social support-enhancing interventions that also manage depressive symptoms may be more timely and effective than interventions that target depressive symptoms alone in promoting adherence to medication adherence and self-care activities in this population.
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Affiliation(s)
- Chun-Ja Kim
- Department of Adult Health Nursing, Ajou University College of Nursing, Suwon, Korea
| | | | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Moonsun Kim
- Ajou University College of Nursing, Suwon, Korea
| | - Judith A Erlen
- University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA
| | - Se-Eun Kim
- Department of Nursing, Koje College, Geoje, Korea
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Fiore V, Marci M, Poggi A, Giagulli VA, Licchelli B, Iacoviello M, Guastamacchia E, De Pergola G, Triggiani V. The association between diabetes and depression: a very disabling condition. Endocrine 2015; 48:14-24. [PMID: 24927794 DOI: 10.1007/s12020-014-0323-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 05/27/2014] [Indexed: 12/29/2022]
Abstract
Rates of depression are significantly increased in diabetic patients, and even more in the elderly. About 20-30% of patients with diabetes suffer from clinically relevant depressive disorders, 10% of which being affected by the major depression disorder. Moreover, people with depression seem to be more prone to develop an associated diabetes mellitus, and depression can worsen glycemic control in diabetes, with higher risk to develop complications and adverse outcomes, whereas improving depressive symptoms is generally associated with a better glycemic control. Thus, the coexistence of depression and diabetes has a negative impact on both lifestyle and quality of life, with a reduction of physical activity and an increase in the request for medical care and prescriptions, possibly increasing the healthcare costs and the susceptibility to further diseases. These negative aspects are particularly evident in the elderly, with further decrease in the mobility, worsening of disability, frailty, geriatric syndromes and increased mortality. Healthcare providers should be aware of the possible coexistence of depression and diabetes and of the related consequences, to better manage the patients affected by these two pathological conditions.
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Affiliation(s)
- Vincenzo Fiore
- Unit of Internal Medicine-Geriatrics, "S. Giovanni Evangelista" Hospital, Via Parrozzani 3, 00019, Tivoli (RM), Italy
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Reeves GC, Alhurani AS, Frazier SK, Watkins JF, Lennie TA, Moser DK. The association of comorbid diabetes mellitus and symptoms of depression with all-cause mortality and cardiac rehospitalization in patients with heart failure. BMJ Open Diabetes Res Care 2015; 3:e000077. [PMID: 26056566 PMCID: PMC4452727 DOI: 10.1136/bmjdrc-2014-000077] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 04/23/2015] [Accepted: 04/28/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND More than 22% of individuals with diabetes mellitus have concomitant heart failure (HF), and the prevalence of diabetes in those with HF is nearly triple that of individuals without HF. Comorbid depressive symptoms are common in diabetes and HF. Depressive symptoms are an independent predictor of mortality in individuals with diabetes alone, as well as those with HF alone and are a predictor of rehospitalization in those with HF. However, the association of comorbid HF, diabetes and depressive symptoms with all-cause mortality and rehospitalization for cardiac causes has not been determined. OBJECTIVE The purpose of this study was to evaluate the association of comorbid HF, diabetes and depression with all-cause mortality and rehospitalization for cardiac cause. METHOD Patients provided data at baseline about demographic and clinical variables and depressive symptoms; patients were followed for at least 2 years. Participants were divided into four groups based on the presence and absence of diabetes and depressive symptoms. Cox regression analysis was used to determine whether comorbid diabetes and depressive symptoms independently predicted all-cause mortality and cardiac rehospitalization in these patients with HF. RESULTS Patients (n=663) were primarily male (69%), white (76%), and aged 61±13 years. All-cause mortality was independently predicted by the presence of concomitant diabetes and depressive symptoms (HR 3.71; 95% CI 1.49 to 9.25; p=0.005), and depressive symptoms alone (HR 2.29; 95% CI 0.94 to 5.40; p=0.05). The presence of comorbid diabetes and depressive symptoms was also an independent predictor of cardiac rehospitalization (HR 2.36; 95% CI 1.27 to 4.39; p=0.007). CONCLUSIONS Comorbid diabetes and depressive symptoms are associated with poorer survival and rehospitalization in patients with HF; effective strategies to regularly evaluate and effectively manage these comorbid conditions are necessary to improve survival and reduce rehospitalization rates.
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Affiliation(s)
| | - Abdullah S Alhurani
- University of Kentucky, Lexington, USA
- The University of Jordan, Amman, Jordan
| | | | | | | | - Debra K Moser
- University of Kentucky, Lexington, USA
- The University of Ulster, Newtownabbey, UK
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Sumlin LL, Garcia TJ, Brown SA, Winter MA, García AA, Brown A, Cuevas HE. Depression and adherence to lifestyle changes in type 2 diabetes: a systematic review. DIABETES EDUCATOR 2014; 40:731-44. [PMID: 24939883 DOI: 10.1177/0145721714538925] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Depression affects millions of people worldwide and is prevalent among those with diabetes. The purpose of this review was to synthesize recent research on depression and adherence to dietary and physical activity recommendations in persons with type 2 diabetes (T2DM). METHODS This systematic review is a subanalysis of an NIH-funded model-testing meta-analysis. Thirteen electronic databases were searched using terms: depression, adherence, T2DM, diabetes. Selected studies: were reported in English between 2000 and 2012, focused on adults with T2DM, and measured depression and dietary and/or physical activity adherence. RESULTS Twenty-seven studies involving 7266 participants were selected; participants were 54% female and 62 years of age, on average. When reported, depression prevalence in study samples ranged from 4.5% to 74%. Six intervention studies targeted diabetes treatment, with or without depression treatment; no studies focused solely on treating depression. Twenty-one descriptive studies examined relationships between depression and diet/physical activity adherence, finding a negative association. Only 2 of the 6 intervention studies examined this relationship; findings were inconsistent. CONCLUSION Depression was associated with lower adherence to diabetes self-care, as evidenced primarily by descriptive studies; results of intervention studies were conflicting. Future research should focus on the effects of treating depression on diabetes health outcomes.
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Affiliation(s)
- Lisa L Sumlin
- School of Nursing, The University of Texas at Austin, Austin, Texas (Ms Sumlin, Dr S. Brown, Dr AA Garcia, Dr Cuevas, Ms Winter, Dr A. Brown)
| | - Theresa J Garcia
- College of Nursing & Health Sciences, Texas A&M University-Corpus Christi, USA (Dr TJ Garcia)
| | - Sharon A Brown
- School of Nursing, The University of Texas at Austin, Austin, Texas (Ms Sumlin, Dr S. Brown, Dr AA Garcia, Dr Cuevas, Ms Winter, Dr A. Brown)
| | - Mary A Winter
- School of Nursing, The University of Texas at Austin, Austin, Texas (Ms Sumlin, Dr S. Brown, Dr AA Garcia, Dr Cuevas, Ms Winter, Dr A. Brown)
| | - Alexandra A García
- School of Nursing, The University of Texas at Austin, Austin, Texas (Ms Sumlin, Dr S. Brown, Dr AA Garcia, Dr Cuevas, Ms Winter, Dr A. Brown)
| | - Adama Brown
- School of Nursing, The University of Texas at Austin, Austin, Texas (Ms Sumlin, Dr S. Brown, Dr AA Garcia, Dr Cuevas, Ms Winter, Dr A. Brown)
| | - Heather E Cuevas
- School of Nursing, The University of Texas at Austin, Austin, Texas (Ms Sumlin, Dr S. Brown, Dr AA Garcia, Dr Cuevas, Ms Winter, Dr A. Brown)
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Penckofer S, Doyle T, Byrn M, Lustman PJ. State of the science: depression and type 2 diabetes. West J Nurs Res 2014; 36:1158-82. [PMID: 24577866 DOI: 10.1177/0193945914524491] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Depression is a significant comorbid condition in diabetes. Individuals with type 2 diabetes (T2DM) are 2 times more likely to experience depression or elevated depressive symptoms compared to those without T2DM. The aims of this state of the science review were to summarize the putative links between diabetes and depression and review empirically supported treatments of depression in diabetes. Findings suggest that a bidirectional association between depression and T2DM exists and that several biological and psychosocial mediators underlie these conditions. Available data indicate that conventional treatments (antidepressant medication, cognitive behavioral therapy, and collaborative care) reduce depression and symptoms of depression; however more controlled studies and development of novel therapies are needed. Glycemic outcomes have most frequently been examined, but findings have been mixed. Self-care and adherence outcomes have been less well studied. Emerging evidence suggests that these outcomes may be important targets for future depression research in T2DM.
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Affiliation(s)
| | - Todd Doyle
- Loyola University Chicago, Maywood, IL, USA
| | - Mary Byrn
- Saint Mary's College, Notre Dame, IN, USA
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Ong WM, Chua SS, Ng CJ. Barriers and facilitators to self-monitoring of blood glucose in people with type 2 diabetes using insulin: a qualitative study. Patient Prefer Adherence 2014; 8:237-46. [PMID: 24627628 PMCID: PMC3931581 DOI: 10.2147/ppa.s57567] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Self-monitoring of blood glucose (SMBG) helps to improve glycemic control and empowerment of people with diabetes. It is particularly useful for people with diabetes who are using insulin as it facilitates insulin titration and detection of hypoglycemia. Despite this, the uptake of SMBG remains low in many countries, including Malaysia. PURPOSE This study aimed to explore the barriers and facilitators to SMBG, in people with type 2 diabetes using insulin. PATIENTS AND METHODS Qualitative methodology was employed to explore participants' experience with SMBG. Semistructured, individual in-depth interviews were conducted on people with type 2 diabetes using insulin who had practiced SMBG, in the primary care clinic of a teaching hospital in Malaysia. Participants were purposively sampled from different age groups, ethnicity, education level, and level of glycemic control (as reflected by the glycated hemoglobin [HbA1c]), to achieve maximum variation in sampling. All interviews were conducted using a topic guide and were audio-recorded, transcribed verbatim, checked, and analyzed using a thematic approach. RESULTS A total of 15 participants were interviewed, and thematic saturation was reached. The factors that influenced SMBG were mainly related to cost, participants' emotion, and the SMBG process. The barriers identified included: frustration related to high blood glucose reading; perception that SMBG was only for insulin titration; stigma; fear of needles and pain; cost of test strips and needles; inconvenience; unconducive workplace; and lack of motivation, knowledge, and self-efficacy. The facilitators were: experiencing hypoglycemic symptoms; desire to see the effects of dietary changes; desire to please the physician; and family motivation. CONCLUSION Participants' perceptions of the purpose of SMBG, the emotions associated with SMBG, and the complexity, pain, and cost related to SMBG as well as personal and family motivation are the key factors that health care providers must consider when advising people with diabetes on SMBG.
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Affiliation(s)
- Woon May Ong
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Siew Siang Chua
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chirk Jenn Ng
- University of Malaya Primary Care Research Group (UMPCRG), Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Sweileh WM, Abu-Hadeed HM, Al-Jabi SW, Zyoud SH. Prevalence of depression among people with type 2 diabetes mellitus: a cross sectional study in Palestine. BMC Public Health 2014; 14:163. [PMID: 24524353 PMCID: PMC3929146 DOI: 10.1186/1471-2458-14-163] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 02/11/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Diabetes mellitus is a common chronic metabolic disorder and one of the main causes of death in Palestine. Palestinians are continuously living under stressful economic and military conditions which make them psychologically vulnerable. The purpose of this study was to investigate the prevalence of depression among type II diabetic patients and to examine the relationship between depression and socio-demographic factors, clinical factors, and glycemic control. METHODS This was a cross-sectional study at Al-Makhfiah primary healthcare center, Nablus, Palestine. Two hundred and ninety-four patients were surveyed for the presence of depressive symptoms using Beck Depression Inventory (BDI-II) scale. Patients' records were reviewed to obtain data pertaining to age, sex, marital status, Body Mass Index (BMI), level of education, smoking status, duration of diabetes mellitus, glycemic control using HbA1C test, use of insulin, and presence of additional illnesses. Patients' medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). RESULTS One hundred and sixty four patients (55.8%) of the total sample were females and 216 (73.5%) were < 65 years old. One hundred and twenty patients (40.2%) scored ≥ 16 on BDI-II scale. Statistical significant association was found between high BDI-II score (≥ 16) and female gender, low educational level, having no current job, having multiple additional illnesses, low medication adherence and obesity (BMI ≥ 30 kg/m2). No significant association between BDI score and glycemic control, duration of diabetes, and other socio-demographic factors was found. Multivatriate analysis showed that low educational level, having no current job, having multiple additional illnesses and low medication adherence were significantly associated with high BDI-II scores. CONCLUSION Prevalence of depression found in our study was higher than that reported in other countries. Although 40% of the screened patients were potential cases of depression, none were being treated with anti-depressants. Psychosocial assessment should be part of routine clinical evaluation of these patients at primary healthcare clinics to improve quality of life and decrease adverse outcomes among diabetic patients.
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Affiliation(s)
- Waleed M Sweileh
- Department of Pharmacology/ Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | | | - Samah W Al-Jabi
- Department of Clinical and Comunity Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Sa’ed H Zyoud
- Department of Pharmacology/ Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Mathew R, Gucciardi E, De Melo M, Barata P. Self-management experiences among men and women with type 2 diabetes mellitus: a qualitative analysis. BMC FAMILY PRACTICE 2012; 13:122. [PMID: 23249410 PMCID: PMC3538503 DOI: 10.1186/1471-2296-13-122] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 12/05/2012] [Indexed: 05/26/2023]
Abstract
Background The purpose of this study is to better understand differences in diabetes self-management, specifically needs, barriers and challenges among men and women living with type 2 diabetes mellitus (T2DM). Methods 35 participants were recruited from a diabetes education center (DEC) in Toronto, Canada. Five focus groups and nine individual interviews were conducted to explore men and women's diabetes self-management experiences. Results The average age of participants was 57 years and just over half (51.4%) were female. Analyses revealed five themes: disclosure and identity as a person living with diabetes; self-monitoring of blood glucose (SMBG); diet struggles across varying contexts; utilization of diabetes resources; and social support. Women disclosed their diabetes more readily and integrated management into their daily lives, whereas men were more reluctant to tell friends and family about their diabetes and were less observant of self-management practices in social settings. Men focused on practical aspects of SMBG and experimented with various aspects of management to reduce reliance on medications whereas women focused on affective components of SMBG. Women restricted foods from their diets perceived as prohibited whereas many men moderated their intake of perceived unhealthy foods, except in social situations. Women used socially interactive resources, like education classes and support groups whereas men relied more on self-directed learning but also described wanting more guidance to help navigate the healthcare system. Finally, men and women reported wanting physician support for both affective and practical aspects of self-management. Conclusions Our findings highlight the differences in needs and challenges of diabetes self-management among men and women, which may inform gender-sensitive diabetes, care, counseling and support.
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Affiliation(s)
- Rebecca Mathew
- Northern Ontario School of Medicine, East Campus, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario, P3E 2C6, Canada.
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Personal and Cultural Influences on Diabetes Self-Care Behaviors Among Older Hispanics Born in the U.S. and Mexico. J Immigr Minor Health 2012; 14:1052-62. [DOI: 10.1007/s10903-012-9639-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
With the changing health care environment, prevalence of chronic health conditions, and burgeoning challenges of health literacy, obesity, and homelessness, self-management support provides an opportunity for clinicians to enhance effectiveness and, at the same time, to engage patients to participate in managing their own personal care. This article reviews the differences between patient education and self-management and describes easy-to-use strategies that foster patient self-management and can be used by health care providers in the medical setting. It also highlights the importance of linking patients to nonmedical programs and services in the community.
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Affiliation(s)
- Patrick T McGowan
- Centre on Aging, University of Victoria, Victoria, British Columbia, Canada.
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Shin JK, Chiu YL, Choi S, Cho S, Bang H. Serious psychological distress, health risk behaviors, and diabetes care among adults with type 2 diabetes: the California Health Interview Survey 2007. Diabetes Res Clin Pract 2012; 95:406-14. [PMID: 22169109 DOI: 10.1016/j.diabres.2011.10.043] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2011] [Revised: 10/25/2011] [Accepted: 10/31/2011] [Indexed: 11/21/2022]
Abstract
AIMS To examine the association between type 2 diabetes and serious psychological distress (SPD) and to assess if SPD was an independent risk factor for health risk behaviors and diabetes care among adults with diabetes. METHODS Cross-sectional analysis was performed using the 2007 California Health Interview Survey with adults in California. Multiple logistic models were used to examine the associations between the multiple risk and outcome factors. RESULTS Of the participants, 6.9% of adults had diagnoses of type 2 diabetes. SPD was present in 7.0% of adults with diabetes but only in 3.5% of adults without diabetes. Multiple logistic regression analysis revealed that participants with diabetes were significantly more likely than those without diabetes to experience SPD (OR=1.81; 95% CI=[1.3-2.5], p=0.0002), adjusting for other factors. In addition, participants with diabetes and SPD were more likely to report insufficient physical activity and more current cigarette smoking than participants without SPD. SPD among participants with diabetes, however, did not significantly affect good diabetes care. CONCLUSIONS The findings suggest that adults with diabetes are more likely to experience SPD than adults without diabetes. Further research is needed to explore the underlying mechanisms for this association among adults with both diabetes and SPD.
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Affiliation(s)
- Jinah K Shin
- Psychiatric Department at Elmhurst Hospital Center, 79-01 Broadway, Elmhurst, NY 11373, USA.
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Roy T, Lloyd CE, Pouwer F, Holt RIG, Sartorius N. Screening tools used for measuring depression among people with Type 1 and Type 2 diabetes: a systematic review. Diabet Med 2012; 29:164-75. [PMID: 21824180 DOI: 10.1111/j.1464-5491.2011.03401.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Depression is common in patients with Type 1 or Type 2 diabetes, has a strong negative impact on the quality of life of patients and is associated with poor outcomes and higher mortality rates. Several guidelines encourage screening of patients with diabetes for depression. It is unclear which depression screening tools are currently being used in people with diabetes and which are most appropriate. METHODS A systematic review was conducted to examine which depression screening instruments are currently being used in diabetes research, and the operating characteristics of these tools in diabetes populations. Literature searches for the period January 1970 to October 2010 were conducted using MEDLINE, PSYCH-INFO, ASSIA, SCOPUS, ACADEMIC SEARCH COMPLETE, CINAHL and SCIENCE DIRECT. RESULTS Data are presented for the 234 published studies that were examined. The Beck Depression Inventory and the Centre for Epidemiologic Studies Depression Scale were the most popular screening tools (used in 24% and 21% of studies). Information on the cultural applicability of screening tools was mostly unavailable and, where reported, included only details of the language translation process. A small number of studies reported reliability data, most of which showed moderate-good sensitivity and specificity but a high rate of false positives. CONCLUSIONS Although a range of depression screening tools have been used in research, there remains few data on their reliability and validity. Information on the cultural applicability of these instruments is even scantier. Further research is required in order to determine the suitability of screening tools for use in clinical practice and to address the increasing problem of co-morbid diabetes and depression.
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Affiliation(s)
- T Roy
- Division of Social Research in Medicines and Health, University of Nottingham, Nottingham Faculty of Health and Social Care, The Open University, Milton Keynes, UK
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Park H, Kim MT. Impact of social role strain, depression, social support and age on diabetes self-efficacy in Korean women with type 2 diabetes. J Cardiovasc Nurs 2012; 27:76-83. [PMID: 21558865 PMCID: PMC4512290 DOI: 10.1097/jcn.0b013e318214d9d9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study describes levels of role strain, diabetes mellitus (DM)-related self-efficacy, depression, and social support in middle-aged Korean women with type 2 DM. Using a cross-sectional correlational survey design, we examined the relationships among these constructs in a purposive sample of 154 Korean women (40-65 years old) residing in Cheon-An, a midsized city in South Korea, who had had a diagnosis of type 2 DM for 6 or more months. Our findings indicated that significant numbers of these women are experiencing significant role strain (52.43 [SD, 8.81]) and are at risk for clinical depression (30%). In bivariate analysis, the level of role strain was negatively associated with diabetes self-efficacy (r = -0.27, P < .01), whereas social support was positively associated with diabetes self-efficacy (r = 0.22, P < .05). A multivariate analysis confirmed that social role strain (β = -.33, P = .00), social support (β = 0.19, P = .05), and age (β = 0.19 P = .03) were statistically significant predictors of DM-related self-efficacy. These findings highlight the importance of social role strain in managing DM and point to the need for appropriate interventions that incorporate the ways to relieve the role strain experienced by this highly vulnerable population.
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Affiliation(s)
- Hyunjeong Park
- College of Nursing, The Catholic University of Korea, Seoul, Korea.
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Min LJ, Drury VB, Taylor BJ. The experiences of and meaning for women living and coping with type 2 diabetes: a systematic review of qualitative evidence. ACTA ACUST UNITED AC 2012; 10:2998-3047. [DOI: 10.11124/jbisrir-2012-24] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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So ES, Chin YR, Lee IS. Relationship Between Health-related Behavioral and Psychological Factors and Cardiovascular and Cerebrovascular Diseases Comorbidity Among Korean Adults With Diabetes. Asian Nurs Res (Korean Soc Nurs Sci) 2011; 5:204-9. [PMID: 25030521 DOI: 10.1016/j.anr.2011.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 11/18/2011] [Accepted: 11/21/2011] [Indexed: 10/14/2022] Open
Abstract
PURPOSE This study aims to explore the relationships between health-related behavioral and psychological factors and cardiovascular and cerebrovascular diseases (CCVD) comorbidities among Korean adults with diabetes mellitus (DM). METHODS Data included in the Fourth Korean National Health and Nutrition Examination Survey were used. This study compared three groups: those diagnosed with DM only, DM and hypertension, DM, hypertension and CCVD using multinomial logistic regression analyses and the classification and regression tree (CART) model. RESULTS Weight control (OR = 4.01) and depression (OR = 2.37) are related with increased odds of having hypertension and CCVD comorbidity in those with DM. The CART model suggested that the high prevalence risk groups for hypertension or CCVD comorbidities were diabetic adults aged between 51 and 69 with a body mass index of 25 and above and those aged 70 and above. CONCLUSION For effective control of CCVD comorbidities among diabetic Korean adults, psychological support for depression and weight control need to be prioritized when managing DM. Weight control intervention needs to be reinforced for DM patients aged between 51 and 69 and that even if BMI is below 25, the occurrence of comorbidities needs to be carefully monitored for DM patients aged 70 or older.
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Affiliation(s)
- Eun Sun So
- Suwon Women's College, Suwon, South Korea
| | - Young Ran Chin
- Korea Health Industry Development Institute, Chungcheongbuk-do, South Korea
| | - In Sook Lee
- College of Nursing, Seoul National University, Seoul, South Korea
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Al-Amer RM, Sobeh MM, Zayed AA, Al-Domi HA. Depression among adults with diabetes in Jordan: risk factors and relationship to blood sugar control. J Diabetes Complications 2011; 25:247-52. [PMID: 21601482 DOI: 10.1016/j.jdiacomp.2011.03.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Revised: 02/18/2011] [Accepted: 03/08/2011] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aims of this study were to estimate the prevalence of undiagnosed depression among adults with diabetes mellitus in Jordan and to determine the factors that may indicate the presence of depression and to examine the relationship between depression and blood sugar control among Jordanian subjects with diabetes. METHODS A systemic random sample of 649 type 1 and type 2 diabetic patients aged 18-75 years was selected during the period from July 2009 to January 2010. A prestructured questionnaire was used for collecting the information about sociodemographic data and clinical characteristics. Depression was evaluated using the Patients' Health Questionnaire-8 (PHQ-8). A PHQ-8 score ≥10 has been recommended as a cutoff point for depression. Self-care management behaviors and barrier to adherence were collected. Weights and heights were measured. Glycated hemoglobin was abstracted from each patient directly after the interview. RESULT Of the 649, 128 (19.7) have depression according to the PHQ-8 scores. According to the multivariate analysis, females are more likely to develop depression than males with [odds ratio (OR), 1.91; P=001] and low-educated people versus educated people (OR, 3.09; P≤.002). Being on insulin treatment also has a significant association with depression (OR, 3.31; P=.001). Not following eating plans as recommended by dietitians, lacking self-monitoring blood glucose and increased barriers to adherence scale scores were also associated with depression among the subjects with diabetes. CONCLUSION The prevalence of depression among Jordanian subjects with type 1 and type 2 diabetes is high compared with some developed countries. This was associated with gender, educational level, insulin treatment, low self-management behaviors and increased barriers to adherence. This result shows the urgent need to include the routine screening of depression during outpatient visit, which might help prevention, early detection and management of depression.
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Affiliation(s)
- Rasmieh M Al-Amer
- Department of Community Nursing, Faculty of Nursing, The University of Jordan, Amman, Jordan.
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Khamseh ME, Baradaran HR, Javanbakht A, Mirghorbani M, Yadollahi Z, Malek M. Comparison of the CES-D and PHQ-9 depression scales in people with type 2 diabetes in Tehran, Iran. BMC Psychiatry 2011; 11:61. [PMID: 21496289 PMCID: PMC3102614 DOI: 10.1186/1471-244x-11-61] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 04/16/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The quality of life in patients with various chronic disorders, including diabetes has been directly affected by depression. Depression makes patients less likely to manage their self-care regimens. Accurate assessment of depression in diabetic populations is important to the treatment of depression in this group and may improve diabetes management. To our best knowledge, there are few studies that have looked for utilizing questionnaires in screening for depression among patients with diabetes in Iran. Therefore the aim of this study was to assess the efficacy and accuracy of the Center for Epidemiological Studies Depression (CES-D) scale and the Patient Health Questionnaire-9 (PHQ-9), in comparison with clinical interview in people with type 2 diabetes. METHODS Outpatients who attended diabetes clinics at IEM were recruited on a consecutive basis between February 2009 and July 2009. Inclusion criteria included patients with type 2 diabetes who could fluently read and speak Persian, had no severe diabetes complications and no history of psychological disorders. The history of psychological disorders was ascertained through patients' medical files, taking history of any medications in this regard. The study design was explained to all patients and informed consent was obtained. Volunteer patients completed the Persian version of the questionnaires (CES-D and PHQ-9) and a psychiatrist interviewed them based on Structured Clinical Interview (SCID) for DSM-IV criteria. RESULTS Of the 185 patients, 43.2% were diagnosed as having Major Depressive Disorder (MDD) based on the clinical interview, 47.6% with PHQ-9 and 61.62% with CES-D. The Area Under the Curve (AUC) for the total score of PHQ-9 was 0.829 ± 0.30. A cut-off score for PHQ-9 of ≥ 13 provided an optimal balance between sensitivity (73.80%) and specificity (76.20%). For CES-D the AUC for the total score was 0.861 ± 0.029. Optimal balance between sensitivity (78.80%) and specificity (77.1%) was provided at cut-off score of ≥ 23. CONCLUSIONS It could be concluded that the PHQ-9 and CES-D perform well as screening instruments, but in diagnosing major depressive disorder, a formal diagnostic process following the PHQ-9 and also the CES-D remains essential.
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Affiliation(s)
- Mohammad E Khamseh
- Endocrine Research Center (Firoozgar), Institute of Endocrinology and Metabolism, Tehran University of Medical Sciences, Iran
| | - Hamid R Baradaran
- Endocrine Research Center (Firoozgar), Institute of Endocrinology and Metabolism, Tehran University of Medical Sciences, Iran
| | - Anna Javanbakht
- Endocrine Research Center (Firoozgar), Institute of Endocrinology and Metabolism, Tehran University of Medical Sciences, Iran
| | - Maryam Mirghorbani
- Endocrine Research Center (Firoozgar), Institute of Endocrinology and Metabolism, Tehran University of Medical Sciences, Iran
| | - Zahra Yadollahi
- Tehran Psychiatry Institute, Tehran University of Medical Sciences, Iran
| | - Mojtaba Malek
- Endocrine Research Center (Firoozgar), Institute of Endocrinology and Metabolism, Tehran University of Medical Sciences, Iran
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Chen HY, Ruppert K, Charron-Prochownik D, Noullet WV, Zgibor JC. Effects of depression and antidepressant use on goal setting and barrier identification among patients with type 2 diabetes. DIABETES EDUCATOR 2011; 37:370-80. [PMID: 21460104 DOI: 10.1177/0145721711400662] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study was to examine the effects of depression and antidepressant use on goal setting and barrier identification in patients with type 2 diabetes. METHODS In a large diabetes education network, 778 patients with type 2 diabetes were enrolled in the American Association of Diabetes Educators (AADE) Outcomes System as part of their routine diabetes education between 2005 and 2008. Self-reported depression, 7 self-identified behavior change goals, and 13 barriers to diabetes self-care were collected from the Diabetes Self-Management Assessment Report Tool (D-SMART(®)); antidepressant use was documented from the Diabetes Educator Tool (D-ET(®)). Multiple linear regression was used to evaluate the effects of depression or antidepressant use on the number of goals or the number of barriers while controlling for relevant covariates. RESULTS Among 778 patients (507 nondepressed, 181 depressed with antidepressant use, 90 depressed without antidepressant use), median age was 58, 60.9% were female, and 85.9% were Caucasian. Patients with and without depression had a similar number of self-identified behavior change goals, whereas patients with depression had 1 additional barrier to diabetes self-care compared with those without depression. In the depressed subgroup, antidepressant use had no association with the number of goals that the subjects set or the number of barriers they identified. CONCLUSIONS Among patients with type 2 diabetes, depression was associated with a slightly greater number of barriers, which may support the importance of depression screening and depression treatment in patients with diabetes.
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Affiliation(s)
- Hsiang-Yu Chen
- The Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania (Ms Chen, Dr Ruppert, Mr Noullet, Dr Zgibor)
| | - Kristine Ruppert
- The Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania (Ms Chen, Dr Ruppert, Mr Noullet, Dr Zgibor)
| | | | - William V Noullet
- The Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania (Ms Chen, Dr Ruppert, Mr Noullet, Dr Zgibor)
| | - Janice C Zgibor
- The Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania (Ms Chen, Dr Ruppert, Mr Noullet, Dr Zgibor)
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Wong ELY, Woo J, Hui E, Chan C, Chan WLS, Cheung AWL. Primary care for diabetes mellitus: perspective from older patients. Patient Prefer Adherence 2011; 5:491-8. [PMID: 22003287 PMCID: PMC3191926 DOI: 10.2147/ppa.s18687] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Care of diabetes mellitus in the elderly requires an additional perspective to take into account impaired cognitive function, physical function, low level of education, and difficulty making lifestyle changes. Existing services tend to be driven by the views of tertiary and secondary care staff, rather than those of primary care staff and elderly patients. This study aimed to explore the attitudes and preferences of elderly patients with diabetes mellitus towards primary care (clinical care and community program). METHOD Elderly patients with diabetes mellitus aged 60 years or above were recruited from governmental diabetes mellitus clinics and diabetes mellitus specific community centers. Three focus group discussions of 14 diabetic elderly patients were conducted and their perspectives on the new service model were assessed. Participants were interviewed according to an open-ended discussion guide which includes the following items: comments on existing clinic follow up and community program, motivation for joining the community program, and suggestions on further clinical services and community service program development. RESULTS Incapability of the current health service to address their special needs was a common concern in three focus group discussions. The majority highlighted the benefits of the new service program, that is, self-care knowledge and skill, attitudes to living with diabetes mellitus, and supportive network. Key facilitators included experiential learning, a group discussion platform, and goal setting with patients. CONCLUSIONS This study is the first qualitative study to explore the views of elderly diabetic patients' on their self-care needs. Elderly people with diabetes mellitus in this study identified bad experiences of clinical follow-up; benefit from the community program; and recommendations for the future development of primary care. Study findings revealed a number of discrepancies between elderly diabetic patients' needs and existing health services in Hong Kong. The study findings provide health practitioners, researchers and educators with an additional perspective on the provision of quality of care for elderly diabetic patients in the community.
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Affiliation(s)
- Eliza Lai Yi Wong
- School of Public Health and Primary Care, The Chinese University of Hong Kong
- Correspondence: Eliza Lai Yi Wong, 2/F, School of Public Health Building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, People’s Republic of China, Tel +852 2252 8772, Fax +852 2606 3500, Email
| | - Jean Woo
- School of Public Health and Primary Care, Division of Geriatrics, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong
| | - Elsie Hui
- Medical and Geriatric Unit, Shatin Hospital, HK SAR, Hong Kong, People’s Republic of China
| | - Carrie Chan
- School of Public Health and Primary Care, Division of Geriatrics, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong
| | - Wayne LS Chan
- School of Public Health and Primary Care, Division of Geriatrics, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong
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Giddings A. Treatment Interruptions in Radiation Therapy for Head-and-Neck Cancer: Rates and Causes. J Med Imaging Radiat Sci 2010; 41:222-229. [PMID: 31051883 DOI: 10.1016/j.jmir.2010.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Revised: 08/12/2010] [Accepted: 08/18/2010] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND PURPOSE Extending the period over which a course of radiation therapy is delivered can have detrimental effects on treatment success. This is especially true for fast growing tumors of the head-and-neck region. The goal of this study was to establish the rates and causes of treatment interruptions for head-and-neck patients at the Vancouver Cancer Centre of the BC Cancer Agency, and to explore the link between emotional distress and missed appointments. METHODS Head-and-neck patients who had missed treatments other than public holidays were identified using the Oncology Reporting System. The charts of these patients were pulled and examined for cause of treatment interruption. The Psychosocial Screen for Cancer (PSSCAN) found in these patients' charts was used to establish anxiety and depression levels. A random sample of PSSCANs from the charts of patients who had not missed appointments was recorded for comparison. RESULTS Of the 471 head-and-neck patients included in our analysis, 74% had interruptions in treatment. Gaps of greater than three days were present in 11% of treatment courses. The most common cause of treatment breaks was statutory holidays, responsible for 69% of interruptions. The anxiety and depression scores of patients who had missed appointments for reasons other than holidays were not significantly higher than patients who had not missed appointments. CONCLUSION Rates of treatment time extension in Vancouver were higher than expected, given rates reported from other parts of the world. Policies aimed at reducing or compensating for treatment interruptions have been successful elsewhere, and could also be instituted here. Although many published studies have shown emotional distress can lead to noncompliance in health care, this link was not found here. Several weaknesses in our study design may have contributed to the lack of correlation between anxiety and depression and missed appointments.
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Affiliation(s)
- Alison Giddings
- Vancouver Cancer Centre, BC Cancer Agency, Vancouver, British Columbia, Canada.
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The effect of major depression on preventive care and quality of life among adults with diabetes. Gen Hosp Psychiatry 2010; 32:563-9. [PMID: 21112446 DOI: 10.1016/j.genhosppsych.2010.08.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2010] [Revised: 08/06/2010] [Accepted: 08/07/2010] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To examine the association between major depression and preventive care practices and quality-of-life indices among adults with diabetes. METHODS Data from 16,754 participants with diabetes in the 2006 Behavioral Risk Factor Surveillance Survey were examined. Multiple logistic regression was used to assess the independent association between the presence of major depression and a range of (1) preventive care behaviors and (2) quality-of-life indices, after accounting for relevant covariates. RESULTS With regard to preventive care practices, women with major depression were less likely to have received a mammogram in the past 2 years [OR 0.60 (95% CI 0.45-0.79) for women age 40 years and older and OR 0.52 (95% CI 0.37-0.71) for women age 50 and older] relative to their counterparts without major depression. With regard to quality-of-life indices, individuals with major depression were less likely to perceive their health as good [OR 0.24 (95% CI 0.19-0.31)], to report being satisfied with life [OR 0.10 (95% CI 0.07-0.14)] and to report receiving needed social support [OR 0.29 (95% CI 0.22-0.38)] relative to individuals without major depression. Individuals with major depression were also more likely to report one or more poor physical and poor mental health days in the past 30 days [OR 4.36 (95% CI 3.33-5.72) and OR 9.77 (95% CI 7.81-12.22), respectively] than those without major depression. CONCLUSIONS Major depression in adults with diabetes is associated with decreases in a wide range of quality-of-life indices as well as preventive self-care practices that were not entirely limited to diabetes-specific disease management.
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Kluding PM, Singh R, Goetz J, Rucker J, Bracciano S, Curry N. Feasibility and effectiveness of a pilot health promotion program for adults with type 2 diabetes: lessons learned. DIABETES EDUCATOR 2010; 36:595-602. [PMID: 20530663 DOI: 10.1177/0145721710370718] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE The purpose of this pilot study was to assess the feasibility and effectiveness of an intense health promotion program in older adults with diabetes. The program combined individually prescribed and supervised exercise with nutrition and education programs on glycemic control and aerobic fitness. METHODS Various recruitment and retention strategies were analyzed for effectiveness. Out of 28 potential subjects assessed for eligibility, 6 subjects with type 2 diabetes (2 male and 4 female; all white; age, 60.2 +/- 4.7 years) participated in the 10-week intervention. Aerobic and resistance exercise was performed on alternate days (3-4 days per week), with individualized nutrition counseling and diabetes health education sessions once weekly. The primary outcome measures were aerobic fitness and glycemic control (A1C), and secondary outcome measures included body mass index (BMI), self-efficacy, and symptoms of neuropathy. Changes in outcomes were assessed using descriptive statistics and paired t test analysis (alpha = .05). RESULTS Following the intervention, subjects had improvements that approached significance in A1C and pain, with significant improvements in self-efficacy. CONCLUSIONS A systematic approach to analysis of feasibility revealed issues with recruitment and retention that would need to be addressed for future studies or clinical implementation of this program. However, for the subset of subjects who did complete the intervention, adherence was excellent, and satisfaction with the program was confirmed by exit interview comments. Following participation in this pilot health promotion program, subjects had meaningful improvements in glycemic control, pain, and self-efficacy.
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Affiliation(s)
- Patricia M Kluding
- The Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas (Dr Kluding, Ms Singh, Mr Rucker, Dr Bracciano, Dr Curry)
| | - Rupali Singh
- The Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas (Dr Kluding, Ms Singh, Mr Rucker, Dr Bracciano, Dr Curry)
| | - Jeanine Goetz
- The General Clinical Research Center and Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas (Dr Goetz)
| | - Jason Rucker
- The Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas (Dr Kluding, Ms Singh, Mr Rucker, Dr Bracciano, Dr Curry)
| | - Sarah Bracciano
- The Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas (Dr Kluding, Ms Singh, Mr Rucker, Dr Bracciano, Dr Curry)
| | - Natasha Curry
- The Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas (Dr Kluding, Ms Singh, Mr Rucker, Dr Bracciano, Dr Curry)
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Bell RA, Andrews JS, Arcury TA, Snively BM, Golden SL, Quandt SA. Depressive symptoms and diabetes self-management among rural older adults. Am J Health Behav 2010; 34:36-44. [PMID: 19663750 PMCID: PMC2726973 DOI: 10.5993/ajhb.34.1.5] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To assess the association of depressive symptoms with diabetes self-management regimens among older adults with type 2 diabetes in a rural, ethnically diverse community. METHODS Data from 696 rural older African Americans, American Indians, and whites were used to assess depressive symptoms (modified CES-D) and diabetes self-management (physical activity, blood glucose self-monitoring, self foot checks, following a healthful eating plan, and medication adherence). RESULTS In bivariate analyses, high CES-D scores were associated with decreased adherence to a healthful eating plan and physical activity and increased foot checks; the latter 2 remained significant in multivariate analyses. CONCLUSIONS Older adults with diabetes and depression are less likely to adhere to self-management, increasing their risk of complications.
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Affiliation(s)
- Ronny A. Bell
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1063, (336) 716-9736 (phone), (336) 713-4300 (fax)
| | - Jeanette S. Andrews
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1063, (336) 716-0453 (phone), (336) 713-5308 (fax)
| | - Thomas A. Arcury
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, (336) 716-9438 (phone), (336) 716-3206 (fax)
| | - Beverly M. Snively
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1063, (336) 713-0030 (phone), (336) 713-5308 (fax)
| | - Shannon L. Golden
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1063, (336) 716-9714 (phone), (336) 713-4228 (fax)
| | - Sara A. Quandt
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1063, (336) 716-6015 (phone), (336) 713-4157 (fax)
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Cobden DS, Niessen LW, Barr CE, Rutten FFH, Redekop WK. Relationships among self-management, patient perceptions of care, and health economic outcomes for decision-making and clinical practice in type 2 diabetes. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2010; 13:138-147. [PMID: 19695005 DOI: 10.1111/j.1524-4733.2009.00587.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES Type 2 diabetes (T2D) treatment involves complex interactions between biological, psychological, and behavioral factors of care, requiring multifaceted efforts in clinical practice and disease management to reduce health and economic burdens. We aimed to quantify correlations among these factors and characterize their level of inclusion in economic analyses that are part of informed medical decision-making. METHODS A comprehensive, stepwise systematic literature review was performed on published articles dated 1993 to 2008 using medical subject heading and keyword searches in electronic reference libraries. Data were collected using standardized techniques and were analyzed descriptively. RESULTS A total of 97 articles fulfilling all inclusion criteria were reviewed, including 16 on economic models (17% of articles). Most studies were retrospective (41 of 97; 42%) and from managed care perspectives (66%). Oral antidiabetic drugs were a central focus, appearing in 83% of studies. Patient behaviors, particularly medication adherence and persistence in real-world settings, are well researched (n=65) and may influence diabetes outcomes, cardiovascular risk, mortality rates, and treatment-specific resource use (e.g., hospitalizations) and costs (<or=$3400 annually per patient). Nevertheless, they are absent from current economic models. CONCLUSIONS Strong correlations exist between patient behaviors, perspectives of care, health outcomes, and costs in T2D. Enhancing their inclusion in pharmacoeconomic modeling, notably the influence on clinical effectiveness of variation in self-management between treatments, should ultimately lead to more accurate estimates of comparative cost-effectiveness, and thereby improve value-based resource allocation and patient access to appropriate therapy.
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Affiliation(s)
- David S Cobden
- Department of Health Policy & Management, Section of Health Economics-Medical Technology Assessment (HE-MTA), Erasmus MC, Erasmus University Rotterdam, The Netherlands.
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Egede LE, Ellis C, Grubaugh AL. The effect of depression on self-care behaviors and quality of care in a national sample of adults with diabetes. Gen Hosp Psychiatry 2009; 31:422-7. [PMID: 19703635 DOI: 10.1016/j.genhosppsych.2009.06.007] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2009] [Revised: 06/23/2009] [Accepted: 06/24/2009] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To examine the effect of minor and major depression on self-care behaviors and quality of care among adults with diabetes. METHODS Data from 16,754 participants with diabetes in the 2006 Behavioral Risk Factor Surveillance Survey were examined. Multiple logistic regression was used to assess the independent association between depression status and indices of (1) self-care behaviors and (2) quality of diabetes care received, after accounting for confounders. RESULTS Individuals with minor (OR 0.69, 95% CI 0.57-0.84) and major (OR 0.50, 95% CI 0.39-0.64) depression were less likely to engage in leisure-time physical activity. Individuals with minor (OR 1.51, 95% CI 1.18-1.94) and major (OR 1.66, 95% CI 1.28-2.15) depression were more likely to be current smokers. With regard to quality of care, individuals with minor (OR 0.81, 95% CI 0.66-0.99) and major (OR 0.70, 95% CI 0.54-0.89) depression were less likely to receive an annual dilated eye exam. Additionally, individuals with minor (OR 0.79, 95% CI 0.65-0.95), but not major (OR 0.85, 95% CI 0.67-1.09) depression, were less likely to receive a flu shot in the past 12 months. CONCLUSIONS In adults with diabetes, both minor and major depression are associated with decreased self-care behavior and quality of care.
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Affiliation(s)
- Leonard E Egede
- Department of Medicine, Center for Health Disparities Research, Medical University of South Carolina, Charleston, SC 29425, USA.
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Yang J, Li S, Zheng Y. Predictors of depression in Chinese community-dwelling people with type 2 diabetes. J Clin Nurs 2009; 18:1295-304. [PMID: 19413557 DOI: 10.1111/j.1365-2702.2008.02703.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS To examine levels of perceived social support and depression and to identify the related factors and predictors of depression among Chinese community-dwelling people with type 2 diabetes. BACKGROUND People with type 2 diabetes have a high risk for depression. Depression is a serious issue that leads to poor metabolic control and increased health care costs. However, little is known about the factors contributing to depression in Chinese people with type 2 diabetes. DESIGN A cross-sectional, descriptive correlation design was used. METHODS A convenient sample consisting of 148 people with type 2 diabetes participated. Personal information questionnaire was used to obtain socio-demographic characteristics; Zung Self-Rating Depression Scale and Multidimensional Scale of Perceived Social Support were used to measure depression and perceived social support, respectively. Spearman's correlation and Stepwise multiple regression analysis were used in data analysis. RESULTS The mean index score for depression was 46.53 and 39.2% of the subjects reported depression. The mean score for perceived social support was 5.24. Age, education level, marital status, monthly family income, living status, work status, regular exercise, duration of diabetes, diabetic complications, other chronic diseases and perceived social support were significantly correlated with depression. The best predictors of depression were perceived social support, duration of diabetes, regular exercise, work status and other chronic diseases. CONCLUSIONS Depression was common in people with type 2 diabetes. The people who had lower levels of perceived social support, longer diabetic duration, did not exercise regularly, were unemployed or retired and had other chronic diseases were more likely to report depression. RELEVANCE TO CLINICAL PRACTICE Nurses working in communities should assist people with type 2 diabetes in earlier detecting and treating their depression. Nurses should also design practical interventions to decrease depressive symptoms of those people through improving their diabetic conditions and perceived social support.
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Affiliation(s)
- Juan Yang
- Nursing Faculty, Hunan Traditional Chinese Medical College, Zhuzhou, China.
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Riley AA, McEntee ML, Gerson L, Dennison CR. Depression as a Comorbidity to Diabetes: Implications for Management. J Nurse Pract 2009. [DOI: 10.1016/j.nurpra.2009.03.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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