1
|
Nam HJ, Yoon JY. Pathways linking health literacy to self-care in diabetic patients with physical disabilities: A moderated mediation model. PLoS One 2024; 19:e0299971. [PMID: 38484001 PMCID: PMC10939260 DOI: 10.1371/journal.pone.0299971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/19/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION Health literacy is widely considered to be a determinant of self-care behavior in people with diabetes. However, the mechanisms underlying how health literacy is linked to self-care behaviors have not been clearly elucidated. The aim of the present study was to explore the mediating roles of access to healthcare, provider-patient interaction, motivation, self-efficacy in the effect of health literacy on diabetes self-care behaviors among diabetic patients with physical disabilities and investigate the moderating effect of age in a moderated mediation model. METHODS The online survey was participated by a total of 214 diabetic patients with physical disabilities from November to December 2021. The moderated mediation analysis was examined using the Hayes' PROCESS macro modeling tool based on the bias-corrected bootstrapping method. RESULTS After controlling for education, the results yielded a significant indirect effect of health literacy on diabetes self-care through motivation and self-efficacy. A partially mediating relationship also was confirmed, as there is a positive direct effect of health literacy on diabetes self-care. Furthermore, age groups (i.e., age <40 and ≥ 40) functioned as a moderator of the mediating effects of motivation and self-efficacy between health literacy and diabetes self-care. CONCLUSION This study emphasized the important role of motivation and self-efficacy which play in linking health literacy and self-care behavior, especially for younger diabetic patients with physical disabilities. In the light of these findings, a health-literacy tailored motivation and self-efficacy enhancing program may be key targets for interventions promoting diabetes self-care behaviors in people with physical disabilities.
Collapse
Affiliation(s)
- Hye Jin Nam
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Ju Young Yoon
- College of Nursing, Seoul National University, Seoul, South Korea
- Research Institute of Nursing Science, Seoul National University, Seoul, South Korea
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul, South Korea
| |
Collapse
|
2
|
Jang GY, Chang SJ, Noh JH. Relationships Among Health Literacy, Self-Efficacy, Self-Management, and HbA1c Levels in Older Adults with Diabetes in South Korea: A Cross-Sectional Study. J Multidiscip Healthc 2024; 17:409-418. [PMID: 38314013 PMCID: PMC10838094 DOI: 10.2147/jmdh.s448056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/29/2023] [Indexed: 02/06/2024] Open
Abstract
Purpose This study investigated the levels of health literacy, self-efficacy, self-management, and glycated hemoglobin (HbA1c) levels in older adults with diabetes to identify the relationships between these factors. Patients and Methods This descriptive study consisted of 162 elderly outpatients with diabetes at the departments of endocrinology of three general hospitals in J Province, South Korea. Data were collected using a structured self-report questionnaire between October 21 and November 16, 2019. The data were analyzed using SPSS/WIN version 23.0. Results Health literacy was positively correlated with self-efficacy (rs=0.64, p<0.001) and self-management (rs=0.44, p<0.001) and significantly negatively correlated with HbA1c levels (rs=-.42, p<0.001). Self-efficacy showed a significantly positive correlation with self-management (rs=0.65, p<0.001) and a significantly negative correlation with HbA1c levels (rs=-.30, p<0.001). Moreover, a significant negative correlation was found between self-management and HbA1c levels (rs=-.35, p<0.001). Hence, health literacy and patient self-management levels were associated with HbA1c levels in older adults with DM. Conclusion Health education for community-dwelling older adults with diabetes should consider their health literacy levels. Moreover, measures to improve self-management abilities may be needed when developing educational programs for older adults with diabetes.
Collapse
Affiliation(s)
- Geun Young Jang
- College of Nursing, Graduate School of Woosuk University, Wanju-gun, Jeonbuk, South Korea
| | - Soo Jung Chang
- Department of Nursing Gangneung-Wonju National University, Wonju, Gangwon-do, South Korea
| | - Jun Hee Noh
- College of Nursing, Woosuk University, Wanju-gun, Jeonbuk, South Korea
| |
Collapse
|
3
|
Yu X, Fan M, Zhao X, Ding Y, Liu X, Yang S, Zhang X. Prevalence of impaired awareness of hypoglycaemia in people with diabetes mellitus: A systematic review and meta-analysis from 21 countries and regions. Diabet Med 2023; 40:e15129. [PMID: 37143390 DOI: 10.1111/dme.15129] [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: 12/01/2022] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 05/06/2023]
Abstract
AIMS Impaired awareness of hypoglycaemia (IAH) is a complication of glucose-lowering therapies for diabetes. The purpose of this review was to estimate the pooled prevalence of IAH and unawareness of hypoglycaemia (UAH). METHODS We searched the major databases from inception to 8 August 2022 and included all cross-sectional and cohort studies reporting IAH prevalence in people with diabetes. A random-effects model was used to pool effect values. Subgroup analysis and meta-regression were used to identify study-level characteristics affecting prevalence. RESULTS Sixty-two studies from 21 countries published between 2000 and 2022 were included, with 39,180 participants (type 1 diabetes: 19,304 vs. Type 2 diabetes: 14,650). The pooled prevalence was 23.2% (95% CI: 18.4%-29.3%) via the Clarke questionnaire, 26.2% (95% CI: 22.9%-29.9%) via the Gold score, and 58.5% (95% CI: 53.0%-64.6%) via the Pedersen-Bjergaard method, all from studies classified as presenting a moderate and low risk of bias. The prevalence of IAH was generally higher in people with type 1 diabetes than in those with type 2 diabetes and lowest in Europe. Meta-regression results show that the duration of diabetes was a factor influencing the prevalence of IAH. The prevalence of UAH by the Pedersen-Bjergaard method was 17.6 (95% CI: 14.9%-20.3%). CONCLUSIONS IAH is a prevalent risk event among people with type 1 and type 2 diabetes, showing clinical heterogeneity and regional variability. UAH, an adverse progression of IAH, is also a serious burden. More primary research on the prevalence of IAH is needed in areas with a high diabetes burden.
Collapse
Affiliation(s)
- Xiaohui Yu
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Min Fan
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Xia Zhao
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Yanan Ding
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Xueli Liu
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Shengju Yang
- Department of Endocrinology, The First Affiliated Hospital of the University of Science and Technology of China (Anhui Provincial Hospital), Hefei, Anhui, China
| | - Xinqiong Zhang
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| |
Collapse
|
4
|
Lin CW, Lin WH, Hung WC, Lee YC, Yang YC, Wang YW, Ho CJ, Tang TQ. Examining Health Literacy in Taiwanese Smoking Cessation Populations: A Multidimensional Evaluation of Sociodemographic Factors and Domain-Specific Competencies. Healthcare (Basel) 2023; 11:2350. [PMID: 37628547 PMCID: PMC10454805 DOI: 10.3390/healthcare11162350] [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: 06/02/2023] [Revised: 08/10/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Cigarette smoking is a serious global health issue. Limited studies previously analyzed health literacy components in patients undergoing smoking cessation interventions. This study focuses on individuals enrolled in smoking cessation services and investigates the distribution of health literacy in three domains (health care, disease prevention, and health promotion) and four abilities (access, understand, appraise, and apply health information). The study also explores the correlation between background factors (age, BMI, etc.) and health literacy, as well as the differences in health literacy levels among different background variables (gender, etc.). METHODS 228 individuals completed the health literacy questionnaire. Descriptive statistical analysis, Pearson Correlation, and a Chi-Squared Test were employed to investigate the various health literacy levels and background variables. RESULTS 68% had excellent or sufficient health literacy. A total of 32% were considered problematic or to have inadequate health literacy. Of the three domains of health literacy, participants performed better in the healthcare domain. More than one-third were problematic in accessing and appraising information. CONCLUSIONS this paper, being the pilot study in providing an analysis of health literacy components in individuals undergoing smoking cessation, could serve as a useful reference for devising interventions for different population groups in trying to maximize successful cessation rates.
Collapse
Affiliation(s)
- Chi-Wei Lin
- Department of Family and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung City 84001, Taiwan;
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City 84001, Taiwan; (W.-C.H.); (Y.-C.L.)
| | - Wei-Hsuan Lin
- Department of Family and Community Medicine, E-Da Hospital, Kaohsiung City 84001, Taiwan;
| | - Wei-Chieh Hung
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City 84001, Taiwan; (W.-C.H.); (Y.-C.L.)
- Department of Family Medicine, E-Da Hospital, Kaohsiung City 84001, Taiwan
| | - Yi-Che Lee
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City 84001, Taiwan; (W.-C.H.); (Y.-C.L.)
- Division of Nephrology, Department of Internal Medicine, E-Da Hospital, Kaohsiung City 84001, Taiwan
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan City 704302, Taiwan;
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan City 70401, Taiwan
| | - Ying-Wei Wang
- Department of Family Medicine, Hualien Tzu Chi Hospital, Hualien City 970473, Taiwan;
- Department of Medical Humanities, School of Medicine, Tzu Chi University, Hualien City 97004, Taiwan
| | - Ching-Jung Ho
- Graduate Institute of Adult Education, National Kaohsiung Normal University, Kaohsiung City 80201, Taiwan
| | - Tao-Qian Tang
- Department of Family and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung City 84001, Taiwan;
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung City 84001, Taiwan
- International Intercollegiate Ph.D. Program, National Tsing Hua University, Hsinchu City 30013, Taiwan
| |
Collapse
|
5
|
Wu J, Tao Z, Gao N, Shen J, Chen ZL, Zhou H, Zheng S. The Use of Multidimensional Nomial Logistic Model and Structural Equation Model in the Validation of the 14-Item Health-Literacy Scale in Chinese Patients Living with Type 2 Diabetes. Risk Manag Healthc Policy 2023; 16:1567-1579. [PMID: 37602365 PMCID: PMC10439802 DOI: 10.2147/rmhp.s419879] [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: 05/23/2023] [Accepted: 08/04/2023] [Indexed: 08/22/2023] Open
Abstract
Objective To evaluate the psychometric properties of the 14-item health literacy scale (HL-14) in patients living with type 2 diabetes mellitus (T2DM) in clinical setting. Methods Cross-sectional study using item response theory and structural equation modeling (SEM) for testing the item difficulty and three dimensional-HL configurations was adopted in this study. Chinese patients living with T2DM admitted to endocrinology department of Huadong hospital were evaluated by the HL-14 including communication, functional and critical health literacy from August to December 2021. Results The multidimensional random coefficients multinomial logistic model indicated the difficulty settings of the scale are appropriate for the study populations, and differential item functioning was not observed for sex in the study. SEM demonstrated that the three-dimensional configuration of the scale is good in the study population (x2/df=2.698, Comparative Fit Index = 0.965, Root Mean Square Error of Approximation = 0.076, standard residual mean root = 0.042). Conclusion The HL-14 scale is a reliable and valid measurement, which can perform equitably across sex in evaluating the health literacy in Chinese patients living with T2DM. Moreover, the scale may help fill the gaps of multidimensional health literacy assessment and rapid screening of health literacy ability for clinical practice.
Collapse
Affiliation(s)
- JianBo Wu
- Department of Pharmacy, Huadong Hospital, Fudan University, Shanghai, People’s Republic of China
| | - ZhuJun Tao
- Department of Pharmacy, Huadong Hospital, Fudan University, Shanghai, People’s Republic of China
| | - NingZhou Gao
- Department of Pharmacy, Huadong Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Jie Shen
- Department of Pharmacy, Huadong Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Zhi-Long Chen
- Department of Pharmacy, Huadong Hospital, Fudan University, Shanghai, People’s Republic of China
| | - HaiFeng Zhou
- Department of Pharmacy, Huadong Hospital, Fudan University, Shanghai, People’s Republic of China
| | - SongBai Zheng
- Department of Geriatrics, Huadong Hospital, Fudan University, Shanghai, People’s Republic of China
| |
Collapse
|
6
|
Tian CY, Mo PKH, Dong D, Qiu H, Cheung AWL, Wong ELY. Associations between Health Literacy, Trust, and COVID-19 Vaccine Hesitancy: The Case of Hong Kong. Vaccines (Basel) 2023; 11:vaccines11030562. [PMID: 36992145 DOI: 10.3390/vaccines11030562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023] Open
Abstract
This study investigates how health literacy (HL) and trust in health information affected COVID-19 vaccine hesitancy among Chinese Hong Kong adults. A cross-sectional study was conducted in August 2022. A total of 401 participants completed the study. Participants completed a newly developed Hong Kong HL scale and self-reported their trust levels in health information from different resources. The proportions of early uptake of the first dose and booster dose of COVID-19 vaccine were 69.1% and 71.8%, respectively. The risk of delaying the first dose was higher among participants with inadequate functional HL (OR = 0.58, p = 0.015), adequate levels of two subdomains of critical HL (OR = 1.82, p = 0.013; OR = 1.91, p < 0.01), and low-level trust in health information from the government (OR = 0.57, p = 0.019). Respondents with adequate interactive HL (OR = 0.52, p = 0.014) and inadequate level of one subdomain of critical HL (OR =1.71, p = 0.039) were more likely to delay the booster dose. This negative association between critical HL and vaccination was suppressed by trust in health information from the government. This study shows that HL and trust in health information from the government are associated with COVID-19 vaccine hesitancy. Efforts should be directed at providing tailored communication strategies with regard to people’s HL and increasing public confidence in health authorities to decrease vaccine hesitancy.
Collapse
Affiliation(s)
- Cindy Yue Tian
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Phoenix Kit-Han Mo
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Dong Dong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Hong Qiu
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Annie Wai-Ling Cheung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Eliza Lai-Yi Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, China
| |
Collapse
|
7
|
Yu H, Gao Y, Tong T, Liang C, Zhang H, Yan X, Wang L, Zhang H, Dai H, Tong H. Self-management behavior, associated factors and its relationship with social support and health literacy in patients with obstructive sleep apnea–hypopnea syndrome. BMC Pulm Med 2022; 22:352. [PMID: 36115966 PMCID: PMC9482733 DOI: 10.1186/s12890-022-02153-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 09/13/2022] [Indexed: 11/23/2022] Open
Abstract
Background The proportion of patients with obstructive sleep apnea–hypopnea syndrome (OSAHS) is increasing year by year in China, which has become a major public health problem. Self-management of OSAHS and multiple support from caregivers are key to low hospital admissions and high quality of life for patients with OSAHS. Social support and health literacy are the main promoters of self-management behavior. However, their contributions have not been adequately studied. The purpose of this study is to investigate the level of self-management among patients with OSAHS and its relationship with general demographics, social support, and health literacy. Methods A total of 280 patients with OSAHS treated in two Classiii Grade A hospitals in Jinzhou City, Liaoning Province from October 2020 to July 2021 were selected as the study subjects. Patients were investigated by General Characteristics Questionnaire, Social Support Rating Scale (SSRS), Health Literacy Scale for Chronic Patients (HLSCP), and OSAHS Self-management Behavior Questionnaire, and the influencing factors of self-management of patients with OSAHS were analyzed. Results The average score of OSAHS self-management was 74.49(SD = 8.06), SSRS and HLSCP scores were positively correlated with total scores of self-management behavior. Furthermore, we found that disease duration, SSRS, and HLSCP scores were the main predictors of self-management behavior (R2 = 0.390, P < 0.001). Conclusion This study found that OSAHS patients with a longer duration of disease and higher SSRS or HLSCP scores also had higher levels of self-management. The factors discussed in this study may be helpful in developing individualized interventions in self-management for patients with OSAHS.
Collapse
|
8
|
Zhu Y, Cheng K, Wang H, Xu Z, Zhang R, Cheng W, Wang Y, Lyu W. Exercise Adherence and Compliance and Its Related Factors Among Elderly Patients with Type 2 Diabetes in China: A Cross-Sectional Study. Patient Prefer Adherence 2022; 16:3329-3339. [PMID: 36568916 PMCID: PMC9785139 DOI: 10.2147/ppa.s374120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/01/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To explore exercise adherence and compliance as well as its related factors among elderly patients with type 2 diabetes mellitus (T2DM) to provide a basis for clinical intervention strategies. PATIENTS AND METHODS The present study was a cross-sectional study of 205 elderly patients with T2DM who regularly visited a Shanghai community health center from August 2020 to July 2021. Exercise adherence and compliance was measured using an exercise adherence and compliance questionnaire, and potential correlates were explored using multiple linear regression analysis. RESULTS The mean total score of the exercise adherence and compliance questionnaire was 16.72±5.08. The stepwise regression results revealed that exercise adherence and compliance was positively correlated with self-monitoring (F=3.510, P=0.005), exercise knowledge (r=0.784, P<0.001), exercise willingness (r=0.556, P<0.001), professional support (r=0.426, P<0.001), and self-efficiency (r=0.5, P<0.001). There was a negative correlation between hypoglycemia and exercise adherence and compliance (F=-3.672, P<0.001). CONCLUSION Low exercise adherence and compliance was related to low glucose self-monitoring frequency, increased hypoglycemia, less exercise knowledge, less exercise willingness, less professional support, and less self-efficiency. When developing exercise instructions adapted to the cognitive and volitional needs of diabetic patients, it is essential to focus on their daily self-management habits and extrinsic motivation to improve exercise adherence and compliance.
Collapse
Affiliation(s)
- Yingyi Zhu
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Kangyao Cheng
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Hui Wang
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Ziwei Xu
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Ruiyu Zhang
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Wenjie Cheng
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Yan Wang
- Nursing Department, Tangzhen Community Healthcare Center, Shanghai, People’s Republic of China
- Correspondence: Yan Wang, Tangzhen Community Healthcare Center, 75 Middle Chuangxin Road, Shanghai, 201203, People’s Republic of China, Tel +86 13816514677, Email
| | - Weibo Lyu
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
- Weibo Lyu, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201210, People’s Republic of China, Tel +86 13661498053, Email
| |
Collapse
|
9
|
Irrational beliefs trigger depression and anxiety symptoms, and associated with increased inflammation and oxidative stress markers in the 10-year diabetes mellitus risk: the ATTICA epidemiological study. J Diabetes Metab Disord 2021; 20:727-739. [PMID: 34178861 DOI: 10.1007/s40200-021-00805-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/21/2021] [Indexed: 01/24/2023]
Abstract
Purpose To investigate the combined role of irrational beliefs, anxiety and depression in the 10-year incidence of type 2 diabetes, and the underlying effect of biochemical, and socio-behavioural factors. Methods Within the context of the ATTICA cohort study (2002-2012), 853 participants without evidence of CVD [453 men (45 ± 13 years) and 400 women (44 ± 18 years)] underwent psychological evaluation through the Irrational Beliefs Inventory (IBI) (range 0-88), the Zung Self-Rating-Depression-Scale (ZDRS) and the State-Trait-Anxiety-Inventory (STAI). Diagnosis of diabetes at follow-up examination was based on the criteria of the American Diabetes Association (ADA). Results Mean IBI score was 53 ± 10 in men and 51 ± 11 in women (p = 0.68). Participants with high irrational beliefs who also had anxiety symptoms had a 93% excess risk of developing diabetes during the 10-year follow-up (Hazard Ratio 1.93; 95%CI 1.34, 2.78) as compared to those without anxiety. Moreover, diabetes risk was 73% higher among individuals with high levels of irrational beliefs and depression as compared to those where depression was absent (1.73; 1.21, 2.46). Lower education status, family history of diabetes, hypercholesterolemia, high BMI, as well as tumor necrosis factor and total antioxidant capacity were revealed as mediating risk factors related to the tested associations. Conclusion Irrational beliefs among apparently healthy adults trigger depression and anxiety symptomatology, and through the increased inflammation and oxidative stress profile, were associated with increased diabetes risk. This observation moves psychological research a step forward in supporting and guiding primary prevention of mental health and metabolic conditions.
Collapse
|