1
|
Derese A, Gebreegzhiabhere Y, Medhin G, Sirgu S, Hanlon C. Impact of depression on self-efficacy, illness perceptions and self-management among people with type 2 diabetes: A systematic review of longitudinal studies. PLoS One 2024; 19:e0302635. [PMID: 38709771 PMCID: PMC11073729 DOI: 10.1371/journal.pone.0302635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 04/09/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Treating comorbid depression does not always improve outcomes for people with type 2 diabetes. Evidence is lacking on potential psychological and behavioural intermediaries of the impact of depression on diabetes outcomes. OBJECTIVE To synthesise evidence on the impact of comorbid depression on self-efficacy, illness perceptions, and self-management in people with type 2 diabetes. DATA SOURCES We searched PubMed, Embase, PsycINFO, and Global Health databases from inception up to 29th March 2023. STUDY ELIGIBILITY CRITERIA Only prospective studies (cohort or intervention studies) were included, with no restrictions on language. The outcomes were self-efficacy, illness perceptions, and self-management. PARTICIPANTS People with type 2 diabetes in community or health settings. EXPOSURE Comorbid depression or depressive symptoms in people with type 2 diabetes. SYNTHESIS OF RESULTS A narrative review of heterogeneous studies. RISK OF BIAS The risk of bias was assessed using the Effective Public Health Practice Project (EPHPP) quality assessment tool for quantitative studies. RESULTS Twenty-five studies were included, all from high-income countries. Depression was associated with lower self-efficacy (2 studies), poor illness perception (1 study), and poor self-management practices (17 studies) in people with type 2 diabetes. In 6/7 studies, depressive symptoms predicted less adherence to dietary recommendations, 8/10 studies found depressive symptoms were associated with poor medication adherence, 1/3 study found that depressive symptoms were associated with poor weight control, 3/4 with less physical exercise, and 2/3 with general self-care practices. LIMITATIONS There were no studies from low- and middle-income countries and non-Western settings, and we cannot assume the mechanisms linking comorbid depression with diabetes outcomes are similar. CONCLUSIONS Comorbid depression was associated with lower self-efficacy, poorer self-management, and less adaptive illness perceptions among people with diabetes.
Collapse
Affiliation(s)
- Andualem Derese
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yohannes Gebreegzhiabhere
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sisay Sirgu
- Department of Internal Medicine, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Health Service and Population Research Department and WHO Collaborating Centre for Mental Health Research and Training, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, King’s College London, London, United Kingdom
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
2
|
Xin M, Chan VWY, Kong APS, Lau JTF, Cameron LD, Mak WWS, Mo PKH. Using the common-sense model to explicate the role of illness representation in self-care behaviours and anxiety symptoms among patients with Type 2 diabetes. PATIENT EDUCATION AND COUNSELING 2023; 107:107581. [PMID: 36470126 DOI: 10.1016/j.pec.2022.107581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/29/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES Based on the common-sense model of self-regulation, this study aimed to explicate the mechanism underlying the effect of illness representations on self-care behaviours and anxiety symptoms among patients with type 2 diabetes. METHODS A telephone survey was administered to 473 patients in Hong Kong. Structural equation modelling was used to test if threat and control perceptions regarding diabetes would be associated with self-reported self-care behaviours and anxiety symptoms through adoption of adaptive/maladaptive coping strategies and diabetes-related self-efficacy. RESULTS Control perceptions but not threat perceptions were positively associated with self-care behaviours. Control perceptions had a positive indirect association with self-care behaviours through more problem-focused coping and diabetes-related self-efficacy. Threat perceptions simultaneously had a positive indirect association through more problem-focused coping and a negative indirect association through more avoidant coping and lower diabetes-related self-efficacy. In contrast, threat and control perceptions were positively and negatively, respectively, associated with anxiety symptoms. Problem-focused and avoidant coping consistently mediated the indirect association between threat perceptions and anxiety symptoms. CONCLUSION Threat and control perceptions were associated with diabetes self-care behaviours and anxiety symptoms through different self-regulation pathways. PRACTICE IMPLICATIONS Our findings inform possible targets for self-management interventions to simultaneously enhance self-care behaviours and alleviate diabetes-associated anxiety.
Collapse
Affiliation(s)
- Meiqi Xin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
| | | | - Alice P S Kong
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Joseph T F Lau
- School of Mental Health, Wenzhou Medical University, Wenzhou, China; Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China; School of Public Health, Zhejiang University, Hangzhou, China; Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Linda D Cameron
- School of Social Science, Humanities, and the Arts, University of California, Merced, USA.
| | - Winnie W S Mak
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
3
|
Brazeal M, Blackmon BJ, Zakaras L. The Role of Mood in the Self-Care Activities of Primary Care Patients with Type 2 Diabetes. SOCIAL WORK IN PUBLIC HEALTH 2022; 37:397-406. [PMID: 34927569 DOI: 10.1080/19371918.2021.2017380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study investigated the impact of anxiety and depression on self-care activities among patients with type 2 diabetes mellitus (T2DM) using a longitudinal, ex-post-facto design. Concepts from the Theory of Reasoned Action, the Theory of Planned Behavior, and Albert Bandura's work exploring self-efficacy were used to inform this study. Data were collected from primary care clinics providing social work-led integrated care to adults with T2DM. Results showed significant improvements in anxiety, depression, and self-care from the first to the third clinic visits. Findings indicated a significant relationship between anxiety and general diet scores, but anxiety did not have a statistically significant impact on any other self-care activities. No significant relationships were observed between depression and self-care, which was surprising given previous research. Findings have implications for working with adults with T2DM and provide directions for future research in understanding the relationship between mood and self-care among patients with T2DM.
Collapse
Affiliation(s)
- Michelle Brazeal
- School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Bret J Blackmon
- School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Lauren Zakaras
- School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi, USA
| |
Collapse
|
4
|
Lee LY, Hsieh CJ, Lin YT. Life satisfaction and emotional distress in people living with type 2 diabetes mellitus: The mediating effect of cognitive function. J Clin Nurs 2021; 30:2673-2682. [PMID: 33655571 DOI: 10.1111/jocn.15740] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 01/24/2021] [Accepted: 02/25/2021] [Indexed: 10/22/2022]
Abstract
AIMS AND OBJECTIVES To explore the relationships among emotional distress, cognitive function and life satisfaction in people living with type 2 diabetes mellitus (T2DM), and to verify the mediating role of cognitive function. BACKGROUND People with T2DM face cognitive decline caused by age and disease complications. Emotional distress will reduce their life satisfaction, and cognitive function will also affect the life satisfaction, but whether cognitive function mediates the effect of emotional distress on life satisfaction has not been verified. DESIGN A cross-sectional study. METHODS A total of 200 people living with T2DM in the community by convenience sampling were enrolled from November-December 2018. Data collection involved a demographic and disease characteristic questionnaire, Problem Areas in Diabetes Scale, Subjective and Objective Cognitive Function Evaluation and Life Satisfaction Questionnaire. Data analysis included descriptive statistics and structural equation modelling. This report followed the STROBE guideline. RESULTS The emotional distress and subjective memory complaints of cognitive function had a significant positive correlation, while both emotional distress and cognitive function showed significant negative correlations with life satisfaction. In addition, cognitive function completely mediated the relationship between emotional distress and life satisfaction. CONCLUSION The cognitive function played a mediating role in life satisfaction and explains how emotional distress affects life satisfaction of people with T2DM. Therefore, it is suggested that diabetes nurses should early identify the decline of cognitive function, and to intervene at an early stage. RELEVANCE TO CLINICAL PRACTICE This study provides opinions on the mediating factors of cognitive function. Coping strategies and supporting resources to help the T2DM people to improve their life satisfaction are suggested.
Collapse
Affiliation(s)
- Li-Yen Lee
- School of nursing, College of Nursing, Lecturer of Cardinal Tien Junior of Healthcare and Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Chia-Jung Hsieh
- School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Ya-Ting Lin
- School of nursing, College of Nursing, Lecturer of St. Mary's Junior College of Medicine, Nursing and Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| |
Collapse
|
5
|
Chan VWY, Kong APS, Lau JTF, Mak WWS, Cameron LD, Mo PKH. An Intervention to Change Illness Representations and Self-Care of Individuals With Type 2 Diabetes: A Randomized Controlled Trial. Psychosom Med 2021; 83:71-84. [PMID: 33141790 DOI: 10.1097/psy.0000000000000883] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Suboptimal self-care by individuals with diabetes mellitus (DM) is a significant public health concern. The common-sense model (CSM) proposes that illness representations are associated with coping and health outcomes across various conditions. The present study examined the efficacy of a CSM-based intervention in improving illness representations, self-care, self-care self-efficacy, use of adaptive coping strategies, and glycated hemoglobin among individuals with type 2 DM (T2DM). METHODS A two-arm randomized controlled trial was used. A total of 455 T2DM patients were recruited from an outpatient DM clinic and randomized to an intervention group that consisted of five weekly group-based education sessions or a control group that received five weekly educational booklets. Evaluation was conducted at baseline and at 1- and 6-month follow-up. RESULTS The 2 × 3 linear mixed-model analysis using a modified intention to treat revealed a significant time by condition interaction effect on level of self-care (F(2,840) = 7.78, p < .001), self-care self-efficacy (F(1.89,794.57) = 14.40, p < .001), and use of adaptive coping strategies (F(1.94,812.93) = 4.75, p = .010) in which participants in the intervention group reported greater improvement in such aspects compared with those in the control group. A significant time effect was observed in some dimensions of illness representations. No significant effect was found in glycated hemoglobin. Participants reported positive feedback to the intervention and perceived improvement in various domains. CONCLUSIONS The CSM-based intervention was effective in improving self-care and coping among DM patients. The intervention also demonstrated high feasibility and acceptability. Findings provided important insights in improving health-related outcomes for patients with T2DM using the CSM framework.
Collapse
Affiliation(s)
- Virginia W Y Chan
- From the Centre for Health Behaviours Research, School of Public Health and Primary Care (Chan, Lau, Mo), and Departments of Medicine and Therapeutics (Kong) and Psychology (Mak), the Chinese University of Hong Kong, Shatin, Hong Kong; and Department of Psychological Sciences (Cameron), University of California Merced, Merced, California
| | | | | | | | | | | |
Collapse
|
6
|
Richmond RS, Connolly M. A delineation of self-management and associated concepts. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2020. [DOI: 10.1080/20479700.2020.1810963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
7
|
Abstract
BACKGROUND The majority of people with anxiety tend to seek help in primary care. Patients' illness perception regarding their own anxiety can influence the assessment, treatment processes, and outcomes. This cross-sectional study explored possible relationships between patients' illness perception of their anxiety and the severity of their anxiety. MATERIALS AND METHODS Ninety-five patients with anxiety were recruited at two primary care clinics in Singapore. Their responses to the generalized anxiety disorder-7 (GAD-7) and illness perception questionnaire mental health (IPQ-MH) were examined with Spearman's rho correlation coefficients and multiple regression analyses. RESULTS Four illness perception subscales, i.e., consequences (rs = 0.23), personal control (rs = -0.27), coherence (rs = -0.22), and biological (rs = 0.34) significantly correlated to anxiety (P < 0.05). A multiple regression analysis identified that attribution to biological factors (β = 0.348, P =0.001) and attribution to personal control (β = -0.262, P =0.008) were significantly associated with anxiety. CONCLUSIONS Interventions for anxiety reduction in primary care can be enhanced with methods that promote (1) patients' awareness of the reasons for their anxiety beyond mostly bodily ones to include psychosocial ones and (2) patients' confidence in their own capacity to influence their recovery.
Collapse
Affiliation(s)
| | - Mei Yin Wong
- National Healthcare Group Polyclinics, Singapore
| | | |
Collapse
|
8
|
Chylińska J, Łazarewicz M, Rzadkiewicz M, Adamus M, Jaworski M, Haugan G, Lillefjel M, Espnes GA, Włodarczyk D. The role of gender in the active attitude toward treatment and health among older patients in primary health care-self-assessed health status and sociodemographic factors as moderators. BMC Geriatr 2017; 17:284. [PMID: 29216837 PMCID: PMC5721697 DOI: 10.1186/s12877-017-0677-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 11/27/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Active attitude toward treatment and health (ATH) leads to improved cooperation and better health outcomes in patients. Supporting it in the population of older adults is a growing need in primary care. Recognising the role of gender, health and other sociodemographic factors can help to distinguish patients who need the most assistance in activation from general practitioners (GPs). The objective of the study was to investigate gender differences in ATH as well as the moderating role of self-assessed health (SAH) and selected sociodemographic factors (age, education, financial status, marital status). METHODS A cross-sectional, multicentre study among 4936 primary care older patients (aged 50+) was conducted. The PRACTA-Attitude toward Treatment and Health questionnaire (PRACTA-ATH) was used to measure the cognitive, emotional (positive and negative affect), and motivational dimensions of ATH. Patients were approached before and after their visits in the primary health-care facilities randomly selected in Central Poland. RESULTS Generalised linear models (GENLIN) revealed the main effects of gender, SAH, and sociodemographic characteristics, such as financial status, marital status and education. Interaction effects of gender and age (Wald's χ2 = 24.767, p < 0.001 for ATH Global), as well as gender and SAH (Wald's χ2 = 16.712, p < 0.002 for ATH Global) on ATH were found. The most assistance in regard to ATH was required by men aged 50-74 and men declaring good self-assessed health. Generally, women declared a more active attitude than men, showing more knowledge (M = 5.40, SD = 0.07 and M = 5.21, SD = 0.07, for women and men, respectively, p = 0.046), positive emotion (M = 5.55, SD = 0.06 and M = 5.33, SD =0.06, for women and men, respectively, p = 0.015) and motivation to be involved in their health issues (M = 5.71, SD = 0.07 and M = 5.39, SD = 0.07, for women and men, respectively, p = 0.001). The level of negative emotions related to health was not significantly different between genders (p = 0.971). CONCLUSIONS The need to create health promoting programmes taking account of particular gender differences in older adults emerges. In regard to clinical practice, building a sense of efficacy and individual responsibility for health, providing information about the means of health promotion and prevention, and recognising health-related cognitions, is recommended especially for men who feel well and are less advanced in age (50-74).
Collapse
Affiliation(s)
- Joanna Chylińska
- Department of Medical Psychology, Medical University of Warsaw, Ul. Żwirki i Wigury 81, 02-091, Warsaw, Poland.
| | - Magdalena Łazarewicz
- Department of Medical Psychology, Medical University of Warsaw, Ul. Żwirki i Wigury 81, 02-091, Warsaw, Poland
| | - Marta Rzadkiewicz
- Department of Medical Psychology, Medical University of Warsaw, Ul. Żwirki i Wigury 81, 02-091, Warsaw, Poland
| | - Mirosława Adamus
- Department of Medical Psychology, Medical University of Warsaw, Ul. Żwirki i Wigury 81, 02-091, Warsaw, Poland
| | - Mariusz Jaworski
- Department of Medical Psychology, Medical University of Warsaw, Ul. Żwirki i Wigury 81, 02-091, Warsaw, Poland
| | - Gørill Haugan
- NTNU Center for Health Promotion Research, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Monica Lillefjel
- NTNU Center for Health Promotion Research, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Geir A Espnes
- NTNU Center for Health Promotion Research, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Dorota Włodarczyk
- Department of Medical Psychology, Medical University of Warsaw, Ul. Żwirki i Wigury 81, 02-091, Warsaw, Poland
| |
Collapse
|