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German J, Yang Q, Hatch D, Lewinski A, Bosworth HB, Kaufman BG, Chatterjee R, Pennington G, Matters D, Lee D, Urlichich D, Kokosa S, Canupp H, Gregory P, Roberson CL, Smith B, Huber S, Doukellis K, Deal T, Burns R, Crowley MJ, Shaw RJ. EXpanding Technology-Enabled, Nurse-Delivered Chronic Disease Care (EXTEND): Protocol and Baseline Data for a Randomized Trial. Contemp Clin Trials 2024; 146:107673. [PMID: 39216685 DOI: 10.1016/j.cct.2024.107673] [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: 06/03/2024] [Revised: 07/31/2024] [Accepted: 08/27/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Approximately 10-15 % of individuals with type 2 diabetes have persistently poorly-controlled diabetes mellitus (PPDM) despite receiving available care, and frequently have comorbid hypertension. Mobile monitoring-enabled telehealth has the potential to improve outcomes in treatment-resistant chronic disease by supporting self-management and facilitating patient-clinician contact but must be designed in a manner amenable to real-world use. METHODS Expanding Technology-Enabled, Nurse-Delivered Chronic Disease Care (EXTEND) is an ongoing randomized trial comparing two 12-month interventions for comorbid PPDM and hypertension: 1) EXTEND, a mobile monitoring-enabled self-management intervention; and 2) EXTEND Plus, a comprehensive, nurse-delivered telehealth program incorporating mobile monitoring, self-management support, and pharmacist-supported medication management. Both arms leverage a novel platform that uses existing technological infrastructure to enable transmission of patient-generated health data into the electronic health record. The primary study outcome is difference in HbA1c change from baseline to 12 months. Secondary outcomes include blood pressure, weight, implementation barriers/facilitators, and costs. RESULTS Enrollment concluded in June 2023 following randomization of 220 patients. Baseline characteristics are similar between arms; mean age is 54.5 years, and the cohort is predominantly female (63.6 %) and Black (68.2 %), with a baseline HbA1c of 9.81 %. CONCLUSION The EXTEND trial is evaluating two mobile monitoring-enabled telehealth approaches that seek to improve outcomes for patients with PPDM and hypertension. Critically, these approaches are designed around existing infrastructure, so may be amenable to implementation and scaling. This study will promote real-world use of telehealth to maximize benefits for those with high-risk chronic disease.
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Affiliation(s)
- Jashalynn German
- Division of Endocrinology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Qing Yang
- School of Nursing, Duke University, Durham, NC, USA
| | - Daniel Hatch
- School of Nursing, Duke University, Durham, NC, USA
| | - Allison Lewinski
- School of Nursing, Duke University, Durham, NC, USA; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, United States of America
| | - Hayden B Bosworth
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Brystana G Kaufman
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, United States of America; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA; Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA
| | - Ranee Chatterjee
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, NC 27713, USA
| | | | | | - Donghwan Lee
- School of Nursing, Duke University, Durham, NC, USA
| | | | - Sarah Kokosa
- Department of Pharmacy, Duke University, Durham, NC, USA
| | - Holly Canupp
- Department of Pharmacy, Duke University, Durham, NC, USA
| | | | | | - Benjamin Smith
- Department of Pharmacy, Duke University, Durham, NC, USA
| | - Sherry Huber
- Duke Office of Clinical Research, Duke University School of Medicine, Durham, NC, USA
| | - Katheryn Doukellis
- Duke Office of Clinical Research, Duke University School of Medicine, Durham, NC, USA
| | - Tammi Deal
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, NC 27713, USA
| | - Rose Burns
- Duke Office of Clinical Research, Duke University School of Medicine, Durham, NC, USA
| | - Matthew J Crowley
- Division of Endocrinology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, United States of America
| | - Ryan J Shaw
- School of Nursing, Duke University, Durham, NC, USA.
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Joiner KL, Adams MP, Bayrakdar A, Speight J. A Spanish-language translation for the U.S. of the type 2 diabetes stigma assessment scale (DSAS-2 Spa-US). FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:1057559. [PMID: 36992721 PMCID: PMC10012130 DOI: 10.3389/fcdhc.2022.1057559] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/05/2022] [Indexed: 12/25/2022]
Abstract
BackgroundDiabetes stigma is recognized to negatively impact health-related outcomes for people living with type 2 diabetes (T2D), but there is a dearth of evidence among U.S. Latino adults with T2D. Our aim was to develop a Spanish-language translation of the Type 2 Diabetes Stigma Assessment Scale (DSAS-2) and examine its psychometric properties among U.S. Latino adults with T2D.MethodsThe translation was developed through a multi-step process, including a focus group with community health workers (n=5) and cognitive debriefing interviews with Latino adults with T2D (n=8). It was field-tested in an online survey of U.S. Latino adults with T2D, recruited via Facebook (October 2018 to June 2019). Exploratory factor analysis examined structural validity. Convergent and divergent validity were assessed by testing hypothesized correlations with measures of general chronic illness stigma, diabetes distress, depressive and anxiety symptoms, loneliness, and self-esteem.ResultsAmong 817 U.S. Latino adults with T2D who participated in the online survey, 517 completed the Spanish-language DSAS-2 (DSAS Spa-US) and were eligible for the study (mean age 54 ± 10 years, and 72% female). Exploratory factor analysis supported a single-factor solution (eigenvalue=8.20), accounting for 82% of shared variance among the 19 items, all loading ≥ 0.5. Internal consistency reliability was high (α=0.93). As expected, strong, positive correlations were observed between diabetes stigma and general chronic illness stigma (rs=0.65) and diabetes distress (rs=0.57); medium, positive correlations, between diabetes stigma and depressive (rs=0.45) and anxiety (rs=0.43) symptoms, and loneliness (rs=0.41); and a moderate negative correlation between diabetes stigma and self-esteem (rs=-0.50). There was no relationship between diabetes stigma and diabetes duration (rs=0.07, ns).ConclusionThe DSAS-2 Spa-US is a version of the DSAS-2, translated into Spanish, that has good psychometric properties for assessing diabetes stigma in U.S. Latino adults with T2D.
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Affiliation(s)
- Kevin L. Joiner
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States
- *Correspondence: Kevin L. Joiner,
| | - Mackenzie P. Adams
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Amani Bayrakdar
- School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
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Wallace DD, Núñez I, Barrington C. Revising the Diabetes Distress Scale for Use Among Adults in the Dominican Republic: Findings From Cognitive Interviews. DIABETES EDUCATOR 2022; 48:459-468. [PMID: 36218379 PMCID: PMC9693704 DOI: 10.1177/26350106221128003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study is to assess the content validity of the Diabetes Distress Scale (DDS) among adults with type 2 diabetes mellitus (T2DM) living in rural Dominican Republic communities. METHODS Researchers conducted cognitive interviews with 20 adults with T2DM to assess how they answered a Spanish version of the 17-item DDS, a commonly used scale to measure diabetes distress. Interviews were done iteratively to allow for revisions and testing of those revisions with the participants. Analysis involved field notes, text summaries, and cognitive coding. RESULTS The sample was 55% women, had a mean age of 55 years, and came from 10 rural communities. The cognitive interviews highlighted needed changes across comprehension, judgment (clarity), recall, response process, and logical/structural issue domains. Participants generally understood the DDS; however, 4 items, the introduction, and response options were revised to improve participant response. The items were revised using wording from the participants themselves. By changing certain terms and splitting a couple of items, these items improved comprehension and judgment. The introduction was simplified from 2 paragraphs to 1 to reduce structural issues (ie, scale's features), and the response options were reduced from 6 options to 5 options to improve the response process. CONCLUSIONS Based on iterative study findings, the researchers propose expanding the 17-item DDS to 19 items to improve participant response. Revising the DDS to account for cultural and structural changes will improve clinical and public health understanding of the role of diabetes distress on T2DM management among Dominican adults.
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Affiliation(s)
- Deshira D Wallace
- Department of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Ivania Núñez
- Department of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Clare Barrington
- Department of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina
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Langendoen-Gort M, Groeneveld L, Prinsen CAC, Beulens JW, Elders PJM, Halperin I, Mukerji G, Terwee CB, Rutters F. Patient-reported outcome measures for assessing health-related quality of life in people with type 2 diabetes: A systematic review. Rev Endocr Metab Disord 2022; 23:931-977. [PMID: 35779199 PMCID: PMC9515038 DOI: 10.1007/s11154-022-09734-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2022] [Indexed: 11/26/2022]
Abstract
Patient-Reported Outcome Measures (PROMs) are important tools to assess outcomes relevant to patients, with Health-Related Quality Of Life (HRQOL) as an important construct to be measured. Many different HRQOL PROMs are used in the type 2 diabetes field, however a complete overview of these PROMs is currently lacking. We therefore aimed to systematically describe and classify the content of all PROMs that have specifically been developed or validated to measure (aspects of) HRQOL in people with type 2 diabetes. A literature search was performed in PubMed and EMBASE until 31 December 2021. Studies on the development or validation of a PROM measuring HRQOL, or aspects of HRQOL, in people with type 2 diabetes were included. Title and abstract and full-text screening were conducted by two independent researchers and data extraction was performed independently by one of the researchers. Data were extracted on language in which the PROM was developed, target population, construct(s) being measured, names of (sub)scales and number of items per (sub)scale. In addition, all PROMs and subscales were classified according to specific aspects of HRQOL based on the Wilson & Cleary model (symptom status, functional status, general health perceptions) to aid researchers in PROM selection. In total 220 studies were identified that developed or validated PROMs that measure (aspects of) HRQOL in people with type 2 diabetes. Of the 116 unique HRQOL PROMs, 91 (of the subscales) measured symptom status, 60 measured functional status and 26 measured general health perceptions. In addition, 16 of the PROMs (subscales) measured global quality of life. 61 of the 116 PROMs (subscales) also include characteristics of the individual (e.g. aspects of personality, coping) or environment (e.g. social or financial support) and patient-reported experience measures (PREMs, e.g. measure of a patient's perception of their personal experience of the healthcare they have received, e.g. treatment satisfaction), which are not part of the HRQOL construct. Only 9 of the 116 PROMs measure all aspects of HRQOL based on the Wilson & Cleary model. Finally, 8 of the 116 PROMs stating to measure HRQOL, measured no HRQOL construct. In conclusion, a large number of PROMs are available for people with type 2 diabetes, which intend to measure (aspects of) HRQOL. These PROMs measure a large variety of (sub)constructs, which are not all HRQOL constructs, with a small amount of PROMs not measuring HRQOL at all. There is a need for consensus on which aspects of HRQOL should be measured in people with type 2 diabetes and which PROMs to use in research and daily practice. PROSPERO: CRD42017071012. COMET database: http://www.comet-initiative.org/studies/details/956 .
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Affiliation(s)
- Marlous Langendoen-Gort
- General Practice, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Lenka Groeneveld
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Cecilia A C Prinsen
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Methodology, Amsterdam, The Netherlands
| | - Joline W Beulens
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, The Netherlands
| | - Petra J M Elders
- General Practice, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, The Netherlands
| | - Ilana Halperin
- Department of Medicine, Temerty Faculty of Medicine, Sunnybrook Health Sciences Center, King's College Circle, University of Toronto, Toronto, ON, Canada
| | - Geetha Mukerji
- Department of Medicine, Temerty Faculty of Medicine, Sunnybrook Health Sciences Center, King's College Circle, University of Toronto, Toronto, ON, Canada
- Women's College Hospital Institute for Health System Solutions and Virtual Care, 76 Grenville Street, Toronto, ON, Canada
| | - Caroline B Terwee
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Methodology, Amsterdam, The Netherlands
| | - Femke Rutters
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands.
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands.
- Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, The Netherlands.
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Hawkins J, Kieffer EC, Sinco B, Piatt G, Jones L, Mitchell J, Espitia N, LeBron A, Kloss KA, Kurnick K, Palmsiano G, Spencer MS. Using Path Analysis and Linear Regression to Test for Gender and Participation: Effects in a Culturally Tailored Diabetes Intervention for Latino Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11982. [PMID: 36231282 PMCID: PMC9565909 DOI: 10.3390/ijerph191911982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/17/2022] [Accepted: 09/17/2022] [Indexed: 06/16/2023]
Abstract
While the incidence and prevalence of type 2 diabetes is higher among Latino/as, Latino men are disproportionately affected and have poorer outcomes. We aimed to determine whether gender impacted any outcomes in a culturally tailored type 2 diabetes (T2D) intervention and to evaluate the effects of gender and intervention participation intensity on outcomes at 6-month follow-up. Nested path and regression models were compared with the likelihood ratio test and information criteria in a sample of Latino/a adults with T2D (n = 222) participating in a T2D community health worker (CHW)-led intervention. Path analysis showed that the effect of the intervention did not vary by gender. The intervention was associated with significant improvements in knowledge of T2D management 0.24 (0.10); p = 0.014, diabetes distress, -0.26 (0.12); p = 0.023, and self-efficacy, 0.61 (0.21); p = 0.005. At 6-month follow-up, improved self-management was associated with greater self-efficacy and Hemoglobin A1c (HbA1c) was lower by -0.18 (0.08); p = 0.021 for each unit of self-management behavior. Linear regressions showed that class attendance and home visits contributed to positive intervention results, while gender was non-significant. Pathways of change in a CHW-led culturally tailored T2D intervention can have a significant effect on participant behaviors and health status outcomes, regardless of gender.
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Affiliation(s)
- Jaclynn Hawkins
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Edith C. Kieffer
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Brandy Sinco
- Center for Healthcare Outcomes & Policy, University of Michigan, 2800 Plymouth Road, North Campus Research Complex, Bldg. 16, Ann Arbor, MI 48109, USA
| | - Gretchen Piatt
- Department of Learning Health Sciences, School of Medicine, University of Michigan, 1111 E. Catherine Street, Ann Arbor, MI 48109, USA
| | - Lenette Jones
- School of Nursing, University of Michigan, 400 North Ingalls Building, Ann Arbor, MI 48109, USA
| | - Jamie Mitchell
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Nicolaus Espitia
- Department of Sociology, Anthropology, Social Work and Criminal Justice Oakland University, 614 Pioneer Dr, Rochester, MI 48309, USA
| | - Alana LeBron
- School of Public Health, University of California, Irvine, 3151 Social Science Plaza, SST 369 (Chicano/Latino Studies) OR 653 E Peltason Drive, AIRB 2026 (Public Health), Irvine, CA 92697, USA
| | - Katherine A. Kloss
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Katie Kurnick
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Gloria Palmsiano
- Community Health and Social Services Center, 5635 West Fort Street, Detroit, MI 48209, USA
| | - Michael S. Spencer
- School of Social Work, University of Washington, 4101 15th Avenue NE, Seattle, WA 98105, USA
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Krzemińska S, Bąk E. Psychometric Properties of the Polish Version of the Diabetes Distress Scale (DDS). Psychol Res Behav Manag 2021; 14:1149-1156. [PMID: 34377037 PMCID: PMC8349218 DOI: 10.2147/prbm.s320675] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/08/2021] [Indexed: 11/23/2022] Open
Abstract
Background Type 2 diabetes is a disease that affects the functioning and life of both the patient and their family. It involves the constant treatment, self-care, monitoring of blood glucose levels and adherence to physical activity recommendations. As a result, it causes discomfort, distress and reduces the quality of life. Aim Due to the lack of a scale that would precisely evaluate the level of distress in patients with diabetes in Poland, we decided to linguistically adapt the DDS scale to the Polish population and investigate its psychometric properties in relation to Polish patients. Material The study group consisted of 336 individuals in total, including 156 females (46.43%) and 180 males (53.57%), aged 59.13±8.4 on average. The patients were under the care of a specialist diabetes clinic. The research tool was the Diabetic Stress Scale (DDS). Results and Conclusion Our analysis showed that the reliability of both the scale and its components was at a good level. Only the RD-related part was characterised by a lower Cronbach’s alpha coefficient of 0.614. The DDS scale can be successfully used for the assessment of distress in the Polish population of patients with type 2 diabetes.
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Affiliation(s)
- Sylwia Krzemińska
- Department of Clinical Nursing, Faculty of Health Science, Medical University in Wroclaw, Wroclaw, Poland
| | - Ewelina Bąk
- Department of Nursing, Faculty of Health Sciences, University of Bielsko-Biala, Bielsko-Biała, Poland
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Niroomand M, Babaniamansour S, Aliniagerdroudbari E, Golshaian A, Meibodi AM, Absalan A. Distress and depression among patients with diabetes mellitus: prevalence and associated factors: a cross-sectional study. J Diabetes Metab Disord 2021; 20:141-151. [PMID: 34178826 PMCID: PMC8212327 DOI: 10.1007/s40200-020-00721-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/20/2020] [Accepted: 12/28/2020] [Indexed: 01/01/2023]
Abstract
PURPOSE This study aimed to validate the internal consistency of the Persian version of the diabetes distress scale-17 (DDS-17) and to investigate the prevalence of diabetes distress (DD), depression, and possible relevant factors. METHODS This was a cross-sectional study on 820 diabetes patients (62.4 % females) in Tehran, Iran between January and June 2017. The Ethics Committee of Shahid Beheshti University of Medical Sciences approved the protocol. Patients filled out a demographic and health survey, DDS-17, the Beck Depression Inventory Second Edition (BDI-II) and the Summary of Diabetes Self-Care Activities Measure (SDSCA). DDS-17 consist of emotional burden, and physician, regimen, and interpersonal related distress. The correlation between DDS subscales and association between DDS and BDI-II or SDSCA scores were assessed using SPSS. RESULTS The mean age was 58.91 ± 12.35 years. Majority of patients had high DD (37.2 %) and severe depression (38.7 %). The general and specific diets got the highest score in six SDSCA subscales. The Persian version of DDS-17 had excellent internal consistency with Cronbach's alpha coefficient of 0.924. The DDS score had significant relationship with socioeconomic level (p < .001), type of DM (p < .001), type of treatment (p < .001), glycemic control status (p < .001), complication (p < .001) and depression level (p < .001). The level of hemoglobin A1c was the most useful predictor of DDS score (p < .001). CONCLUSIONS High prevalence of depression and distress in patient with diabetes calls for greater emphasizes on the importance of enhanced physicians and patients' knowledge in these areas.
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Affiliation(s)
- Mahtab Niroomand
- Division of Endocrinology, Department of Internal Medicine, Clinical Research Development Unit of Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Arabi Ave, Daneshjoo Blvd, Velenjak, 7th Floor, Bldg. No 2, Tehran, Iran
| | - Sepideh Babaniamansour
- Department of Internal Medicine, School of Medicine, Islamic Azad University Tehran Faculty of Medicine, Tehran, Iran
| | - Ehsan Aliniagerdroudbari
- Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Golshaian
- Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Abdorrahim Absalan
- Department of Clinical Laboratory Sciences, Khomein Faculty of Medical Sciences, Markazi, Iran
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Nguyen VB, Tran TT, Dang TL, Nguyen VVH, Tran BT, Le CV, Toan ND. Diabetes-Related Distress and Its Associated Factors Among Patients with Diabetes in Vietnam. Psychol Res Behav Manag 2020; 13:1181-1189. [PMID: 33363418 PMCID: PMC7754255 DOI: 10.2147/prbm.s285291] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 11/24/2020] [Indexed: 12/01/2022] Open
Abstract
Background Psychometric properties are regarded as one of the significant contributors related to diabetes treatment efficacy. Diabetes-related distress (DD) is one of the emotional burdens. The aims of this study were to investigate the prevalence of DD and to determine its associated factors among Vietnamese diabetic patients. Methods A cross-sectional study was conducted at a single medical center in the central of Vietnam. A total of 138 eligible DM outpatients were invited and a total of 112 patients who completed the questionnaire were utilized in this analysis using convenience sampling. DD was assessed using the diabetes distress scale (DDS). The participant’s sociodemographic and clinical information was obtained through face-to-face interviews and medical records. Multivariate logistic regression was used to determine independent factors associated with the presence of DD. Results Approximately, 12.5% of the patients experienced DD based on DDS self-administered questionnaire. The rates of mild/moderate and high distress were 8.0% and 4.5%, respectively. DD was found to be significantly higher in type 1 DM (p=0.04), insulin only in treatment regime (p=0.04), physical inactivities (p=0.02), times of mild hypoglycemia (time/month) (p=0.01), and fasting plasma glucose (mmol/l) (p=0.04). The occurrence of distress among DM patients was negatively correlated with their age and amount of physical exercise. Meanwhile, poor HbA1c control (HbA1c≥7%) was associated with an increased occurrence of diabetes distress. Conclusion The findings of single medical center in Vietnam highlights that DD is prevalent among DM patients. It should be of marked concerns, particularly the type 1 diabetic patients, younger age, and poor glycemic control patients.
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Affiliation(s)
- Van Bang Nguyen
- Center of Endocrinology and Diabetes, Family Hospital, Da Nang, Vietnam
| | - Tam Thi Tran
- Center of Endocrinology and Diabetes, Family Hospital, Da Nang, Vietnam
| | - Thi Ly Dang
- Center of Endocrinology and Diabetes, Family Hospital, Da Nang, Vietnam
| | - Van Vy Hau Nguyen
- Center of Endocrinology and Diabetes, Family Hospital, Da Nang, Vietnam
| | - Binh Thang Tran
- Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Chi Van Le
- Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Nguyen Dinh Toan
- Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
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Huang H, Chen N, Yin H, Skirko JR, Guo C, Ha P, Li J, Shi B. Validation of the Chinese Velopharyngeal Insufficiency Effects on Life Outcomes Instrument. Laryngoscope 2019; 129:E395-E401. [PMID: 30671957 DOI: 10.1002/lary.27792] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Hanyao Huang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Maxillofacial Surgery West China Hospital of Stomatology, Sichuan University, Chengdu, China;West China Second University Hospital, Sichuan University Chengdu China
| | - Nan Chen
- Key Laboratory of Birth Defects and Related Diseases of Women and Children and Office of Educational AdministrationWest China Second University Hospital, Sichuan University Chengdu China
| | - Heng Yin
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Maxillofacial Surgery West China Hospital of Stomatology, Sichuan University, Chengdu, China;West China Second University Hospital, Sichuan University Chengdu China
| | - Jonathan R. Skirko
- Pediatric Otolaryngology (ENT) and Pediatric Facial Plastic SurgeryUniversity of Utah and Primary Children's Medical Center Salt Lake City Utah U.S.A
| | - Chunli Guo
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Maxillofacial Surgery West China Hospital of Stomatology, Sichuan University, Chengdu, China;West China Second University Hospital, Sichuan University Chengdu China
| | - Pin Ha
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Maxillofacial Surgery West China Hospital of Stomatology, Sichuan University, Chengdu, China;West China Second University Hospital, Sichuan University Chengdu China
| | - Jingtao Li
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Maxillofacial Surgery West China Hospital of Stomatology, Sichuan University, Chengdu, China;West China Second University Hospital, Sichuan University Chengdu China
| | - Bing Shi
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Maxillofacial Surgery West China Hospital of Stomatology, Sichuan University, Chengdu, China;West China Second University Hospital, Sichuan University Chengdu China
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Nanayakkara N, Pease A, Ranasinha S, Wischer N, Andrikopoulos S, Speight J, de Courten B, Zoungas S. Depression and diabetes distress in adults with type 2 diabetes: results from the Australian National Diabetes Audit (ANDA) 2016. Sci Rep 2018; 8:7846. [PMID: 29777153 PMCID: PMC5959930 DOI: 10.1038/s41598-018-26138-5] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 04/30/2018] [Indexed: 01/15/2023] Open
Abstract
This study explores the prevalence of, and factors associated with, likely depression and diabetes distress in adults with type 2 diabetes in a large, national sample. Australian National Diabetes Audit data were analysed from adults with type 2 diabetes attending 50 diabetes centres. The Brief Case find for Depression and Diabetes Distress Score 17 were administered to screen for likely depression and diabetes-related distress, respectively. A total of 2,552 adults with type 2 diabetes participated: (mean ± SD) age was 63 ± 13 years, diabetes duration was 12 ± 10 years, and HbA1c was 8 ± 2%. Twenty-nine percent of patients had likely depression, 7% had high diabetes distress, and 5% had both. Difficulty following dietary recommendations, smoking, forgetting medications, and diabetes distress were all associated with greater odds of depression whereas higher own health rating was associated with lower odds (all p < 0.02). Female gender, increasing HbA1c, insulin use, difficulty following dietary recommendations and depression were all associated with greater odds of diabetes distress & older age, higher own health rating and monitoring blood glucose levels as recommended were associated with lower odds (all p < 0.04). Depression was associated with sub-optimal self-care, while diabetes distress was associated with higher HbA1c and sub-optimal self-care.
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Affiliation(s)
- Natalie Nanayakkara
- School Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3168, Australia.,Diabetes and Vascular Medicine Unit, Monash Health, Clayton, VIC, 3168, Australia
| | - Anthony Pease
- School Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3168, Australia.,Diabetes and Vascular Medicine Unit, Monash Health, Clayton, VIC, 3168, Australia
| | - Sanjeeva Ranasinha
- School Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3168, Australia
| | - Natalie Wischer
- National Association Diabetes Centres, Sydney, NSW, 2000, Australia
| | - Sofianos Andrikopoulos
- School Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3168, Australia.,The University of Melbourne, Department of Medicine, Heidelberg, VIC, 3168, Australia
| | - Jane Speight
- Deakin University, School of Psychology, Geelong, Victoria, Australia.,The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia.,AHP Research, Hornchurch, UK
| | - Barbora de Courten
- School Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3168, Australia.,Diabetes and Vascular Medicine Unit, Monash Health, Clayton, VIC, 3168, Australia
| | - Sophia Zoungas
- School Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3168, Australia. .,Diabetes and Vascular Medicine Unit, Monash Health, Clayton, VIC, 3168, Australia. .,The George Institute for Global Health, Camperdown, NSW, 2050, Australia.
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Doubova SV, Martinez-Vega IP, Aguirre-Hernandez R, Pérez-Cuevas R. Association of hypertension-related distress with lack of self-care among hypertensive patients. PSYCHOL HEALTH MED 2016; 22:51-64. [PMID: 27677320 DOI: 10.1080/13548506.2016.1239830] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Research on factors associated with poor adherence to self-care focuses primarily on psychiatric emotional disorders such as depression and anxiety, whereas non-psychiatric chronic-disease-related emotional distress has received little attention in hypertensive patients. The objective of this study was to evaluate the association of hypertension-related distress with the lack of self-care including low adherence to pharmacological treatment, lack of regular physical activity, low intake of fruits and vegetables and frequent intake of high-salt foods. A cross-sectional survey was conducted in 2014 in two family medical units affiliated with the Mexican Institute of Social Security. The study included 487 hypertensive patients >19 years of age. The conceptual framework for the study was based on the Health Promotion Model. The analysis included multiple Poisson regression models. We found that 21.1% of participants had hypertension-related distress. Low adherence to pharmacological treatment was identified in 45.8% of patients, whereas 46.8% lacked regular physical activity, 30.8% reported a low consumption of fruits and vegetables, and 54.6% frequently consumed foods high in salt content. Hypertension-related distress was associated with lack of regular physical activity and low intake of fruits and vegetables. These findings highlight the importance of addressing distress in order to improve self-care of hypertensive patients.
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Affiliation(s)
- Svetlana V Doubova
- a Epidemiology and Health Services Research Unit, CMN Siglo XXI , Mexican Institute of Social Security , Mexico City , Mexico
| | - Ingrid Patricia Martinez-Vega
- a Epidemiology and Health Services Research Unit, CMN Siglo XXI , Mexican Institute of Social Security , Mexico City , Mexico
| | - Rebeca Aguirre-Hernandez
- b Departamento de Farmacología de la Facultad de Medicina , Universidad Nacional Autónoma de México, Ciudad Universitaria , Mexico City , Mexico
| | - Ricardo Pérez-Cuevas
- c Division of Social Protection and Health , Inter-American Development Bank , Mexico City , Mexico
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