Emotional Distress is Associated with Lower Health-Related Quality of Life Among Patients with Diabetes Using Antihypertensive and/or Antihyperlipidemic Medications: A Multicenter Study in Indonesia

Diabetes Distress and Health-Related Quality of Life among Patients with Type 2 Diabetes-Mediating Role of Experiential Avoidance and Moderating Role of Post-Traumatic Growth

OBJECTIVES

Many people living with type 2 diabetes experience diabetes distress which impacts negatively on their health-related quality of life (HRQoL). However, little is known about the modifiable factors or psychological processes that make this happen. The current study examines the role of experiential avoidance and post-traumatic growth (PTG) in association with diabetes distress and the HRQoL.

METHODS

Participants included 303 patients with type 2 diabetes conveniently selected from two tertiary healthcare institutions in Nigeria. They completed relevant self-report measures. The Hayes PROCESS macro for SPSS was used for data analysis.

RESULTS

The results showed that experiential avoidance mediated the association between diabetes distress and the HRQoL [95% CI: -0.15, -0.07]. PTG significantly moderated the association between diabetes distress and the HRQoL [95% CI: 0.01, 0.02]. Specifically, diabetes distress was associated with a poor HRQoL only among patients with low levels of PTG but not among those with average and high levels of PTG.

CONCLUSION

These findings underscore the importance of Acceptance and Commitment Therapy as it can potentially decrease the experiential avoidance behaviour of patients. Moreover, intervention should also target the facilitation of PTG due to its beneficial effects in reducing the negative effects of diabetes distress on health and recovery.

Effects of a theory-based training program with follow-up home visits on self-management behavior, glycemic index, and quality of life among Iranian patients with type 2 diabetes mellitus

Background

Uncontrolled diabetes is an important public health problem that endangers the quality of life of patients. Promoting self-management through well-planned training is an essential strategy to control diabetes effectively. This study aimed to examine the effects of a training program based on social cognitive theory (SCT) on self-management behavior, glycemic index, and quality of life among patients with type 2 diabetes mellitus.

Methods

This is a quasi-experimental study with a pretest–posttest design. The statistical population included 106 adults with type 2 diabetes mellitus assigned to the intervention and control groups [n₁ = n₂ = 53], who received services from two urban health centers. A multi-method, SCT-based training program consisting of six 60–80-min sessions was run, followed by 2–3 follow-up home visits [once a month for each participant] for the intervention group. The data were collected before and three months after the intervention and were analyzed in SPSS 19.

Results

Before the intervention, there was no significant difference between the two groups regarding the main variables. After the intervention, there was a significant increase in the intervention group's mean scores of knowledge, self-efficacy, social support, outcome expectations, self-regulation, self-management behavior, glycemic index, and quality of life. There were no significant changes in these constructs in the control group after the intervention. The regression analysis results indicated that social cognitive theory and self-management could explain the variance in quality of life [adjusted R-squared = 0.476].

Conclusions

The findings support the effectiveness of the multi-method, SCT-based educational intervention in improving self-management behaviors, glycemic index, and quality of life among patients with type 2 diabetes mellitus. It is suggested that the quality of type 2 diabetes care programs should be promoted. However, further research is needed to evaluate the long-term outcomes.