Assessment of diabetic distress and disease related factors in patients with type 2 diabetes in Isfahan: A way to tailor an effective intervention planning in Isfahan-Iran

Journal of Diabetes & Metabolic Disorders
Azar Tol1, Abdolvahab Baghbanian2, Golamreza Sharifirad3, Davoud Shojaeizadeh1, Ahmad Ali Eslami3, Fatemeh Alhani4, Mohamadreza Mohajeri Tehrani5
1School of Public Health, Tehran University of Medical Sciences, 4th Floor, School of Public Health, Pour Sina Ave., Tehran, P.O. Box: 1417613191, Iran
2Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
3Department of Health Education and Promotion, School of Public Health, Isfahan University of Medical Sciences, Ground Floor, School of Public Health, Hezarjarib Ave., P.O. Box: 8174673461, Isfahan, Iran
4School of Medicine, Tarbiat Modarres University Jalal-All-Ahmad, Tehran, P.O. Box: 14115331, Iran
5Endocrine and Metabolism Research Centre, Tehran University of Medical Sciences, 5th floor, Dr. Shariati Hospital, Northen Karegar Ave., P.O. Box: 1411413137, Tehran, Iran

Tóm tắt

Abstract Background The purpose of this study was to assess diabetes distress and its related factors among type 2 diabetic patients to better tailor intervention planning in Isfahan-Iran. Methods A cross-sectional study was conducted in 2011. Study population was patients with type 2 diabetes referring to Omolbanin, an outpatient diabetic center in Isfahan. 140 diabetic patients met the inclusion criteria and were all included in the study. Patient’s diabetes distress was measured by DDS. A 17-item self-report diabetes distress scale was used with subscales reflecting 5 domains: 1) Emotional burden (5 items), 2) Physician distress (4 items), 3) Regimen distress (5 items) and 4) Interpersonal distress (3 items). The responses to each item were rated between 1 and 6 (1 = not a problem, 2 = a slight problem, 3 = a moderate problem, 4 = somewhat serious problem, 5 = a serious problem, 6 = a very serious problem). The minimum and the maximum of score in the scale were 17 and 114 respectively. Collected data was analyzed by using SPSS software version 11.5. Results Mean age of participants were 53.23 years (SD = 7.82). 54.3% was female, 97.1% was married, and 57.1% had education lower than diploma. The average score of total diabetes distress was 2.96 ± 0.83. The average score of each domain was (3.40 ± 1.18), (2.57 ± 0.88), (2.97 ± 0.90), (2.76 ± 0.91) respectively. ‘Emotional Burden’ was considered as the most important domain in measuring diabetes distress. Total diabetes distress had significant association with age (p = 0.02), duration of diabetes (p<0.001), marital status, comorbidity, complications (p<0.001), and history of diabetes (p = 0.01). Pearson correlation coefficient revealed that diabetes distress of type 2 diabetic patients has a linear and direct relation with HbAlc (r = 0.63, p<0.001). Conclusion It seems some keywords have a main role in diabetes distress such as emotional support, communication with patient and physician, self-efficacy and social support. All of these points are achievable through empowerment approach in diabetes care plan.

Từ khóa


Tài liệu tham khảo

Spinaci S, Currat L, Shetty P, Crowell V, Kehler J, Tough Choices: Investing in health for development: Experiences from national follow- up to commission on macroeconomics and health. WHO Report; 2006.

International Diabetes Federation: Diabetes Atlas. 4th edition. IDF; 2009.

Afkhami M, Rashidi M: Type 2 diabetes risk factors. J Rafsanjan Medical Sci University 2005, 4(4):348–365.

Egede LE, Zheng D: Independent factors associated with major depressive disorder in a national sample of individuals with diabetes. Diabetes Care 2003, 26(1):104–111. https://doi.org/10.2337/diacare.26.1.104

Polonsky WH, Earles J, Smith S, Pease DJ, Macmillan M, Christensen R, et al.: Integrating medical management with diabetes self-management training: a randomized control trial of the Diabetes Outpatient Intensive Treatment Program. DiabetesCare 2003, 26: 3094–3053.

Macrodimitris SD, Endler NS: Coping, Control and adjustment in type 2 diabetes. Health psychology 2001, 20(3):208–216.

Spenser MS, Kieffer EC, Sinco BR, Palmisano G, Guzman JR, James SA, et al.: Diabetes -specific emotional distress among African American and Hispanics with type 2 diabetes. J Health Care for the poor and underserved 2006, 17: 88–105.

Whittermore R, Melkus G, Grey M: Metabolic control, Self-management and psychosocial adjustment in women with type 2 diabetes. J Clinical Nursing 2005, 14(2):195–203. https://doi.org/10.1111/j.1365-2702.2004.00937.x

West C, McDowell J: The distress experienced by people with type 2 diabetes. British J Community Nursing 2002, 7(12):606–613.

Peyrot M, Rubin RR, Lauritzen T, Snoek FJ, Matthews DR, Skovlund SE: psychosocial problems and barriers to improved diabetes management: Result of the cross- National Diabetes Attitude, Wishes and Needs (DAWN) study. Diabetic medicine 2005, 22: 1379–1385. https://doi.org/10.1111/j.1464-5491.2005.01644.x

Funnell MM, Anderson RM: Patient Empowerment: A look back, A look ahead. The diabetes Educator 2003, 29(3):454–464. https://doi.org/10.1177/014572170302900310

American Diabetes Association: Standards of medical care diabetes. Diabetes Care 2011, 34(Supplement 1):S11-S61.

Polonsky WH, Fisher L, Earles P, Dudl RJ, Lees J, Mullan J, et al.: Assessing Psychosocial Distress in Diabetes: Development of the Diabetes Distress Scale. DiabetesCare 2005, 28(3):626–631.

Funnell MM, Brown T, Childs B, Hass L, Hoset G, Jensen B: National Standards for Diabetes Self-Management Education. Diabetes Care 2010, 33(Suppl 1):89-S96.

Nichols GA, Hillier TA, Javor KY, Betz Brown J: Predictors of glycemic control in insulin-using adults with type 2 diabetes. Diabetes Care 2000, 23(3):273–277. https://doi.org/10.2337/diacare.23.3.273

Liu MY, Tai YK, Hung WW, Hsieh MC, Wang RH: Relationships between emotional distress, empowerment perception and self-care behavior and quality of life in patients with type 2 diabetes. Hu Li Za Zhi 2010, 57(2):49–60.

Lee YY, Lin JL: The effects of trust in physician on self-efficacy, adherence and diabetes outcomes. Social Sci & Med 2009, 68(6):1060–1068. https://doi.org/10.1016/j.socscimed.2008.12.033

Davidson BM: Daily self-monitoring unlikely to be cost-effective in adults with type 2 diabetes not using insulin in Canada. [Commentary on: Cameron C, Coyle D, Ur E, et al. Cost-effectiveness of self-monitoring of blood glucose in patients with type 2 diabetes mellitus managed without insulin CMAJ2010; 182:28–34]. Evidence- based Med 2010, 15(3):75–76. https://doi.org/10.1136/ebm1062

Allen N, Fain J, Braun B, Hart J, Chipkin R: Continuous glucose monitoring counseling improves physical activity behaviors of individuals with type 2 diabetes: A randomized clinical trial. Diabetes Res Clin Practice 2008, 80(3):371–379. https://doi.org/10.1016/j.diabres.2008.01.006

Tang T, Brown MB, Funnell MM, Anderson RM: Social support, Quality of life, and self- care behaviors among African Americans with type 2 diabetes. Diabetes Educators 2008, 34(2):266–276. https://doi.org/10.1177/0145721708315680

Alley G, Brown L: A diabetes problem solving support group: issues, process and preliminary outcomes. Social Work in Health Care 2002, 36(1):1–9. https://doi.org/10.1300/J010v36n01_01

Tol A, Baghbanian A, Rahimi A, Shojaeizadeh D, Mohebbi B, Majlessi F: The Relationship between perceived social support from family and diabetes control among patients with diabetes type 1 and type 2. J Diabetes and Metabolic Disorders 2011, 10: 1–8.

Minet L, Mohler S, Vach W, Wagner L, Henriksen J: Mediating the effect of self-care management intervention in type 2 diabetes: A meta-analysis of 47 randomized controlled trials. Patient Education and Counseling 2010, 80(1):29–41. https://doi.org/10.1016/j.pec.2009.09.033

Tang TS, Funnell MM, Anderson RM: Group education strategies for diabetes self-management. Diabetes Spectrum 2006, 19(2):99–105. https://doi.org/10.2337/diaspect.19.2.99

Arzaghi SM, Mahjouri MY, Heshmat R, Khashayar P, Larijani B: Psychometric properties of the Iranian version of the Problem Areas in Diabetes scale (IR-PAID-20). J Diabetes and Metabolic Disorders 2011, 10: 1–7.

Mahjouri MY, Arzaghi SM, Qorbani M, Nasli-Esfahani E, Larijani B: Evaluation of psychometric properties of the third version of the Iranian Diabetes Attitude Scale (IR-DAS-3). Iranian J Diabetes and Lipid Disorders 2011, 10: 1–6.

Thông tin
Thông tin xuất bản

Journal of Diabetes & Metabolic Disorders

Thông tin tác giả