scholarly journals Spousal Influence on Diabetes Self-care: Moderating Effects of Distress and Relationship Quality on Glycemic Control

Author(s):  
Emily C Soriano ◽  
James M Lenhard ◽  
Jeffrey S Gonzalez ◽  
Howard Tennen ◽  
Sy-Miin Chow ◽  
...  

Abstract Background Spouses often attempt to influence patients' diabetes self-care. Spousal influence has been linked to beneficial health outcomes in some studies, but to negative outcomes in others. Purpose We aimed to clarify the conditions under which spousal influence impedes glycemic control in patients with type 2 diabetes. Spousal influence was hypothesized to associate with poorer glycemic control among patients with high diabetes distress and low relationship quality. Methods Patients with type 2 diabetes and their spouses (N = 63 couples) completed self-report measures before patients initiated a 7-day period of continuous glucose monitoring. Mean glucose level and coefficient of variation (CV) were regressed on spousal influence, diabetes distress, relationship quality, and their two- and three-way interactions. Results The three-way interaction significantly predicted glucose variability, but not mean level. Results revealed a cross-over interaction between spousal influence and diabetes distress at high (but not low) levels of relationship quality, such that spousal influence was associated with less variability among patients with low distress, but more among those with high distress. Among patients with high distress and low relationship quality, a 1 SD increase in spousal influence predicted a difference roughly equivalent to the difference between the sample mean CV and a CV in the unstable glycemia range. Conclusions This was the first study to examine moderators of the link between spousal influence and glycemic control in diabetes. A large effect was found for glucose variability, but not mean levels. These novel results highlight the importance of intimate relationships in diabetes management.

2020 ◽  
Author(s):  
Yuexia Gao ◽  
Yarong Han ◽  
Xin Zou ◽  
Judy Xu ◽  
Dean Getrude Mawen ◽  
...  

Abstract BackgroundDiabetes distress has been distinguished from depressive symptoms in the linkages to type 2 diabetes management and glycemic control. There are few evidences in rural China untangled the underlying pathways among them. The aim of our study was to examine whether self-efficacy reduced the detrimental effects of psychological variables on diabetes outcomes such as self-care behaviors, glycemic control and health-related quality of life (HRQoL).Methods1574 adults diagnosed with type 2 diabetes from 31 rural clinics in China were assessed for psychological variables, self-management and HRQoL. Hemoglobin A1c (HbA1c) data at 6 months after the survey were extracted from electronic medical records. Hierarchical regression model examined independent effects of psychological variables, self-efficacy on diabetes outcomes. KHB method and bootstrapping confidence intervals were employed to test the mediating effect of self-efficacy.ResultsHierarchical regression analysis showed both diabetes distress and depressive symptoms were significantly related to diet and HRQoL, but not related to glycemic control and medication adherence. Depressive symptoms, but not diabetes distress, was directly associated with physical activity. Mediation analysis demonstrated self-efficacy mediated the relationships of both diabetes distress and depressive symptoms on self-care behaviors, glycemic control and HRQoL.ConclusionsSelf-efficacy may contribute to better diabetes outcome by ameliorating the effects of diabetes distress and depressive symptoms. Patients with psychological conditions may need tailored intervention that enhance self-efficacy to improve diabetes management.


Author(s):  
Hidayat Arifin ◽  
Kusnanto Kusnanto ◽  
Erna Dwi Wahyuni ◽  
Rifky Octavia Pradipta

Introduction: Treatment that must continue, control, and diet that must be obeyed by people with DM can cause boredom (burnout) - inability to care for themselves, and blood sugar that is not controlled. The purpose of this study was to determine the effect of diabetes resilience training on self-care, glycemic control, and diabetes burnout of adult type 2 diabetes mellitus. Methods: This study was a quasi-experimental design. The total samples were 70 respondents (treatment and control) obtained by cluster sampling. The independent variable was diabetes resilience training and dependent variables were self-care, glycemic control, and diabetes burnout. The intervention provided for one month with four meetings. Instrument used self-care questionnaire of Self-Care Inventory-Revised (SCI-R), glycemic control questionnaire used an observation sheet for fasting blood sugar, and diabetes burnout questionnaire used Diabetes Distress-Screening Scale (DDS17). Data were analyzed with Wilcoxon signed ranks test, Mann Whitney U Test, Independent-sample t-test, and 1-Sample K-S. Results: There was an effect of diabetes resilience training on self-care (p = 0.003; p <0.05), glycemic control (p = 0.020; p <0.05), and diabetes burnout (p = 0,000; p <0.05). Conclusions: Diabetes resilience training provided by researchers to respondents can improve good self-care behavior, decreased glycemic control values, and decreased distress (diabetes burnout) in adult type 2 diabetes mellitus.  Based on the results, it is recomandation to nurses and health care provider to implementation the diabetes resilience training regularly.


Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 584-P
Author(s):  
JACLYNN M. HAWKINS ◽  
NIKOLAS J. KOSCIELNIAK ◽  
ROBIN NWANKWO ◽  
MARTHA M. FUNNELL ◽  
KATHERINE A. KLOSS ◽  
...  

2018 ◽  
Vol Volume 12 ◽  
pp. 2377-2385 ◽  
Author(s):  
Allah Bukhsh ◽  
Tahir Mehmood Khan ◽  
Muhammad Sarfraz Nawaz ◽  
Hafiz Sajjad ◽  
Kok Gan Chan ◽  
...  

2021 ◽  
Vol 9 (1) ◽  
pp. 62-72
Author(s):  
Allison DaSantos ◽  
◽  
Carlisle Goddard ◽  
Dalip Ragoobirsingh ◽  
◽  
...  

<abstract><sec> <title>Purpose</title> <p>Diabetes management requires adherence to complicated self-care behaviors. Therefore, the emotional state of the individual living with diabetes, is likely to affect their ability to comply with recommendations. This study explored the relationship of self-care adherence to diabetes distress and depression in Barbadian adults with type 2 diabetes.</p> </sec><sec> <title>Methods</title> <p>Adults aged 20 to 80 years, with type 2 diabetes, completed self-report questionnaires comprised of a profile section consisting of demographic and clinical characteristics; and standardized questionnaires comprising, The Diabetes Distress Scale (DDS), The Patient Health Questionnaire (PQH-9), and the Summary of Diabetes Self-care Activities Scale (SDSCA). Additionally biological measures (BP and HbA1c) were collected.</p> </sec><sec> <title>Results</title> <p>For the 509 participants there were no differences in adherence for males (30.8%) and females (69.2%), high diabetes distress and depression were associated with low adherence. General diet was negatively associated with BP and HbA1c; while HbA1c was positively correlated with blood glucose testing.</p> </sec><sec> <title>Conclusion</title> <p>Self-care non-adherence is more than a behavioral problem; it is a multidimensional phenomenon inclusive of demographic factors, condition or disease factors, psychological and social factors.</p> </sec></abstract>


2019 ◽  
Vol 13 (5) ◽  
pp. 474-480 ◽  
Author(s):  
Taiga Shibayama ◽  
Somayeh Tanha ◽  
Yoshiki Abe ◽  
Hiromi Haginoya ◽  
Asadollah Rajab ◽  
...  

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