scholarly journals Psychosocial moderators of the impact of diabetes stigma: results from the second Diabetes MILES – Australia (MILES-2) study

2020 ◽  
Author(s):  
Elizabeth Holmes-Truscott ◽  
Adriana D Ventura ◽  
Sharmala Thuraisingam ◽  
Frans Pouwer ◽  
Jane Speight
Keyword(s):  
Social Support ◽  
Type 2 Diabetes ◽  
Standard Deviation ◽  
Self Efficacy ◽  
Self Esteem ◽  
Anxiety Symptoms ◽  
Diabetes Distress ◽  
Male Age

<b>Objective</b> <p>To examine the association between diabetes stigma, psychological, behavioural, and Hba1c outcomes and to investigate moderation effects of self-esteem, self-efficacy and/or social support. </p> <h3><b>Research Design and Methods</b></h3> <p>Second national Diabetes MILES–Australia (MILES-2) survey: adults with type 1 diabetes (n=959, 41% male; mean±SD age: 44±15 years), insulin-treated (n=487, 60% male; age: 61±9), and non-insulin treated type 2 diabetes (n=642, 55% male; age: 61±10). (Un)adjusted linear regression analyses tested the association between diabetes stigma (DSAS) and psychological outcomes (depressive symptoms: PHQ-8; anxiety symptoms: GAD-7; diabetes-specific distress: PAID), behavioural outcomes (healthy diet and physical activity: SDSCA), and self-reported HbA1c. Interaction effects tested whether associations varied by self-esteem (RSE), self-efficacy (CIDS) and/or diabetes-specific social support (DSS). </p> <h3><b>Results </b></h3> <p>Significant positive associations were observed between DSAS and PHQ-8, GAD-7 and PAID across diabetes type/treatment groups (all p<.001), whereby each standard deviation increase in DSAS scores was associated with an approximate half standard deviation deterioration in emotional well-being. Associations between DSAS and SDSCA and HbA1c were non-meaningful. Self-esteem moderated psychological outcomes among participants with type 1 and non-insulin treated type 2 diabetes, and diabetes distress among those with insulin-treated type 2 diabetes. Interaction effects were partially observed for social support but not for self-efficacy. </p> <h3><b>Conclusions </b></h3> <p>This study provides evidence of the association between diabetes stigma and depressive/anxiety symptoms and diabetes distress, and for the moderating effects of self-esteem and social support, among adults with type 1 and type 2 diabetes. Further research is needed to examine associations with objectively-measured behavioural and clinical outcomes. </p>

scholarly journals Psychosocial moderators of the impact of diabetes stigma: results from the second Diabetes MILES – Australia (MILES-2) study

2020 ◽  
Author(s):  
Elizabeth Holmes-Truscott ◽  
Adriana D Ventura ◽  
Sharmala Thuraisingam ◽  
Frans Pouwer ◽  
Jane Speight
Keyword(s):  
Social Support ◽  
Type 2 Diabetes ◽  
Standard Deviation ◽  
Self Efficacy ◽  
Self Esteem ◽  
Anxiety Symptoms ◽  
Diabetes Distress ◽  
Male Age

<b>Objective</b> <p>To examine the association between diabetes stigma, psychological, behavioural, and Hba1c outcomes and to investigate moderation effects of self-esteem, self-efficacy and/or social support. </p> <h3><b>Research Design and Methods</b></h3> <p>Second national Diabetes MILES–Australia (MILES-2) survey: adults with type 1 diabetes (n=959, 41% male; mean±SD age: 44±15 years), insulin-treated (n=487, 60% male; age: 61±9), and non-insulin treated type 2 diabetes (n=642, 55% male; age: 61±10). (Un)adjusted linear regression analyses tested the association between diabetes stigma (DSAS) and psychological outcomes (depressive symptoms: PHQ-8; anxiety symptoms: GAD-7; diabetes-specific distress: PAID), behavioural outcomes (healthy diet and physical activity: SDSCA), and self-reported HbA1c. Interaction effects tested whether associations varied by self-esteem (RSE), self-efficacy (CIDS) and/or diabetes-specific social support (DSS). </p> <h3><b>Results </b></h3> <p>Significant positive associations were observed between DSAS and PHQ-8, GAD-7 and PAID across diabetes type/treatment groups (all p<.001), whereby each standard deviation increase in DSAS scores was associated with an approximate half standard deviation deterioration in emotional well-being. Associations between DSAS and SDSCA and HbA1c were non-meaningful. Self-esteem moderated psychological outcomes among participants with type 1 and non-insulin treated type 2 diabetes, and diabetes distress among those with insulin-treated type 2 diabetes. Interaction effects were partially observed for social support but not for self-efficacy. </p> <h3><b>Conclusions </b></h3> <p>This study provides evidence of the association between diabetes stigma and depressive/anxiety symptoms and diabetes distress, and for the moderating effects of self-esteem and social support, among adults with type 1 and type 2 diabetes. Further research is needed to examine associations with objectively-measured behavioural and clinical outcomes. </p>

scholarly journals Psychosocial moderators of the impact of diabetes stigma: results from the second Diabetes MILES – Australia (MILES-2) study

2020 ◽  
Author(s):  
Elizabeth Holmes-Truscott ◽  
Adriana D Ventura ◽  
Sharmala Thuraisingam ◽  
Frans Pouwer ◽  
Jane Speight
Keyword(s):  
Social Support ◽  
Type 2 Diabetes ◽  
Standard Deviation ◽  
Self Efficacy ◽  
Self Esteem ◽  
Anxiety Symptoms ◽  
Diabetes Distress ◽  
Male Age

<b>Objective</b> <p>To examine the association between diabetes stigma, psychological, behavioural, and Hba1c outcomes and to investigate moderation effects of self-esteem, self-efficacy and/or social support. </p> <h3><b>Research Design and Methods</b></h3> <p>Second national Diabetes MILES–Australia (MILES-2) survey: adults with type 1 diabetes (n=959, 41% male; mean±SD age: 44±15 years), insulin-treated (n=487, 60% male; age: 61±9), and non-insulin treated type 2 diabetes (n=642, 55% male; age: 61±10). (Un)adjusted linear regression analyses tested the association between diabetes stigma (DSAS) and psychological outcomes (depressive symptoms: PHQ-8; anxiety symptoms: GAD-7; diabetes-specific distress: PAID), behavioural outcomes (healthy diet and physical activity: SDSCA), and self-reported HbA1c. Interaction effects tested whether associations varied by self-esteem (RSE), self-efficacy (CIDS) and/or diabetes-specific social support (DSS). </p> <h3><b>Results </b></h3> <p>Significant positive associations were observed between DSAS and PHQ-8, GAD-7 and PAID across diabetes type/treatment groups (all p<.001), whereby each standard deviation increase in DSAS scores was associated with an approximate half standard deviation deterioration in emotional well-being. Associations between DSAS and SDSCA and HbA1c were non-meaningful. Self-esteem moderated psychological outcomes among participants with type 1 and non-insulin treated type 2 diabetes, and diabetes distress among those with insulin-treated type 2 diabetes. Interaction effects were partially observed for social support but not for self-efficacy. </p> <h3><b>Conclusions </b></h3> <p>This study provides evidence of the association between diabetes stigma and depressive/anxiety symptoms and diabetes distress, and for the moderating effects of self-esteem and social support, among adults with type 1 and type 2 diabetes. Further research is needed to examine associations with objectively-measured behavioural and clinical outcomes. </p>

scholarly journals Mediating role diet self-efficacy plays in the relationship between social support and diet self-management for patients with type 2 diabetes

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Li Yang ◽  
Kun Li ◽  
Yan Liang ◽  
Qiuli Zhao ◽  
Dan Cui ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Social Support ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Self Efficacy ◽  
Self Management ◽  
Mediating Role ◽  
Diet Behavior ◽  
The Relationship

Abstract Background It has previously been established that patients who have strong barriers to their diet self-management are more likely to have weak social support; however, the key mechanisms underlying the association between these two variables have not yet been established. This study aims to examine the potential role that diet self-efficacy plays in the relationship between social support and diet behavior in patients with type 2 diabetes mellitus (T2DM). Methods It was a cross-sectional survey. Three hundred-eighty patients diagnosed with T2DM were recruited for this study from five community health centers in China. The Chronic Disease Resource Scale (CIRS), Cardiac Diet Self-efficacy Scale (CDSE), and Food Control Behavior Scale (FCBS) were used to estimate participants’ utilization of social resources, diet self-efficacy, and diet self-management, respectively. The data were analyzed utilizing structural equation modelling. Results The results suggest that both higher levels of social support and diet self-efficacy are related to higher levels of diet self-management. The mediating effect that diet self-efficacy has on the relationship between social support and diet self-management was significant (β = .30, p < .05), explaining 55.68% of the total effect of social support on diet self-management. Conclusions Diet self-efficacy plays a mediating role in the association between social support and diet behavior in patients with type 2 diabetes mellitus.

scholarly journals Web-Based Benefit-Finding Writing for Adults with Type 1 or Type 2 Diabetes: Preliminary Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Joanna Crawford ◽  
Kay Wilhelm ◽  
Judy Proudfoot
Keyword(s):  
Mental Health ◽  
Type 2 Diabetes ◽  
Positive Affect ◽  
Active Control ◽  
Benefit Finding ◽  
Diabetes Distress ◽  
Web Based ◽  
To Receive

BACKGROUND The high prevalence of diabetes distress and subclinical depression in adults with type 1 and type 2 diabetes mellitus (T1DM and T2DM, respectively) indicates the need for low-intensity self-help interventions that can be used in a stepped care approach to address some of their psychological needs. However, people with diabetes can be reluctant to engage in mental health care. Benefit-finding writing (BFW) is a brief intervention that involves writing about any positive thoughts and feelings concerning a stressful experience such as an illness, avoiding potential mental health stigma. It has been associated with increases in positive affect and positive growth and has demonstrated promising results in trials in other clinical populations. However, BFW has not been examined in people with diabetes. OBJECTIVE This study aimed to evaluate the efficacy of a Web-based BFW intervention for reducing diabetes distress and increasing benefit finding in diabetic adults with T1DM or T2DM compared to a control writing condition. METHODS Adults with T1DM or T2DM and diabetes distress were recruited online through the open access Writing for Health program. After completing baseline questionnaires, they were randomly allocated to receive online BFW or an active control condition of online writing about the use of time (CW). Both groups completed 15-minute online writing sessions, once per day, for 3 consecutive days. Online measures were administered at baseline, 1 month, and 3 months postintervention. Participants were also asked to rate their current mood immediately prior to and following each writing session. RESULTS Seventy-two adults with T1DM or T2DM were recruited and randomly allocated to receive BFW (n=24) or CW (n=48). Participants adhered to the BFW regimen. Greater increases in positive affect immediately postwriting were found in the BFW group than in the CW group. However, there were no significant group-by-time interactions (indicating intervention effects) for benefit finding or diabetes distress at either the 1-month or 3-month follow-up. Both the BFW and CW groups demonstrated small, significant decreases in diabetes distress over time. CONCLUSIONS BFW was well tolerated by adults with diabetes in this study but did not demonstrate efficacy in improving diabetes distress or benefit finding compared to an active control writing condition. However, due to recruitment difficulties, the study was underpowered and the sample was skewed to individuals with minimal diabetes distress and none to minimal depression and anxiety at baseline. Future research should continue to investigate the efficacy of variants of therapeutic writing for adults with T1DM or T2DM, using larger samples of participants with elevated diabetes distress. CLINICALTRIAL Australiand New Zealand Clinical Trials Registry ACTRN12615000241538; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368146

scholarly journals The Effect of Social Support on Glycemic Control in Patients with Type 2 Diabetes Mellitus: The Mediating Roles of Self-Efficacy and Adherence

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Yechang Shao ◽  
Lu Liang ◽  
Linjing Shi ◽  
Chengsong Wan ◽  
Shouyi Yu
Keyword(s):  
Diabetes Mellitus ◽  
Social Support ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Self Efficacy ◽  
Goodness Of Fit ◽  
Equation Modeling ◽  
Ample Evidence

Ample evidence suggests that social support, self-efficacy, and adherence significantly, independently, and together affect glycemic control in patients with type 2 diabetes mellitus (T2DM), but the pathway from social support to glycemic control remains unclear. This study hypothesized that the effect of social support on glycemic control was mediated sequentially by self-efficacy and adherence. Patients with T2DM were recruited from two hospitals in Guangzhou, China, from January 1 to July 31, 2014, and their sociodemographic clinical data and their assessments on social support, self-efficacy, and adherence were obtained from medical records and self-completed questionnaires. Of the 532 patients who participated, 35% achieved glycemic control (i.e., HbA1c < 7%). Social support, self-efficacy, and adherence had significant correlations with each other and with glycemic control (P<0.05). Regression analyses and structural equation modeling showed that better social support was associated to better patient self-efficacy, which, in turn, was associated with better medical adherence, which was associated with improved glycemic control, and the relationship between social support and glycemic control was sequentially and completely mediated by self-efficacy and adherence. The five goodness-of-fit indices confirmed that our data fitted the hypothesized pathway model strongly.

scholarly journals Diabetes Distress, Depressive Symptoms and Type 2 Diabetes Management and Glycemic Control: the Mediating Role of Self-efficacy

2020 ◽  
Author(s):  
Yuexia Gao ◽  
Yarong Han ◽  
Xin Zou ◽  
Judy Xu ◽  
Dean Getrude Mawen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Depressive Symptoms ◽  
Glycemic Control ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Diabetes Distress ◽  
Hierarchical Regression ◽  
Psychological Variables ◽  
Diabetes Outcomes

Abstract Background: Diabetes 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).Methods: 1574 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.Results: Hierarchical 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.Conclusions: Self-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.

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