1 University of California , San Diego, San Diego, California.
2 Behavioral Diabetes Institute , San Diego, California.
Diabetes Technol Ther. 2016 May;18(5):292-7. doi: 10.1089/dia.2015.0451. Epub 2016 Feb 9.
Although the widespread prevalence of diabetes-related distress (DD) in adults with type 1 diabetes (T1D) has been well established, there has been little inquiry into the experiences of their spouse/partners. Therefore the goal of this study was to investigate the prevalence and sources of DD in the spouses and partners of adults with T1D ("T1D partner") and to examine the associations of DD in this population with key demographic and contextual factors.
Qualitative interviews with 11 T1D partners led to the development of 44 DD survey items, which were examined by exploratory factor analysis (EFA). Regression models examined associations of the resulting DD scales with four groups of variables: partner demographics and contextual variables, as well as person with diabetes (PWD) demographics, diabetes status, and behavioral factors.
EFA with 317 T1D partners yielded a 22-item scale with four factors: Hypoglycemia Distress, Emotional Distress, Management Distress, and Role Distress. All scales were significantly correlated with the three criterion variables (depression, general life stress, and diabetes-related relationship satisfaction), suggesting satisfactory concurrent validity. High DD was most common for Hypoglycemic Distress (64.4% of the sample) and least common for Management Distress (28.4%). Greater DD was significantly and independently linked with being younger, female, greater involvement in the PWD's diabetes management, lower levels of relationship satisfaction, less trusting of the PWD's physician, poorer PWD glycemic control, and more frequent hypoglycemic episodes. T1D partners also reported low levels of diabetes-related support from all sources.
Four sources of partner DD were identified. Results suggest that DD in T1D partners is common, especially distress associated with hypoglycemia. Predictors of T1D partner DD come from multiple sources: demographic, disease-related, and contextual arenas, all pointing to opportunities for acknowledging and addressing DD directly in this population.
尽管成年人 1 型糖尿病（T1D）患者的糖尿病相关困扰（DD）普遍存在，但对于其配偶/伴侣的相关经历却鲜有探究。因此，本研究的目的是调查 T1D 患者配偶/伴侣（“T1D 伴侣”）的 DD 患病率及其来源，并探讨该人群中 DD 与关键人口统计学和环境因素的关联。
对 11 名 T1D 伴侣进行定性访谈，由此开发了 44 项 DD 调查项目，并对其进行了探索性因素分析（EFA）。回归模型考察了由此产生的 DD 量表与四组变量的关联：伴侣的人口统计学和环境变量，以及糖尿病患者（PWD）的人口统计学、糖尿病状况和行为因素。
对 317 名 T1D 伴侣进行 EFA 后，得到一个包含四个因素的 22 项量表：低血糖困扰、情绪困扰、管理困扰和角色困扰。所有量表与三个标准变量（抑郁、一般生活压力和糖尿病相关的关系满意度）均呈显著相关，提示具有满意的同时效度。DD 最常见的是低血糖困扰（64.4%的样本），最不常见的是管理困扰（28.4%）。DD 较高与年龄较小、女性、更多参与 PWD 的糖尿病管理、较低的关系满意度、对 PWD 医生的信任度较低、较差的 PWD 血糖控制和更频繁的低血糖发作显著相关。T1D 伴侣还报告来自所有来源的糖尿病相关支持度较低。
确定了四个来源的伴侣 DD。结果表明，T1D 伴侣的 DD 很常见，特别是与低血糖相关的困扰。T1D 伴侣 DD 的预测因素来自多个来源：人口统计学、疾病相关和环境领域，所有这些都指向在该人群中直接承认和解决 DD 的机会。
