Tanenbaum M L, Kane N S, Kenowitz J, Gonzalez J S
Department of Pediatrics, Stanford University School of Medicine, 780 Welch Rd., Palo Alto, CA 94304, USA.
Ferkauf Graduate School of Psychology, Yeshiva University, Ferkauf Graduate School of Psychology, Yeshiva University, 1300 Morris Park Ave., Rousso Building, Bronx, NY 10461, USA.
J Diabetes Complications. 2016 Aug;30(6):1060-8. doi: 10.1016/j.jdiacomp.2016.04.023. Epub 2016 May 4.
To explore diabetes distress in a sample of adults with type 2 diabetes, treated and not treated with insulin.
Six focus groups were conducted with 32 adults with type 2 diabetes, divided by treatment regimen (insulin-treated N=15; 67% female; 60% black; 46% Hispanic; M age 54; M HbA1c 73mmol/mol (8.8%); non-insulin-treated N=17; 53% female; 65% black; 13% Hispanic; M age 58; M HbA1c 55mmol/mol (7.2%)). A coding team transcribed and analyzed interviews to describe themes. Themes were then compared between groups and with existing diabetes distress measures.
Participants in both groups described a range of sources of diabetes distress, including lack of support/understanding from others, difficulties communicating with providers, and distress from the burden of lifestyle changes. Insulin-treated participants described significant emotional distress related to the burden of their insulin regimen. They were more likely to report physical burden related to diabetes; to describe feeling depressed as a result of diabetes; and to express distress related to challenges with glycemic control. Non-insulin-treated participants were more likely to discuss the burden of comorbid medical illnesses.
Our data generate hypotheses for further study into the emotional burdens of diabetes for insulin-treated adults with type 2 diabetes and are in line with quantitative research documenting increased diabetes-related distress among insulin-treated individuals. Data describe needs, currently unmet by most models of care, for comprehensive assessment and tailored management of diabetes-related distress.
探讨2型糖尿病成年患者样本中，接受胰岛素治疗和未接受胰岛素治疗者的糖尿病困扰情况。
对32名2型糖尿病成年患者进行了6次焦点小组访谈，根据治疗方案分组（胰岛素治疗组N = 15；女性占67%；黑人占60%；西班牙裔占46%；平均年龄54岁；平均糖化血红蛋白73mmol/mol（8.8%）；非胰岛素治疗组N = 17；女性占53%；黑人占65%；西班牙裔占13%；平均年龄58岁；平均糖化血红蛋白55mmol/mol（7.2%））。一个编码团队对访谈进行转录和分析以描述主题。然后对两组之间的主题以及与现有的糖尿病困扰测量方法进行比较。
两组参与者都描述了一系列糖尿病困扰的来源，包括缺乏他人的支持/理解、与医疗服务提供者沟通困难以及生活方式改变带来的负担所导致的困扰。接受胰岛素治疗的参与者描述了与胰岛素治疗负担相关的严重情绪困扰。他们更有可能报告与糖尿病相关的身体负担；描述因糖尿病而感到沮丧；并表达与血糖控制挑战相关的困扰。未接受胰岛素治疗的参与者更有可能讨论合并症的负担。
我们的数据为进一步研究2型糖尿病成年胰岛素治疗患者的糖尿病情绪负担提出了假设，并且与记录胰岛素治疗个体中糖尿病相关困扰增加的定量研究一致。数据描述了目前大多数护理模式尚未满足的需求，即对糖尿病相关困扰进行全面评估和量身定制的管理。
