Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia; University of Utrecht, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
University of Utrecht, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
Diabetes Res Clin Pract. 2018 Aug;142:74-84. doi: 10.1016/j.diabres.2018.05.021. Epub 2018 May 24.
To examine whether diabetes distress (DD), when measured by three different instruments, was associated differently with self-efficacy, self-care activity, medication adherence and disease control in people with Type 2 diabetes mellitus.
A cross-sectional study in three health clinics. DD was assessed with the 17-item Diabetes Distress Scale, the 2-item DDS-2 (DDS-2) and the 5-item Problem Areas in Diabetes Scale (PAID-5). Dependent variables included self-efficacy, self-care activities, medication adherence, HbA, systolic and diastolic blood pressure (SBP, DBP). Multiple linear and logistic regression were used in analyses.
In total 338 participants (56% women), with a mean age of 61 years and diabetes duration of 9.8 years, were included. DDS-2 was an independent determinant of SBP (β = 1.89, 95% CI 0.14, 3.64), DBP (β = 1.19, 95% CI 0.16, 2.21) and blood pressure target (OR = 2.09, 95% CI 1.12, 3.83). PAID-5 was an independent determinant of medication adherence (adjusted β = -0.05, 95% CI -0.08, -0.01) and self-care activities (OR = 0.50, 95% CI 0.26, 0.99).
Associations of DD with important aspects of diabetes care are substantially influenced by confounders and depend on the way DD is measured. Our findings call for a judicious use of different DD measures in clinical practice and research. The study is registered on ClinicalTrials.gov (NCT02730754).
探讨使用三种不同工具测量的糖尿病困扰（DD）与 2 型糖尿病患者的自我效能、自我护理活动、药物依从性和疾病控制之间的相关性是否存在差异。
在三个健康诊所进行横断面研究。使用 17 项糖尿病困扰量表（Diabetes Distress Scale，DDS）、2 项 DDS-2（DDS-2）和 5 项糖尿病问题领域量表（Problem Areas in Diabetes Scale，PAID-5）评估 DD。因变量包括自我效能、自我护理活动、药物依从性、糖化血红蛋白（HbA）、收缩压和舒张压（SBP、DBP）。分析采用多元线性和逻辑回归。
共纳入 338 名参与者（56%为女性），平均年龄 61 岁，糖尿病病程 9.8 年。DDS-2 是 SBP（β=1.89，95%CI 0.14，3.64）、DBP（β=1.19，95%CI 0.16，2.21）和血压目标（OR=2.09，95%CI 1.12，3.83）的独立决定因素。PAID-5 是药物依从性（调整后β=-0.05，95%CI -0.08，-0.01）和自我护理活动（OR=0.50，95%CI 0.26，0.99）的独立决定因素。
DD 与糖尿病护理的重要方面的相关性受到混杂因素的极大影响，并且取决于测量 DD 的方式。我们的研究结果呼吁在临床实践和研究中谨慎使用不同的 DD 测量方法。本研究在 ClinicalTrials.gov 注册（NCT02730754）。
