Margaret M. McCarthy, PhD, RN, FNP-BC, is an Assistant Professor, the New York University Rory Meyers College of Nursing, New York. Robin Whittemore PhD, APRN, is Professor and Codirector, the National Clinician Scholars Program, Yale School of Nursing, West Haven, Connecticut. Margaret Grey, DrPH, RN, is Annie Goodrich Professor of Nursing, Yale School of Nursing, West Haven, Connecticut. Georica Gholson, PhD, is Psychologist, Walter Reed Medical Center, Bethesda, Maryland.
Nurs Res. 2019 Nov/Dec;68(6):445-452. doi: 10.1097/NNR.0000000000000387.
The prevalence of adults with Type 1 diabetes (T1D) is increasing, and their risk of cardiovascular disease is high. Comorbid diabetes distress and depressive symptoms may affect their cardiovascular health.
The purpose of this study was to describe the relationship between diabetes distress and depressive symptoms with cardiovascular health factors.
This was a cross-sectional survey of a sample of adults with T1D. Valid and reliable instruments were used to collect the data on sociodemographics, diabetes-related complications, psychological factors, and cardiovascular health factors. Independent-sample t tests, analysis of variance, chi-square analyses, and linear regression were used to compare the cardiovascular health factors among the three levels of diabetes distress scores and the two levels of depressive symptom scores.
Our sample included 83 adults with a mean age of 45.2 years and a mean duration of T1D of 20 years. The majority scored low in the Diabetes Distress Scale, whereas 18% scored moderate and 18% scored high. Twenty-two percent had increased levels of depressive symptoms. There were significant correlations between diabetes distress and fear of hypoglycemia, depressive symptom scores, hemoglobin A1c, and total cholesterol. Depressive symptom scores were significantly correlated with hemoglobin A1c. Hemoglobin A1c and total cholesterol were significantly higher in those with higher levels of diabetes distress. There were no significant differences in cardiovascular health between those who scored below or above the cut point for depressive symptoms, but there was a finding toward higher mean body mass index, hemoglobin A1c, and a lower weekly step count in those who had elevated depressive symptoms. In the linear regression, only diabetes distress was significantly associated with hemoglobin A1c.
This is a sample with elevated diabetes distress and depressive symptoms, both of which may affect their risk of cardiovascular disease.
成人 1 型糖尿病（T1D）的患病率正在增加，其心血管疾病风险较高。合并糖尿病困扰和抑郁症状可能会影响其心血管健康。
本研究旨在描述糖尿病困扰和抑郁症状与心血管健康因素之间的关系。
这是一项对 T1D 成人样本的横断面调查。使用有效且可靠的工具收集社会人口统计学、糖尿病相关并发症、心理因素和心血管健康因素的数据。采用独立样本 t 检验、方差分析、卡方分析和线性回归分析比较糖尿病困扰评分三个水平和抑郁症状评分两个水平的心血管健康因素。
我们的样本包括 83 名平均年龄为 45.2 岁、T1D 平均病程为 20 年的成年人。大多数人的糖尿病困扰量表得分较低，而 18%的人得分中等，18%的人得分较高。22%的人有较高水平的抑郁症状。糖尿病困扰与低血糖恐惧、抑郁症状评分、糖化血红蛋白和总胆固醇之间存在显著相关性。抑郁症状评分与糖化血红蛋白显著相关。糖尿病困扰程度较高的患者糖化血红蛋白和总胆固醇明显较高。抑郁症状评分低于或高于截点的患者之间的心血管健康无显著差异，但发现抑郁症状升高的患者平均体重指数、糖化血红蛋白较高，每周步数较少。在线性回归中，只有糖尿病困扰与糖化血红蛋白显著相关。
这是一个糖尿病困扰和抑郁症状都较高的样本，两者都可能影响其患心血管疾病的风险。
