Lin Yi-Hsin, Chen Di-An, Lin Chemin, Huang Hsuan
Division of Endocrinology and Metabolism, Department of Internal Medicine, Taiwan Adventist Hospital, Taipei, Taiwan (R.O.C.).
Department of Clinic Psychology, Fu Jen Catholic University, Taipei, Taiwan (R.O.C.).
Psychol Res Behav Manag. 2020 May 1;13:373-381. doi: 10.2147/PRBM.S245226. eCollection 2020.
Type D personality (TDP) has been recognized as a risk factor for many diseases. The aims of our study were to estimate the prevalence of TDP and glycemic control on the patients with type 2 diabetes mellitus (T2DM) and to assess their relationship between TDP and socio-psychological factors, such as perceived stress, self-efficacy, self-care behaviors, and psychological distress.
A total of 198 T2DM patients (male 62.6%, mean age 51.2±11.0, mean HbA1c 7.3±1.8%) were recruited consecutively from the Department of Endocrinology of a regional hospital in Taipei, Taiwan, from December 2017 to April 2018. They completed questionnaires that contain questions about sociodemographic characteristics, TDP, illness-related stress, self-efficacy, execution of diabetes management and emotional distress. Their medical records were reviewed for biomedical data.
Of the 198 patients, 82 (41.4%) had TDP. Controlling for sociodemographic factors, patients with TDP were reported significantly poorer on glycemic control than those without TDP (mean HbA1c (%) 7.6±1.9 vs 7.1±1.8, <0.05). Compared to those without TDP, the results showed significantly higher levels of perceived stress (<0.001) and psychological distress (anxiety and depression) (<0.001), as well as significantly lower levels of self-efficacy (<0.001) and self-care behaviors (<0.001) on patients with TDP. TDP was positively correlated with perceived stress and psychological distress and negatively correlated with self-efficacy and self-care behaviors scores.
This study provides the evidence linking TDP with poor glycemic control, low levels of self-efficacy and self-care behaviors, as well as high levels of perceived stress and psychological distress, which highlights the screening of TDP and the tailored needs for the care among T2DM patients with TDP.
D型人格（TDP）已被公认为多种疾病的危险因素。我们研究的目的是评估2型糖尿病（T2DM）患者中TDP的患病率和血糖控制情况，并评估TDP与社会心理因素之间的关系，如感知压力、自我效能感、自我护理行为和心理困扰。
2017年12月至2018年4月，从台湾台北一家地区医院的内分泌科连续招募了198例T2DM患者（男性占62.6%，平均年龄51.2±11.0岁，平均糖化血红蛋白[HbA1c]为7.3±1.8%）。他们完成了包含社会人口统计学特征、TDP、疾病相关压力、自我效能感、糖尿病管理执行情况和情绪困扰等问题的问卷。对他们的病历进行回顾以获取生物医学数据。
在198例患者中，82例（41.4%）有TDP。在控制社会人口统计学因素后，有TDP的患者血糖控制情况明显比没有TDP的患者差（平均HbA1c（%）7.6±1.9 vs 7.1±1.8，<0.05）。与没有TDP的患者相比，结果显示有TDP的患者感知压力水平（<0.001）和心理困扰（焦虑和抑郁）水平（<0.001）显著更高，而自我效能感水平（<0.001）和自我护理行为水平（<0.001）显著更低。TDP与感知压力和心理困扰呈正相关，与自我效能感和自我护理行为得分呈负相关。
本研究提供了证据，表明TDP与血糖控制不佳、自我效能感和自我护理行为水平低以及感知压力和心理困扰水平高有关，这突出了对TDP的筛查以及对患有TDP的T2DM患者进行个性化护理的需求。
