School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia.
Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia.
J Clin Nurs. 2021 Sep;30(17-18):2462-2468. doi: 10.1111/jocn.15741. Epub 2021 Apr 7.
The aim of the study was to test the association between subthreshold depression and self-care behaviours in adults with type 2 diabetes (T2D) attending a tertiary healthcare service.
Suboptimal adherence to self-care behaviours is associated with poor glycaemic control. The estimated point prevalence of subthreshold depression in people with T2D is 17%. Two previous studies have examined the association between subthreshold depression and self-care behaviours in T2D, reported observations were inconsistent.
A cross-sectional observational study.
We surveyed adults with T2D attending a tertiary healthcare facility in Nepal. Self-care behaviours and subthreshold depression were assessed using the Summary of Diabetes Self-care Activities and the Patient Health Questionnaire-9, respectively. We used linear and logistic regression to test the association of subthreshold depression with total and individual self-care behaviours. Our reporting complies with STROBE reporting guideline for observational research.
Just over a third (37%) of the participants had subthreshold depression. People with subthreshold depression had slightly lower total diabetes self-care score compared to those with no depression. More than half of participants with subthreshold depression had suboptimal adherence to diet, physical activity and foot care. Subthreshold depression was associated with total self-care score (B = -0.27, 95% CI: -0.54, -0.01). In addition, association between subthreshold depression and diet adherence was observed (AOR = 0.26, 95% CI: 0.15, 0.44).
Subthreshold depression is associated with decreased adherence to self-care behaviour in people with T2D. Identification and treatment of subthreshold depression in T2D may lead to better adherence to diabetes self-care behaviours.
The recognition and treatment of subthreshold depression warrants further investigation as a strategy to improve the adherence to self-care behaviours.
本研究旨在检验在接受三级医疗服务的 2 型糖尿病（T2D）成人中，亚临床抑郁与自我护理行为之间的关联。
自我护理行为不达标与血糖控制不佳有关。T2D 患者亚临床抑郁的估计点患病率为 17%。两项先前的研究已经检查了 T2D 中亚临床抑郁与自我护理行为之间的关联，报告的观察结果不一致。
横断面观察性研究。
我们调查了在尼泊尔一家三级医疗机构就诊的 T2D 成人。使用糖尿病自我护理活动总结和患者健康问卷-9 分别评估自我护理行为和亚临床抑郁。我们使用线性和逻辑回归来测试亚临床抑郁与总自我护理行为和个别自我护理行为的关联。我们的报告符合 STROBE 观察性研究报告准则。
超过三分之一（37%）的参与者有亚临床抑郁。与无抑郁的人相比，有亚临床抑郁的人糖尿病自我护理总评分略低。超过一半有亚临床抑郁的参与者饮食、体育活动和足部护理不达标。亚临床抑郁与总自我护理评分相关（B = -0.27，95%CI：-0.54，-0.01）。此外，还观察到亚临床抑郁与饮食依从性之间的关联（AOR = 0.26，95%CI：0.15，0.44）。
亚临床抑郁与 T2D 患者自我护理行为的依从性下降有关。在 T2D 中识别和治疗亚临床抑郁可能会导致更好地遵守糖尿病自我护理行为。
需要进一步研究识别和治疗亚临床抑郁，作为提高自我护理行为依从性的策略。
