Chen Yi-Chien, Huang Yi-Hua, Lee Chao-Hsien
Department of Nursing, Taipei Veterans General Hospital, Yuli Branch, Hualien, Taiwan, Republic of China.
Department of Social Work, Meiho University, Pingtung, Taiwan, Republic of China.
Diabetes Metab Syndr Obes. 2025 May 5;18:1431-1443. doi: 10.2147/DMSO.S503754. eCollection 2025.
Diabetes is a highly prevalent metabolic disease worldwide. In Taiwan, healthcare services emphasize self-management strategies and interventions focusing on self-care. However, there is a lack of literature on diabetes distress (DD). Therefore, this study aims to explore the relationship between demographic characteristics, diabetes knowledge, and diabetes self-care behaviors with diabetes distress among Type 2 diabetes mellitus (T2DM) patients and identify predictive factors.
This study employs a cross-sectional survey, targeting T2DM patients from the internal medicine outpatient clinic of a regional hospital in eastern Taiwan. Participants were recruited through purposive sampling from April 11, 2023, to May 16, 2023. The study examines the correlation between diabetes knowledge, diabetes self-care behaviors, and diabetes distress, as well as other influencing factors. The data analysis methods include (1) differences in diabetes knowledge, diabetes self-care behaviors, and diabetes distress scores, analyzed using -tests or ANOVA, (2) Scheffe's tests for significant differences identified by ANOVA to locate group differences in means, and (3) multiple regression analysis to identify key predictive factors of diabetes distress.
The findings reveal that both diabetes knowledge (β=-0.046, p=0.029) and diabetes self-care behaviors (β=-0.186, p=0.006) significantly predict diabetes distress. Additionally, gender (β=0.251, p=0.004), family history of diabetes (β=0.213, p=0.017), and diabetes complications (β=0.228, p=0.018) are significant predictors of diabetes distress. The overall -test reached significance (F=7.61, p<0.001), and the explanatory power of the regression model (R²=0.17) is statistically significant, indicating that diabetes knowledge, diabetes self-care behaviors, gender, family history of diabetes, and diabetes complications are important predictors of diabetes distress in T2DM patients. These findings can provide valuable insights for clinicians in identifying risk factors for diabetes distress and understanding the factors that influence diabetes distress in T2DM patients.
It is crucial to integrate the assessment and management of diabetes distress into routine diabetes care and even implement distress screening during the health promotion stage. Strengthening the ability of healthcare professionals to identify diabetes distress through early detection of risk factors and providing individualized interventions and care plans tailored to T2DM patients is of great importance.
糖尿病是一种在全球范围内高度流行的代谢性疾病。在台湾，医疗服务强调自我管理策略以及专注于自我护理的干预措施。然而，关于糖尿病困扰（DD）的文献却很匮乏。因此，本研究旨在探讨2型糖尿病（T2DM）患者的人口统计学特征、糖尿病知识、糖尿病自我护理行为与糖尿病困扰之间的关系，并确定预测因素。
本研究采用横断面调查，以台湾东部一家区域医院内科门诊的T2DM患者为研究对象。通过目的抽样法，于2023年4月11日至2023年5月16日招募参与者。该研究考察糖尿病知识、糖尿病自我护理行为与糖尿病困扰之间的相关性以及其他影响因素。数据分析方法包括：（1）使用t检验或方差分析（ANOVA）分析糖尿病知识、糖尿病自我护理行为和糖尿病困扰得分的差异；（2）对方差分析确定的显著差异进行谢费检验，以找出均值的组间差异；（3）多元回归分析以确定糖尿病困扰的关键预测因素。
研究结果显示，糖尿病知识（β=-0.046，p=0.029）和糖尿病自我护理行为（β=-0.186，p=0.006）均能显著预测糖尿病困扰。此外，性别（β=0.251，p=0.004）、糖尿病家族史（β=0.213，p=0.017）和糖尿病并发症（β=0.228，p=0.018）也是糖尿病困扰的显著预测因素。总体F检验达到显著水平（F=7.61，p<0.001），回归模型的解释力（R²=0.17）具有统计学意义，表明糖尿病知识、糖尿病自我护理行为、性别、糖尿病家族史和糖尿病并发症是T2DM患者糖尿病困扰的重要预测因素。这些发现可为临床医生识别糖尿病困扰的风险因素以及了解影响T2DM患者糖尿病困扰的因素提供有价值的见解。
将糖尿病困扰的评估和管理纳入常规糖尿病护理至关重要，甚至在健康促进阶段就应进行困扰筛查。加强医护人员通过早期发现风险因素来识别糖尿病困扰的能力，并为T2DM患者提供个性化干预措施和护理计划非常重要。
