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Patients aged 18-65 years with newly diagnosed diabetes mellitus ( n = 89) or rheumatoid arthritis ( n = 100) were studied by the General Coping Questionnaire at baseline and after 24 months. In total, 34 diabetes mellitus and 46 rheumatoid arthritis patients were diagnosed with psychosocial problems. The use of negative coping strategies, such as protest, isolation, and intrusion, was associated mostly with being classified as having psychosocial problems. With the risk of experiencing a strong impact of the disease at 2 years of follow-up as outcome, intrusion was a significant and independent risk factor, while minimization was a significant and independent protective factor.

We followed up the psychosocial situation two years after diabetes diagnosis in patients (n = 82) aged 18-65 years, with psychosocial problems (PSP; n = 27) or not (NPSP; n = 55). We used a social questionnaire, the Hospital Anxiety and Depression scale (HAD), the Sense of Coherence scale (SOC), and the General Coping Questionnaire (GCQ). The PSP group had a more difficult situation with more strained economy, lower social support, more anxiety and depression, and lower SOC on both occasions. Being in the PSP group predicted experiencing a strong negative influence of the disease at follow-up. Regarding coping strategies, "problem focusing" decreased in both PSP and NPSP over time. "Social trust" and "intrusion" decreased only in NPSP. Otherwise the coping pattern was unchanged, with PSP showing lower scores on "self-trust" and "minimization" and higher scores on "protest," "isolation," and "intrusion." The most influenced areas at follow-up in the PSP group were work, relationship to partner and economy, and in the NPSP leisure-time activities, sexual life and work. Our findings underline the need to identify patients with psychosocial problems early.

Patients with diabetes aged 35-64 years from four primary health care centres in Stockholm County were identified from electronic patient records (EPRs): diabetes prevalence occurred 414 of 15,317 men, and 250 of 15,388 women. The age- and sex-standardized prevalence of diabetes was as follows: Non-European immigrants, 5.82% (95% CI 5.06-6.58), European immigrants 1.96% (95% CI 1.53-2.39), and Swedish-born subjects 1.80% (95% CI 1.63-1.97). In conclusion, non-European immigrants showed a three-fold higher prevalence of diabetes compared to Swedish-born subjects.

We evaluated psychosocial work with patients in ordinary clinical practice who were newly diagnosed with type 1 or type 2 diabetes and experienced psychosocial problems at disease onset. We examined types of psychosocial problems, causes of these problems, psychosocial interventions, extent of achievement of psychosocial treatment goals, and whether the patients felt they benefited from the treatment. Eighty-nine working-age (18–65-year-old) Swedish adults newly diagnosed with diabetes were included. Each was interviewed and responded to questionnaires at the beginning and end of the study period. Thirty-four (38%) received psychosocial treatment as needed over 2 years. A psychosocial treatment plan with a defined goal was developed for each. Interventions included counseling, problem-focused support, social information, and advice. The treatment process was documented. Eighteen patients had type 1, and 16 had type 2 diabetes. One-third had emotional problems directly caused by receiving a diagnosis. Several of them had crisis reactions. The rest had problems primarily caused by their life situations. Those with psychosocial problems caused by receiving a diagnosis achieved treatment goals more frequently than the others. Distinguishing the cause of the psychosocial problems of newly diagnosed patients may help ensure that social work resources in health care are used as effectively as possible. [ABSTRACT FROM AUTHOR]

The study examines internal item/scale structure and concurrent validity of a newly developed 48-item questionnaire [General Coping Questionnaire (GCQ)] that measures 10 aspects of coping with chronic illness (self-trust, problem-reducing actions, change of values, social trust, minimization, fatalism, resignation, protest, isolation and intrusion). The tests were performed in two independent samples of persons with diabetes mellitus. The first sample consisted of 119 subjects with type I diabetes and the second sample of 184 subjects with type II diabetes. Concurrent validity was examined by comparisons with measures of health-related quality of life (SF-36), a measure of metabolic control (HbA1c) and incidence of diabetic complications. The item/scale structure was found to be similar and very good in both samples. The 10 dimensions correlated as expected with the measure of mental health, although the 'negative' dimensions of the GCQ correlated higher compared with the 'positive' dimensions. Weaker relations with metabolic control were also found in one of the samples. These tests provide further evidence that GCQ is a well-structured, relevant and reliable instrument for assessing coping reactions in chronic somatic conditions. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this study was to assess coping strategies of foreign-born men and women with type 2 diabetes in relation to demographic (sex, age, time in Sweden), medical, and socio-economic situation, and as compared with Swedish-born patients. Participants were foreign-born type 2 diabetic patients of European and non-European origin in primary health care in Stockholm County, comprising 41 men and 36 women aged 35–64 years, compared with Swedish-born type 2 diabetes patients, 121 men and 111 women. The General Coping Questionnaire, which measures five main orientations, dichotomised into “positive” and “negative” factors, i.e. 10 coping strategies, was used in the assessment. Medical and socio-economic data were obtained from medical records and postal questionnaires. Foreign-born men showed an impact on 6 of 10 coping strategies, and foreign-born women on 2 of 10 coping strategies, as compared to Swedish-born subjects. Longer time since migration and higher educational level were associated with lower scores for stressful coping strategies, while having financial problems and receiving a disability pension were associated with higher scores. In conclusion, the most stressful coping strategies were found among foreign-born men. It seems to be essential to improve and adjust diabetes care for immigrants, also including the psycho-social perspective. [Copyright &y& Elsevier]

This study estimates the prevalence of known diabetes, and complications of type 2 diabetes, among subjects aged 35–64 years, in relation to socio-economic factors and gender at four primary health care centres (PHCCs) in Stockholm County, Sweden. A total of 685 diabetic subjects aged 35–64 years of age were identified in primary care by diagnosis using electronic patient records. Data were supplied from medical records, and postal questionnaires. The prevalence of known diabetes among subjects aged 35–65 years differed between the PHCCs, with standardised rates between 1.7 and 3.6%, with the highest figure at the PHCC in an underprivileged area. The prevalence was higher among men (2.8% versus 1.7%). A subgroup of the patients, i.e. 389 subjects aged 35–64 years with type 2 diabetes, was studied with regard to complications. Higher education level was protective for microvascular complications (OR 0.50; CI 0.25–1.00). In addition, microvascular complications were predicted by male sex, duration, HbA1c, and hypertension, and macrovascular complications by male sex, age, and hypertension. Prevalence of known diabetes and microvascular complications in type 2 diabetes, are associated with lower socio-economic status and male sex. [Copyright &y& Elsevier]

Chronic complications in diabetes are sometimes associated with living habits. To investigate whether diabetic people's habits of smoking, drinking alcohol and taking physical exercise differed from those of the general population, a questionnaire was sent to 561 insulin-treated diabetic people and to 1,125 controls, matched for age, sex and domicile. Diabetic people were current smokers as often as controls (21% vs 23%; ns), but they drank less alcohol and more of them were non-drinkers (22% vs 13%; p<0.001). Diabetic people more often took physical exercise than did controls (40% vs 28%; p< 0.001). Diabetic women were more seldom smokers (18% vs 26%; p<0.05), more often non-drinkers (26% vs 14%; p<0.001) and exercised regularly more (44% vs 28%; p<0.001) than female controls. Diabetic men were more similar to male controls in their habits. Young diabetic people drank less alcohol and were more often non-drinkers (22% vs 9%; p<0.001) compared with their controls. Comparison within the diabetic group showed that men drank alcohol more frequently and in greater amounts, and that more women were non-drinkers (26% vs 18%;p<0.05). People with chronic complications drank less frequently and exercised less regularly (34% vs 44%; p<0.05) than those without complications. These findings suggest that diabetic people's smoking, drinking and exercise habits are rather similar to general people's. However, diabetic women seem to take risk factors for developing complications into consideration more than men, which could reflect a true gender pattern and/or be an effect of worrying more about diabetes. [ABSTRACT FROM PUBLISHER]