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Disease-related distress, self-care and clinical outcomes among low-income patients with diabetes.
- Source :
- Journal of Epidemiology & Community Health; Jun2014, Vol. 68 Issue 6, p557-564, 8p, 7 Charts
- Publication Year :
- 2014
-
Abstract
- Background The purpose of this study is to determine the prevalence of diabetes distress and its relationship with health behaviours and clinical outcomes in low-income patients. Methods Secondary analyses were conducted using baseline data from a clinical trial evaluating a diabetes self-management intervention. Interviews were conducted with 666 participants receiving care at nine safety net clinics in Missouri. Distress was measured using the Diabetes Distress Scale, and outcomes included medication adherence, physical activity, nutrition and clinical biomarkers (haemoglobin A1C (HbA1C), blood pressure, low-density lipoprotein (LDL) cholesterol). Results In a sample of 666 participants, 14.1% and 27.3% of patients were identified as highly and moderately distressed, respectively, with higher rates among younger, female and lower income patients. When compared with moderately and no distress groups, highly distressed patients were less adherent to medications (20.7% vs 29.9% vs 39.4%, p<0.001) and had higher HbA1C values (9.3% (SD=2.0) vs 8.2% (SD=1.8) vs 7.8% (SD=1.7), p<0.001), diastolic blood pressure (81.8 (SD=9.4) vs 80.2 (9.7) vs 78.9 (SD=8.8), p=0.02) and LDL cholesterol (104.6 (SD=42.4) vs 97.2 (34.3) vs 95.5 (37.9)) In multivariable analyses, high and moderate distress were associated with lower medication adherence (OR=0.44; 0.27 to 0.23, p=0.001) and (OR=0.58; 0.42 to 0.79; p=0.001), respectively, and higher HbA1C in only the highly distressed group (B=1.3; 0.81 to 1.85; p<0.001) compared with the no distress group. Conclusions Diabetes distress is prevalent and linked to poorer adherence to health behaviours and glycemic control in a sample of patients receiving care from low-income clinics. [ABSTRACT FROM AUTHOR]
- Subjects :
- DIABETES & psychology
AGE distribution
ANALYSIS of variance
BIOMARKERS
CHI-squared test
CONFIDENCE intervals
EPIDEMIOLOGY
HEALTH behavior
INCOME
INTERVIEWING
RESEARCH methodology
EVALUATION of medical care
PATIENT compliance
RESEARCH funding
HEALTH self-care
SEX distribution
PSYCHOLOGICAL stress
DATA analysis
SECONDARY analysis
DATA analysis software
DESCRIPTIVE statistics
Subjects
Details
- Language :
- English
- ISSN :
- 0143005X
- Volume :
- 68
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Journal of Epidemiology & Community Health
- Publication Type :
- Academic Journal
- Accession number :
- 95888785
- Full Text :
- https://doi.org/10.1136/jech-2013-203063