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J Diabetes Complications. 2015 May-Jun;29(4):572-7. doi: 10.1016/j.jdiacomp.2015.01.012. Epub 2015 Feb 7.

Understanding the sources of diabetes distress in adults with type 1 diabetes.

Author information

1
Department of Family & Community Medicine, UCSF, San Francisco, California. Electronic address: fisherl@fcm.ucsf.edu.
2
Behavioral Diabetes Institute, San Diego, California.
3
Department of Family & Community Medicine, UCSF, San Francisco, California.
4
Department of Medicine, UCSF, San Francisco, California.
5
Charles H. Best Diabetes Centre, Ontario, Canada.
6
University of Southern California, Los Angeles, California.
7
Oregon Research Institute, Eugene, Oregon.

Abstract

AIMS:

To identify the unique sources of diabetes distress (DD) for adults with type 1 diabetes (T1D).

METHODS:

Sources of DD were developed from qualitative interviews with 25 T1D adults and 10 diabetes health care providers. Survey items were then developed and analyzed using both exploratory (EFA) and confirmatory CFA) analyses on two patient samples. Construct validity was assessed by correlations with depressive symptoms (PHQ8), complications, HbA1C, BMI, and hypoglycemia worry scale (HWS). Scale cut-points were created using multiple regression.

RESULTS:

An EFA with 305 U.S. participants yielded 7 coherent, reliable sources of distress that were replicated by a CFA with 109 Canadian participants: Powerlessness, Negative Social Perceptions, Physician Distress, Friend/Family Distress, Hypoglycemia Distress, Management Distress, Eating Distress. Prevalence of DD was high with 41.6% reporting at least moderate DD. Higher DD was reported for women, those with complications, poor glycemic control, younger age, without a partner, and non-White patients.

CONCLUSIONS:

We identified a profile of seven major sources of DD among T1D using a newly developed assessment instrument. The prevalence of DD is high and is related to glycemic control and several patient demographic and disease-related patient characteristics, arguing for a need to address DD in clinical care.

KEYWORDS:

Assessing distress; Diabetes distress; Distress profile; Type 1 diabetes; Types of distress

PMID:
25765489
PMCID:
PMC4414881
DOI:
10.1016/j.jdiacomp.2015.01.012
[Indexed for MEDLINE]
Free PMC Article

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