Effects of gender, age, family support, and treatment on perceived stress and coping of patients with type 2 diabetes mellitus

Abstract

BackgroundWe previously found that the empowerment of patients with type 2 diabetes mellitus can be strongly affected by gender and age in addition to self-managed diet and exercise behaviors and treatment. This study was to examine the effects of gender, age, family support, and treatment on the perceived stress and coping of patients with type 2 diabetes mellitus living with family.MethodsA survey was conducted of 140 adults with type 2 diabetes mellitus who were living with family. There was no significant difference in hemoglobin A1c (HbA1c) between male and female. Perceived stress and coping were measured with the Japanese version of the Appraisal of Diabetes Scale and the Lazarus Type Stress Coping Inventory. Stepwise regression analysis and path analysis were performed to identify factors that affect the perceived stress and coping of patients.Results(1) Perceived stress and coping were strongly affected by gender. (2) Perceived stress and coping were affected by age for males, but perceived stress was not affected by age for females. However, females showed a greater “psychological impact of diabetes” than did males. Females aged between 50 and 69 years engaged in active problem solving, but awareness of diabetes was low. (3) Treatment regimens had an effect on HbA1c for both sexes, and diet therapy affected the awareness of diabetes of males and coping of females. (4) For females, “sense of self-control” was strongly associated with coping, and those who were living with non-spouse family members had a greater psychological impact of diabetes than those living with only their spouse. (5) For males, coping was strongly affected by living with their spouse.ConclusionsThe results suggest that perceived stress, coping, and diet regimen are deeply associated with gender and age and that a male with type 2 diabetes mellitus living with his spouse is strongly dependent on support from the spouse. It is important to take into account gender, age, and family environment to provide patients with an individualized approach to addressing perceived stress and to provide education program for coping that can maximize treatment and maintain better, continuous glycemic control.

Psychological impacts from expectation of worsening conditions and obstacles to life planning are affected by glycemic control, self‐reported symptoms, and drug therapy in patients with type 2 diabetes mellitus

“…Our studies of patients with type 2 diabetes mellitus in the past confirm that the psychological impact of diabetes scale correlates well with HbA1c levels and treatment methods, reflecting anxieties routinely felt by patients 9,10 . Some questions remain, however, as to what aspects of the patients' everyday anxieties are affected by HbA1c levels and treatment methods, or whether patient empowerment education is sufficient to alleviate the psychological impacts felt by the patients.…”

“…With respect to impact from diabetes (S1), for which a sex difference was particularly noticeable, it was suggested that women were particularly sensitive to the psychological impact caused by diabetes, because significance disappeared after adjustments by sex, disease duration, glycemic control and number of ( Figure 1a), and stratification by age showed significance only in women ( Table 2). In an earlier study that we carried out into perceived stress and coping behaviors in 140 type 2 diabetes patients aged 40 years or older 10 , factor analysis identified clear sex differences in perceived stress and coping among these patients: relative to men, women were always aware of the psychological stress of having diabetes, but their coping was passive, with the 50-69 years age group showing the lowest level of self-awareness, sense of responsibility or self-empowerment relating to diabetes. The sex difference in perceived stress and coping was assumed to be a result of social, innate and situational factors 11,12 .…”

Family and Couple Variables Regarding Adherence in Type 2 Diabetes Patients in the Initial Stages of the Disease

“…Hara et al. () found that male patients with T2DM living with their spouses exhibited better coping skills to deal with the stress from the disease compared to females.…”

“…Actually, some studies illustrate the importance of family coping on adherence to T2DM treatment and showed an association between coping and metabolic control (Gafvels & Wandell, 2006). Hara et al (2014) found that male patients with T2DM living with their spouses exhibited better coping skills to deal with the stress from the disease compared to females. *** p < .001; ** p < .01; * p < .05 Moreover, higher levels of partner positive support (e.g., encouragement, remembrance, congratulations, planning) from the patients' perspective at T1 predicted higher levels of adherence to glucose monitoring at T2.…”

Glycemic control and coping with stress in type 2 diabetes patients

“…Its prevalence has also been increasing across the world. 3 According to The Turkish epidemiology survey of diabetes, hypertension, obesity and endocrine disease (TURDEP-II), incidence of diabetes has reached up to 13.7% in Turkish adult population. 4 Diabetes being common in the society is an important public health concern because it leads to economic losses, its complications seriously influence life quality of the patient, and it has high morbidity and mortality.…”