Relationship Among Diabetes Distress, Decisional Conflict, Quality of Life, and Patient Perception of Chronic Illness Care in a Cohort of Patients With Type 2 Diabetes and Other Comorbidities

Abstract

The primary outcome is to evaluate the relationship between diabetes distress and decisional conflict regarding diabetes care in patients with diabetes and two or more comorbidities. Secondary outcomes include the relationships between diabetes distress and quality of life and patient perception of chronic illness care and decisional conflict. RESEARCH DESIGN AND METHODS This was a cross-sectional study of 192 patients, ‡18 years of age, with type 2 diabetes and two or more comorbidities, recruited from primary care practices in the Greater Toronto Area. Baseline questionnaires were completed using validated scales: Diabetes Distress Scale (DDS), Decisional Conflict Scale (DCS), Short-Form Survey 12 (SF-12), and Patient Assessment of Chronic Illness Care (PACIC). Multiple linear regression models evaluated associations between summary scores and subscores, adjusting for age, education, income, employment, duration of diabetes, and social support. RESULTS Most participants were >65 years old (65%). DCS was significantly and positively associated with DDS (b = 0.0139; CI 0.00374-0.0246; P = 0.00780). DDS-emotional burden subscore was significantly and negatively associated with SF-12-mental subscore (b =23.34; CI 24.91 to 21.77; P < 0.0001). Lastly, DCS was significantly and negatively associated with PACIC (b = 26.70; CI 29.10 to 24.32; P < 0.0001). CONCLUSIONS We identified a new positive relationship between diabetes distress and decisional conflict. Moreover, we identified negative associations between emotional burden and mental quality of life and patient perception of chronic illness care and decisional conflict. Understanding these associations will provide valuable insights in the development of targeted interventions to improve quality of life in patients with diabetes.

Decreased Quality of Life in Individuals with Type 2 Diabetes Mellitus Is Associated with Emotional Distress

“…In consequence, they live with high diabetes related emotional-distress as was observed in the present study [24]. The differences observed in individuals with high and low diabetes-related emotional-distress are relevant as they seemed to be non-related to demographic features or any other variables (such as body mass index), features that have been previously described as related to emotional distress [25]. Early detection and intervention of individuals with diabetes mellitus are a priority for preventing diabetes-related emotional-distress, medical comorbidities and psychiatric disorders such as depression.…”

Life satisfaction and emotional distress in people living with type 2 diabetes mellitus: The mediating effect of cognitive function

“…Emotional distress in individuals with diabetes refers to the comprehensive psychosocial distress related to the coexistence with diabetes and the expression of negative emotions (Polonsky et al., 2005). Emotional distress is defined as the psychological shock experienced by people with diabetes during the course of disease, including denial of disease, fear, anxiety and guilt; emotional instability and other situations may occur repeatedly in the whole process of adaption to the disease, and if symptoms of severe emotional distress occur and are not managed in time, more care problems and complications may appear, which will lead to the aggravation of the disease and even the occurrence of depression, thus affecting their life satisfaction (Bruno et al., 2019; Perrin et al., 2017).…”

Insulin pricing and other major diabetes-related concerns in the USA: a study of 46 407 tweets between 2017 and 2019

“…1 Diabetes distress is associated with decisional conflict and therefore has an impact on day-to-day disease management and the long-term risk of diabetes-related complications. 2 Reducing diabetes-related distress may improve hemoglobin A1c and reduce the burden of disease among people with diabetes. 3 4 However, there is still limited knowledge about the sources of stress, anxiety and concerns among people with diabetes and it is difficult to capture them with existing evaluation scales such as the Problem Areas in Diabetes Scale (PAID…”