Work-related diabetes distress among Finnish workers with type 1 diabetes: a national cross-sectional survey

Abstract

BackgroundDiabetes distress is common among people with type 1 diabetes, but knowledge is scarce regarding the perceived burden of reconciling work with this disease. This cross-sectional study investigated work-related diabetes distress among Finnish workers with type 1 diabetes.MethodsA questionnaire was mailed to 2500 randomly sampled 18- to 65-year-old Finns with type 1 diabetes; 49.3 % responded. Work-related diabetes distress was measured by combining worry and exhaustion in reconciling work with diabetes. Self-perceived work-related diabetes distress was evaluated in the context of physical and psychosocial work conditions, job demands, work ability, general stress, diabetes acceptance, glycosylated hemoglobin (HbA1c) level, high blood glucose maintenance at work, and depressive symptoms. The data were analyzed with the use of cross-tabulation, chi-square tests, ANOVA analysis, Spearman correlation coefficients, and structural equation modeling.ResultsOf the respondents, 70 % experienced work-related diabetes distress. Problems with physical work conditions (β = 0.27), work ability (β = -0.21), difficulty in accepting diabetes (β = 0.18), and job demands (β = 0.14) were found to be associated with work-related diabetes distress. This distress was strongly associated with the maintenance of a high blood glucose level at work (β = 0.34). In turn, a high blood glucose level at work was associated with a high HbA1c level (β = 0.29). Work-related diabetes distress and depressive symptoms had a bi-directional association (β = 0.06 and β = 0.14). Difficulty accepting diabetes had three-dimensional associations: work-related diabetes distress (β = 0.18), depressive symptoms (β = 0.13), and high HbA1c level (β = 0.12). There was no notable association between work-related diabetes distress and general stress.ConclusionsWork-related diabetes distress is common among workers with type 1 diabetes, and it may influence metabolic control. This stress could be prevented by adapting physical work conditions. People with type 1 diabetes should also be encouraged to pursue their full educational potential, and psychological support should be provided for those with difficulty accepting their diabetes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12995-016-0099-4) contains supplementary material, which is available to authorized users.

Concealment of type 1 diabetes at work in Finland: a mixed-method study

“… 7 We reported in our previously published study that work-related diabetes distress, such as worry and exhaustion in reconciling work with T1D, was strongly associated with keeping blood glucose level high at work. 14 In addition, it has been shown that young workers with T1D experience time pressure at their work and therefore they sometimes neglect or delay self-management activities at work. 5 As both concealment and time pressure among young workers with T1D hinder their self-management activities at work, special attention should be focused on supporting them for avoiding long-term complications and diminishing of work ability.…”

“…The questionnaire included items on demographics, diabetes history, diabetes and work, work ability, health, diabetes and current work community, occupational health and safety and diabetes, and occupational health and diabetes. 14 …”

A call for inclusion of work-related diabetes distress in the spectrum of diabetes management: Results from a cross-sectional survey among working people with type 1 diabetes

“…We adapted the two questions from the previous study exploring WRDD [15] to the format of the widely used and validated PAID scale. WRDD was thus assessed by asking participants to rate "Which of the following issues are currently a problem for you?"…”

“…In a recent Finnish study [15], the first attempt to capture the psychosocial burden of diabetes in work life used the novel self-reported measure of work-related diabetes distress (WRDD). The measure consisted of two questions about worry and exhaustion related to balancing work with diabetes, which were combined to a sum score for WRDD [15].…”

“…In a recent Finnish study [15], the first attempt to capture the psychosocial burden of diabetes in work life used the novel self-reported measure of work-related diabetes distress (WRDD). The measure consisted of two questions about worry and exhaustion related to balancing work with diabetes, which were combined to a sum score for WRDD [15]. Using structural equation modeling, the authors found that WRDD was independently associated with maintaining a high blood glucose level at work (hereafter referred to as intentional hyperglycaemia at work), which was in turn associated with a high haemoglobin A1c (HbA1c) level.…”