Association between subthreshold depression and self-care behaviours in adults with type 2 diabetes: A cross-sectional study.
Nepal
self-care behaviours
self-management
subthreshold depression
type 2 diabetes
Journal
Journal of clinical nursing
ISSN: 1365-2702
Titre abrégé: J Clin Nurs
Pays: England
ID NLM: 9207302
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
revised:
09
02
2021
received:
20
12
2020
accepted:
01
03
2021
pubmed:
9
4
2021
medline:
7
8
2021
entrez:
8
4
2021
Statut:
ppublish
Résumé
The aim of the study was to test the association between subthreshold depression and self-care behaviours in adults with type 2 diabetes (T2D) attending a tertiary healthcare service. Suboptimal adherence to self-care behaviours is associated with poor glycaemic control. The estimated point prevalence of subthreshold depression in people with T2D is 17%. Two previous studies have examined the association between subthreshold depression and self-care behaviours in T2D, reported observations were inconsistent. A cross-sectional observational study. We surveyed adults with T2D attending a tertiary healthcare facility in Nepal. Self-care behaviours and subthreshold depression were assessed using the Summary of Diabetes Self-care Activities and the Patient Health Questionnaire-9, respectively. We used linear and logistic regression to test the association of subthreshold depression with total and individual self-care behaviours. Our reporting complies with STROBE reporting guideline for observational research. Just over a third (37%) of the participants had subthreshold depression. People with subthreshold depression had slightly lower total diabetes self-care score compared to those with no depression. More than half of participants with subthreshold depression had suboptimal adherence to diet, physical activity and foot care. Subthreshold depression was associated with total self-care score (B = -0.27, 95% CI: -0.54, -0.01). In addition, association between subthreshold depression and diet adherence was observed (AOR = 0.26, 95% CI: 0.15, 0.44). Subthreshold depression is associated with decreased adherence to self-care behaviour in people with T2D. Identification and treatment of subthreshold depression in T2D may lead to better adherence to diabetes self-care behaviours. The recognition and treatment of subthreshold depression warrants further investigation as a strategy to improve the adherence to self-care behaviours.
Sections du résumé
AIMS AND OBJECTIVES
OBJECTIVE
The aim of the study was to test the association between subthreshold depression and self-care behaviours in adults with type 2 diabetes (T2D) attending a tertiary healthcare service.
BACKGROUND
BACKGROUND
Suboptimal adherence to self-care behaviours is associated with poor glycaemic control. The estimated point prevalence of subthreshold depression in people with T2D is 17%. Two previous studies have examined the association between subthreshold depression and self-care behaviours in T2D, reported observations were inconsistent.
DESIGN
METHODS
A cross-sectional observational study.
METHODS
METHODS
We surveyed adults with T2D attending a tertiary healthcare facility in Nepal. Self-care behaviours and subthreshold depression were assessed using the Summary of Diabetes Self-care Activities and the Patient Health Questionnaire-9, respectively. We used linear and logistic regression to test the association of subthreshold depression with total and individual self-care behaviours. Our reporting complies with STROBE reporting guideline for observational research.
RESULTS
RESULTS
Just over a third (37%) of the participants had subthreshold depression. People with subthreshold depression had slightly lower total diabetes self-care score compared to those with no depression. More than half of participants with subthreshold depression had suboptimal adherence to diet, physical activity and foot care. Subthreshold depression was associated with total self-care score (B = -0.27, 95% CI: -0.54, -0.01). In addition, association between subthreshold depression and diet adherence was observed (AOR = 0.26, 95% CI: 0.15, 0.44).
CONCLUSIONS
CONCLUSIONS
Subthreshold depression is associated with decreased adherence to self-care behaviour in people with T2D. Identification and treatment of subthreshold depression in T2D may lead to better adherence to diabetes self-care behaviours.
RELEVANCE TO CLINICAL PRACTICE
CONCLUSIONS
The recognition and treatment of subthreshold depression warrants further investigation as a strategy to improve the adherence to self-care behaviours.
Types de publication
Journal Article
Observational Study
Langues
eng
Pagination
2462-2468Subventions
Organisme : La Trobe University Postgraduate Research Scholarship (LTUPRS)
Organisme : La Trobe University Full Fee Research Scholarship (LTUFFRS)
Informations de copyright
© 2021 John Wiley & Sons Ltd.
Références
Albertorio-Diaz, J. R., Eberhardt, M. S., Oquendo, M., Mesa-Frias, M., He, Y., Jonas, B., & Kang, K. (2017). Depressive states among adults with diabetes: Findings from the National Health and Nutrition Examination Survey, 2007-2012. Diabetes Research and Clinical Practice, 127, 80-88. https://doi.org/10.1016/j.diabres.2017.02.031
Bell, R. A., Andrews, J. S., Arcury, T. A., Snively, B. M., Golden, S. L., & Quandt, S. A. (2010). Depressive symptoms and diabetes self-management among rural older adults. American Journal of Health Behavior, 34(1), 36-44. https://doi.org/10.5993/AJHB.34.1.5
Dirmaier, J., Watzke, B., Koch, U., Schulz, H., Lehnert, H., Pieper, L., & Wittchen, H.-U. (2010). Diabetes in primary care: Prospective associations between depression, nonadherence and glycemic control. Psychotherapy and Psychosomatics, 79(3), 172-178. https://doi.org/10.1159/000296135
Egede, L. E., Ellis, C., & Grubaugh, A. L. (2009). The effect of depression on self-care behaviors and quality of care in a national sample of adults with diabetes. General Hospital Psychiatry, 31(5), 422-427. https://doi.org/10.1016/j.genhosppsych.2009.06.007
Garcia, A. A., Villagomez, E. T., Brown, S. A., Kouzekanani, K., & Hanis, C. L. (2001). The Starr County Diabetes Education Study: Development of the Spanish-language diabetes knowledge questionnaire. Diabetes Care, 24(1), 16-21. https://doi.org/10.2337/diacare.24.1.16
Gonzalez, J. S., Safren, S. A., Cagliero, E., Wexler, D. J., Delahanty, L., Wittenberg, E., Blais, M. A., Meigs, J. B., & Grant, R. W. (2007). Depression, self-care, and medication adherence in type 2 diabetes: Relationships across the full range of symptom severity. Diabetes Care, 30(9), 2222-2227. https://doi.org/10.2337/dc07-0158
Kang, H. (2013). The prevention and handling of the missing data. Korean Journal of Anesthesiology, 64(5), 402. https://doi.org/10.4097/kjae.2013.64.5.402
Kroenke, K., & Spitzer, R. L. (2002). The PHQ-9: A new depression diagnostic and severity measure. Psychiatric Annals, 32(9), 509-515. https://doi.org/10.3928/0048-5713-20020901-06
Little, R. J. A., & Schenker, N. (1995). Missing Data. In G. Arminger, C. C. Clogg, & M. E. Sobel (Eds.), Handbook of statistical modeling for the social and behavioral sciences (pp. 39-75). Springer. https://doi.org/10.1007/978-1-4899-1292-3_2
Mickey, R. M., & Greenland, S. (1989). The impact of confounder selection criteria on effect estimation. American Journal of Epidemiology, 129(1), 125-137. https://doi.org/10.1093/oxfordjournals.aje.a115101
Nam, S., Chesla, C., Stotts, N. A., Kroon, L., & Janson, S. L. (2011). Barriers to diabetes management: Patient and provider factors. Diabetes Research and Clinical Practice, 93(1), 1-9. https://doi.org/10.1016/j.diabres.2011.02.002
Rothman, K. J., Greenland, S., & Lash, T. L. (2008). Modern epidemiology, 3rd ed. .
Shin, N., Hill-Briggs, F., Langan, S., Payne, J. L., Lyketsos, C., & Golden, S. H. (2017). The association of minor and major depression with health problem-solving and diabetes self-care activities in a clinic-based population of adults with type 2 diabetes mellitus. Journal of Diabetes and Its Complications, 31(5), 880-885. https://doi.org/10.1016/j.jdiacomp.2017.01.026
Shreck, E., Gonzalez, J. S., Cohen, H. W., & Walker, E. A. (2014). Risk perception and self-management in urban, diverse adults with type 2 diabetes: The improving diabetes outcomes study. International Journal of Behavioral Medicine, 21(1), 88-98. https://doi.org/10.1007/s12529-013-9291-4
Shrestha, M., Ng, A., Al-Ghareeb, A., Alenazi, F., & Gray, R. (2020). Association between subthreshold depression and self-care behaviors in people with type 2 diabetes: A systematic review of observational studies. Systematic Reviews, 9(1), 1-9. https://doi.org/10.1186/s13643-020-01302-z
Shrestha, M., Ng, A. H., & Gray, R. J. (2020). Association between subthreshold depression and self-care behaviours in adults with type 2 diabetes: A protocol for a cross-sectional study. Journal of Clinical Nursing, 1-9. https://doi.org/10.1111/jocn.15250
Sturt, J., Hearnshaw, H., & Wakelin, M. (2010). Validity and reliability of the DMSES UK: A measure of self-efficacy for type 2 diabetes self-management. Primary Health Care Research & Development, 11(4), 374-381. https://doi.org/10.1017/S1463423610000101
Toobert, D. J., Hampson, S. E., & Glasgow, R. E. (2000). The summary of diabetes self-care activities measure: Results from 7 studies and a revised scale. Diabetes Care, 23(7), 943-950. https://doi.org/10.2337/diacare.23.7.943
Von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. Annals of Internal Medicine, 147(8), 573-577. https://doi.org/10.7326/0003-4819-147-8-200710160-00010
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52(1), 30-41. https://doi.org/10.1207/s15327752jpa5201_2