Diabetic Distress Among Diabetic Patients in the Amhara Regional State,Ethiopia

Abstract

Diabetes distress is a psychological reaction to the threat of diabetes, when an individuals diagnosed with diabetes consider the coping resources they possess as insufficient to manage the illness threat, thus triggering emotional distress specific to diabetes. Research conducted in Ethiopia regarding diabetes-related distress is scant. The main purpose of this study was to assess the status of diabetic distress among diabetic patients in the hospitals of the Amhara Region. A hospital-based cross-sectional survey research approach was employed. A total of 14 hospitals was included in the study using stratified simple random sample methods. The participans of the study were 532 diabetic patients who were selected using systematic simple random sampling methods. The pertinent data were collected using diabetic distress scale-17 (DDS-17). The instrument of the study was rated, piloted, and finally validated. Both descriptive and inferential techniques were used to analyze the data. The cutoff for low, moderate, and high distress level was <2, 2–2.9, and >3, respectively. The study revealed that the participant in the study area experienced a moderate level of distress. The status of diabetic distress for the diabetic sub-scale was also determined for emotional burden, physician-related distress, regimen-related distress, and interpersonal distress, it was also found to be (2.79 ± 0.85), (3.14 ± 0.87), (3.19 ± 0.81), and (3.04 ± 0.93) respectively. The most important domain in measuring diabetic distress was regimen-related distress. Statistically, a significant difference was detected in the level of diabetic distress among diabetic patients concerning marital status, educational status, the experience of living with diabetes, and having habits of planned physical exercise. Statistically, a significant difference was not observed for age, sex, and occupational status. Diabetic distress was a solemn psychological problem among diabetic patients in the hospitals of the Amhara Region. A strong policy document is required to bind the physical treatment with psychological elements to reduce distress

Keywords

distress diabetic distress diabetic patients hospitals Amhara region

Get full access to this article

View all access options for this article.

References

Islam

Karim

Habib

, et al. Diabetes distress among type 2 diabetic patients. Int J Med Biomed Res 2013; 2: 113–124.

IDF. IDF diabetes atlas. 7th ed. Brussels: International Diabetes Federation, 2015.

National Collaborating Centre for Chronic Conditions. Type 2 diabetes: national clinical guideline for management in primary and secondary care (update). London: Royal College of Physicians, 2008.

Tol

Baghbanian

Sharifirad

, et al. Assessment of diabetic distress and disease-related factors in patients with type 2 diabetes in Isfahan: a way to tailor an effective intervention plan in Isfahan-Iran. J Diabetes Metab Disord 2012; 11: 20.

Spencer

Kieffer

Sinco

, et al. Diabetes-specific emotional distress among African Americans and Hispanics with type 2 diabetes. J Health Care Poor Underserved 2006; 17: 88–105.

International Diabetes Federation. Diabetes atlas. 7th ed. Brussels: IDF, 2019.

Afkhami

Rashidi

Type 2 diabetes risk factors. J Rafsanjan Medical Science University 2005; 4: 348–365.

Anderson

Freedland

Clouse

, et al. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 2001; 24: 1069–1078.

Egede

Zheng

Independent factors associated with major depressive disorder in a national sample of individuals with diabetes. Diabetes Care 2003; 26: 104–111.

10.

Fisher

Hessler

Polonsky

, et al. When is diabetes distress clinically meaningful? Establishing cut points for the diabetes distress scale. Diabetes Care 2012; 35: 259–264.

11.

Berry

Lockhart

Davies

, et al. Diabetes distress: understanding the hidden struggles of living with diabetes and exploring intervention strategies. Postgrad Med J 2015; 91: 278–283. 10.1136/postgradmedj-2014-133017.

12.

Polonsky

Fisher

, et al. Assessing psychosocial stress in diabetes: development of the diabetes distress scale. Diabetes Care 2005; 28: 626–631.

13.

Abebe

Kebede

Addis

Diabetes in Ethiopia 2000-2016 – prevalence and related acute and chronic complications; a systematic review. Afr J Diabetic Med 2017; 25: 1–7. research gate.

14.

Aljuaid

Almutairi

Assiri

, et al. Diabetes-related distress assessment among type 2 diabetes patients. J Diabetes Res 2018; 2018: 7328128.

15.

Jeong

Reifsnider

Associations of diabetes-related distress and depressive symptoms with glycemic control in Korean Americans with type 2 diabetes. Diabetes Educ 2018; 44: 531–540.

16.

Zanchetta

Trevisan

Apolinario

, et al. Clinical and sociodemographic variables associated with diabetes-related distress in patients with type 2 diabetes mellitus. Einstein (Sao Paulo) 2016; 14: 346–351.

17.

Feigl

AB.

Managing non-communicable disease risk factors in developing countries : tobacco control, cardiovascular disease risk surveillance, and diabetes prevention. Doctoral dissertation, Harvard T.H. Chan School of Public Healthl; 2015.

18.

Wolde

Wondim

MG.

Diabetic distress among diabetic patients in the referral hospital of Amhara regional state, Ethiopia. Int Q Community Health Educ 2020; 40: 105–114.

19.

Forshaw

Essential health psychology (chapter 1.9). London: Arnold, 2003, pp. 11–17.

20.

Patterson

BL.

The shifting perspective model of chronic illness. J Nurs Scholarsh 2001; 33: 21–26.

21.

Arifin

van Asselt

ADI

Setiawan

, et al. Diabetes distress in Indonesian patients with type 2 diabetes: a comparison between primary and tertiary care. BMC Health Serv Res 2019; 19: 773.

22.

Fisher

Glasgow

Strycker

LA.

The relationship between diabetes distress and clinical depression with glycemic control among patients with type 2 diabetes. Diabetes Care 2010; 33: 1034–1036.

23.

Mathiesen

Thomsen

Jensen

, et al. The influence of diabetes distress on digital interventions for diabetes management in vulnerable people with type 2 diabetes: a qualitative study of patient perspectives. J Clin Transl Endocrinol 2017; 9: 41–47.

24.

Kretchy

Koduah

Ohene-Agyei

, et al. The association between diabetes-related distress and medication adherence in adult patients with type 2 diabetes mellitus: a cross-sectional study. J Diabetes Res 2020; 2020: 4760624.

25.

Ramkisson S, Pillay BJ and Sartorius B. ‘Diabetes distress and related factors in South African adults with type 2 diabetes’. Journal of Endocrinology, Metabolism and Diabetes of South Africa 2016; 21(2): 35–39. https://doi.org/10.1080/16089677.2016.1205822

26.

T/Kiros

Huruy

Abadi

Assessment of risk factors associated with type 2 diabetes mellitus in Central zone of Tigray, North, Ethiopia. Int J Pharm Biol Sci Fund 2014; 07: 2278–3997.

27.

Gebreyohannes

Netere

Belachew

SA.

Glycemic control among diabetic patients in Ethiopia: a systematic review and Meta-analysis. PLoS One 2019; 14: e0221790.

28.

Zekewos

Loha

Egeno

, et al. Prevalence of diabetes mellitus and associated factors in bona district, Sidama zone: a community based study. Ethiop J Health Sci 2018; 28: 451.

29.

Yohannes S. Dermatoglyphic meta-analysis indicates early epigenetic outcomes & possible implications on genomic zygosity in type-2 diabetes [version 1; referees: 2 approved] F1000Research 2015; 4: 617. doi: 10.12688/f1000research.6923.1.

30.

Alemu

Prevalence of diabetes mellitus disease and its association with level of education among adult patients attending at Dilla referral hospital, Ethiopia. J Diabetes Metab 2015; 6: 1–5.

31.

Whittermore

D'Eramo Melkus

Grey

Metabolic control, self-management, and psychosocial adjustment in women with type 2 diabetes. J Clin Nurs 2005; 14: 195–203.

32.

Tesfa

Prevalence of depression among type 2 diabetic outpatients in black lion general, specialized hospital, Addis Ababa, Ethiopia. J Depress Res Treat 2015; 2015; 184902.

33.

Funnell

Brown

Childs

, et al. National standards for diabetes self-management education. Diabetes Care 2010; 33: S89–S96.

34.

Polonsky WH, Fisher L, Earles J, Dudl RJ, Lees J, Mullan J, Jackson RA (2005). Assessing psychosocial distress in diabetes: development of the diabetes distress scale. Diabetes Care Mar;28(3): 626–31. doi: 10.2337/diacare.28.3.626. PMID: 15735199.

35.

Kiefer

Diabetes distress and diabetes outcomes: the association between distress and patient-provider communication, quality of life, and glycemic control. Unpublished MA Thesis, University of Washington, USA, 2014.

36.

Islam M, Islam M, Karim M, Alam U and Yesmin K. Predictors of diabetes distress in patients with type 2 diabetes mellitus. International Journal of Research in Medical Sciences 2014; 2(2): 631. https://doi.org/10.5455/2320-6012.ijrms20140549

37.

Kong AP, Xu G, Brown N, So WY, Ma RC, Chan JC. Diabetes and its comorbidities--where East meets West. Nat Rev Endocrinol 2013; Sep;9(9): 537–47. doi: 10.1038/nrendo.2013.102. Epub 2013 May 28. PMID: 23712250.

38.

Hlatky

Chung

Escobedo

, et al. The effect of obesity on quality of life in patients with diabetes and coronary artery disease. Am Heart J 2010; 159: 292–300.

39.

Vidya

Jayanthkumar

Assessment of diabetes distress and disease-Related factors in patients with type 2 diabetes attending a tertiary care hospital. Int J Public Mental Health Neurosci 2015; 2: 60–62.

40.

Lee

Lin

JL.

The effects of trust in physicians on self-efficacy, adherence, and diabetes outcomes. Soc Sci Med 2009; 68: 1060–1068.

41.

Rook

August

Choi

, et al. Emotional reactivity to daily distress, spousal emotional support, and fasting blood glucose among patients with type 2 diabetes. J Health Psychol 2016; 21: 2538–2549.

42.

Fisher

Mullan

Skaff

, et al. Predicting diabetes distress in patients with type 2 diabetes: a longitudinal study. Diabet Med 2009; 26: 622–627.