title: Ethnic differences in the relationship between depressive symptoms and health-related quality of life in people with type 2 diabetes.
abstract: OBJECTIVE
  To examine ethnic differences in the relationship between depressive symptoms and specific aspects of heath-related quality of life in people with type 2 diabetes.
  
  
  METHODS
  Cross-sectional data from 190 people with type 2 diabetes of Native Hawaiian (50%), Filipino (16%), Japanese (18%), and mixed-ethnic (16%) ancestries from the rural community of North Kōhala, Hawai'i were examined in this study. Depressive symptoms were measured with the Center for Epidemiological Studies-Depression (CES-D) scale. Health-related quality of life was measured with the Short Form-36 Health Survey (SF-36). Eight health-related quality of life constructs were examined: Physical Functioning, Role-Physical Functioning, Role-Emotional Functioning, Social Functioning, Bodily Pain, Vitality, General Health, and Health Transition.
  
  
  RESULTS
  Hierarchical regression analyses of the interaction between ethnicity and the SF-36 subscales of Physical Functioning, Role-Emotional Functioning, Bodily Pain, Vitality, and General Health indicated statistically significant associations with CES-D scores after controlling for sociodemographic factors, glycemic status, and social support.
  
  
  CONCLUSIONS
  Ethnicity moderated the relationship between depressive symptoms and the health-related quality of life aspects of physical and role-emotional functioning, bodily pain, vitality, and general health perception in people with type 2 diabetes. This relationship was strongest for Filipinos followed by Native Hawaiians and people of mixed-ethnic ancestries.
authors.affiliation: Department of Native Hawaiin Health, University of Hawai'i at Mānoa, Honolulu, HI 96813, USA. kaholoku@hawaii.edu
authors.forename: Joseph Keawe'aimoku
authors.initials: JK
authors.lastname: Kaholokula
authors.forename: Stephen N
authors.initials: SN
authors.lastname: Haynes
authors.forename: Andrew
authors.initials: A
authors.lastname: Grandinetti
authors.forename: Healani K
authors.initials: HK
authors.lastname: Chang
mesh_terms: D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003863:Depression / Q000208:ethnology* / Q000209:etiology; D048909:Diabetes Complications; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012044:Regression Analysis; D012944:Social Support