title: Evaluation of stress in korean patients with diabetes mellitus using the problem areas in diabetes-Korea questionnaire.
abstract: BACKGROUND
  It is known that diabetes and stress are directly or indirectly related, and that it is important to evaluate stress in patients with diabetes. The relationship between Korean diabetics and diabetes-related stress has never been reported. The objective of this study was to develop a stress questionnaire suitable for use with Korean diabetics and to evaluate its utility.
  
  
  METHODS
  This study subjects were 307 Korean diabetics, aged 40 to 74 years old, who visited the Department of Endocrinology and Metabolism at Gachon University Gil Hospital, Yeungnam University Medical Center, and Inha University Hospital in Korea between March 2006 and February 2008. We developed a Korean version of Polonsky's Problem Areas in Diabetes (PAID) stress questionnaire (PAID-K) and used it to assess degrees of stress in our sample of Korean patients. We evaluated the utility of the questionnaire and analyzed the relationships between clinical characteristics of the study subjects and degrees of stress.
  
  
  RESULTS
  Cronbach's alpha for PAID-K was 0.95, and PAID-K scores were significantly correlated with Hypoglycemia Fear Survey scores (r=0.44, P<0.05) and State Trait Anxiety Inventory-6 scores (r=0.21, P<0.05). PAID-K scores were significantly higher in patients with longer durations of diabetes, patients using insulin, and female patients (P=0.02, P=0.038, and P=0.001, respectively). The score also tended to increase as HbA1c levels increased, except for very high HbA1c levels (above 11%) (P for trend<0.05).
  
  
  CONCLUSIONS
  We developed the PAID-K questionnaire and demonstrated its utility to evaluate levels of stress in diabetic patients in Korea.
authors: Department of Internal Medicine, Gachon University of Medicine and Science Graduate School of Medicine, Incheon, Korea.
authors: Young Sil
authors: YS
authors: Eom
authors: Hwa Sun
authors: HS
authors: Park
authors: Sei-Hyun
authors: SH
authors: Kim
authors: Sun Mee
authors: SM
authors: Yang
authors: Moon Suk
authors: MS
authors: Nam
authors: Hyoung Woo
authors: HW
authors: Lee
authors: Ki Young
authors: KY
authors: Lee
authors: Sihoon
authors: S
authors: Lee
authors: Yeun Sun
authors: YS
authors: Kim
authors: Ie Byung
authors: IeB
authors: Park