Positive emotional health and diabetes care: concepts, measurement, and clinical implications.
BACKGROUND
Numerous studies describe the effect of emotional problems, including diabetes-related distress and depression, on diabetes outcomes. Little attention has been devoted to positive emotional health and its potential role in facilitating patients' self-management and improved outcomes.


OBJECTIVE
This review describes the conceptualization and measurement of three empirically-tested aspects of positive emotional health (well-being, positive affect, resilience) in the diabetes literature and their relationship to diabetes outcomes.


METHODS
A literature review was conducted using PubMed and the Cochrane Library databases from 1970 to January 2011 to identify studies focused on well-being, positive affect, and resilience in diabetes patients.


RESULTS
Twenty-two studies were identified based on our inclusion criteria. Well-being studies were least likely to include conceptualizations and relied on two primary measurement instruments compared to more heterogeneous presentations found in positive affect and resilience studies. All three aspects of positive emotional health were linked to health-related outcomes and self-management.


CONCLUSIONS
Positive emotional health may facilitate chronic care self-management and improved health outcomes. We present a model to guide future research and intervention development efforts designed to enhance positive emotional health.
Houston Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA. smr1@bcm.tmc.edu
Suzanne M
SM
Robertson
Melinda A
MA
Stanley
Jeffrey A
JA
Cully
Aanand D
AD
Naik
D000223:Adaptation, Psychological; D016206:Databases, Bibliographic; D003920:Diabetes Mellitus / Q000523:psychology* / Q000628:therapy*; D004644:Emotions; D006240:Happiness; D006801:Humans; D008960:Models, Psychological; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D055500:Resilience, Psychological; D012648:Self Care / Q000523:psychology*; D012649:Self Concept; D016896:Treatment Outcome