title: Stressors may compromise medication adherence among adults with diabetes and low socioeconomic status.
abstract: Studies examining the impact of stressors on diabetes self-care have focused on a single stressor or have been largely qualitative. Therefore, we assessed the stressors experienced by a high-risk population with type 2 diabetes, and tested whether having more stressors was associated with less adherence to multiple self-care behaviors. Participants were recruited from a Federally Qualified Health Center and 192 completed a stressors checklist. Experiencing more stressors was associated with less adherence to diet recommendations and medications among participants who were trying to be adherent, but was not associated with adherence to other self-care behaviors. Because having more stressors was also associated with more depressive symptoms, we further adjusted for depressive symptoms. Stressors remained associated with less adherence to medications, but not to diet recommendations. For adults engaged in adherence, experiencing an accumulation of stressors presents barriers to adherence that are distinct from associated depressive symptoms.
authors.affiliation: Vanderbilt University Medical Center, Nashville, TN, USA chandra.osborn@vanderbilt.edu.
authors.forename: Chandra Y
authors.initials: CY
authors.lastname: Osborn
authors.affiliation: Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Lindsay Satterwhite
authors.initials: LS
authors.lastname: Mayberry
authors.affiliation: University of Connecticut Health Center, Farmington, CT, USA.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Wagner
authors.affiliation: Tufts University School of Medicine, Boston, MA, USA Baystate Medical Center, Springfield, MA, USA.
authors.forename: Garry W
authors.initials: GW
authors.lastname: Welch
mesh_terms: D000328:Adult; D000368:Aged; D003863:Depression / Q000150:complications* / Q000523:psychology; D003920:Diabetes Mellitus / Q000191:economics / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D011203:Poverty / Q000523:psychology* / Q000706:statistics & numerical data; D012648:Self Care / Q000523:psychology* / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications* / Q000191:economics; D013714:Tennessee; D016903:Drug Monitoring
keywords: depression; diabetes; diet; medication adherence; self-care; stress; stressor