title: Effects of gender, age, family support, and treatment on perceived stress and coping of patients with type 2 diabetes mellitus.
abstract: BACKGROUND
  We previously found that the empowerment of patients with type 2 diabetes mellitus can be strongly affected by gender and age in addition to self-managed diet and exercise behaviors and treatment. This study was to examine the effects of gender, age, family support, and treatment on the perceived stress and coping of patients with type 2 diabetes mellitus living with family.
  
  
  METHODS
  A survey was conducted of 140 adults with type 2 diabetes mellitus who were living with family. There was no significant difference in hemoglobin A1c (HbA1c) between male and female. Perceived stress and coping were measured with the Japanese version of the Appraisal of Diabetes Scale and the Lazarus Type Stress Coping Inventory. Stepwise regression analysis and path analysis were performed to identify factors that affect the perceived stress and coping of patients.
  
  
  RESULTS
  (1) Perceived stress and coping were strongly affected by gender. (2) Perceived stress and coping were affected by age for males, but perceived stress was not affected by age for females. However, females showed a greater "psychological impact of diabetes" than did males. Females aged between 50 and 69 years engaged in active problem solving, but awareness of diabetes was low. (3) Treatment regimens had an effect on HbA1c for both sexes, and diet therapy affected the awareness of diabetes of males and coping of females. (4) For females, "sense of self-control" was strongly associated with coping, and those who were living with non-spouse family members had a greater psychological impact of diabetes than those living with only their spouse. (5) For males, coping was strongly affected by living with their spouse.
  
  
  CONCLUSIONS
  The results suggest that perceived stress, coping, and diet regimen are deeply associated with gender and age and that a male with type 2 diabetes mellitus living with his spouse is strongly dependent on support from the spouse. It is important to take into account gender, age, and family environment to provide patients with an individualized approach to addressing perceived stress and to provide education program for coping that can maximize treatment and maintain better, continuous glycemic control.
authors: School of Nursing, Kurume University, Higashikushiharamachi 777-1, Kurume, Fukuoka 830-0003, Japan.
authors: Yoriko
authors: Y
authors: Hara
authors: Tanushimaru Central-clinic, Fukuoka, Japan.
authors: Mizuho
authors: M
authors: Hisatomi
authors: Ito Internal Medicine Clinic, Fukuoka, Japan.
authors: Hisao
authors: H
authors: Ito
authors: Department of Public Health, School of Medicine, Kurume University, Fukuoka, Japan.
authors: Motoyuki
authors: M
authors: Nakao
authors: Department of Psychosomatic Medicine, School of Medicine, Toho University, Tokyo, Japan.
authors: Koji
authors: K
authors: Tsuboi
authors: Department of Public Health, School of Medicine, Kurume University, Fukuoka, Japan.
authors: Yoko
authors: Y
authors: Ishihara
keywords: Appraisal of Diabetes Scale; Gender; Spouse; Stress Coping Inventory; Type 2 diabetes mellitus