title: Depression and Its Associated Factors Among Rural Diabetic Residents.
abstract: BACKGROUND
  Type 2 diabetes is a huge burden both for individuals and society as a whole. Although depression has been negatively associated with ideal glycemic control, little is known about the prevalence of depression or its associated factors among rural Taiwanese adults with Type 2 diabetes mellitus (type2 DM).
  
  
  OBJECTIVE
  The purposes of this study were to investigate the prevalence of depression in rural-dwelling sufferers of type2 DM and to highlight the relationships between their depression status and health promoting behaviors such as physical activity, keeping active in life, sleep sufficiency, and adopting a diabetic diet.
  
  
  METHODS
  A cross-sectional, correlational design was used to recruit 696 participants from local healthcare centers in rural areas of Chiayi County, Taiwan. Data were collected from March 30, 2010, to August 30, 2012. The Chinese version of the Geriatric Depression Scale and its associated physiological biomarkers were used as screening tools. Logistic regression was used to identify the factors that were associated with depression status.
  
  
  RESULTS
  The prevalence of depression in this study was 16.8%. Factors found to be associated with depression included being female, having a low level of education, receiving reduced family support, having little physical activity, failing to follow a diabetic diet, frequent inactivity, and having insufficient sleep. There were no significant differences in the physiological indicators between the depressive and nondepressive groups. After controlling for confounding factors, a logistic regression model showed that depression status was associated with a lack of sleep (OR = 2.85, p < .001), less frequent exercise (OR = 2.67, p < .001), and frequent inactivity (OR = 2.35, p = .001).
  
  
  CONCLUSIONS
  This study showed that the prevalence of depression among adults with type2 DM living in rural areas is relatively high. From the perspective of health promotion, future research should focus on how to improve quality of sleep by enhancing daily physical activity and on investigating the effect of promoting a more active lifestyle among those at risk on depression.
authors.affiliation: 1MSN, RN, Instructor, Min-Hwei College of Health Care Management 2MSN, RN, Instructor, Nursing Department, Chang Gung University of Science and Technology 3PhD, RN, Assistant Professor, Nursing Department, Chang Gung University of Science and Technology 4PhD, RN, Professor, College of Nursing, Chang Gung University of Science and Technology Chiayi, Professor (Joint Appointment), Department of Nursing, Chang Gung University, Taoyuan, and Research Fellow (Joint Appointment), Department of Cardiology, Chang Gung Memorial Hospital, Chiayi.
authors.forename: Chia-Mou
authors.initials: CM
authors.lastname: Lee
authors.forename: Chyong-Fang
authors.initials: CF
authors.lastname: Chang
authors.forename: Mei-Yu
authors.initials: MY
authors.lastname: Pan
authors.forename: Tsui-Hua
authors.initials: TH
authors.lastname: Hsu
authors.forename: Mei-Yen
authors.initials: MY
authors.lastname: Chen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology