title: Factors Affecting the Ability of People With Diabetes to Avoid Hypoglycemia.
abstract: BACKGROUND
  Hypoglycemia is recognized as a limiting factor in diabetes management. Fear of experiencing hypoglycemia may lead to lower quality of life, impaired glycemic control, and emotional distress, all of which impair the ability of patients to self-manage their diabetes effectively. Problem solving is central to diabetes self-management and may help patients achieve effective self-care of their disease.
  
  
  OBJECTIVE
  The aim of this study was to investigate the ability of people with diabetes to avoid hypoglycemia and to explore associated factors.
  
  
  METHODS
  A cross-sectional, descriptive design was used for the study. Data were collected using a demographic and disease characteristics datasheet, the Hypoglycemic Problem Solving Scale, and the Disease-Associated Negative Mood Scale.
  
  
  RESULTS
  Three hundred thirteen participants were recruited, with a mean age of 55.49 years. The average item score for the questions on hypoglycemic problem-solving ability was 2.43 (SD = 0.75). In comparing Hypoglycemic Problem Solving Scale subscales, participants scored highest on the problem orientation subscales and lowest on the problem-solving skills subscales. Multiple regression analysis revealed that being younger and unmarried and having a higher level of education, a diagnosis of Type 1 diabetes, and a lower negative mood score were each significantly associated with greater problem-solving ability as regards hypoglycemic events.
  
  
  CONCLUSIONS
  We suggest that patients with diabetes, especially those who are older or with lower levels of education, receive disease-related psychological interventions and that healthcare professionals teach problem-solving abilities in conjunction with hypoglycemia management.
authors.affiliation: PhD, RN, Assistant Professor, Department of Nursing, Chang Gung University of Science and Technology.
authors.forename: Fei-Ling
authors.initials: FL
authors.lastname: Wu
authors.affiliation: PhD, Emeritus Professor, Department of Psychology, National Taiwan University.
authors.forename: En-Chang
authors.initials: EC
authors.lastname: Wu
authors.affiliation: PhD, Professor, Department of Mathematics, Tamkang University.
authors.forename: Yue-Cune
authors.initials: YC
authors.lastname: Chang
authors.affiliation: PhD, RN, Professor, School of Nursing, College of Medicine, National Taiwan University.
authors.forename: Wen-Yu
authors.initials: WY
authors.lastname: Hu
authors.affiliation: MD, Professor, Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, and School of Medicine, College of Medicine, Chang Gung University.
authors.forename: Jyuhn-Huarng
authors.initials: JH
authors.lastname: Juang
authors.forename: Mei Chang
authors.initials: MC
authors.lastname: Yeh
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000517:prevention & control* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D012307:Risk Factors; D012648:Self Care / Q000523:psychology*; D012959:Socioeconomic Factors