title: Diabetes-related distress and its associated factors among patients with type 2 diabetes mellitus in China.
abstract: Diabetes-related distress is one of the psychological disorders affecting patients with diabetes, yet there are few studies about diabetes-related distress in Chinese patients. To assess the level of psychological distress and examine its associated factors, we conducted a cross-sectional analysis of patients with type 2 diabetes mellitus from a Chinese tertiary hospital. The Diabetes Distress Scale (DDS) and the General Self-Efficacy Scale (GSES) were administered. There were 210 (57.85%) patients with little or no diabetes-related distress, 84 (23.14%) with moderate diabetes-related distress and 69 (19.01%) with high diabetes-related distress. Stepwise multiple linear regression showed that sleep time was significantly related to the DDS total score and the subscale scores of emotional burden (EB) (β=-0.190, -0.379), respectively. GSES was associated with the DDS total score (β=-0.128) and the EB score (β=-0.153). Oral medication plus insulin was significantly related to regimen-related distress (RD) (β=0.137), physician-related distress (PD) (β=0.152) and interpersonal distress (ID) (β=0.103). Physical activity (β=-0.185) and making meal plan with health care professionals(HCP) (β=-0.169) were associated with RD. The prevalence of diabetes-related distress among patients with type 2 diabetes mellitus was high in China. DDS and EB were associated with poorer sleep time and lower self-efficacy. Interventions to improve sleep are needed. Qualitative and longitudinal studies are required to understand why type 2 diabetic patients are not getting enough sleep.
authors.affiliation: Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China; Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu Province, China; Nursing College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China.
authors.forename: Huanhuan
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, USA.
authors.forename: Junya
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China; Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu Province, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Liu
authors.affiliation: Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China; Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu Province, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Li
authors.affiliation: College of Nursing (ISP Program), University of Missouri-St. Louis, St. Louis, MO, USA.
authors.forename: Anne F
authors.initials: AF
authors.lastname: Fish
authors.affiliation: Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
authors.forename: Tao
authors.initials: T
authors.lastname: Chen
authors.affiliation: Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China; Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu Province, China. Electronic address: lqq188@yahoo.com.
authors.forename: Qingqing
authors.initials: Q
authors.lastname: Lou
mesh_terms: D000328:Adult; D044466:Asian People / Q000523:psychology*; D001294:Attitude to Health; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000523:psychology*; D004644:Emotions; D015444:Exercise / Q000523:psychology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D020377:Self Efficacy; D012890:Sleep / Q000502:physiology; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*; D013997:Time Factors
keywords: Chinese; Diabetes; Diabetes-related distress; Self-efficacy; Sleep time, Insulin, Physical activity