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The association of diabetes-related self-care activities with perceived stress, anxiety, and fatigue: a cross-sectional study

Authors Zhao FF, Suhonen R, Katajisto J, Leino-Kilpi H

Received 31 March 2018

Accepted for publication 12 May 2018

Published 4 September 2018 Volume 2018:12 Pages 1677—1686

DOI https://doi.org/10.2147/PPA.S169826

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen


Fang-Fang Zhao,1,2 Riitta Suhonen,1,3 Jouko Katajisto,4 Helena Leino-Kilpi1,5

1Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland; 2School of Nursing Science, Nantong University, Nantong, People’s Republic of China; 3Turku University Hospital and City of Turku, Welfare Division, Turku, Finland; 4Department of Mathematics and Statistics, University of Turku, Turku, Finland; 5Turku University Hospital, Turku, Finland

Purpose: Many people with type 2 diabetes (T2DM) do not sustain sufficient diabetes-related self-care activities (DRSCA) in their daily lives. To provide additional information about the positive influence of DRSCA, this study was conducted to examine whether DRSCA were associated with reduced perceived stress, anxiety, and fatigue among people with T2DM and to explore the level of DRSCA, perceived stress, anxiety, and fatigue and their association with background information.
Patients and methods: This study was a cross-sectional survey including 251 participants aged 18 years and older recruited from two hospitals in the eastern part of China. The study utilized self-report questionnaires that consisted of background information, DRSCA, perceived stress, anxiety, and fatigue. Hierarchical multiple regression analysis was conducted to explore the association of DRSCA with perceived stress, anxiety, and fatigue while adjusting for background information.
Results: The results indicated that the level of self-care activities, stress, and fatigue was around middle level. The prevalence of anxiety was 19%. A high level of DRSCA was likely to reduce perceived stress but was not linked to anxiety and fatigue. Women were more susceptible to stress and anxiety, and people who had diabetes for >5 years were more likely to have anxiety. The background information included diabetes duration, standardized diabetes education, and high social support, all of which are factors that may influence DRSCA.
Conclusion: The findings suggest that improving the level of DRSCA might effectively reduce perceived stress. The potential benefits of DRSCA can provide both motivational and evaluative data for self-care programs. In addition, the findings show that DRSCA were not linked to anxiety and fatigue, which implies that their positive influence on anxiety and fatigue may be offset by the load of frequent DRSCA. It is suggested that helping patients to make tailored plans to integrate DRSCA into their daily lives is needed. Meanwhile, in the background information, it is suggested that standardized diabetes education and high social support can benefit DRSCA; in improving psychological health, more attention should be paid to women and patients with diabetes duration >5 years.

Keywords: diabetes, self-care, adherence, benefits, negative feelings

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