12. tbl. 94. árg. 2008
Fræðigrein
Diabetes type 1 in young adults: The relationship between psycho-social variables, glycemic control, depression and anxiety
Objective: The aim of the present study was to investigate whether psycho-social variables, for example social support and task- and emotion-oriented coping would predict psychological and physical we
Material and Methods: Participants were 56 individuals in their twenties suffering from type 1 diabetes. Response rate was 78%. The participants came from the whole of Iceland, 64.3% from the Greater Reykjavík area and 33.9% from rural areas. One participant did not indicate his place of residence. Self-assessment scales were used to assess depression, anxiety, task-, avoidance- and emotion-oriented coping, social support and problems relating to diabetes. Additional information was obtained from patients? records concerning the results of blood glucose measurements (HbA1c).
Results: Good social support was related to less anxiety and depression and to less self-reported problems related to having diabetes. Emotion-oriented coping was related to not feeling well and task- oriented coping to feeling better. No relationship was found between psychosocial variables and blood glucose measurements and a limited relationship between self-reported problems related to having diabetes and these measurements.
Conclusions: Social support and coping are strongly related to measurements of depression, anxiety and problems related to having diabetes in the present age group. The results indicate that it is very important to teach and strengthen usage, as possible, of task-oriented coping instead of emotion-oriented coping. The results also indicate that social support is highly important for young adults with diabetes type 1. It is clear that friends and family have to be more involved in the treatment and also more educated about the disease and the importance of giving the right kind of support.
Table I. Means and standard deviations of HADS which measures depression and anxiety, CISS which measures coping, Problem Areas in Diabetes Scale (PAID) and the latest glycosylated haemoglobin (HbA1c).
___________________________________________________________________________
Mean Standard deviation
HADS-Depression 10.6 3.7
HADS-Anxiety 13.6 4.5
Emotion-oriented coping 42.0 12.5
Task-oriented coping 52.2 10.8
Avoidance-oriented coping 42.6 9.5
Social support 31.7 4.0
Problem Areas in Diabetes Scale 40.1 12.2
Latest glycosylated hemoglobin (HbA1c) 8.1 1.6
___________________________________________________________________________
Table II. Correlation between depression, anxiety, coping, problem areas in diabetes and the most recent glycosylated haemoglobin (HbA1c).
___________________________________________________________________________
HADS-A Social S. Emotion C. Task C. Avoidance C. PAID HbA1c
HADS-D 0,76** -0,48** 0,71** -0,33* 0,02 0,65** -0,05
HADS-A -0,31* 0,64* -0,27* 0,04 0,58** -0,01
Social Support -0,30* 0,03 0,01 -0,45** 0,05
Emotion C. -0,06 0,31* 0,56** 0,01
Task C. 0,17 -0,09 -0,04
Avoidance C. 0,21 0,08
PAID 0,30*
___________________________________________________________________________
*p<0,05; **p<0,001.
HADS-A=HADS Anxiety, HADS-D=HADS Depression, Social S.=Social Support, Emotion C.= Emotion-oriented coping, Task C.=Task-oriented coping, Avoidance C.=Avoidance-oriented coping, PAID=Problem Areas in Diabetes.
Table III. The extent to which social support and coping can explain 1) Anxiety, 2) Depression, 3) Problem areas in diabetes.
1) The score on HADS Anxiety is predicted by hierarchical regression.
Age, gender and age at diagnoses is entered at phase 1, social support at phase 2 and coping at phase 3.
___________________________________________________________________________
Phase 1 Beta p value
Age -0.01 >0.10
Gender -0.03 >0.10
Age at diagnoses 0.07 >0.10
Phase 2
Age 0.06 >0.10
Gender -0.07 >0.10
Age at diagnoses 0.12 >0.10
Social Support -0.34 0.016
Phase 3
Age -0.12 >0.10
Gender -0.06 >0.10
Age at diagnoses -0.02 >0.10
Social Support -0.09 >0.10
Emotion-oriented coping 0.67 <0.001
Task-oriented coping -0.19 0.09
Avoidance-oriented coping -0.19 >0.10
___________________________________________________________________________
R2 at phase 1=0.01 (p>0.10), R2 at phase 2=0.11 (p=0.016), R2 at phase 3=0.39 (p<0.001)
2) The score on HADS Depression is predicted by hierarchical regression.
Age, gender and age at diagnoses is entered at phase 1, social support at phase 2 and coping at phase 3.
___________________________________________________________________________
Phase 1 Beta p value
Age 0.002 >0.10
Gender -0.03 >0.10
Age at diagnoses 0.13 >0.10
Phase 2
Age 0.11 >0.10
Gender -0.09 >0.10
Age at diagnoses 0.22 0.09
Social Support -0.54 <0.001
Phase 3
Age -0.07 >0.10
Gender -0.11 >0.10
Age at diagnoses 0.10 >0.10
Social Support -0.32 0.001
Emotion-oriented coping 0.66 0.001
Task-oriented coping -0.24 0.008
Avoidance-oriented coping -0.23 0.029
___________________________________________________________________________
R2 at phase 1=0.02 (p>0.10), R2 at phase 2=0.27 (p<0.001), R2 at phase 3=0.41 (p<0.001)
3) The score on Problem Areas in Diabetes scale (PAID) is predicted by hierarchical regression. Age, gender and age at diagnoses is entered at phase 1, social support at phase 2 and coping at phase 3.
____________________________________________________________________
Phase 1 Beta p value
Age -0.07 >0.10
Gender -0.15 >0.10
Age at diagnoses -0.03 >0.10
Phase 2
Age 0.18 >0.10
Gender -0.21 >0.10
Age at diagnoses 0.10 0.08
Social Support -0.52 <0.001
Phase 3
Age 0.11 >0.10
Gender 0.13 >0.10
Age at diagnoses 0.03 >0.10
Social Support -0.37 0.005
Emotional-oriented coping 0.38 0.006
Task-oriented coping -0.10 >0.10
Avoidance-oriented coping 0.07 >0.10
__________________________________________________________________________
R2 at phase 1=0.03 (p>0.10), R2 at phase 2=0.25 (p<0.001), R2 at phase 3=0.15 (p=0.01)