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The European Journal of Public Health 2000 10(1):68-74; doi:10.1093/eurpub/10.1.68
© 2000 by European Journal of Public Health
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ORIGINAL ARTICLES

Disease-related distress among insulin-treated diabetic patients

Associations with health status, psychosocial factors and self-care practices

ANNA-MARI AALTO, ANTTI UUTELA and ARJA R. ARO

1 National Research and Development Centre for Welfare and Health Helsinki, Finland
2 National Public Health Institute Helsinki, Finland

Correspondence: Anna-Man Aalto, Msc, National Research and Development Centre for Welfare and Health, P.O. Box 220, Fin-00531, Helsinki, Finland, tel. +358 9 3967 2252, fax +358 9 3967 2485, e-mail: Anna-Marl.Aalto{at}stakes.fl

Background: Diabetes is a chronic illness that affects many domains of life. This cross-sectional study examined disease-related distress and its associations with health and psychosocial factors among insulin-treated diabetic persons. Method: The sample (n=423) was drawn from the Social Insurance Institution's drug registry. Health indicators were duration of diabetes, complications, and glycaemlc control. Psychosocial measures included general and diabetes-specific social support, diabetes locus of control (DLC), self-efficacy, diabetes health beliefs and self-care practices and subjective health. Results: Most respondents reported moderate diabetes-related distress. In multi-variate analysis, severe diabetes distress was related to lower net benefits of regimen (ß = –0.29, and p<0.001), poorer perceived health (ß = –0.25, and p<0.001), higher perceived threat of complications (ß = 0.19, and p<0.001), less adequate social support (ß = –0.16, and p<0.01), stronger beliefs in chance (ß = 0.15, and p<0.01) and internal DLC (ß = 0.11, and p<0.05) and more frequent exercising (ß = 0.10, and p<0.05). Conclusions: The results suggest that emotional adjustment to diabetes is predominantly determined by diabetes-related cognitions and subjective health and to a lesser degree by objective diabetes indlcators, which underlines the Importance of assisting the patient with adjustment with the disease in health care centres.

Keywords: diabetes cognitions, diabetes distress, health status, insulin-treated diabetes, social support


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