Predicting Type 2 Diabetes Care Results with Social Psychological Factors
Abstract
Pan Yen-Chu and Shiow-Luan Tsay
The prevalence rate of diabetes is very high in Taiwan that poses a serious threat to the health of people. Patients’ physical and psychosocial factors always have an impact on the treatment results. However, this issues have not been extensively discussed in previous researches. The purpose of this study is to investigate the effects of sociopsychological factors on the care outcomes of Type 2 diabetes. The study is a descriptive and correlation design; Instruments included a basic information form, Social Support Scale, Chinese version of Patient Health and Depression Questionnaire, Perceived Stress Scale, and Health-related Quality of Life Scale.The analysis methods included descriptive statistics, independent-sample t-test, one-way ANOVA, Pearson product-moment correlation, multiple linear regression, and binary logistic regression. The sample consisted of 133 patients. Results showed, depression is significantly negatively related to social support (r=-0.27, p<.05), psychological distress is significantly negatively related to social support (r=-0.21, p<.05), psychological distress is significantly positively related to depression (r=0.85, p<.01), quality of life is significantly negatively related to depression (r=- 0.64, p<.01) and psychological distress (r=-0.59, p <.01). Continuous outcome variables are analyzed using regression analysis, depression and economic independence jointly explained 32.1% of variance in the physical aspect of quality of life (27.9% by depression and 4.2% by economic independence). Depression and psychological distress jointly explained 61.3% of variance in the psychological aspect of quality of life (59% by depression and 2.3% by psychological distress). Economic dependence on others explained 3.1% of variance in the number of hospital stays. Depression explained 3.7% of variance in the number of emergency department visits. Education level explained 4.3% of variance in the number of complications. Categorical outcome variables are analyzed using binary logistic regression, ducation has a significant effect on average glucose level over the last year (p>.03). Depression has a significant effect on both the last HbA1c level (p<.05) and average glucose level over the last year (p>.03). Results of this study suggest that when providing clinical care to diabetes, nurses should also consider the effects of socio-psychological factors on the care outcomes and provide necessary counseling and treatment of depression to enhance the effectiveness of care.