Disease-related distress among insulin-treated diabetic patients - Associations with health status, psychosocial factors and self-care practices

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 glycaemic 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 multivariate analysis, severe diabetes distress was related to lower net benefits of regimen (beta = -0.29, and p<0.001), poorer perceived health (beta = -0.25, and p<0.001), higher perceived threat of complications (beta = 0.19, and p<0.001), less adequate social support (beta = -0.16, and p<0.01), stronger beliefs in chance (beta = 0.15, and p<0.01) and internal DLC (beta = 0.11, and p<0.05) and more frequent exercising (beta = 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 indicators, which underlines the importance of assisting the patient with adjustment with the disease in health care centres.