Associations of changes in psychosocial factors and their interactions with diabetes distress in patients with type 2 diabetes: a longitudinal study

Aim. To assess the associations of changes in self-management behaviours, diabetes self-efficacy, resilience, social support, patient empowerment and their interactions with changes in diabetes distress in patients with type 2 diabetes mellitus. Background. Many patients with type 2 diabetes mellitus experience diabetes distress. Few longitudinal studies have investigated the associations of changes in various psychosocial factors with changes in diabetes distress in patients with type 2 diabetes mellitus. Design. This study adopted a longitudinal design. Data were collected at baseline and 12 months later. Methods. Overall, 304 patients with type 2 diabetes were recruited from four hospitals in southern Taiwan by convenience sampling. A self-report questionnaire and medical record were used to collect demographic data, clinical indicators, self-management behaviours, diabetes self-efficacy, resilience, social support, patient empowerment, and diabetes distress. Data were collected from February 2014-March 2015. Results/Findings. An increase in resilience or diabetes self-efficacy significantly associated with a decrease in diabetes distress, whereas an increase in patient empowerment significantly associated with an increase in diabetes distress. The interactions between increase in patient empowerment and increase in self-management behaviours significantly associated with decrease in diabetes distress. Conclusion. Nurses could endeavour to improve the diabetes self-efficacy and resilience to reducing diabetes distress. Arbitrarily empowering patients may increase diabetes distress. Increasing self-care management behaviours and patient empowerment might need to be simultaneously addressed to reduce the diabetes distress in patients with type 2 diabetes.