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Xiao WH, Yang XC, Xu SJ, Bian Y, Zou GY. Prevalence and associated factors of depressive symptoms in Chinese diabetic patients: A study based on Andersen’s behavioral model. World J Diabetes 2025; 16:100638. [DOI: 10.4239/wjd.v16.i4.100638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2024] [Revised: 12/17/2024] [Accepted: 01/22/2025] [Indexed: 02/28/2025] Open
Abstract
BACKGROUND Diabetes mellitus (DM) is a rapidly growing global health emergency of the 21st century. Comorbidities, such as DM and depression, are common, presenting challenges to the healthcare system.
AIM To investigate the prevalence of depression and its associated factors in patients with DM and to strengthen the management of depression in this patient group.
METHODS Participants were selected from the 2018 China Health and Retirement Longitudinal Study. Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale, with a score of 10 or more indicating depression. Group differences were compared using analysis of variance and χ2 tests. Binary logistic regression was conducted to explore the odds ratios (ORs) of independent variables. Following Andersen’s behavioral model, predisposing, enabling, health need, and health behavior variables were introduced stepwise into the logistic model.
RESULTS Of the 1673 patients with diabetes, 41.4% had depressive symptoms. Regarding the predisposing characteristics, patients who were male (OR 0.426, P < 0.05), married (OR 0.634, P < 0.05), and received a high school education or higher (OR 0.432, P < 0.05) reported fewer depressive symptoms. Healthcare needs, including better self-rated health (OR 0.458 for fair and OR 0.247 for good, P < 0.05) and more sleep (OR 0.642, P < 0.05), were associated with a lower likelihood of depressive symptoms. In contrast, pain (OR 1.440 for mild and OR 2.644 for severe, P < 0.05) and impairment in the basic activities of daily living (OR 1.886, P < 0.05) were inversely associated. Additionally, patients highly satisfied with healthcare services (OR 0.579, P < 0.05) were less likely to have depressive symptoms.
CONCLUSION Nearly half of the patients with DM reported depressive symptoms, which were strongly associated with predisposing characteristics and healthcare needs, particularly physical pain and impairment in basic activities of daily living. Our study emphasizes the significance of enhanced screening and intervention for depression in diabetes care along with improved management of functional impairments.
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Affiliation(s)
- Wen-Hui Xiao
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau 999078, China
| | - Xiao-Cong Yang
- School of Public Administration, Guangzhou University, Guangzhou 510006, Guangdong Province, China
| | - Si-Jie Xu
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
| | - Ying Bian
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau 999078, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macau 999078, China
| | - Guan-Yang Zou
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
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Zhou Y, Wang S, Liu M, Gan G, Qin N, Luo X, Zhang C, Xie J, Wang K, Cheng AS. The role of sleep quality and perceived stress on depressive symptoms among tertiary hospital nurses: a cross-sectional study. BMC Psychiatry 2023; 23:416. [PMID: 37308915 DOI: 10.1186/s12888-023-04936-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/07/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Nurses in tertiary hospitals are at high risk for depression. Understanding sleep quality and perceived stress may contribute to nurses' mental health and health-related nursing productivity. The aim of this study was to investigate the role of sleep quality and perceived stress on depressive symptoms among nurses in tertiary hospitals. METHODS A total of 2,780 nurses (overall response rate = 91.1%) were recruited through a cross-sectional survey in 23 tertiary hospitals in China. Questionnaires included the Self-Rating Depression Scale, the Pittsburgh Sleep Quality Index, and the Chinese Perceived Stress Scale. Variables that were significant in Chi-square tests were further entered into binary logistic stepwise regression. RESULTS The prevalence of depressive symptoms was 60.3% (n = 1,676), of which 97.4% (n = 1,633) were female, and 77.8% were younger than 35 years (n = 1,304). Nurses who had moderate, poor, severe sleep quality and poor perceived pressure were more likely to be depressed. Master's degree, 6-10 years of work, and physical activity were protective factors, while the opposite was the case for shift work and high dissatisfaction. CONCLUSIONS More than half of nurses working in tertiary care hospitals reported depressive symptoms, and lower sleep quality and higher perceived stress were more associated with this. Perceived stress is an interesting concept, which may provide a new entry point for the well-known idea that there is a relationship between poor sleep quality and depression. It is possible to reduce depressive symptoms among public hospital nurses by providing information on sleep health and stress relief.
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Affiliation(s)
- Yi Zhou
- Nursing Department, The Third Xiangya Hospital, Xiangya School of Nursing, Central South University, Central South University, Changsha, Hunan, China
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Sha Wang
- Nursing Department, The Third Xiangya Hospital, Xiangya School of Nursing, Central South University, Central South University, Changsha, Hunan, China
| | - Min Liu
- Nursing Department, The Third Xiangya Hospital, Xiangya School of Nursing, Central South University, Central South University, Changsha, Hunan, China
| | - Gang Gan
- Nursing Department, The Third Xiangya Hospital, Xiangya School of Nursing, Central South University, Central South University, Changsha, Hunan, China
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Ning Qin
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Xiaofei Luo
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Chun Zhang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jianfei Xie
- Nursing Department, The Third Xiangya Hospital, Xiangya School of Nursing, Central South University, Central South University, Changsha, Hunan, China.
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China.
| | - Kewei Wang
- Pediatrics Research Institute of Hunan Province, Hunan Children's Hospital, Changsha, Hunan, China.
| | - Andy Sk Cheng
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China
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Liu Y, Chen L, Zhou H, Guan H, Feng Y, Yangji B, Liu Q, Liu X, Xia J, Li J, Zhao X. Does awareness of diabetic status increase risk of depressive or anxious symptoms? Findings from the China Multi-Ethnic cohort (CMEC) study. J Affect Disord 2023; 320:218-229. [PMID: 36191641 DOI: 10.1016/j.jad.2022.09.135] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 09/24/2022] [Accepted: 09/27/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION People with diabetes mellitus (DM) have increased risk of depressive symptoms (DS) or anxious symptoms (AS). This study explores whether awareness of DM will contribute to prevalence of DS or AS. METHODS The baseline data including 81,717 adults from Southwest China was analyzed. DS and AS were assessed using PHQ-2 and GAD-2. Exposures were defined as 1) having self-reported physician diagnosis of diabetes (self-reported DM), 2) no prior diagnosis of diabetes but meeting diagnostic criteria (newly diagnosed DM), 3) having self-reported physician diagnosis or meeting criteria of non-diabetic diseases (non-diabetic patients), 4) healthy participants. Generalized linear mixed models were used to assess impact of presence and awareness of DM on DS or AS, adjusting for regional and individual related factors. RESULTS The prevalence of DS in self-reported DM, newly diagnosed DM, non-diabetic patient and healthy participants was 7.08 %, 4.30 %, 5.37 % and 3.17 %. The prevalence of AS was 7.80 %, 5.77 %, 6.37 % and 3.91 %. After adjusting for related factors, compared with healthy participants, self-reported DM and non-diabetic patients were associated with DS [AORDS, self-reported = 1.443(1.218,1.710), AORDS, nondiabetic patients = 1.265(1.143,1.400)], while the association between newly diagnosed DM and DS was not statistically significant. The associations between self-reported DM, newly diagnosed DM, non-diabetic patients and AS were all statistically significant. LIMITATIONS DS and AS were assessed through self-report and may suffer recall or information bias. CONCLUSIONS The association between awareness of diabetes and DS/AS suggests to pay attention to distinguish between self-reported and newly diagnosed DM and screening for DS and AS in diabetic population.
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Affiliation(s)
- Yuanyuan Liu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Liling Chen
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Hanwen Zhou
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Han Guan
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Guizhou Medical University, Guiyang, Guizhou, China
| | - Yuemei Feng
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Baima Yangji
- School of Medicine, Tibet University, Lhasa, Tibet Autonomous Region, China
| | - Qiaolan Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiang Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jinjie Xia
- Chengdu Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Jingzhong Li
- Tibet Center for Disease Control and Prevention, Lhasa, Tibet Autonomous Region, China
| | - Xing Zhao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
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Li Q, Chen Y, Välimäki M, Long Q, Yang J, Guo J. The Association Between General Self-Efficacy and Depressive Symptoms in People with Type 2 Diabetes Mellitus: The Mediating Role of Coping Styles Preference. Psychol Res Behav Manag 2022; 15:2501-2511. [PMID: 36104998 PMCID: PMC9467442 DOI: 10.2147/prbm.s381742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 09/01/2022] [Indexed: 11/23/2022] Open
Abstract
Background Depressive symptoms are prevalent in persons with type 2 diabetes mellitus and related with poor disease outcomes. Both general self-efficacy and coping style are associated with depressive symptoms. A model about proactive coping indicates that coping style plays a mediation role between general self-efficacy and depressive symptoms. But, empirical evidence is missing about this potential mediation relationship which may be a barrier of taking precise strategies for relieving depressive symptoms. Objective This study aims to investigate the prevalence of elevated depressive symptoms in persons with type 2 diabetes mellitus and explore whether coping style preference mediates the association between general self-efficacy and depressive symptoms. Methods This was a secondary data analysis of a cross-sectional survey (June-July 2017) among 721 persons with type 2 diabetes mellitus (45.4% male and 54.6% female) aged from 22 to 96 years old. Data on general self-efficacy, coping style preference and depressive symptoms were collected using validated questionnaires in hospital setting. The mediation model was tested using the bootstrapping (K=5000) in the MPlus program version 7.4. The results were reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results The prevalence of elevated depressive symptoms was 58% (n = 418) among persons with type 2 diabetes mellitus at hospital setting. A higher level of general self-efficacy was related to less depressive symptoms via positive coping preference (p < 0.01). Discussion About two-thirds of persons with type 2 diabetes mellitus experienced elevated depressive symptoms during hospitalization. The intervention elements, including strengthening general self-efficacy and promoting positive coping, are promising to decrease their depressive symptoms.
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Affiliation(s)
- Qingting Li
- Xiangya School of Nursing, Central South University, Changsha, 410013, People's Republic of China
| | - Yao Chen
- Xiangya School of Nursing, Central South University, Changsha, 410013, People's Republic of China
| | - Maritta Välimäki
- Xiangya School of Nursing, Central South University, Changsha, 410013, People's Republic of China
| | - Qing Long
- Xiangya School of Nursing, Central South University, Changsha, 410013, People's Republic of China
| | - Jundi Yang
- School of Nursing, the University of Hong Kong, Pokfulam, 999077, People's Republic of China
| | - Jia Guo
- Xiangya School of Nursing, Central South University, Changsha, 410013, People's Republic of China
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Azmiardi A, Murti B, Febrinasari RP, Tamtomo DG. Low Social Support and Risk for Depression in People With
Type 2 Diabetes Mellitus: A Meta-analysis. J Prev Med Public Health 2022; 55:37-48. [PMID: 35135047 PMCID: PMC8841196 DOI: 10.3961/jpmph.21.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 10/31/2021] [Indexed: 11/15/2022] Open
Abstract
Objectives Depression is a frequent complication of type 2 diabetes mellitus. This study aimed to investigate the relationship between low social support and risk for depression in people with type 2 diabetes through a meta-analysis. Methods PubMed, ProQuest, SpringerLink, ScienceDirect, Scopus, the Cochrane Library, Embase, and Google Scholar were searched for English-language articles published up to 2021. Pooled adjusted odds ratios (aORs) were calculated using a random-effect model with 95% confidence intervals (CIs). Heterogeneity was evaluated by using the Cochrane Q test and I2 statistics. The risk of publication bias was estimated using a funnel plot, the Egger test, and the Begg test. The Joanna Briggs Institute Critical Appraisal Tools were used to assess the quality of evidence and the risk of bias. Results Eleven studies were included in this meta-analysis, containing a total of 3151 people with type 2 diabetes mellitus. The pooled analysis showed that people with type 2 diabetes mellitus who had low social support had twice as high a risk of depression as those with high social support (aOR, 2.02; 95% CI, 1.51 to 2.70; p<0.001). A random-effect model was used because the heterogeneity was high (I2= 87%). Conclusions Low social support was found to increase the risk of depression among people with type 2 diabetes mellitus. Further investigation into factors that may moderate this relationship is required.
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Affiliation(s)
- Akhmad Azmiardi
- Doctoral Program on Public Health, Universitas Sebelas Maret, Surakarta, Indonesia
- Department of Public Health, Universitas Veteran Bangun Nusantara, Sukoharjo, Indonesia
- Corresponding author: Akhmad Azmiardi Doctoral Program on Public Health, Universitas Sebelas Maret, 36 Ir. Sutami Street, Surakarta 57126, Indonesia E-mail:
| | - Bhisma Murti
- Doctoral Program on Public Health, Universitas Sebelas Maret, Surakarta, Indonesia
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Jiang M, Li S, She D, Yan F, Chung YF, Han L. The psychological effect of 2019 coronavirus disease outbreak on nurses living in Islamic culture dominant region, China. Arch Psychiatr Nurs 2020; 34:513-519. [PMID: 33280674 PMCID: PMC7499051 DOI: 10.1016/j.apnu.2020.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/28/2020] [Accepted: 09/07/2020] [Indexed: 01/08/2023]
Abstract
• This study investigated the psychological effect of COVID-19 pandemic on nurses living in Islamic culture dominant region. • Nurses who are of the Islamic culture were affected slightly by the COVID-19 outbreak in early February. • The factors associated with psychological variables were social support, family role, fear of contagion, etc.
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Affiliation(s)
- Mengyao Jiang
- School of Nursing, Lanzhou University, Lanzhou 730000, Gansu, China
| | - Siyan Li
- School of Nursing, Lanzhou University, Lanzhou 730000, Gansu, China
| | - Dongli She
- Department of Nursing, Gansu Provincial Hospital, Lanzhou 730000, Gansu, China
| | - Fanghong Yan
- School of Nursing, Lanzhou University, Lanzhou 730000, Gansu, China
| | - Yuet Foon Chung
- School of Nursing, Lanzhou University, Lanzhou 730000, Gansu, China
| | - Lin Han
- School of Nursing, Lanzhou University, Lanzhou 730000, Gansu, China; Department of Nursing, Gansu Provincial Hospital, Lanzhou 730000, Gansu, China.
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Han L, Wong FKY, She DLM, Li SY, Yang YF, Jiang MY, Ruan Y, Su Q, Ma Y, Chung LYF. Anxiety and Depression of Nurses in a North West Province in China During the Period of Novel Coronavirus Pneumonia Outbreak. J Nurs Scholarsh 2020; 52:564-573. [PMID: 32652884 PMCID: PMC7405411 DOI: 10.1111/jnu.12590] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/11/2020] [Accepted: 06/24/2020] [Indexed: 12/15/2022]
Abstract
Purpose To investigate the anxiety and depression levels of frontline clinical nurses working in 14 hospitals in Gansu Province, China, during this period. Design A cross‐sectional survey was conducted online between February 7 and 10, 2020, with a convenience sample of 22,034 nurses working in 14 prefecture and city hospitals in Gansu Province, located in northwest China. Methods A self‐reported questionnaire with four parts (demographic characteristics, general questions related to novel coronavirus‐infected pneumonia, self‐rating anxiety scale, and self‐rating depression scale) was administered. Descriptive statistics including frequencies, means, and SDs were computed. The associations between anxiety and depression with sociodemographic characteristics, work‐related concerns, and impacts were analyzed, followed by multiple stepwise linear regression to identify factors that best predicted the nurses’ anxiety and depression levels. Findings A total of 21,199 questionnaires were checked to be valid, with an effective recovery rate of 96.21%. The mean ± SD age of the respondents was 31.89 ± 7.084 years, and the mean ± SD length of service was 9.40 ± 7.638 years. The majority of the respondents were female (98.6%) and married (73.1%). Some demographic characteristics, related concerns, and impacts of COVID‐19 were found to be significantly associated with both anxiety (p < .001) and depression (p < .001). Nurses who needed to take care of children or elderly relatives, took leave from work because they were worried about COVID‐19, avoided contact with family and friends, and wanted to obtain more COVID‐19‐related knowledge had higher levels of both anxiety and depression. Conclusions Results show that nurses faced with the COVID‐19 outbreak are at risk for experiencing anxiety and depression. Demographic background, psychosocial factors, and work‐related factors predicted the psychological responses. The family responsibilities and burdens of women may explain the higher levels of anxiety and depression among nurses with these obligations as compared to those without. On the other hand, nurses who chose not to take leave from work or who did not avoid going to work during this period were less anxious and depressed. Clinical Relevance Professional commitment might be a protective factor for adverse psychological responses. It is pertinent to provide emotional support for nurses and recognize their professional commitment in providing service to people in need.
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Affiliation(s)
- Lin Han
- Nursing Administrator, Gansu Provincial Hospital, Lanzhou, Gansu, China, and Head of School, Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Gansu, China
| | - Frances Kam Yuet Wong
- Professor, School of Nursing, Hong Kong Polytechnic University Hung Hom, Kowloon, Hong Kong and Associate Dean, Faculty of Health and Social Science, Hong Kong Polytechnic University Hung Hom, Kowloon, Hong Kong
| | - Dong Li M She
- Registered Nurse, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Si Yan Li
- MSN student, Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Yun Fang Yang
- MSN student, Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Meng Yao Jiang
- MSN student, Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Yue Ruan
- MSN student, Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Qian Su
- Registered Nurse, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Yuxia Ma
- Associate Professor, Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Loretta Yuet Foon Chung
- Professor, School of Nursing, Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
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Jin X, Liu GG, Gerstein HC, Levine MAH, Guan H, Li H, Xie F. Minimally important difference and predictors of change in quality of life in type 2 diabetes: A community-based survey in China. Diabetes Metab Res Rev 2018; 34:e3053. [PMID: 30064154 DOI: 10.1002/dmrr.3053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 07/10/2018] [Accepted: 07/20/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND To identify the minimally important difference (MID) of the EQ-5D-3L and determinants of change in quality of life (QoL) as measured by the EQ-5D-3L over 1 year for Chinese type 2 diabetic patients (T2DPs). METHODS Clinically diagnosed T2DPs were recruited from 66 community health centres in five Chinese cities using a multistage quota sampling method between December 2010 and October 2011. Demographics, diabetes-related information, and health-related behaviours were collected at baseline. The EQ-5D-3L was administered at baseline and at 12 months. Anchor-based and distribution-based approaches were employed to estimate MIDs. Using the MIDs as cut-points, we identified the change in EQ-5D-3L-measured QoL into "worsening," "no change," and "bettering." Logistic and ordered logistic regressions were conducted for those who reported best possible EQ-5D health state ("best possible HS") and impaired EQ-5D health states ("impaired HS") at baseline, respectively. Explanatory variables included demographics, diabetes-related information, and health-related behaviours. RESULTS A total of 1958 patients (54.9% female, mean age 61.2 years, mean diabetes duration 7.9 years) were included in our analysis. MIDs of the EQ-5D-3L for deterioration and improvement were estimated as -0.066 to -0.003, and 0.049 to 0.077, respectively. For the impaired HS group, older age, lower education, and less exercise were significant predictors for worsening in QoL; whereas, those predictors were older age, female gender, and lower income for the best possible HS group. CONCLUSIONS Minimally important differences for deterioration and improvement were estimated for the EQ-5D-3L. Age, gender, education, income, and exercise were significant determinants of QoL change for Chinese T2DPs.
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Affiliation(s)
- Xuejing Jin
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- China Center for Health Economic Research, Peking University, Beijing, China
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Gordon G Liu
- China Center for Health Economic Research, Peking University, Beijing, China
- National School of Development, Peking University, Beijing, China
| | | | - Mitchell A H Levine
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Haijing Guan
- China Center for Health Economic Research, Peking University, Beijing, China
- School of Pharmaceutical Science, Peking University, Beijing, China
| | - Hongchao Li
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
| | - Feng Xie
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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D'Souza MS, Ruppert SD, Parahoo K, Karkada SN, Amirtharaj A, Jacob D, Balachandran S, Al Salmi NMD. Foot care behaviors among adults with type 2 diabetes. Prim Care Diabetes 2016; 10:442-451. [PMID: 27282830 DOI: 10.1016/j.pcd.2016.04.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 04/22/2016] [Accepted: 04/25/2016] [Indexed: 12/18/2022]
Abstract
AIM The aim of the study was to determine factors influencing foot care behaviors among adults with type 2 diabetes. METHODS A correlational descriptive study was conducted with a random sample of 160 adults with type 2 diabetes from the public hospital between April and July 2014. RESULTS Just over 15% of the sample had a history of foot ulcers and almost 42% had numbness/tingling and pain in their feet. Positive foot care behaviors were correlated with higher income, higher educational attainment, lower body weight, positive attitude and higher awareness of diabetes and its management. CONCLUSION Targeting type 2 diabetes people with low level of education, low income and overweight may help to enhance their foot care and reduce foot complications in similar populations, Implications. Those most at risk of foot problems should be targeted for education to increase their awareness of ways to prevent and to manage foot problems.
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Affiliation(s)
- Melba Sheila D'Souza
- Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman.
| | - Susan D Ruppert
- Adult/Gerontology Primary Care Nurse Practitioner Program, Department of Acute & Continuing Care, The University of Texas Health Science, Oman.
| | - Kader Parahoo
- Nursing and Health Research, School of Nursing University of Ulster - Coleraine Campus, Londonderry, United Kingdom.
| | | | - Anandhi Amirtharaj
- Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman.
| | - Devakirubai Jacob
- Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman.
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Sun N, Lou P, Shang Y, Zhang P, Wang J, Chang G, Shi C. Prevalence and determinants of depressive and anxiety symptoms in adults with type 2 diabetes in China: a cross-sectional study. BMJ Open 2016; 6:e012540. [PMID: 27531739 PMCID: PMC5013513 DOI: 10.1136/bmjopen-2016-012540] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To evaluate the prevalence and determinants of anxiety and depression and to assess their impact on glycaemic control in participants with type 2 diabetes mellitus. DESIGN A cross-sectional study. SETTING Community-based investigation in Xuzhou, China. PARTICIPANTS 893 Chinese men and women aged 18-84 years who fulfilled the inclusion criteria. METHODS People with type 2 diabetes completed the Pittsburgh Sleep Quality Index and the Zung Self-Rating Anxiety and Depression Scales. Demographic and physiological characteristics were recorded. Multiple logistic regression was used to evaluate the combined effect of factors associated with anxiety and depression and to assess the effects of anxiety and depression on glycaemic control. RESULTS The prevalence of depressive symptoms and anxiety symptoms was 56.1% and 43.6%, respectively. Multivariate logistic regression analysis indicated that anxiety symptoms were associated with being woman, low income, chronic disease, depressive symptoms and poor sleep quality. Depressive symptoms were associated with being woman, older age, low education level, being single, diabetes complications, anxiety symptoms and poor sleep quality. Glycaemic control was not related to anxiety symptoms (OR=1.31, 95% CIs 0.94 to 1.67) or depressive symptoms (OR=1.23, 95% CI 0.85 to 1.63). A combination of depressive symptoms and anxiety symptoms was associated with poor glycaemic control (relative excess risk due to interaction: 4.93, 95% CI 2.09 to 7.87; attributable proportion due to interaction: 0.27, 95% CI 0.12 to 0.45). CONCLUSIONS There was a high prevalence of depressive and anxiety symptoms in this Chinese sample of participants, although depression and anxiety were not singly associated with glycaemic control. However, a combination of depressive and anxiety symptoms was negatively correlated with glycaemic control in participants with type 2 diabetes.
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Affiliation(s)
- Nianquan Sun
- Department of Endocrinology, Xuzhou Third People's Hospital, Xuzhou, China
| | - Peian Lou
- Department of Non-communicable Disease Control, Xuzhou Center for Disease Control and Prevention, The School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Yan Shang
- Department of Endocrinology, Xuzhou Third People's Hospital, Xuzhou, China
| | - Pan Zhang
- Department of Non-communicable Disease Control, Xuzhou Center for Disease Control and Prevention, The School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Jian Wang
- Department of Endocrinology, Xuzhou Third People's Hospital, Xuzhou, China
| | - Guiqiu Chang
- Department of Non-communicable Disease Control, Xuzhou Center for Disease Control and Prevention, The School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Chunlei Shi
- Department of Non-communicable Disease Control, Xuzhou Center for Disease Control and Prevention, The School of Public Health, Xuzhou Medical University, Xuzhou, China
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11
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Liu H, Xu X, Hall JJ, Wu X, Zhang M. Differences in depression between unknown diabetes and known diabetes: results from China health and retirement longitudinal study. Int Psychogeriatr 2016; 28:1191-9. [PMID: 26926248 DOI: 10.1017/s104161021600020x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Both diabetes and depression have become serious public health problems and are major contributors to the global burden of disease. People with diabetes have been shown to have higher risk of depression. The purpose of this study was to observe the differences in depression between older Chinese adults with known or unknown diabetes. METHODS Data came from the national baseline survey of China Health and Retirement Longitudinal Study (CHARLS). The Center for Epidemiologic Studies Depression Scale was used to assess depression. Participants with a history of diabetes diagnosis were considered to have known diabetes, and those with newly-diagnosed diabetes were considered to have unknown diabetes. Multiple logistic regression analysis was applied to estimate odds ratio (OR) for depression in predictor variables. RESULTS Overall, 39.1% of the 2,399 participants with diabetes suffered from depression. The prevalence of depression was significantly higher (p < 0.001) in people with known diabetes (43.5%) than those with unknown diabetes (35.1%). The biggest differences between the two groups were found in the middle aged, in women, in the less educated and in married people. In known diabetes, people treated with traditional Chinese medicine (TCM) coupled with oral western medicine (WM) and/or insulin had two-fold odds of depression compared to those without treatment. CONCLUSION The knowledge of having diabetes, treatments and suffering from other chronic diseases were associated with the higher prevalence of depression in people with known diabetes compared to those with unknown diabetes. Prevention of depression in diabetics should receive more attention in the middle aged, women and the less education.
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Affiliation(s)
- Huaqing Liu
- Department of Preventive Medicine,Bengbu Medical College,Anhui,China
| | - Xiaoyue Xu
- Centre for Clinical Epidemiology and Biostatistics,School of Medicine and Public Health,Hunter Medical Research Institute,University of Newcastle,Newcastle,NSW,Australia
| | - John J Hall
- Centre for Clinical Epidemiology and Biostatistics,School of Medicine and Public Health,Hunter Medical Research Institute,University of Newcastle,Newcastle,NSW,Australia
| | - Xuesen Wu
- Department of Preventive Medicine,Bengbu Medical College,Anhui,China
| | - Min Zhang
- Department of Health Management,Bengbu Medical College,Anhui,China
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12
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D'Souza MS, Venkatesaperumal R, Ruppert SD, Karkada SN, Jacob D. Health Related Quality of Life among Omani Men and Women with Type 2 Diabetes. J Diabetes Res 2016; 2016:8293579. [PMID: 26682234 PMCID: PMC4670671 DOI: 10.1155/2016/8293579] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 04/04/2015] [Accepted: 05/06/2015] [Indexed: 12/27/2022] Open
Abstract
The aim of this study was to explore predictors of health related quality of life (HRQoL) among men and women with type 2 diabetes. This cross-sectional descriptive study consisted of a random sample of 300 adults with type 2 diabetes in a selected public hospital. Euro-QoL and Revised Summary of Diabetes Self-Care Activities scales were used to collect data between January and June 2010. Schooling and ability to manage positively were highly significant predictors of quality of life (QoL) among women as compared to men. Age, prevention of activities of daily living and knowledge/management of diabetes were significant predictors of Health state among women as compared to men. Findings demonstrate that 30.6% (versus 35.7%) of the variance in the total QoL and 14% (versus 23%) of the variance in health state could be explained by personal and clinical characteristics among women and men, respectively. The study underlines the importance for nurse educators to assess HRQoL among men and women and to develop effective self-care management strategies based on personal and clinical characteristics.
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Affiliation(s)
- Melba Sheila D'Souza
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, 123 Muscat, Oman
- *Melba Sheila D'Souza:
| | - Ramesh Venkatesaperumal
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, 123 Muscat, Oman
| | - Susan D. Ruppert
- The University of Texas Health Science Center at Houston School of Nursing, Houston, TX 77030, USA
| | | | - Devakirubai Jacob
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, 123 Muscat, Oman
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13
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Wang J, He M, Zhao X. Depressive Symptoms, Family Functioning and Quality of Life in Chinese Patients with Type 2 Diabetes. Can J Diabetes 2015; 39:507-12. [PMID: 26297526 DOI: 10.1016/j.jcjd.2015.06.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 05/08/2015] [Accepted: 06/01/2015] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Patients with type 2 diabetes mellitus often have depression or depressive symptoms, impaired family functioning and poor quality of life. This study aimed to examine relationships among psychological variables, including depressive symptoms, family functioning and quality of life, for Chinese patients with type 2 diabetes and to explore the influencing factors on quality of life for these patients. METHOD In this cross-sectional study, 257 patients with type 2 diabetes and 259 nondiabetic community controls completed the Beck Depression Inventory, the Family Assessment Device, and the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form. RESULTS Patients with type 2 diabetes reported significant family impairment in the dimension of affective involvement compared with nondiabetic community controls (p<0.05). Mean Family Assessment Device scores were negatively associated with quality of life scores among patients with type 2 diabetes. Age, depressive symptoms, duration of diabetes, communication, affective involvement and behavioural control were associated with quality of life in patients with type 2 diabetes. CONCLUSIONS The results indicate that having type 2 diabetes was associated with some difficulties with family functioning and that poor family functioning was associated with a poorer quality of life. Additional factors, including older age, depressive symptoms, duration of diabetes, and some dimensions of family functioning, were found to be associated with quality of life in Chinese individuals with type 2 diabetes.
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Affiliation(s)
- Jikun Wang
- Key Laboratory of Brain Functional Genomics, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China; Department of Psychosomatic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Ming He
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xudong Zhao
- Department of Psychosomatic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
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14
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Mngomezulu N, Yang CC. Quality of life and its correlates in diabetic outpatients in Swaziland. Int Health 2015; 7:464-71. [PMID: 25858279 DOI: 10.1093/inthealth/ihv019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 02/16/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Diabetes is a chronic disease requiring frequent monitoring that may be accompanied by considerable quality of life (QOL) burden. Low- and middle-income countries such as Swaziland are facing a double disease burden exacerbated by the high prevalence of infectious diseases. This study aimed to understand the QOL and its correlates in diabetic outpatients in Swaziland. METHODS Participants were consecutively recruited during their routine visits to a referral hospital in Swaziland. Face-to-face interviews were conducted with outpatients using the Diabetes-39 questionnaire to measure their QOL. Raw scores were transformed to a standard domain-specific score using linear transformation with scores ranging from 0 (lowest impact) to 100 (highest impact). RESULTS Among the 340 participants in this cross-sectional study anxiety and worry was the most affected QOL domain. In multiple linear regression analyses, the presence of complications and/or comorbidities, low income, limited education and being on insulin therapy, showed higher impacts of diabetes on the participants' QOL. CONCLUSIONS The high impact of diabetes on anxiety and worry QOL score highlights the need to address diabetic patients' psychological wellbeing in the clinical management of diabetes. An integrated diabetes care program that takes into account the impacts of sociodemographic and clinical factors on QOL may improve the QOL of diabetic patients.
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Affiliation(s)
- Nelisiwe Mngomezulu
- International Health Program, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chen-Chang Yang
- Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang-Ming University, Taipei, Taiwan Division of Clinical Toxicology and Occupational Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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15
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Wang L, Song R, Chen Z, Wang J, Ling F. Prevalence of depressive symptoms and factors associated with it in type 2 diabetic patients: a cross-sectional study in China. BMC Public Health 2015; 15:188. [PMID: 25884919 PMCID: PMC4349459 DOI: 10.1186/s12889-015-1567-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 02/17/2015] [Indexed: 11/10/2022] Open
Abstract
Background Depressive symptoms in patients with type 2 diabetes mellitus (T2DM) have attracted much attention in recent years, and negatively affect the health of diabetic patients in numerous ways. This study evaluated the prevalence rate of depressive symptoms in T2DM patients in Shanghai, and the potential factors that may be associated with depressive symptoms in this select population. Methods A total of 865 T2DM patients were recruited from Longhua Street, Xuhui, Shanghai by simple random sampling, and all the patients were assessed with the Zung Self-rating Depression Scale to screen for depressive symptoms. Factors associated with depressive symptoms were analyzed by logistic regression. Results Among the 865 patients (403 were male, 462 were female, average age 70.13 ± 20.33 years), 304 (35.1%) patients were categorized as having depressive symptoms. Rates of myocardial infarction and stress in one month were higher in the depressive symptoms group than in the non-depressive symptoms group by the X2 test. Rates of patients having a job, having a college education or above, and sleeping less than 7 h/24 h day were also higher in the depressive symptoms group by the X2 test. Body mass index, and levels of total cholesterol, triglyceride, urea, creatinine, uric acid, and homocysteine were higher in the depressive symptoms group by the independent samples t test and non-parametric test. Sleeping hours, history of myocardial infarction, stress in one month, working status, and total cholesterol were significantly associated with depressive symptoms (p < 0.05). Conclusions In the Chinese population analyzed in this study, the prevalence rate of depressive symptoms in patients with T2DM was high. Further research on the relationship between diabetes and depressive symptoms is necessary in a wider Chinese population.
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Affiliation(s)
- Linchuang Wang
- Longhua Street Community Health Center, Xuhui, Shanghai, China.
| | - Rui Song
- Center for Disease Control and Prevention of Xuhui, Shanghai, China.
| | - Zhigang Chen
- Longhua Street Community Health Center, Xuhui, Shanghai, China.
| | - Jun Wang
- Longhua Street Community Health Center, Xuhui, Shanghai, China.
| | - Feng Ling
- Longhua Street Community Health Center, Xuhui, Shanghai, China.
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16
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Huang CY, Lai HL, Lu YC, Chen WK, Chi SC, Lu CY, Chen CI. Risk Factors and Coping Style Affect Health Outcomes in Adults With Type 2 Diabetes. Biol Res Nurs 2015; 18:82-9. [PMID: 25670841 DOI: 10.1177/1099800415569845] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Most psychosocial interventions among individuals with Type 2 diabetes mellitus (T2DM) target depressive symptoms (DSs) rather than causal antecedents that lead to DSs or affect health-related quality of life (HrQoL). This research investigated a conceptual model of the effects of risk factors and coping styles on HrQoL and DSs in patients with T2DM. METHOD A descriptive, correlational design was used with a convenience sample of 241 adults with T2DM aged ≥ 20 years recruited from a hospital metabolic outpatient department. Data were collected using a demographic questionnaire, the modified Ways of Coping Checklist, the Center for Epidemiological Studies Depression Scale, the Short Form 36 Health Survey, and physiological examination. HbA1C was collected from participants' medical records. Structural equation modeling techniques were used to analyze relationships among risk factors, mediators, and HrQoL. RESULTS Younger age, more education, and longer duration of diabetes predicted better physical quality of life. Duration of diabetes and three coping styles predicted DSs. Longer duration of diabetes and lower fasting glucose predicted better mental quality of life. Three coping styles acted as mediators between risk factors and health, that is, active and minimizing styles promoted positive outcomes, while avoidance promoted negative outcomes. CONCLUSIONS This integrated model provides a holistic picture of how risk factors and coping style influence HrQoL and DSs in individuals with T2DM. Nurses could use active coping strategies in cognitive behavioral therapy to enhance glycemic control in patients with T2DM.
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Affiliation(s)
| | - Hui-Ling Lai
- Department of Nursing, Tzu Chi University, Hualien, Taiwan Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Yung-Chuan Lu
- Department of Endocrinology, E-Da Hospital, Kaohsiung, Taiwan I-Shou University, Kaohsiung, Taiwan
| | - Wen-Kuei Chen
- College of Management, I-Shou University, Kaohsiung, Taiwan
| | - Shu-Ching Chi
- I-Shou University, Kaohsiung, Taiwan Department of Nursing, E-Da Hospital, Kaohsiung, Taiwan
| | - Chu-Yun Lu
- Department of Nursing, I-Shou University, Kaohsiung, Taiwan
| | - Chun-I Chen
- College of Management, I-Shou University, Kaohsiung, Taiwan
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17
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Zhang W, Xu H, Zhao S, Yin S, Wang X, Guo J, Zhang S, Zhou H, Wang F, Gu L, Zhu L, Yu H, Qu Z, Tian D. Prevalence and influencing factors of co-morbid depression in patients with type 2 diabetes mellitus: a General Hospital based study. Diabetol Metab Syndr 2015; 7:60. [PMID: 26167205 PMCID: PMC4499190 DOI: 10.1186/s13098-015-0053-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 06/17/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Depression and diabetes have been recognized as major public health issues in China, however, no studies to date examined the factors associated with the development of depression in patients with diabetes in China. This study aimed to estimate the prevalence of co-morbid depression among adults with type 2 diabetes mellitus (DM) and to examine the influence factors of co-morbid depression in a group of patients with type 2 DM. METHODS The study was conducted from March l to May 31, 2012, in the Department of Endocrinology of the First Affiliated Hospital of the General Hospital of the People's Liberation Army (PLA). A systematic random sample of 412 type 2 DM patients aged over 18 years was selected. A structured questionnaire was used for collecting the information about socio-demographic data, lifestyle factors and clinical characteristics. Depression and social support was evaluated by using the Chinese version of Beck Depression Inventory (BDI) and Social Support Rate Scale (SSRS), respectively. Weights and heights were measured. Hemoglobin A1c (HbA1c) was abstracted from each patient directly after the interview. RESULTS Of the total sample, 142 patients had depression according to the BDI scores (BDI scores ≥14), the prevalence of co-morbid depression in this study population was 5.7 % (142/2500). Of which, 56 had major depression (BDI ≥ 21), and 86 had moderate depression (BDI ≥ 14&BDI < 21). Logistic regression analysis indicated that a high HbA1c level, a high BMI, low quality health insurance, and being single, were significantly associated with the development of depression. However, a family history of diabetes and a high social support level are likely protective factors. CONCLUSIONS The prevalence of co-morbid depression was 5.7 % among Chinese subjects with type 2 DM in this study. High HbA1c level, high BMI score, being single, low social support level, and low quality health insurance were associated with the presence of depression. These findings support a recommendation for routine screening and management in China for depression in patients with diabetes, especially for those in primary care, to reduce the number of the depressed or the misrecognized depressed diabetic patients.
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Affiliation(s)
- Weijun Zhang
- />School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
| | - Huiwen Xu
- />Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, Rochester, NY 14642 USA
| | - Shuliang Zhao
- />School of Public Administration, Yunnan University of Finance and Economics, Kunming, 650221 China
| | - Shinan Yin
- />Department of Endocrinology, First Affiliated Hospital of the General Hospital of the People’s Liberation Army (PLA), Beijing, 100853 China
| | - Xiaohua Wang
- />School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
| | - Jing Guo
- />Department of Sociology, Huazhong University of Science and Technology, 1037 Luoyu Road, Wuhan, 430074 China
| | - Shengfa Zhang
- />School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
| | - Huixuan Zhou
- />School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
| | - Fugang Wang
- />School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
| | - Linni Gu
- />School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
| | - Lei Zhu
- />School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
| | - Haibo Yu
- />School of Government, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
| | - Zhiyong Qu
- />School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
| | - Donghua Tian
- />School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
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Gong Y, Han T, Yin X, Yang G, Zhuang R, Chen Y, Lu Z. Prevalence of depressive symptoms and work-related risk factors among nurses in public hospitals in southern China: a cross-sectional study. Sci Rep 2014; 4:7109. [PMID: 25427988 PMCID: PMC5384112 DOI: 10.1038/srep07109] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 10/29/2014] [Indexed: 11/09/2022] Open
Abstract
Poor mental health among nurses not only hinders professional performance but also affects the quality of healthcare provided. To improve the prevention and management of depression among nurses in mainland China, we investigated the association between working conditions and depressive symptoms using a cross-sectional study with a sample of 3474 nurses with more than 1 year of work experience in public hospitals in Shenzhen in southern China. Participants completed a structured questionnaire and a validated measure of depressive symptoms. Multivariable linear mixed models were used to identify work-related risk factors for depressive symptoms scores. An estimated 38% of nurses had depressive symptoms. More than 10% of the nurses often experienced workplace violence, and 64.22% encountered it occasionally. Depressive symptoms were associated with frequent workplace violence, long working hours (more than 45 hours per week), frequent night shifts (two or more per week), and specific departments. These findings indicate that interventions to minimize workload and improve nurse-patient relationships are essential to combat depressive symptoms among nurses. Additionally, in the prevention and management of depression among nurses, we must consider inter-department differences.
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Affiliation(s)
- Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan. 430030, Hubei, P. R. China
| | - Tieguang Han
- Shenzhen Health Education and Promotion Center, Shenzhen, 518001, Guangdong, P. R. China
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan. 430030, Hubei, P. R. China
| | - Guoan Yang
- Shenzhen Health Education and Promotion Center, Shenzhen, 518001, Guangdong, P. R. China
| | - Runsen Zhuang
- Shenzhen Health Education and Promotion Center, Shenzhen, 518001, Guangdong, P. R. China
| | - Yuqi Chen
- Shenzhen Health Education and Promotion Center, Shenzhen, 518001, Guangdong, P. R. China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan. 430030, Hubei, P. R. China
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Gong Y, Han T, Chen W, Dib HH, Yang G, Zhuang R, Chen Y, Tong X, Yin X, Lu Z. Prevalence of anxiety and depressive symptoms and related risk factors among physicians in China: a cross-sectional study. PLoS One 2014; 9:e103242. [PMID: 25050618 PMCID: PMC4106870 DOI: 10.1371/journal.pone.0103242] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 06/30/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Physicians' poor mental health not only hinders their professional performance and affects the quality of healthcare provided but also adversely affects patients' health outcomes. Few studies in China have evaluated the mental health of physicians. The purposes of this study are to quantify Chinese physicians' anxiety and depressive symptoms as well as evaluate associated risk factors. METHODS In our study, 2641 physicians working in public hospitals in Shenzhen in southern China were recruited and interviewed by using a structured questionnaire along with validated scales testing anxiety and depressive symptoms. Multivariable logistic regression models were used to identify risk factors for anxiety and depressive symptoms. RESULTS An estimated 25.67% of physicians had anxiety symptoms, 28.13% had depressive symptoms, and 19.01% had both anxiety and depressive symptoms. More than 10% of the participants often experienced workplace violence and 63.17% sometimes encountered it. Among our study population, anxiety and depressive symptoms were associated with poor self-reported physical health, frequent workplace violence, lengthy working hours (more than 60 hours a week), frequent night shifts (twice or more per week), and lack of regular physical exercise. CONCLUSIONS Our study demonstrates that anxiety and depressive symptoms are common among physicians in China, and the doctor-patient relationship issue is particularly stressful. Interventions implemented to minimize workload, improve doctor-patient relationships, and assist physicians in developing healthier lifestyles are essential to combat anxiety and depressive symptoms among physicians, which may improve their professional performance.
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Affiliation(s)
- Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China
| | - Tieguang Han
- Shenzhen Health Education and Promotion Center, Shenzhen, Guangdong, P. R. China
| | - Wei Chen
- Department of Occupational Health, Laiwu Municipal Center for Disease Control and Prevention, Laiwu, Shandong, P. R. China
| | - Hassan H. Dib
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, P. R. China
| | - Guoan Yang
- Shenzhen Health Education and Promotion Center, Shenzhen, Guangdong, P. R. China
| | - Runsen Zhuang
- Shenzhen Health Education and Promotion Center, Shenzhen, Guangdong, P. R. China
| | - Yuqi Chen
- Shenzhen Health Education and Promotion Center, Shenzhen, Guangdong, P. R. China
| | - Xinyue Tong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China
- * E-mail: (ZL); (XY)
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China
- * E-mail: (ZL); (XY)
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20
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Choi SE, Reed PL, Sarkisian CA. Gender differences in the relationship between diabetes-specific quality of life and depressive symptoms in middle-aged and older korean immigrants. Res Gerontol Nurs 2013; 6:283-92. [PMID: 23971487 PMCID: PMC3882268 DOI: 10.3928/19404921-20130820-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 08/09/2013] [Indexed: 12/12/2022]
Abstract
This study examined age and gender differences in the relationship between diabetes-specific quality of life (DQOL) and depressive symptoms among Korean immigrants with type 2 diabetes. In this cross-sectional study, 160 Korean immigrants ages 40 to 80 with diabetes were assessed for depressive symptoms, DQOL, and related demographic, clinical, and psychosocial factors. The relationship between DQOL and depressive symptoms was stronger for men than women. Whereas there were no main effects of age or gender in predicting depressive symptoms, there was a significant three-way interaction between gender, age (middle-aged or older), and DQOL on depressive symptoms, with older men demonstrating the strongest positive association between DQOL and depression. Age and gender differences should be considered for DQOL and depressive symptoms in Korean immigrants with diabetes. Efforts to address DQOL may likely have the greatest impact in decreasing depressive symptoms when targeted to older male Korean immigrants.
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Zhou JX, Li HC, Bai XJ, Chang BC, Li CJ, Sun P, Chen LM. Functional Val66Met polymorphism of Brain-derived neurotrophic factor in type 2 diabetes with depression in Han Chinese subjects. Behav Brain Funct 2013; 9:34. [PMID: 23968401 PMCID: PMC3765870 DOI: 10.1186/1744-9081-9-34] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 08/20/2013] [Indexed: 12/18/2022] Open
Abstract
Background Brain-derived neurotrophic factor (BDNF) has been implicated in the pathogenesis of major depression. Individuals with type 2 diabetes (T2DM) have a high prevalence of major depression and low levels of BDNF. We therefore explored whether the BDNF Val66Met polymorphism is associated with co-morbid depression and whether depression affects the serum levels of BDNF in a Han Chinese subjects with T2DM. Methods A Total of 296 T2DM patients and 70 healthy volunteers (Health control, HC group) were recruited in this study. T2DM patients were divided into two subgroups: depressive diabetes group (DDM group, n = 64) and non-depressive diabetes group (NDDM group, n = 232), according to the presence or the absence of depression assessed by Center for Epidemiologic Studies Depression Scale (CES-D) and Patient Health Questionnaire-9 (PHQ-9). Val66Met polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP). Serum BDNF levels were measured by ELISA kit. Results In this study, 21.6% (64/296) patients with T2DM had depression. The BDNF Val66Met genotype distributions were statistically different among the three groups (χ2 = 7.39, p < 0.05). DDM group carried the highest frequencies of Met allele (53.9%) compared to HC group (39.3%) and NDDM group (38.8%). Subjects with Met/Met had lowest serum BDNF levels (76.59 ± 5.12 pg/ml, F = 7.39, p < 0.05) compared to subjects with Val/Met (79.04 ± 5.19 pg/ml) and Val/Val (83.83 ± 3.97 pg/ml). Within T2DM group, it was also observed that the serum BDNF levels in DDM group were significantly lower than those in NDDM group (76.67 ± 5.35 vs. 79.84 ± 3.97 pg/ml, p < 0.05). In type 2 diabetes subjects, BDNF serum levels were significant correlations with genotypes (r = −0.346, p < 0.01), depression scores (r = −0.486, p < 0.01) and HbA1c (r = −0.168, p < 0.05). After adjustment for gender, HbA1c, BMI and numbers of complications, BDNF Val/Met genotype distributions (OR = 2.105, p < 0.05) and decreased serum BDNF levels (OR = 0.835, p < 0.01) were independently associated with depression in T2DM. Conclusions The BDNF Val66Met polymorphism might be implicated in the pathogenesis of depression in T2DM by decreasing serum BDNF levels in Han Chinese Subjects.
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Affiliation(s)
- Jian-Xin Zhou
- 2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, Key Laboratory of Hormone and Development (Ministry of Health), Metabolic Disease Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China.
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