ABSTRACT

Type 2 diabetes is a chronic condition primarily self-managed by the individual. Mastery is a protective factor linked to better control of chronic conditions, effective self-management and improved medication adherence. Mastery appears increasingly important as treatment regimens and self-management demands become more complex and burdensome. Diabetes distress negatively impacts self-management, glycaemic control and treatment adherence. Understanding the relationship between diabetes distress and mastery may provide opportunities to improve condition management and adherence . This relationship may be impacted by other factors affecting the individual's perceived sense of control over their condition. This study examined the role of diabetes empowerment and depression in the relationship between diabetes distress and mastery. Data were drawn from a randomised controlled trial of 131 adults with type 2 diabetes transitioning to injection therapy. Participants completed measures of diabetes distress , mastery , depression and empowerment . Diabetes distress and depression were negatively associated with mastery, whilst diabetes empowerment was positively associated . A significant interaction effect (b = .024, t(112) = 3.79, p = <.005) confirmed the relationship between diabetes distress and mastery was moderated by depression. Findings highlight the additive deleterious effects of depression. Interventions to improve mastery among those living with type 2 diabetes should address diabetes distress and depression to optimise outcomes.

摘要

2 型糖尿病是一种主要由个人自我管理的慢性疾病。掌握是一个保护因素，与更好地控制慢性病、有效的自我管理和提高药物依从性有关。随着治疗方案和自我管理需求变得更加复杂和繁重，掌握似乎越来越重要。糖尿病困扰对自我管理、血糖控制和治疗依从性产生负面影响。了解糖尿病困扰和掌握之间的关系可能会为改善病情管理和依从性提供机会。这种关系可能会受到其他因素的影响，这些因素会影响个人对其状况的控制感。本研究探讨了糖尿病赋权和抑郁在糖尿病困扰和掌握之间关系中的作用。数据来自一项随机对照试验，该试验对 131 名 2 型糖尿病过渡到注射治疗的成年人进行。参与者完成了糖尿病困扰、掌握、抑郁和赋权的测量。糖尿病困扰和抑郁与掌握负相关，而糖尿病赋权正相关。显着的交互作用（b = .024, t (112) = 3.79, p = <.005) 证实了抑郁症缓解了糖尿病困扰和掌握之间的关系。研究结果突出了抑郁症的附加有害影响。改善 2 型糖尿病患者掌握情况的干预措施应解决糖尿病困扰和抑郁症，以优化结果。