Ruey-Hsia Wang1,2, Chia-Chin Lin3,4,5, Shi-Yu Chen6, Hui-Chun Hsu7, Chiu-Ling Huang8. 1. College of Nursing, 38023Kaohsiung Medical University, Kaohsiung. 2. Department of Medical Research, 38023Kaohsiung Medical University Hospital, Kaohsiung. 3. School of Nursing, College of Nursing, Taipei Medical University, Taipei. 4. School of Nursing, Li Ka Shing Faculty of Medicine, 25809The University of Hong Kong, Pokfulam, Hong Kong. 5. Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Hong Kong. 6. 63452Tri-Service General Hospital, Taipei. 7. Lee Endocrinology Clinic, Pingtung City. 8. Department of Nursing, Yuan General Hospital, Kaohsiung.
Abstract
PURPOSES: Women with diabetes (WD) are more severely impacted by the consequence of suboptimal diabetes control. This study aims to examine the impact of demographic and disease characteristics, baseline self-stigma, role strain, diabetes distress on Hemoglobin A1C (A1C) levels, quality of life (D-QoL) and 6-month A1C levels in younger WD. METHODS: This study was a 6-month prospective study. In total, 193 WD aged 20-64 years were selected by convenience sampling from three outpatient clinics in Taiwan. Demographic and disease characteristics, self-stigma, role strain, diabetes distress, A1C levels, and D-QoL were collected at baseline. A1C levels were further collected 6 months later. Structural equation modeling was conducted to test the hypothesized model. RESULTS: The final model supported that higher baseline D-QoL directly associated with lower concurrent A1C levels and indirectly associated with lower 6-month A1C levels through baseline A1C levels. Higher baseline self-stigma, role strain, and diabetes distress directly associated with lower baseline D-QoL, and indirectly associated with higher 6-month A1C levels through D-QoL. CONCLUSION: Improving self-stigma, role strain, and diabetes distress should be considered as promising strategies to improve D-QoL in young WD. D-QoL plays a mediation role between baseline self-stigma, role strain, diabetes distress and subsequent glycemic control in younger WD. Enhancing baseline D-QoL is fundamental to improve subsequent glycemic control.
PURPOSES: Women with diabetes (WD) are more severely impacted by the consequence of suboptimal diabetes control. This study aims to examine the impact of demographic and disease characteristics, baseline self-stigma, role strain, diabetes distress on Hemoglobin A1C (A1C) levels, quality of life (D-QoL) and 6-month A1C levels in younger WD. METHODS: This study was a 6-month prospective study. In total, 193 WD aged 20-64 years were selected by convenience sampling from three outpatient clinics in Taiwan. Demographic and disease characteristics, self-stigma, role strain, diabetes distress, A1C levels, and D-QoL were collected at baseline. A1C levels were further collected 6 months later. Structural equation modeling was conducted to test the hypothesized model. RESULTS: The final model supported that higher baseline D-QoL directly associated with lower concurrent A1C levels and indirectly associated with lower 6-month A1C levels through baseline A1C levels. Higher baseline self-stigma, role strain, and diabetes distress directly associated with lower baseline D-QoL, and indirectly associated with higher 6-month A1C levels through D-QoL. CONCLUSION: Improving self-stigma, role strain, and diabetes distress should be considered as promising strategies to improve D-QoL in young WD. D-QoL plays a mediation role between baseline self-stigma, role strain, diabetes distress and subsequent glycemic control in younger WD. Enhancing baseline D-QoL is fundamental to improve subsequent glycemic control.
Entities:
Keywords:
diabetes distress; glycemic control; quality of life; role strain; self-stigma; women with diabetes