The Relationship among Uncertainty in Illness, Coping Strategies and Diabetes-related Distress in Type 2 Diabete Mellitus

• Main Authors: SU, TZU-FANG, 蘇姿方
• Other Authors: SHEU, SHEILA
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/uhx2xv

碩士 === 輔英科技大學 === 護理系碩士班 === 104 === Objective: Diabetes is one of the largest global health emergencies of the 21 st century. The International Diabetes Federation estimate there are now 415 million adults aged 20-79 with diabetes worldwide, the number of diabetic patients will grow 55% in 2040. The prevalence of diabetes and related healthcare expenditures are higher than the global burden in Taiwan. The among the top ten causes of death and end-stage renal failure of diabetes in Taiwan. Diabetes-related Distress refers to the unique, often hidden emotional burdens and worries that are part of the spectrum of patient experience when managing a severe about to disease management. That is important issue for Diabetes care, but now to lack study for Diabetes-related Distress in Taiwan. Purpose: This study to identify the The Relationship among Uncertainty in Illness, Coping Strategies and Diabetes-related Distress in Type 2 Diabetes Mellitus. Research Design & Methods: This cross-sectional and correlation study included a convenience sampling of two hundred type 2 diabetic patients in the outpatient from primary hospital in Kaohsiung, Taiwan. Data were collected through questionnaires, which included the Diabetes Distress Scale, Mishel Uncertainty in Illness Scale and Revised Jalowiec Coping Scale. By the SPSS 22.0 statistical software using to analysis descriptive statistics, independent t-test, one-way ANOVA, pearson correlation analysis and multiple linear regression techniques were used to analyze outcome among variables relationship and predictors of Diabetes-related Distress. Results: Uncertainty in Illness of diabetes source manily from the Ambiguity factor. Faced with the disease will be used mixture of positive and negative coping strategies to adapt to Diabetes, to use the overall positive coping strategies be higher than the negative coping strategies. Diabetes-related Distress of low to moderate degree, the sources mainly from the emotional burden and the regimen- and social support – related distress. In t-test and ANOVA comparative analysis showed degree of higher education level and use combined oral anti-diabetes medication and insulin therapy of uncertainty in illness and frequency of use coping strategies higher than lower education level and use monotherapy of diabetes, degree of use of insulin treatment of diabetes-related distress higher than use of oral anti-diabetes medication, high frequency degree of medium to high socio-economic status of mixed coping strategies higher than low socio-economic status, There are health education experience of positive coping strategies using a higher frequency in non-health education experience. In Pearson correlation analysis showed ages were significantly negatively correlated with the uncertainty in illness（r=–0.246，p<0.001）, diabetes distress（r=–0.314，p<0.001）and use of coping strategies （r=–0.245，p<0.001）, the fasting blood glucose level and glycated hemoglobin values were significantly positive correlation with diabetes-related distress (r=0.16, r=0.166, p<0.05) and significantly negatively correlation with use of positive coping strategies(r=-0.162; p<0.05; r= -0.187, p<0.01), perceived severity of the disease was significantly positively correlated with diabetes-related distress （r=0.357，p<0.001）and use of negative coping strategies（r=0.165，p<0.05）, the type 2 diabetes of uncertainty in illness（r=0.42，p<0.001）, use of negative coping strategies（r=0.516，p<0.01） high significantly positive correlation with diabetes-related distress, the uncertainty in illness moderate significantly positive correlation with use of negative coping strategies（r=0.468，p<0.01）. Finally, those of used negative coping strategies, perception of disease severity, uncertainty in illness and fasting plasma glucos can to explained 39.4 % of variance in diabetes-related distress, 32.9 % of variance in emotional burden and 37.4% of variance in the regimen- and social support – related distress. These predictors of disease severity in order to consciously influence the highest level of diabetes distress. Conclusions: Follow diabetes-related distress can to reduce patients' psychological resistance and improve the effectiveness of self-management in diabetes.The type 2 diabetes of uncertainty in illness, use of negative coping strategies and diabetes-related distress were positively correlated with each other. Increase knowledge of the disease contribute to a positive response may indirectly improve distress and uncertainty in illness. There is not enough evidence to support of Taiwan's overall diabetes distress. The study recommends that can be further troubled by diabetes Mediating variables of diabetes-related distress relationship as a reference follow-up interventions development in the future.