Start Date

18-6-2019 9:00 AM

End Date

18-6-2019 10:30 AM

Description

Diabetes Distress Differentiation from Depression

An Integrated Review of Literature

Anthony Warpecha

Background and Significance: According to Bennetter, Clench-Aas, and Raanaas (2016), people with diabetes have a higher probability of developing depression. These rates were found to be about 2-3 times as likely for individuals with diabetes to have depression compared to individuals who do not have diabetes (Bennetter et al., 2016). This has profound effects on an individual such as decreased quality of life, complications increase, and a lowered life expectancy (Dieter & Lauerer, 2017). There is also the increase in hospital stays, admissions, and health expenditure. However, more recently, there have been studies demonstrating people with diabetes do not really meet the criteria for a diagnosis of depression, but their symptoms are more reflective of diabetes distress (Winchester, Williams, Wolfman, & Egede, 2016). Of the individuals who have diabetes, about 70% do not meet the criteria for clinical depression (Fisher et al., 2013). Roughly 18-35% of individuals with diabetes experience diabetes distress which directly affects the management and glycemic control (Winchester et al., 2016). Diabetes Distress (DD) can be defined as emotional burdens, stresses, and worries which come with how an individual manages diabetes (Fisher et al., 2013).

Objectives: To conduct an integrative literature study with the compilation and analysis of research studies on what variables and common symptoms of depression have been found to be correlated with diabetes distress.

Methods: The review of literature was guided using the framework constructed by Whittemore and Knafl (2005). Six research studies were examined and analyzed from 2008 to 2016. Articles containing current research were obtained from a variety of electronic databases including CINAHL, PubMed, and Ebscohost. Data was synthesized and analyzed for themes in relation to answering the research question with a state of the research literature.

Results: A total of 6 research article studies were reviewed and analyzed in relation to the above research question. The articles were grouped into 3 themes. The first theme was in relation to self-care diabetes. suggest symptoms of depression to have a greater negative relationship with diabetes self-care than diabetes distress (r = 0.54, p < 0.0001), even among those who did not meet the screening criteria for MDD. The second theme was Diabetes and Anxiety Sample consisted of 6,6827 cross-sectional study of adults ages 18 years and over of which 629 participants did not have diabetes. Diabetics were three times more likely to experience anxiety (p <0.05). The third theme was A1C, Diabetes Distress, and Depression. The relationship between the depressive symptoms and diabetes distress (r=0.48, p<0.001) was greater than the relationship of either with MDD (r=0.29, p<0.001). The depressive symptoms (r = 0.14, p = 0.002) and diabetes distress (r = 0.17, p = 0.001) were significantly correlated with A1C; only diabetes distress reached significance (p < .004) in the cross-sectional relationships. Diabetes distress was found to be related to A1C (95% CI=0.1764, 0.6125). In the cross-sectional relationships between diabetes distress, depressive symptoms, and MDD; only diabetes distress reached significance (p < 0.004). Diabetes distress and not depression severity was significantly related to medication nonadherence (b= - 4.19, SE = 1.47, p = .005), and A1C (b = .21, SE = .10, and p = .040). Medication adherence over one month with 79% of participants (112/142). Regime related to stress and personal control were significant contributors in a final model predicting A1C level: regime stress (p= 0.005), personal control (p <0.001). Diabetics in comparison to nondiabetic adults were three times more likely to experience anxiety (p <0.05

Conclusion: The major limitations of the IRL: 1) lack of qualitative establishment of how the symptoms are different, how they are treated differently, and how to effectively screen for both. 2) half of the studies lacked a conceptual/theoretical framework to guide the studies. Future research recommendations are establishment of qualitative studies on diabetes distress and Leventhal’s common sense model to demonstrate recognizes how the emotional response to the health threat plays a role which is more of the patient’s perspective.

Key words used included: “diabetes distress”, “depression”, “different”, “adults”, “diabetes” “versus” and “psychology”.

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Jun 18th, 9:00 AM Jun 18th, 10:30 AM

Diabetes Distress Differentiation from Depression An Integrated Review of Literature

Diabetes Distress Differentiation from Depression

An Integrated Review of Literature

Anthony Warpecha

Background and Significance: According to Bennetter, Clench-Aas, and Raanaas (2016), people with diabetes have a higher probability of developing depression. These rates were found to be about 2-3 times as likely for individuals with diabetes to have depression compared to individuals who do not have diabetes (Bennetter et al., 2016). This has profound effects on an individual such as decreased quality of life, complications increase, and a lowered life expectancy (Dieter & Lauerer, 2017). There is also the increase in hospital stays, admissions, and health expenditure. However, more recently, there have been studies demonstrating people with diabetes do not really meet the criteria for a diagnosis of depression, but their symptoms are more reflective of diabetes distress (Winchester, Williams, Wolfman, & Egede, 2016). Of the individuals who have diabetes, about 70% do not meet the criteria for clinical depression (Fisher et al., 2013). Roughly 18-35% of individuals with diabetes experience diabetes distress which directly affects the management and glycemic control (Winchester et al., 2016). Diabetes Distress (DD) can be defined as emotional burdens, stresses, and worries which come with how an individual manages diabetes (Fisher et al., 2013).

Objectives: To conduct an integrative literature study with the compilation and analysis of research studies on what variables and common symptoms of depression have been found to be correlated with diabetes distress.

Methods: The review of literature was guided using the framework constructed by Whittemore and Knafl (2005). Six research studies were examined and analyzed from 2008 to 2016. Articles containing current research were obtained from a variety of electronic databases including CINAHL, PubMed, and Ebscohost. Data was synthesized and analyzed for themes in relation to answering the research question with a state of the research literature.

Results: A total of 6 research article studies were reviewed and analyzed in relation to the above research question. The articles were grouped into 3 themes. The first theme was in relation to self-care diabetes. suggest symptoms of depression to have a greater negative relationship with diabetes self-care than diabetes distress (r = 0.54, p < 0.0001), even among those who did not meet the screening criteria for MDD. The second theme was Diabetes and Anxiety Sample consisted of 6,6827 cross-sectional study of adults ages 18 years and over of which 629 participants did not have diabetes. Diabetics were three times more likely to experience anxiety (p <0.05). The third theme was A1C, Diabetes Distress, and Depression. The relationship between the depressive symptoms and diabetes distress (r=0.48, p<0.001) was greater than the relationship of either with MDD (r=0.29, p<0.001). The depressive symptoms (r = 0.14, p = 0.002) and diabetes distress (r = 0.17, p = 0.001) were significantly correlated with A1C; only diabetes distress reached significance (p < .004) in the cross-sectional relationships. Diabetes distress was found to be related to A1C (95% CI=0.1764, 0.6125). In the cross-sectional relationships between diabetes distress, depressive symptoms, and MDD; only diabetes distress reached significance (p < 0.004). Diabetes distress and not depression severity was significantly related to medication nonadherence (b= - 4.19, SE = 1.47, p = .005), and A1C (b = .21, SE = .10, and p = .040). Medication adherence over one month with 79% of participants (112/142). Regime related to stress and personal control were significant contributors in a final model predicting A1C level: regime stress (p= 0.005), personal control (p <0.001). Diabetics in comparison to nondiabetic adults were three times more likely to experience anxiety (p <0.05

Conclusion: The major limitations of the IRL: 1) lack of qualitative establishment of how the symptoms are different, how they are treated differently, and how to effectively screen for both. 2) half of the studies lacked a conceptual/theoretical framework to guide the studies. Future research recommendations are establishment of qualitative studies on diabetes distress and Leventhal’s common sense model to demonstrate recognizes how the emotional response to the health threat plays a role which is more of the patient’s perspective.

Key words used included: “diabetes distress”, “depression”, “different”, “adults”, “diabetes” “versus” and “psychology”.