ABSTRACT
Background: An association between psychological stress and metabolic control can occur in patients with diabetes. Aim: To determine the longitudinal association between different psychological stress domains (emotional burden, physician-related distress, regimen-related distress, diabetes-related interpersonal distress) and metabolic control of adolescents with Type 1 diabetes. Material and Methods: An intentional sample of 20 Type 1 diabetic adolescents aged 15 ± 4 years was followed-up for one year. Three HbA1c determinations were performed and a stress self-report was obtained with the Polonsky' Diabetes Distress Scale. Results: Several analyses were conducted using growth curve modeling. The first model included the HbA1c measures, the time term (coded as 0, 1, 2) and several covariates (age, years living with type 1 diabetes mellitus, sex, and physical activity). An overall negative linear trend was found for HbA1c. Subsequent models added the stress domains finding that high levels of emotional burden and regimen related-distress were associated with higher HbA1c levels across all exams. A marginal association was found between diabetes-related interpersonal distress and HbA1c. Conclusions: Stress levels in type 1 diabetic adolescents deserve attention. Different psychological stress factors predicting metabolic control trajectories in type 1 diabetic adolescents were found.
Subject(s)
Adolescent , Child , Female , Humans , Male , Diabetes Mellitus, Type 1/psychology , Stress, Psychological/psychology , Blood Glucose/analysis , Diabetes Mellitus, Type 1/blood , Glycated Hemoglobin/analysis , Stress, Psychological/bloodABSTRACT
La identificación de niveles de estrés en pacientes diabéticos tiene implicancias clínicas y prácticas. En Chile no hay escalas válidas y confiables que midan estrés en pacientes diabéticos. Con el objetivo de estimar las propiedades psicométricas de la Escala de estrés para diabéticos de Polonsky et al. (2005) en una muestra de pacientes diabéticos chilenos, se realizó análisis de confiabilidad, análisis factorial exploratorio y correlaciones con la escala de síntomas depresivos (CES-D) y con el marcador fisiológico hemoglobina glicosilada (HbA1c), en una muestra de 76 pacientes diabéticos tipo 2 de la ciudad de Temuco, Chile. Tras los análisis, se estimó una consistencia interna de 0.74, una estructura de 4 subfactores y evidencia de validez convergente con la escala CES-D y HbA1c. La escala de estrés para diabéticos posee propiedades psicométricas adecuadas, permite la identificación de 4 subfactores y es de fácil aplicación en el campo clínico e investigativo.
The measurement of stress levels in type 2 diabetic patients has clinical and practical meaning. In Chile, there is a lack of reliable and valid scales that allow for the right assessment of stress level among diabetic patients. The study purpose was to determine the psychometric properties of the Diabetes Distress Scale (DDS) in a sample of Type 2 Chilean diabetic patients. Several analyses including reliability analysis, exploratory factor analysis, and correlations with the depressive symptoms scale (CES-D), and the HbA1c biomarker were conducted with a Type 2 diabetic sample (n= 76) from Temuco City, Chile. The results provided a reliability of 0.74, a four-factor structure, and evidence for convergent validity with both the CES-D scale and the HbA1c marker. The DDS has acceptable psychometrics properties. It allows for the assessment of 4 factors, and has as advantage to be easy to apply in both clinical and research settings.