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Affective symptoms and change in diabetes self‐efficacy and glycaemic control
Author(s) -
Robertson S. M.,
Amspoker A. B.,
Cully J. A.,
Ross E. L.,
Naik A. D.
Publication year - 2013
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.12146
Subject(s) - medicine , diabetes mellitus , psychological intervention , anxiety , self efficacy , context (archaeology) , depression (economics) , type 2 diabetes , intervention (counseling) , physical therapy , clinical psychology , psychiatry , endocrinology , psychology , psychotherapist , economics , biology , paleontology , macroeconomics
Aims To examine the role of baseline depression, anxiety and stress symptoms on post‐intervention diabetes self‐efficacy and glycaemic control (HbA 1c ). Methods The current study analysed data from patients ( n = 85) with treated but uncontrolled Type 2 diabetes who participated in a comparative effectiveness study of two diabetes self‐management interventions. Hierarchical linear regression was used to examine the relationships between baseline affective symptoms and post‐intervention diabetes self‐efficacy and the moderating effects of baseline affective symptoms on the relationship between changes in diabetes self‐efficacy and post‐intervention HbA 1c . Results Baseline depression was inversely associated with post‐intervention diabetes self‐efficacy ( P = 0.0001) after adjusting for baseline characteristics including diabetes self‐efficacy. In contrast, normal–mild levels of stress were associated with higher post‐intervention diabetes self‐efficacy ( P = 0.04). Anxiety and stress symptoms significantly and independently moderated the relationship between changes in diabetes self‐efficacy and post‐intervention HbA 1c ( P = 0.02 and P = 0.03, respectively). Further evaluation of these interactions demonstrated that changes in diabetes self‐efficacy were associated with lower post‐intervention HbA 1c , but only among those with higher baseline affective symptoms. Conclusions We found a moderating effect across affective symptoms on the relationship between diabetes self‐efficacy changes and post‐intervention HbA 1c in the context of a self‐management intervention. Results suggest that patients with poorly controlled diabetes who have higher levels of depression, anxiety and stress symptoms may derive greater benefits from self‐management interventions known to improve diabetes self‐efficacy.