RESUMEN
BACKGROUND: Among people with diabetes, depression is more common and is associated with greater morbidity and mortality. A better understanding of mechanisms underlying the link between poor health and depression is needed. Pain and functional impairment may account for the effect of poor health on depression in diabetes. PURPOSE: The purpose of the study was to examine whether pain and functional impairment mediate the association between diabetes-related medical symptoms and depression in type 2 diabetes. METHOD: Adults diagnosed with type 2 diabetes (N = 77) completed the following measures: Patient Health Questionnaire (PHQ), Diabetes Symptom Checklist (DSC), and Medical Outcomes Study 12-item Short-Form Health Survey (SF-12). Body mass index (BMI) was computed using height and weight data from medical records. Mediation and linear regression analyses were conducted. RESULTS: Pain and functional impairment made significant, independent contributions to depression. Functional impairment mediated the link between diabetes-related medical symptoms and depression. Pain mediated the association between higher BMI and depression. CONCLUSION: Pain and functional impairment appear to play important, independent roles in depression in type 2 diabetes. Mediation analyses suggest the following: 1. diabetes-related medical problems increase functional impairment, which in turn leads to greater depression; and 2. the burden of carrying greater body mass (higher BMI) increases pain, which leads to increased depression.
Asunto(s)
Actividades Cotidianas/psicología , Depresión/complicaciones , Trastorno Depresivo/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Dolor/complicaciones , Adolescente , Adulto , Anciano , Índice de Masa Corporal , Depresión/psicología , Trastorno Depresivo/psicología , Diabetes Mellitus Tipo 2/psicología , Femenino , Estado de Salud , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Dolor/psicología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
AIMS: Those with less education are at increased risk for developing diabetes and have a poorer prognosis. Intensive diabetes self-care interventions have been more effective at improving glycemic control in those with lower educational attainment. Due to limited resources, the focus has shifted to brief, cost-effective health interventions. This study examined whether educational attainment moderates the effect of a brief, telephone delivered self-care intervention on glycemic control in people with type 2 diabetes. METHODS: Randomized clinical trial. Participants (N=62) were assigned to receive treatment as usual or treatment as usual plus a brief telephone intervention. The primary outcome measure was hemoglobin A1c. RESULTS: A significant education by intervention group interaction effect indicated that participants with higher educational attainment had greater improvement in glycemic control (A1c) than those with less educational attainment; whereas, educational attainment was unrelated to change in glycemic control (A1c) within the control group. CONCLUSIONS: People with higher educational attainment may benefit to a greater extent from brief self-care interventions for diabetes, while those with lower educational attainment may require more intensive treatment.
Asunto(s)
Consejo , Diabetes Mellitus Tipo 2/psicología , Diabetes Mellitus Tipo 2/terapia , Hemoglobina Glucada/metabolismo , Autocuidado/psicología , Adulto , Glucemia , Diabetes Mellitus Tipo 2/sangre , Escolaridad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
A meta-analysis was conducted to determine the relationship between appearance and weight-based teasing and three outcome measures: body dissatisfaction, restrictive eating, and bulimic behaviors. Four meta-analyses were conducted. Fifty effect sizes (N=10,618) resulted in a moderate effect size of .39 for the relationship between weight teasing and body dissatisfaction; 24 effect sizes (N=7190) resulted in an effect size of .32 for the relationship between appearance teasing and body dissatisfaction; 20 effect sizes (N=4792) resulted in an effect size of .35 for the relationship between weight teasing and dietary restraint; and 22 effect sizes (N=5091) resulted in an effect size of .36 for the relationship between weight teasing and bulimic behaviors. Significant moderators that emerged were teasing measure type, publication type, study type, age group, and gender. The findings offer further support for the inclusion of strategies in body image and eating disorders' prevention and intervention programs that focus on handling negative, appearance-related commentary.