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The Network of Psychological Variables in Patients With Diabetes and Their Importance for Quality of Life and Metabolic Control
Abstract
OBJECTIVE—The primary goals in treating patients with diabetes are maintaining blood glucose levels as close to normal as possible and making a relatively normal quality of life achievable. Both of these goals are influenced by a multitude of somatic and psychological factors that should be seen as building a complex network. We examined whether a mathematical model can be construed that can depict the relative significance of each factor for achieving these treatment goals. RESEARCH DESIGN AND METHODS—A total of 625 patients from 32 different treatment facilities were examined (224 type 1 and 401 type 2 diabetic patients) using HbA1c values (high-performance liquid chromatography), number of secondary illnesses, and standardized questionnaires with respect to health-related quality of life (World Health Organization Quality of Life questionnaire), coping behavior (Freiburger Illness-Coping Strategies questionnaire), diabetes-specific knowledge (Test of Diabetes-Specific Knowledge), doctor-patient relationship (Medical Interview Satisfaction Scale), and personality characteristics (Giessen Test and Assessment of Beliefs in Self-Efficacy and Optimism). The analyses were carried out by means of a structural equation model. RESULTS—The model proved to be valid (χ2 = 88.5, df = 76, P = 0.16), showing a sound fit (adjusted goodness of fit [AGFI] = 0.94). It explained 62% of the variance of the quality of life and 5% of the HbA1c values. Subjects characterized by strong beliefs in their self-efficacy and an optimistic outlook on life were more likely to be satisfied with their doctor-patient relationships. They demonstrated more active coping behavior and proved to have a higher quality of life. Active coping behavior was the only psychological variable significant for the HbA1c values. CONCLUSIONS—It was possible to illustrate the various factors involved and their mutual dependency and significance for the treatment goals. Belief in self-efficacy and active coping behavior appear to have the greatest relevance for achieving the primary treatment goals.
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“active coping has been shown to improve diabetes self-management [58, 65, 66].”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [66]
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“In patients with diabetes, psychological well-being constructs (e.g., optimism, positive affect) have been associated with superior medical outcomes, including better glucose control and lower mortality rates.”
From Well-being interventions for individuals with diabetes: A systematic review (2019) · cites this paper as [17]
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“또 다른 선행연구에서는 당뇨병 환자에서 바람직한 혈 당 조절을 하는 사람들은 적극적인 문제 극복성향을 보인다고 하였다 [18].”
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“In addition to satisfaction with care, research has shown that self-efficacy positively affects quality of life in adolescents with diabetes (Rose et al. 2002).”
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“If so, it may be worthwhile for health care providers to consider implementing intervention programs that incorporate improving PEWB of patients with diabe - tes (Rose et al., 2002 ).”
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“Recent studies have demonstrated poorer glycemic control in diabetic patients with psychiatric disorders, but few have focused on personality traits as a predictive factor of glycaemic control (Lane et al., 2000; Rose et al., 2002).”
Background
Metadata
- Authors
- Rose, M., Fliege, H., Hildebrandt, M., Schirop, T., & Klapp, B. F.
- Affiliations
- Humboldt-Universität zu Berlin (DE)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2002-01-01
- Volume
- 25
- Issue
- 1
- Pages
- 35-42
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2146350754
- Cited by
- 245
- References
- 50
- Citations by year
- 2025: 2 · 2024: 6 · 2023: 4 · 2022: 7 · 2021: 4 · 2020: 3 · 2019: 2 · 2018: 14 · 2017: 8 · 2016: 7 · 2015: 16 · 2014: 13 · 2013: 22 · 2012: 19
- FWCI
- 7.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Social Sciences › Psychology › Applied Psychology › Optimism, Hope, and Well-being
- Keywords
- diabetes mellitus, quality of life, glycemic control, HbA1c, self-efficacy, optimism, coping styles, physician-patient relationship, diabetes knowledge, type 1 diabetes, type 2 diabetes, psychological factors, structural equation modeling
- MeSH terms
- Blood Glucose, Diabetes Mellitus, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Educational Status, Employment, Family Practice, Female, Health Status, Glycated Hemoglobin, Humans, Male, Medicine, Patient Education as Topic, Personality Inventory, Physician-Patient Relations, Psychological Tests, Quality of Life, Surveys and Questionnaires, Self Concept, Specialization, Reproducibility of Results, Comorbidity, Patient Satisfaction
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