Psychosocial factors predict type 2 diabetes mastery

Abstract

Background Psychosocial aspects of chronic diseases such as Type 2 diabetes (T2D) and cardiovascular disease (CVD) are increasingly recognised as impacting effective self-management. Until now, little was known regarding the moderating effects of empowerment and depression on the relationship between diabetes-specific distress and mastery. Purpose To evaluate the potential mediating role of diabetes empowerment and depression on the relationship between diabetes-specific distress and mastery. Methods Sample comprised 131 participants diagnosed with T2D, mean [SD] age 62.3 [8.8]; 59.5% male. Mean time since diagnosis was 10.4 years. Assessments included: emotional distress (Problem Areas in Diabetes Scale; PAID); depression and anxiety (Hospital Anxiety and Depression Scale; HADS); mastery (Pearlin Mastery Scale); and empowerment (Diabetes Empowerment Scale – Short Form; DES-SF). Data were examined using SPSS: PROCESS a logistic regression-based path analytical framework for multiple mediator models. Results Regression coefficients for the model identified distress (b=−0.249, t(5,112)=−3.71, p<0.001), empowerment (b=0.280, t(5,112)=3.02, p<0.001) and depression (b=−0.980, t(5,112)=−5.73, p<0.001) were all statistically significant predictors of mastery. The PROCESS model assessed ΔR2 as a result of the interaction between distress and depression, which indicated a significant increase (ΔR2=0.08) in variance explained due to the inclusion of both moderators: F(2,112)=16.88, p<0.001, ΔR2=0.14. Also identified were interaction effect sizes: at low levels of empowerment, increasing depression led to increasing levels of distress predicting overall levels of mastery. This held true at moderate and high levels of empowerment; increasing levels of depression led to increasing distress predicting mastery. Conclusions These findings elucidate the impact of empowerment and depression on the association between distress and mastery in a diabetes cohort. The evidence suggests that the psychosocial interventions likely to have greatest impact on mastery are those that target key moderators such as empowerment and depression. Funding Acknowledgement Type of funding source: None