Predictive Factors of Diabetes Distress Among Indonesian Older Persons With Type 2 Diabetes Mellitus

Abstract

This cross-sectional study aimed to identify the level and factors predicting diabetes distress (DD) in older persons suffering from type 2 diabetes mellitus. One hundred ninety eight participants from Central General Hospital of Dr. Soeradji Tirtonegoro Klaten, Indonesia were purposively selected. Information regarding the demographic and clinical data of the participants was collected using the Personal Characteristic Questionnaire. Data related to family support, self-efficacy, spirituality and DD were collected using the Diabetes Family Behavior Checklist (DFBC), Diabetes Management Self-Efficacy Scale (DMSES), Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) expanded version, and Diabetes Distress Scale (DDS), respectively. Content validity of DFBC, DMSES and FACIT-Sp-Ex was examined by three experts. The S-CVI values of these tools were 0.87, 0.91 and 1, respectively. In addition, reliability test showed the Cronbach's alpha coefficient of these tools were 0.72, 0.88, and 0.91, respectively. Data analysis was performed using descriptive statistics, Pearson correlation coefficient, and stepwise regression. The findings showed that the level of DD of the participants was at the low level (M = 1.14, SD = 0.19). The study demonstrated non-supportive family behavior (B = 0.14, p = 0.04), self-efficacy (B = -0.29, p = .00), and spirituality (B = -0.14, p = .04) as variables that could statistically predict DD in older persons with type 2 diabetes mellitus. In addition, self-efficacy was found to be the strongest predictor of DD. The total variance of the significant factors of DD was 16.3%. Therefore, it is recommended that nurses design interventions to enhance patients' self-efficacy and spirituality and reduce non-supportive behavior in the family. This will serve to decrease the level of DD in older persons with type 2 diabetes mellitus.