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Journal Article


McCarthy MM, Whittemore R, Gholson G, Grey M. Nurs. Res. 2019; 68(6): 445-452.


Margaret M. McCarthy, PhD, RN, FNP-BC, is an Assistant Professor, the New York University Rory Meyers College of Nursing, New York. Robin Whittemore PhD, APRN, is Professor and Codirector, the National Clinician Scholars Program, Yale School of Nursing, West Haven, Connecticut. Margaret Grey, DrPH, RN, is Annie Goodrich Professor of Nursing, Yale School of Nursing, West Haven, Connecticut. Georica Gholson, PhD, is Psychologist, Walter Reed Medical Center, Bethesda, Maryland.


(Copyright © 2019, Lippincott Williams and Wilkins)






BACKGROUND: The prevalence of adults with Type 1 diabetes (T1D) is increasing, and their risk of cardiovascular disease is high. Comorbid diabetes distress and depressive symptoms may affect their cardiovascular health.

OBJECTIVES: The purpose of this study was to describe the relationship between diabetes distress and depressive symptoms with cardiovascular health factors.

METHODS: This was a cross-sectional survey of a sample of adults with T1D. Valid and reliable instruments were used to collect the data on sociodemographics, diabetes-related complications, psychological factors, and cardiovascular health factors. Independent-sample t tests, analysis of variance, chi-square analyses, and linear regression were used to compare the cardiovascular health factors among the three levels of diabetes distress scores and the two levels of depressive symptom scores.

RESULTS: Our sample included 83 adults with a mean age of 45.2 years and a mean duration of T1D of 20 years. The majority scored low in the Diabetes Distress Scale, whereas 18% scored moderate and 18% scored high. Twenty-two percent had increased levels of depressive symptoms. There were significant correlations between diabetes distress and fear of hypoglycemia, depressive symptom scores, hemoglobin A1c, and total cholesterol. Depressive symptom scores were significantly correlated with hemoglobin A1c. Hemoglobin A1c and total cholesterol were significantly higher in those with higher levels of diabetes distress. There were no significant differences in cardiovascular health between those who scored below or above the cut point for depressive symptoms, but there was a finding toward higher mean body mass index, hemoglobin A1c, and a lower weekly step count in those who had elevated depressive symptoms. In the linear regression, only diabetes distress was significantly associated with hemoglobin A1c.

DISCUSSION: This is a sample with elevated diabetes distress and depressive symptoms, both of which may affect their risk of cardiovascular disease.

Language: en


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