Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2017

Diabetes distress and its relationship with self-care behaviors, self-efficacy, glycemic control and acculturation levels among Arabic-speaking and Caucasian English-speaking patients with diabetes (#126)

Hamzah Alzubaidi 1 , Kevin Mc Namara 2 , Colette Browning 3
  1. College of Pharmacy and Sharjah Institute for Medical Research , University of Sharjah , Sharjah , United Arab Emirates
  2. School of Medicine, Deaking University , Melbourne , Vic, Australia
  3. Research Institute , Royal District Nursing Service , Melbourne , Vic, Australia

Background

Diabetes-related distress (DRD) represents a major problem in diabetes care. DRD is highly prevalent among people with diabetes especially among migrant communities and culturally and linguistically diverse groups. DRD has been associated with lower adherence levels to self-care activities and treatment regimens, poor quality of life and worse health outcomes.

Objective

To compare diabetes-related distress between Arabic-speaking immigrants and Caucasian English-speaking people with diabetes, and to explore the relationships between DRD and various patient-related factors.

Methods

A cross-sectional study was conducted in healthcare settings with large Arabic populations in rural and metropolitan Victoria, Australia. Diabetes-related distress, adherence to self-care activities and medications, self-efficacy, medication underuse, satisfaction with healthcare decisions, and clinical data were recorded.

Results

701 participants were recruited; 392 Arabic-speaking participants (ASPs) and 309 English-speaking participants (ESPs). About 84% of ASPs screened positively for low functional health literacy. 58.8% of ASPs had inadequate glycemic control HbA1c >7% (53mmol/mol) and 13.85% had inadequate blood pressure control (BP ≥140/90mmHg). ASPs were significantly less adherent to all aspects of diabetes self-care compared with ESPs: dietary behaviors [P <0.01; 95%, CI = -1.17, -0.84], exercise and physical activity (P = <0.001, 95% CI = -1.14, -0.61), blood glucose testing (P <0.001) and foot-care (P <0.001). ASPs displayed higher levels of diabetes-related distress compared with their counterparts in the ESP group (P = 0.04). Significant associations were found between  DRD and age, employment status, medication underuse, self-efficacy, self-care activities, and satisfaction with healthcare decisions.

Conclusions

Arabic-speaking migrants had significantly higher levels of diabetes-related distress, compared with Cascina English-speaking people. Higher distress level was significantly associated with lower self-efficacy, lower adherence levels to prescribed treatment, and lower self-care activities. These findings highlight the need to incorporate assessment of DRD in medical encounters. The tide may be turning in the right direction if suitable interventions are designed to lower DRD aiming at improving diabetes outcomes.