Diabetes distress in adults with type 1 diabetes: Prevalence, incidence and change over time.
Diabetes distress in adults with type 1 diabetes: Prevalence, incidence and change over time.
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DOI：
10.1016/j.jdiacomp.2016.03.032
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发表时间：
2016-08
影响因子：
3
通讯作者：
Peters A
中科院分区：
文献类型：
--
作者：
Fisher L;Hessler D;Polonsky W;Strycker L;Masharani U;Peters A
使用单一阈值和最小临床重要差异 (MCID) 方法记录糖尿病窘迫 (DD) 升高的患病率和 9 个月发病率以及 DD 随时间的稳定性。患有 1 型糖尿病 (T1D) 的成人 (N=224) 在基线和 9 个月时完成了 28 项 T1 糖尿病困扰量表 (T1-DDS)。通过样条分析确定 T1-DDS 阈值，并根据测量的标准误差计算 MCID。分析支持 DD 升高的分界点≥2.0。 DD 升高的患病率和 9 个月发生率分别为 42.1% 和 54.4%。 MCID 为 +/-0.19，但因子量表而异（0.26 至 0.50）。 DD 升高保持稳定：只有 20% 在 9 个月内超过 2.0。 MCID 分析表明，随着时间的推移，那些保持低于或高于 2.0 的人也发生了变化。变化因痛苦的来源而异，其中无力感最为普遍和稳定。使用 MCID，只有参与者的年龄、性别和并发症数量可以预测变化。成人 T1D 中 DD 升高的患病率、9 个月发病率和稳定性较高，且随 DD 来源的不同而变化。我们提出了一个组合的切点/MCID 框架来衡量 DD 的变化，因为每种方法都反映了随时间变化的独特特征。
To document the prevalence and 9-month incidence of elevated diabetes distress (DD) and the stability of DD over time using both single threshold and minimal clinically important differences (MCID) approaches. Adults with type 1 diabetes (T1D) (N=224) completed the 28-item T1-Diabetes Distress Scale (T1-DDS) at baseline and 9 months. A T1-DDS threshold was identified with spline analysis and MCID was calculated from the standard error of measurement. Analyses supported a cut-point of ≥2.0 for elevated DD. The prevalence and 9-month incidence of elevated DD was 42.1% and 54.4%, respectively. MCID was +/−0.19 but varied by subscale (.26 to .50). Elevated DD was stable: only 20% crossed 2.0 over 9 months. MCID analyses showed that change also occurred among those who remained either below or above 2.0 over time. Change varied by source of distress, with Powerlessness the most prevalent and stable. Using MCID, only participant age, gender and number of complications predicted change. The prevalence, 9-month incidence and stability of elevated DD is high among adults with T1D, with change based on source of DD. We propose a combined cut-point/MCID framework for measuring change in DD, since each approach reflects unique characteristics of change over time.