Depression and Its Associated Factors Among Rural Diabetic Residents

Background: Type 2 diabetes is a huge burden both for individuals and society as a whole. Although depression has been negatively associated with ideal glycemic control, little is known about the prevalence of depression or its associated factors among rural Taiwanese adults with Type 2 diabetes mellitus (type2 DM). Purpose: The purposes of this study were to investigate the prevalence of depression in rural-dwelling sufferers of type2 DM and to highlight the relationships between their depression status and health promoting behaviors such as physical activity, keeping active in life, sleep sufficiency, and adopting a diabetic diet. Methods: A cross-sectional, correlational design was used to recruit 696 participants from local healthcare centers in rural areas of Chiayi County, Taiwan. Data were collected from March 30, 2010, to August 30, 2012. The Chinese version of the Geriatric Depression Scale and its associated physiological biomarkers were used as screening tools. Logistic regression was used to identify the factors that were associated with depression status. Results: The prevalence of depression in this study was 16.8%. Factors found to be associated with depression included being female, having a low level of education, receiving reduced family support, having little physical activity, failing to follow a diabetic diet, frequent inactivity, and having insufficient sleep. There were no significant differences in the physiological indicators between the depressive and nondepressive groups. After controlling for confounding factors, a logistic regression model showed that depression status was associated with a lack of sleep (OR = 2.85, p ＜ .001), less frequent exercise (OR = 2.67, p ＜ .001), and frequent inactivity (OR = 2.35, p = .001). Conclusions/Implications for Practice: This study showed that the prevalence of depression among adults with type2 DM living in rural areas is relatively high. From the perspective of health promotion, future research should focus on how to improve quality of sleep by enhancing daily physical activity and on investigating the effect of promoting a more active lifestyle among those at risk on depression.

關鍵字

type 2 diabetes ； depression ； diabetes control ； health promotion

並列摘要

背景　第二型糖尿病造成個人及社會的負擔極重，憂鬱狀況不利於第二型糖尿病的控制，國內有關偏鄉第二型糖尿病社區居民發生憂鬱之盛行率，以及研究此現象之影響因素仍然不足。目的　本研究目的是探討偏鄉第二型糖尿病居民憂鬱之盛行率，及其與健康促進行為，包括身體活動，保持有事做狀態，睡眠時間與採取均衡飲食之相關性。方法　本文採用橫斷面、相關性之研究設計，針對居住於嘉義縣18所偏鄉，共696位第二型糖尿病居民為對象。研究時間自2010年3月至2012年8月；研究工具包括中文版老年憂鬱量表-簡版，以及與憂鬱相關之生理指標測定；並採用多變量邏輯斯迴歸分析影響憂鬱之相關因素。結果　偏鄉地區第二型糖尿病社區居民出現憂鬱之盛行率為16.8%，影響此現象之相關因素有女性、教育程度較低、家庭支持度較少、運動較少、糖尿病飲食攝取較少、不常保持有事做及感覺睡眠不足者；但是在生理指標方面兩組則無差異。在調整干擾因素後多變量分析顯示，感覺睡眠不足（OR = 2.85; p ＜ .001）、缺乏運動（OR = 2.67; p ＜ .001），不常保持有事做者（OR = 2.35; p = .001）有較高之憂鬱傾向。結論／實務應用　本研究顯示偏鄉第二型糖尿病社區居民出現憂鬱之盛行率並不低，從健康促進的觀點，未來研究宜針對如何強化偏鄉第二型糖尿病社區居民每天運動量增加，改善睡眠不足和促進這些個案持續保持有事做的狀態，以降低憂鬱及其不良後果之發生。

並列關鍵字

第二型糖尿病；憂鬱；糖尿病控制；健康促進

參考文獻

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Depression and Its Associated Factors Among Rural Diabetic Residents

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