Fabienne Schmid, Andreas Schmitt, Norbert Hermanns, Bernhard Kulzer, Dominic Ehrmann
{"title":"COVID-19大流行对1型糖尿病患者的社会心理影响:一项生态瞬时评估研究的结果","authors":"Fabienne Schmid, Andreas Schmitt, Norbert Hermanns, Bernhard Kulzer, Dominic Ehrmann","doi":"10.3389/fcdhc.2022.834643","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>Psychological distress due to living with diabetes, demanding self-management tasks, impacts on life, and risks of complications is common among people living with diabetes. COVID-19 could pose a new additional risk factor for psychological distress in this group. This study aimed to analyze levels of COVID-19-related burdens and fears, variables explaining these levels, and associations with the concurrent 7-day COVID-19 incidence in people with type 1 diabetes (T1D).</p><p><strong>Methods: </strong>A total of 113 people with T1D (58% women; age: 42.3 ± 9.9 years) participated in an ecological momentary assessment (EMA) study between December 2020 and March 2021. The participants reported daily levels of COVID-19-related burdens and fears over 10 consecutive days. Global ratings of COVID-19-related burdens and fears were assessed using questionnaires, as were current and previous levels of diabetes distress (PAID), acceptance (DAS), fear of complications (FCQ), depressive symptoms (CES-D), and diabetes self-management (DSMQ). Current levels of diabetes distress and depressive symptoms were compared with pre-pandemic ratings gained during an earlier study phase. Associations between burdens and fears, psychosocial and somatic aspects, and the concurrent 7-day incidence rate were analyzed using multilevel regression.</p><p><strong>Results: </strong>Diabetes distress and depressive symptoms reported during the pandemic were comparable to pre-pandemic levels (PAID: p = .89; CES-D: p = .38). Daily EMA ratings reflected relatively low mean COVID-19-related burdens and fears in everyday life. However, there was substantial day-to-day variation per person indicating higher burdens on specific days. Multilevel analyses showed that daily COVID-19-related burdens and fears were significantly predicted by pre-pandemic levels of diabetes distress and diabetes acceptance but were not associated with the concurrent 7-day incidence rate nor with demographic and medical variables.</p><p><strong>Conclusions: </strong>This study observed no increase in diabetes distress and depressive symptoms during the pandemic in people with T1D. The participants reported low to moderate levels of COVID-19-related burdens. COVID-19-related burdens and fears could be explained by pre-pandemic levels of diabetes distress and acceptance but not by demographic and clinical risk variables. The findings suggest that mental factors may constitute stronger predictors of COVID-19-related burdens and fears than objective somatic conditions and risks in middle-aged adults with T1D.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012070/pdf/","citationCount":"0","resultStr":"{\"title\":\"Psychosocial Impact of the COVID-19 Pandemic on People With Type 1 Diabetes: Results of an Ecological Momentary Assessment Study.\",\"authors\":\"Fabienne Schmid, Andreas Schmitt, Norbert Hermanns, Bernhard Kulzer, Dominic Ehrmann\",\"doi\":\"10.3389/fcdhc.2022.834643\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>Psychological distress due to living with diabetes, demanding self-management tasks, impacts on life, and risks of complications is common among people living with diabetes. COVID-19 could pose a new additional risk factor for psychological distress in this group. This study aimed to analyze levels of COVID-19-related burdens and fears, variables explaining these levels, and associations with the concurrent 7-day COVID-19 incidence in people with type 1 diabetes (T1D).</p><p><strong>Methods: </strong>A total of 113 people with T1D (58% women; age: 42.3 ± 9.9 years) participated in an ecological momentary assessment (EMA) study between December 2020 and March 2021. The participants reported daily levels of COVID-19-related burdens and fears over 10 consecutive days. Global ratings of COVID-19-related burdens and fears were assessed using questionnaires, as were current and previous levels of diabetes distress (PAID), acceptance (DAS), fear of complications (FCQ), depressive symptoms (CES-D), and diabetes self-management (DSMQ). Current levels of diabetes distress and depressive symptoms were compared with pre-pandemic ratings gained during an earlier study phase. Associations between burdens and fears, psychosocial and somatic aspects, and the concurrent 7-day incidence rate were analyzed using multilevel regression.</p><p><strong>Results: </strong>Diabetes distress and depressive symptoms reported during the pandemic were comparable to pre-pandemic levels (PAID: p = .89; CES-D: p = .38). Daily EMA ratings reflected relatively low mean COVID-19-related burdens and fears in everyday life. However, there was substantial day-to-day variation per person indicating higher burdens on specific days. Multilevel analyses showed that daily COVID-19-related burdens and fears were significantly predicted by pre-pandemic levels of diabetes distress and diabetes acceptance but were not associated with the concurrent 7-day incidence rate nor with demographic and medical variables.</p><p><strong>Conclusions: </strong>This study observed no increase in diabetes distress and depressive symptoms during the pandemic in people with T1D. The participants reported low to moderate levels of COVID-19-related burdens. COVID-19-related burdens and fears could be explained by pre-pandemic levels of diabetes distress and acceptance but not by demographic and clinical risk variables. 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引用次数: 0
摘要
目的:糖尿病患者的心理困扰、自我管理任务的要求、对生活的影响以及并发症的风险在糖尿病患者中很常见。COVID-19可能会对这一群体的心理困扰构成新的额外风险因素。本研究旨在分析与COVID-19相关的负担和恐惧水平,解释这些水平的变量,以及与1型糖尿病(T1D)患者同时7天的COVID-19发病率的关系。方法:共113例T1D患者(女性58%;年龄:42.3±9.9岁)在2020年12月至2021年3月期间参加了生态瞬时评估(EMA)研究。参与者连续10天报告了每天与covid -19相关的负担和恐惧水平。使用问卷评估了与covid -19相关的负担和恐惧的全球评级,以及当前和以前的糖尿病困扰(PAID)、接受程度(DAS)、对并发症的恐惧(FCQ)、抑郁症状(CES-D)和糖尿病自我管理(DSMQ)水平。目前的糖尿病痛苦和抑郁症状水平与在早期研究阶段获得的大流行前评级进行了比较。使用多水平回归分析负担与恐惧、心理社会和躯体方面以及同时发生的7天发病率之间的关联。结果:大流行期间报告的糖尿病痛苦和抑郁症状与大流行前的水平相当(PAID: p = 0.89;ce - d: p = .38)。每日EMA评分反映了日常生活中与covid -19相关的平均负担和恐惧相对较低。然而,每个人每天都有很大的差异,表明在特定的日子里负担更重。多水平分析表明,每日与covid -19相关的负担和恐惧可通过大流行前的糖尿病痛苦水平和糖尿病接受程度显著预测,但与同期7天的发病率无关,也与人口统计学和医学变量无关。结论:本研究观察到大流行期间糖尿病患者的糖尿病窘迫和抑郁症状没有增加。参与者报告了与covid -19相关的低至中等水平的负担。与covid -19相关的负担和恐惧可以用大流行前的糖尿病痛苦和接受程度来解释,但不能用人口统计学和临床风险变量来解释。研究结果表明,与客观躯体状况和风险相比,精神因素可能是中年T1D患者与covid -19相关的负担和恐惧的更强预测因素。
Psychosocial Impact of the COVID-19 Pandemic on People With Type 1 Diabetes: Results of an Ecological Momentary Assessment Study.
Aims: Psychological distress due to living with diabetes, demanding self-management tasks, impacts on life, and risks of complications is common among people living with diabetes. COVID-19 could pose a new additional risk factor for psychological distress in this group. This study aimed to analyze levels of COVID-19-related burdens and fears, variables explaining these levels, and associations with the concurrent 7-day COVID-19 incidence in people with type 1 diabetes (T1D).
Methods: A total of 113 people with T1D (58% women; age: 42.3 ± 9.9 years) participated in an ecological momentary assessment (EMA) study between December 2020 and March 2021. The participants reported daily levels of COVID-19-related burdens and fears over 10 consecutive days. Global ratings of COVID-19-related burdens and fears were assessed using questionnaires, as were current and previous levels of diabetes distress (PAID), acceptance (DAS), fear of complications (FCQ), depressive symptoms (CES-D), and diabetes self-management (DSMQ). Current levels of diabetes distress and depressive symptoms were compared with pre-pandemic ratings gained during an earlier study phase. Associations between burdens and fears, psychosocial and somatic aspects, and the concurrent 7-day incidence rate were analyzed using multilevel regression.
Results: Diabetes distress and depressive symptoms reported during the pandemic were comparable to pre-pandemic levels (PAID: p = .89; CES-D: p = .38). Daily EMA ratings reflected relatively low mean COVID-19-related burdens and fears in everyday life. However, there was substantial day-to-day variation per person indicating higher burdens on specific days. Multilevel analyses showed that daily COVID-19-related burdens and fears were significantly predicted by pre-pandemic levels of diabetes distress and diabetes acceptance but were not associated with the concurrent 7-day incidence rate nor with demographic and medical variables.
Conclusions: This study observed no increase in diabetes distress and depressive symptoms during the pandemic in people with T1D. The participants reported low to moderate levels of COVID-19-related burdens. COVID-19-related burdens and fears could be explained by pre-pandemic levels of diabetes distress and acceptance but not by demographic and clinical risk variables. The findings suggest that mental factors may constitute stronger predictors of COVID-19-related burdens and fears than objective somatic conditions and risks in middle-aged adults with T1D.