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Emotional Distress and Self-Rated Health Among Middle-Aged and Older Chinese Americans with Type 2 Diabetes

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Abstract

Background

Self-Rated Health (SRH) is a valid proxy for individuals’ overall well-being and mortality risk. This study examined contributions of diabetes distress (stress from diabetes self-management) and depressive symptoms to SRH among Chinese Americans with type 2 diabetes (T2DM).

Methods

For this cross-sectional study, a survey measuring diabetes distress, depressive symptoms, physical health, and demographics was administered to a convenience sample of 151 foreign-born community-dwelling Chinese Americans with T2DM.

Results

Fifty-five percent of participants rated their health as good or very good. With demographic and physical health variables controlled, hierarchical logistic regression showed that people who reported more diabetes distress (OR = 2.88, p < 0.05) or depressive symptoms (OR = 3.54, p < 0.05) were more likely to have poor SRH. Acculturation (OR = 0.88, p < 0.001) was protective for SRH.

Conclusions

Diabetes distress and depressive symptoms are significantly associated with poor SRH and should be managed in Chinese Americans with T2DM.

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References

  1. Carpenter R, DiChiacchio T, Barker K. Interventions for self-management of type 2 diabetes: an integrative review. Int J Nurs Sci. 2019;6:70–91. https://doi.org/10.1016/ijns2018.12.002.

    Article  PubMed  Google Scholar 

  2. Centers for Diabetes Control and Prevention. National Diabetes Statistics Report 2020. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf Accessed 8 July 2020.

  3. Kolb H, Martin J. Environmental/lifestyle factors in the pathogenesis and prevention of type 2 diabetes. BMC Med. 2017;15:131–41. https://doi.org/10.1186/s12916-017-0901-x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. United States Bureau of the Census. Asian American and Pacific Islander Heritage Month: May 2020. https://www.census.gov/newsroom/facts-for-features/2020/aian.html Accessed 8 July 2020.

  5. Egede LE, Dismuke CE. Serious psychological distress and diabetes: a review of the literature. Curr Psychiatry Rep. 2012;14(1):15–22.

    Article  Google Scholar 

  6. de Groot M, Anderson R, Freedland KE, Clouse RE, Lustman PJ. Association of depression and diabetes complications: a metaanalysis. Psychosom Med. 2001;63(4):619–30.

    Article  Google Scholar 

  7. Snoek FJ, Bremmer MA, Hermanns N. Constructs of depression and distress in diabetes: time for an appraisal. Lancet Diabetes Endocrinol. 2015;3(6):450–60.

    Article  Google Scholar 

  8. Polonsky WH, Fisher L, Earles J, Dudl RJ, Lees J, Mullan J, Jackson RA. Assessing psychosocial distress in diabetes: development of the diabetes distress scale. Diabetes Care. 2002;8(3):626–31.

    Article  Google Scholar 

  9. Gebel. Diabetes Distress. https://www.diabetes.org/living-with-diabetes/complications/mental-health/diabetes-distress.html?referrer%2520=%2520https://www.google.com/. Accessed 28 March 2019.

  10. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). Washington, DC: American Psychiatric Pub; 2013.

    Book  Google Scholar 

  11. Ali S, Stone MA, Peters JL, Davies MJ, Khunti K. The prevalence of co-morbid depression in adults with Type 2 diabetes: a systematic review and meta-analysis. Diabet Med. 2006;23(11):1165–73.

    Article  CAS  Google Scholar 

  12. Egede LE, Ellis C. Diabetes and depression: global perspectives. Diabetes Res Clin Pract. 2010;87(3):302–12.

    Article  Google Scholar 

  13. Yeung A, Yu SC, Fung F, Vorono S, Fava M. Recognizing and engaging depressed Chinese Americans in treatment in a primary care setting. Int J Geriatr Psychiatry. 2006;21(9):819–23.

    Article  Google Scholar 

  14. Hwang WC, Myers HF, Takeuchi DT. Psychosocial predictors of first-onset depression in Chinese Americans. Soc Psychiatry Psychiatr Epidemiol. 2000;35(3):133–45.

    Article  CAS  Google Scholar 

  15. Mak WW, Zane NW. The phenomenon of somatization among community Chinese Americans. Soc Psychiatry Psychiatr Epidemiol. 2004;39(12):967–74.

    Article  Google Scholar 

  16. DeSalvo KB, Bloser N, Reynolds K, He J, Muntner P. Mortality prediction with a single general self-rated health question. J Gen Intern Med. 2006;21(3):267–75.

    Article  Google Scholar 

  17. Assari S, Kumar A. Social determinants of physical self-rated health among Asian Americans. Comp. Six Ethnic Groups Soc. 2018;8(2):1–9.

    Google Scholar 

  18. Jang Y, Huang YC, Yoon H, Lin S. Correlates of self-rated health and self-rated mental health in older Chinese Americans. Soc Work Public Health. 2016;31(4):309–15.

    Article  Google Scholar 

  19. Badawi G, Gariepy G, Pagé V, Schmitz N. Indicators of self-rated health in the Canadian population with diabetes. Diabet Med. 2012;29(8):1021–8.

    Article  CAS  Google Scholar 

  20. Dankner R, Olmer L, Kaplan G, Chetrit A. The joint association of self-rated health and diabetes status on 14-year mortality in elderly men and women. Qual Life Res. 2016;25(11):2889–966.

    Article  CAS  Google Scholar 

  21. Bulut E, Gayman MD. Acculturation and self-rated mental health among Latino and Asian immigrants in the United States: A latent class analysis. J Immigr Minor Health. 2016;18:836–49.

    Article  Google Scholar 

  22. Jang Y, Kim G, Chiriboga D, King-Kallimanis B. A bidimensional model of acculturation for Korean American older adults. J Aging Stud. 2007;21(3):267–75.

    Article  Google Scholar 

  23. Federal Interagency Forum on Aging-Related Statistics. Older Americans: Key indicators of well-being. https://agingstats.gov/docs/LatestReport/Older-Americans-2016-Key-Indicators-of-WellBeing.pdf. Accessed 22 May 2019.

  24. Fisher L, Hessler DM, Polonsky WH, Mullan J. When is diabetes distress clinically meaningful? Establishing cut points for the diabetes distress scale. Diabetes Care. 2012;35(2):259–64.

    Article  Google Scholar 

  25. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401.

    Article  Google Scholar 

  26. Zhang Y, Ting RZ, Lam MH, Lam SP, Yeung RO, Nan H, Ozaki R, Luk AO, Kong AP, Wing YK, Sartorius N. Measuring depression with CES-D in Chinese patients with type 2 diabetes: the validity and its comparison to PHQ-9. BMC Psychiatry. 2015;15:1–10.

    Article  Google Scholar 

  27. Corpo IBM. IBM SPSS Statistics for Windows Version- 25.0. Armonk, New York: IBM Corpo; 2017.

    Google Scholar 

  28. Xu Y, Pan W, Liu H. The role of acculturation in diabetes self-management among Chinese Americans with type 2 diabetes. Diabetes Res Clin Pract. 2011;93(3):363–70.

    Article  CAS  Google Scholar 

  29. Chang E, Chan KS, Han HR. Effect of acculturation on variations in having a usual source of care among Asian Americans and non-Hispanic whites in California. Am J Public Health. 2015;105(2):398–407.

    Article  Google Scholar 

  30. Chun KM, Chesla CA, Kwan CM. “So We Adapt Step by Step”: acculturation experiences affecting diabetes management and perceived health for Chinese American immigrants. Soc Sci Med. 2011;72(2):256–64.

    Article  Google Scholar 

  31. Deng F, Zhang A, Chan CB. Acculturation, dietary acceptability, and diabetes management among Chinese in North America. Front Endocrinol. (Lausanne). 2013;4:1–7.

    Article  Google Scholar 

  32. Renn BN, Feliciano L, Segal DL. The bidirectional relationship of depression and diabetes: a systematic review. Clin Psychol Rev. 2011;31(8):1239–46.

    Article  Google Scholar 

  33. Lin SY. Beliefs about causes, symptoms, and stigma associated with severe mental illness among ‘highly acculturated’ Chinese-American patients. Int J Soc Psychiatry. 2013;59(8):745–51.

    Article  Google Scholar 

  34. Yang LH, Chen FP, Sia KJ, Lam J, Lam K, Ngo H, Lee S, Kleinman A, Good B. “What matters most:” A cultural mechanism moderating structural vulnerability and moral experience of mental illness stigma. Soc Sci Med. 2014;103:84–93.

    Article  Google Scholar 

  35. Tseng J, Halperin L, Ritholz MD, Hsu WC. Perceptions and management of psychosocial factors affecting type 2 diabetes mellitus in Chinese Americans. J Diabetes Complic. 2013;27(4):383–90.

    Article  Google Scholar 

  36. Chesla CA, Chun KM, Kwan CM. Cultural and family challenges to managing type 2 diabetes in immigrant Chinese Americans. Diabetes Care. 2009;32(10):1812–6.

    Article  Google Scholar 

  37. Xu Y, Pan W, Liu H. Self-management practice of Chinese American with type 2 diabetes. Nurs Health Sci. 2010;12(2):228–34.

    Article  Google Scholar 

  38. Ong WM, Chua SS, Ng CJ. Barriers and facilitators to self-monitoring of blood glucose in people with type 2 diabetes using insulin: a qualitative study. Patient Prefer Adherence. 2014;8:237–46.

    PubMed  PubMed Central  Google Scholar 

  39. Sun F, Gao X, Gao S, Li Q, Hodge DR. Depressive symptoms among older Chinese Americans: examining the role of acculturation and family dynamics. J Gerontol B Psychol Sci Soc Sci. 2016;73(5):870–9.

    Google Scholar 

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Acknowledgements

The authors thank all the participants and community organizations that supported and helped with this study.

Funding

The work was supported by the Sigma Theta Tau Epsilon Theta Chapter and the Hogg Foundation for Mental Health (Grant number: FFW-008–17-07).

Author information

Authors and Affiliations

  1. St. David’s School of Nursing, Texas State University, 100 Bobcat Way, Round Rock, TX, 78665, USA

    Ya-Ching Huang

  2. School of Nursing, The University of Texas at Austin, 1710 Red River St., Austin, TX, 78712, USA

    Julie Zuñiga, Yvonne Hua & Alexandra García

  3. Dell Medical School, 1501 Red River St., Austin, TX, 78712, USA

    Alexandra García

Authors
  1. Ya-Ching Huang
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  2. Julie Zuñiga
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  3. Yvonne Hua
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  4. Alexandra García
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Corresponding author

Correspondence to Ya-Ching Huang.

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Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical Approval

The research design was reviewed and approved by a university institutional review board. Oral consent was obtained from each participant prior to data collection.

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Huang, YC., Zuñiga, J., Hua, Y. et al. Emotional Distress and Self-Rated Health Among Middle-Aged and Older Chinese Americans with Type 2 Diabetes. J Immigrant Minority Health 23, 487–493 (2021). https://doi.org/10.1007/s10903-020-01062-x

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