Browsing by Author "Barcinas, Susan"

Now showing 1 - 2 of 2
  • Thumbnail Image
    ItemOpen Access
    Diabetes distress in Veterans with type 2 diabetes mellitus: Qualitative descriptive study.
    (Journal of health psychology, 2024-02) Lewinski, Allison A; Shapiro, Abigail; Crowley, Matthew J; Whitfield, Chelsea; Jones, Joanne Roman; Jeffreys, Amy S; Coffman, Cynthia J; Howard, Teresa; McConnell, Eleanor; Tanabe, Paula; Barcinas, Susan; Bosworth, Hayden B
    Diabetes distress (DD) is a negative psychosocial response to living with type 2 diabetes mellitus (T2DM). We sought insight into Veterans' experiences with DD in the context of T2DM self-management. The four domains in the Diabetes Distress Scale (i.e. regimen, emotional, interpersonal, healthcare provider) informed the interview guide and analysis (structural coding using thematic analysis). The mean age of the cohort (n = 36) was 59.1 years (SD 10.4); 8.3% of patients were female and 63.9% were Black or Mixed Race; mean A1C was 8.8% (SD 2.0); and mean DDS score was 2.4 (SD 1.1), indicating moderate distress. Veterans described DD and challenges to T2DM self-management across the four domains in the Diabetes Distress Scale. We found that (1) Veterans' challenges with their T2DM self-management routines influenced DD and (2) Veterans experienced DD across a wide range of domains, indicating that clinical interventions should take a "whole-person" approach.Trial Registration: NCT04587336.
  • Thumbnail Image
    ItemOpen Access
    Veterans' Interpretation of Diabetes Distress in Diabetes Self-Management: Findings From Cognitive Interviews.
    (The science of diabetes self-management and care, 2021-10) Lewinski, Allison A; Shapiro, Abigail; Bosworth, Hayden B; Crowley, Matthew J; McCant, Felicia; Howard, Teresa; Jeffreys, Amy S; McConnell, Eleanor; Tanabe, Paula; Barcinas, Susan; Coffman, Cynthia J; King, Heather A

    Purpose

    The purpose of this project was to identify additional facets of diabetes distress (DD) in veterans that may be present due to the veteran's military-related experience.

    Methods

    The study team completed cognitive interviews with veterans with type 2 diabetes mellitus (T2DM) to examine how they answered the Diabetes Distress Scale (DD Scale), a tool that assesses DD. The DD Scale was used because of its strong associations with self-management challenges, physician-related distress, and clinical outcomes.

    Results

    The veterans sample (n= 15) was 73% male, mean age of 61 (SD = 8.6), 53% Black, 53% with glycosylated hemoglobin level <9%, and 67% with prescribed insulin. The DD Scale is readily understood by veterans and interpreted. Thematic analysis indicated additional domains affecting DD and T2DM self-management, including access to care, comorbidities, disruptions in routine, fluctuations in emotions and behaviors, interactions with providers, lifelong nature of diabetes, mental health concerns, military as culture, personal characteristics, physical limitations, physical pain, sources of information and support, spirituality, and stigma.

    Conclusions

    This study describes how a veteran's military experience may contribute to DD in the context of T2DM self-management. Findings indicate clinicians and researchers should account for additional domains when developing self-management interventions and discussing self-management behaviors with individuals with T2DM.