Research On The Relationships Among Fear Of Hypoglycemia,Self-efficacy And Quality Of Life In Patients With Type 2 Diabetes Mellitus

Objectives:The research aimed to investigate the status quo of hypoglycemic fear,self-efficacy and quality of life in patients with type 2 diabetes mellitus,analyze their influencing factors and explore the relationships among fear of hypoglycemia,self-efficacy and quality of life,so as to propose the feasible suggestions to alleviate fear of hypoglycemia of patients and provide theoretical basis for developing targeted intervention programs for medical staff.Methods:Convenient sampling method was used in this study.During the period of May to November in 2016,260 patients with type 2 diabetes who met the inclusion criterias and came from the Department of Endocrinology of three comprehensive hospitals in Changchun were chosen as the study subjects.Patients’ general information questionnaire,the Chinese version of Hypoglycemia Fear Survey-Worry Scale(CHFS-WS),the Diabetes Management Self-efficacy Scale(DMSES)and the Euro Qol-5 Dimensions questionnaire(EQ-5D)were used to conduct this investigation.The data was analyzed by SPSS17.0.The patients’ general information was analyzed using descriptive analysis.With regard to the influencing factors of hypoglycemia fear,self-efficacy and quality of life of patients with type 2 diabetes,univariate analysis adopted independent-sample t-test(or t’ test),univariate analysis of variance,chi-square test,and nonparametric rank sum test;multivariate analysis were performed using multiple linear regression analysis and bivariate logistic regression analysis.The relationships among fear of hypoglycemia,self-efficacy and quality of life were analyzed by spearman correlation analysis.Results:1.Of the 260 patients with type 2 diabetes who were enrolled in our study,the median score of CHFS-WS was 11.0 points(interquartile range,7~20 points).The first four items that patients most worried about hypoglycemia were feeling light-headed or dizzy,no one being around to help them during a reaction,having a reaction while alone,and passing out in public.2.The results of univariate analysis showed that patients with different age,gender,ways of living,diabetes duration,treatment modalities,blood glucose fluctuation status,diabetes control status,social support,frequency of hypoglycemia,degree of hypoglycemia and hypoglycemia awareness had statistically significant difference in terms of scores of hypoglycemia fear(P<0.05).The results of multiple linear regression analysis displayed that diabetes duration,ways of living,higher blood glucose fluctuation,less social support,3~6 times hypoglycemia occurred in the past 6 months,more than one time per month hypoglycemia occurred in the past 6months,moderate hypoglycemia and severe hypoglycemia had entered hypoglycemia fear regression equation(R2=0.565,F=24.709,P<0.05).3.The scores of self-efficacy of patients with type 2 diabetes was(130.062±24.388).The results of univariate analysis displayed that patients with different gender,ways of living,treatment modalities,blood glucose fluctuation status,diabetes control status,social support,frequency of hypoglycemia,degree of hypoglycemia and hypoglycemia awareness had statistically significant difference in terms of self-efficacy scores(P<0.05).The multiple linear regression analysis demonstrated that less social support,higher blood glucose fluctuation,poor diabetes control status,moderate hypoglycemia,severe hypoglycemia and hypoglycemia fear had entered the regression equation(R2=0.553,F=30.174,P<0.05).4.Among the five dimensions of EQ-5D,the higher incidence of problems were "pain/discomfort" dimension(55.80%)and "anxiety/depression" dimension(49.20%).Bivariate logistic regression analysis was carried out for each dimension,finally found that age and diabetes duration had been the influencing factors of mobilitydimension;diabetes duration and hypoglycemia fear had been the influencing factors of usual activities dimension;age had been the influencing factor of self-care dimension;hypoglycemia fear had been the influencing factor of "pain/discomfort" dimension;hypoglycemia fear and self-efficacy had been the influencing factors of "anxiety/depression" dimension.5.In patients with type 2 diabetic,there were significantly negative correlations between hypoglycemia fear scores and the total scores of self-efficacy and its all dimensions(P<0.01);hypoglycemia fear scores was significantly negatively correlated with EQ-5D index(P<0.01);and EQ-5D index were obviously positively correlated with the total scores of self-efficacy and its all dimensions(P<0.01).Conclusions:1.Fear of hypoglycemia of patients with type 2 diabetes was influenced by diabetes duration,ways of living,blood glucose fluctuation status,social support,frequency of hypoglycemia and degree of hypoglycemia.Therefore,we should focus on these aspects when conduct intervention scheme in the future.2.The self-efficacy of patients with type 2 diabetic were mostly in the medium level,which still needs to be improved.And their influencing factors included social support,blood glucose fluctuation status,diabetes control status,degree of hypoglycemia and fear of hypoglycemia.3.The current situation of quality of life of patients with type 2 diabetes mellitus was not optimistic.Meanwhile,"pain/discomfort" and "anxiety/depression" were their major health problems.4.Fear of hypoglycemia was the negative influencing factor of self-efficacy and quality of life of patients with type 2 diabetic,that was to say,the higher of the hypoglycemia fear,the lower of patients’ self-efficacy and the worse of their quality of life.5.There was a significantly positive correlation between self-efficacy and quality of life of patients with type 2 diabetes,in other words,the higher of the self-efficacy,the better of patients’ quality of life.