How psychosocial outcomes impact on the self-reported health status in type 2 diabetes patients: Findings from the Diabetes Attitudes, Wishes and Needs (DAWN) study in eastern China

INTRODUCTION The deleterious effects of psychosocial outcomes on diabetic patients' health have not been fully investigated yet. This study was aimed to explore how psychosocial outcomes impacted on the health status of Chinese patients with type 2 diabetes. METHODS A mix of stratified sampling and typical sampling were used to select diabetic patients in Jiangsu Province to conduct individual interviews. Health status was measured by EuroQol Visual Analogue Scale (VAS). Psychosocial outcomes were measured by instruments used in the Diabetes Attitudes, Wishes and Needs survey, including psychological well-being, diabetes distress, patient empowerment, self-management, and patient reported healthcare provision. Clinical characteristics measured included diabetes comorbidities, complications and treatment. OLS regression analyses were used to estimate how health status varied with different characteristics. RESULTS Altogether 1614 patients with type 2 diabetes aged 18-65 years from 6 districts/counties in Jiangsu Province were included in the study. With general characteristics and clinical factors controlled for, psychological well-being among all psychosocial outcomes had the most significant association with health status, with a difference of 9.2 in VAS scores between likely depression and good well-being. VAS scores were also significantly lower in patients with high diabetes distress and significantly higher in those more frequently conducting physical activities. Other psychosocial outcomes were not significantly associated with health status. CONCLUSIONS Likely depression and diabetes-related distress are negatively associated with health status while frequently conducting physical activities are positively associated with health status of type 2 diabetes patients aged 18-65 years from 6 districts/counties in Jiangsu Provinces. These findings underscore the necessity of undertaking routine assessment for depression and diabetes distress and prioritizing interventions on promoting regular physical activities in diabetic patients to improve health management and achieve better health outcomes.