ASSOCIATION BETWEEN DEPRESSIVE SYMPTOMS, ANXIETY, STRESS AND DIABETES SELF-CARE AMONG ADULTS LIVING WITH TYPE 2 DIABETES IN KILIFI COUNTY, KENYA

Abstract

Background: Depression, anxiety and stress are common conditions affecting psychological wellbeing of adults living with Diabetes Mellitus. These conditions can worsen complications due to diabetes and self-care leading to high cost of treatment and early deaths. Despite the increasing number of people living with Diabetes Mellitus in Kenya little is known of the prevalence of psychological problems in this sub-population, and its impact on treatment outcomes. This study set out to translate and adapt tools for assessment of psychological care and self-care. The association between depressive symptoms, anxiety, stress and diabetes self -care among adults living with Type 2 diabetes at Kilifi County Hospital Diabetes Clinic was examined. Methods: The study adopted a sequential mixed methods design 192 adults living with Type 2 diabetes participated in this study. These adults completed the Depression Anxiety Stress Scale, the Summary Diabetes Self Scale Activities and Self- Care Inventory. Demographic and physiological characteristics were recorded. Multiple regression analyses were used to explore the association of self-care and other factors. Results: The prevalence of depression, anxiety and stress in this study was approximately 11.8%, 13.0% and 3.1% respectively. Depression was significantly associated with age in years (OR 0.44, 95% CI 0.22, 0.88 p = 0.02) and social economic status (OR 0.97, 95%Cl 0.95, 0.99 p =0.05) in the univariate analysis. Not being married was associated with stress (OR 3.71 95% CI 1.22, 11.27 p= 0.02). Overall self-care frequency level was at 41%. Depression, social economic status and having health insurance cover were significant predictors of acceptable patterns of diabetes self-care. Conclusion: The study showed that while prevalence of depression and anxiety symptoms was just over 10%, few were stressed. Depressive symptoms are negatively associated vi diabetes self-care. There is a need for integrated management involving psychological aspect and self-care interventions to enhance well-being of adults living with Type 2 diabetes.