Investigating the Relationship of Stress, Anxiety, and Depression with Self-care in Type 2 Diabetic Patients

Diabetes is one of the most common non-communicable diseases, with the highest prevalence among metabolic diseases in the world. Depression, stress, and anxiety are observed in diabetic patients. Patients' Self-care status is the most important factor in controlling diabetes. Therefore, the present study aimed to assess the relationship of stress, anxiety, and depression with self-care in type 2 diabetic patients.

This study was conducted based on a cross-sectional design. The statistical population consisted of 266 people with type 2 diabetes who were referred to the diabetes clinic of Bu-Ali Hospital in Zahedan between December and March 2022. Data collection was performed using the Depression, Anxiety, and Stress Scale-21 Items (DASS-21) and diabetes self-care behavior questionnaire. The content validity ratio and content validity index of the questionnaire was 0.84, and Cronbach's alpha was 0.9. Data were analyzed in SPSS software (version 22) using Pearson's correlation test and logistic regression.

The results demonstrated that the average age of the participants was 53.8 years. Moreover, 69.9% of participants were female, 98.9% were married, and 67.3% had a high school education. The average scores of stress, anxiety, depression, and self-care behavior were 18.8, 17.4, 18.7, and 25.9, respectively. Based on the results of demographic variables, 11% of the participants exhibited self-care behavior, and education level was significant (P<0.05). A higher level of education had a positive effect on behavior (P<0.05). The regression results reported 13% of self-care behavior; moreover, the variables of education level, stress, anxiety, and depression had a significant effect on the behavior (P<0.05). Higher education levels and low stress, anxiety, and depression had a positive impact on behavior.

As evidenced by the results of this study, Self-care increased at higher education levels, and self-care decreased with an increase in stress, anxiety, and depression.