Fatigue-Related Factors for Community-Dwelling Older Adults with Diabetes: A Theory-Guided Multi-Dimensional Approach Using the Dynamic Biopsychosocial Model
Abstract
1. Introduction
Theoretical Framework
2. Materials and Methods
2.1. Participants
2.2. Data Collection
2.3. Instruments
2.3.1. Fatigue
2.3.2. Depression
2.3.3. Sleep Quality
2.3.4. Diabetes Diet-Related Quality of Life
2.3.5. Perceived Social Support
2.4. Data Analyses
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
Appendix A
DBPS Domain | Potential Predictor | Fatigue | |||
---|---|---|---|---|---|
n (%) | M (SD) | F(p) | |||
Biological | Age | <75-years-old | 45 (35.4) | 3.73 (1.79) | 0.634 (0.428) |
≥75-years-old | 82 (64.6) | 4.00 (1.81) | |||
Gender | Men | 50 (39.4) | 3.88 (1.57) | 0.006 (0.937) | |
Women | 77 (60.6) | 3.91 (1.94) | |||
Years with diabetes | <10 years | 58 (45.7) | 3.82 (1.77) | 0.192 (0.662) | |
≥10 years | 69 (54.3) | 3.97 (1.84) | |||
Comorbidities | <2 | 44 (34.6) | 3.98 (1.83) | 0.421 (0.518) | |
≥2 | 83 (65.4) | 3.76 (1.75) | |||
Body mass index (kg/m2) | Normal (<23.0) | 46 (36.2) | 3.83 (1.88) | 0.012 (0.988) | |
Overweight (23.0–24.9) | 34 (26.8) | 3.89 (1.83) | |||
Obesity (≥25.0) | 44 (34.6) | 3.88 (1.73) | |||
Psychological | Depression | Non-Depressed | 63 (49.6) | 3.30 (1.68) | 12.475 (<0.001) |
Moderate Depression | 45 (35.4) | 4.11 (1.76) | |||
Severe Depression | 19 (15.0) | 5.41 (1.24) | |||
Sleep quality | Good | 37 (29.1) | 3.09 (1.53) | 11.547 (0.001) | |
Poor | 90 (70.0) | 4.24 (1.80) | |||
Difficulty with meal planning | Not at all difficult | 48 (37.8) | 3.45 (1.83) | 4.548 (0.012) | |
Not so difficult/ Somewhat | 39 (30.7) | 3.78 (1.59) | |||
Very difficult/ Extremely difficult | 40 (31.5) | 4.56 (1.80) | |||
Satisfaction with diet | <median | 68 (53.5) | 4.32 (1.74) | 8.509 (0.004) | |
≥median | 59 (46.5) | 3.41 (1.75) | |||
Burden of diet therapy | <median | 65 (51.2) | 4.00 (1.74) | 0.407 (0.525) | |
≥median | 62 (48.8) | 3.80 (1.87) | |||
Perceived merits of diet therapy | <median | 70 (55.1) | 4.03 (1.81) | 0.752 (0.387) | |
≥median | 57 (44.9) | 3.75 (1.79) | |||
Perceived social support | <median | 60 (47.2) | 4.12 (1.80) | 1.739 (0.190) | |
≥median | 67 (52.8) | 3.70 (1.79) | |||
Interpersonal | Marital status | Widowed/divorced/ separated | 58 (45.7) | 3.97 (1.84) | 0.165 (0.685) |
Married/partnered | 69 (54.3) | 3.84 (1.78) | |||
Living arrangement | Living alone | 41 (32.3) | 4.14 (1.88) | 1.108 (0.295) | |
Living with others | 86 (67.7) | 3.78 (1.76) | |||
Exclusive eating alone * | No | 92 (72.4) | 3.70 (1.73) | 4.431 (0.037) | |
Yes | 35 (27.6) | 4.44 (1.89) | |||
Eating out | Less than 2 times a week | 93 (73.2) | 4.11 (1.81) | 4.972 (0.028) | |
3 times or more a week | 34 (26.8) | 3.32 (1.66) | |||
Contextual | Education | <High School | 64 (50.4) | 4.01 (2.15) | 0.512 (0.476) |
≥High School | 63 (49.6) | 3.78 (1.52) | |||
Household income | ≤1,000,000 Korean Won | 73 (57.5) | 4.21 (1.81) | 5.365 (0.022) | |
>1,000,000 Korean Won | 54 (42.5) | 3.48 (1.72) |
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Level of Fatigue | Mean (SD; Range) | Frequency (%) |
---|---|---|
Fatigue (total score of 7 points) | 3.94 (1.81; 1–7) | |
Normal (<4) | 66 (51.2) | |
Moderate fatigue (4–4.9) | 22 (17.0) | |
Severe fatigue (≥5) | 41 (31.8) |
Predictors | Unstandardized | Standardized | Correlations | VIF | |||
---|---|---|---|---|---|---|---|
B (95% CI) | SE | β | p | Partial | Part | ||
Biological | |||||||
Age | 0.029 (−0.028, 0.086) | 0.029 | 0.102 | 0.317 | 0.091 | 0.090 | 1.288 |
Gender | 0.083 (−0.582, 0.748) | 0.336 | 0.023 | 0.805 | 0.022 | 0.022 | 1.042 |
Years with diabetes | 0.007 (−0.025,0.038) | 0.016 | 0.042 | 0.672 | 0.038 | 0.038 | 1.231 |
Comorbidities | −0.090 (−0.365, 0.185) | 0.139 | −0.060 | 0.519 | −0.058 | −0.058 | 1.066 |
Body mass index | 0.033 (−0.075, 0.141) | 0.054 | 0.056 | 0.548 | 0.055 | 0.054 | 1.084 |
Model fit | Adjusted R2 = −0.024, F = 0.415, p = 0.838; Durbin-Watson: 0.588 | ||||||
Psychological | |||||||
Depression | 0.187 (0.098, 0.276) | 0.045 | 0.368 | <0.001 | 0.356 | 0.312 | 1.387 |
Poor sleep quality | 0.642 (0.029, 1.255) | 0.309 | 0.163 | 0.040 | 0.187 | 0.156 | 1.091 |
Difficulty with meal planning | 0.233 (0.051, 0.415) | 0.092 | 0.204 | 0.013 | 0.226 | 0.190 | 1.146 |
Satisfaction with diet | −0.090 (−0.172, −0.007) | 0.042 | −0.173 | 0.033 | −0.194 | −0.162 | 1.137 |
Burden of diet therapy | 0.015 (−0.061, 0.092) | 0.039 | 0.031 | 0.695 | 0.036 | 0.029 | 1.119 |
Perceived merits of diet therapy | 0.066 (−0.016, 0.149) | 0.042 | 0.128 | 0.115 | 0.144 | 0.119 | 1.156 |
Perceived social support | −0.001 (−0.014, 0.013) | 0.007 | −0.008 | 0.923 | −0.007 | −0.007 | 1.156 |
Model fit | Adjusted R2 = 0.290, F = 8.348, p < 0.001; Durbin-Watson: 1.026 | ||||||
Interpersonal | |||||||
Marital status | 0.174 (−0.779, 1.126) | 0.481 | 0.048 | 0.719 | 0.032 | 0.032 | 2.323 |
Living arrangement | −0.075 (−1.132, 0.982) | 0.534 | −0.020 | 0.888 | −0.013 | −0.012 | 2.524 |
Exclusive eating alone | 0.795 (−0.076, 1.666) | 0.440 | 0.199 | 0.073 | 0.160 | 0.158 | 1.596 |
Eating out | 0.137 (0.415, 0.144) | 0.140 | 0.090 | 0.330 | 0.087 | 0.085 | 1.114 |
Model fit | Adjusted R2 = 0.024, F = 1.771, p = 0.139; Durbin-Watson: 0.583 | ||||||
Contextual | |||||||
Education | −0.069 (−0.344, 0.205) | 0.139 | −0.050 | 0.617 | −0.046 | −0.046 | 1.158 |
Household income | −0.001 (−0.004, 0.001) | 0.001 | −0.118 | 0.234 | −0.110 | −0.110 | 1.158 |
Model fit | Adjusted R2 = 0.024, F = 1.771, p = 0.139; Durbin-Watson: 0.583 |
Predictors | Unstandardized | Standardized | Correlations | VIF | |||
---|---|---|---|---|---|---|---|
B (95 % CI) | SE | β | p | Partial | Part | ||
Comorbidity | 0.752 (0.096, 1.408) | 0.331 | 0.200 | 0.025 | 0.221 | 0.174 | 1.319 |
Depression | 0.166 (0.066, 0.265) | 0.050 | 0.329 | 0.001 | 0.312 | 0.253 | 1.685 |
Poor sleep quality | 0.762 (0.095, 1.428) | 0.336 | 0.191 | 0.026 | 0.220 | 0.174 | 1.211 |
Difficulty with meal planning | 0.291 (0.091, 0.490) | 0.101 | 0.254 | 0.005 | 0.276 | 0.221 | 1.315 |
Satisfaction with diet | −0.133 (−0.219, −0.047) | 0.043 | −0.261 | 0.003 | −0.293 | 0.236 | 1.226 |
Model fit | Adjusted R2 = 0.319, F = 4.619, p < 0.001; Durbin-Watson: 1.142 |
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
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Kim, H.; Son, H. Fatigue-Related Factors for Community-Dwelling Older Adults with Diabetes: A Theory-Guided Multi-Dimensional Approach Using the Dynamic Biopsychosocial Model. Int. J. Environ. Res. Public Health 2019, 16, 4502. https://doi.org/10.3390/ijerph16224502
Kim H, Son H. Fatigue-Related Factors for Community-Dwelling Older Adults with Diabetes: A Theory-Guided Multi-Dimensional Approach Using the Dynamic Biopsychosocial Model. International Journal of Environmental Research and Public Health. 2019; 16(22):4502. https://doi.org/10.3390/ijerph16224502
Chicago/Turabian StyleKim, Hyerang, and Heesook Son. 2019. "Fatigue-Related Factors for Community-Dwelling Older Adults with Diabetes: A Theory-Guided Multi-Dimensional Approach Using the Dynamic Biopsychosocial Model" International Journal of Environmental Research and Public Health 16, no. 22: 4502. https://doi.org/10.3390/ijerph16224502
APA StyleKim, H., & Son, H. (2019). Fatigue-Related Factors for Community-Dwelling Older Adults with Diabetes: A Theory-Guided Multi-Dimensional Approach Using the Dynamic Biopsychosocial Model. International Journal of Environmental Research and Public Health, 16(22), 4502. https://doi.org/10.3390/ijerph16224502