The relationship between clinical indicators, coping styles, perceived support and diabetes-related distress among adults with type 2 diabetes

J Adv Nurs. 2012 Feb;68(2):391-401. doi: 10.1111/j.1365-2648.2011.05751.x. Epub 2011 Jun 24.


Aim: This article is a report of a cross-sectional study examining the degree to which clinical indicators, coping styles and perceived support from healthcare professionals and family are related to diabetes-related distress.

Background: Many people with type 2 diabetes experience high levels of distress stemming from concerns and worries associated with their disease. Diabetes-related distress has predominantly been studied in relation to diabetes management and metabolic control, and to some extent in relation to coping styles and perceived social support. To date, little is known about the relative contribution of clinical indicators, coping styles and perceptions of social support to perceived distress among people with type 2 diabetes.

Methods: A sample comprising 425 Norwegian adults, aged 30-70, with type 2 diabetes, completed questionnaires assessing coping styles, perceived social support from health professionals and family and diabetes-related distress assessed by the Problem Areas in Diabetes Scale. Demographical and clinical data were collected by self-report. Data were collected in October 2008.

Findings: Results from the regression analyses showed a greater variance in emotional distress accounted for by coping styles (21·3%) and perceived support (19·7%) than by clinical indicators (5·8%).

Conclusion: FINDINGS may indicate that healthcare providers should pay more attention to non-clinical factors such as coping styles and social support, when addressing diabetes-related distress. They should also be aware that interventions based on psychosocial approaches may primarily influence distress, and not necessarily metabolic control.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Aged
  • Body Mass Index
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / nursing
  • Diabetes Mellitus, Type 2 / psychology*
  • Diabetes Mellitus, Type 2 / therapy
  • Emotions
  • Family
  • Female
  • Glycated Hemoglobin A / analysis
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Middle Aged
  • Norway
  • Professional-Patient Relations
  • Regression Analysis
  • Self Care / psychology*
  • Social Support*
  • Stress, Psychological / etiology*
  • Surveys and Questionnaires
  • Time Factors


  • Glycated Hemoglobin A