Date of Award

2003

Degree Type

Dissertation

First Advisor

Patricia M. Burbank

Abstract

Adherence to self-management regimens among individuals with type 2 diabetes is a major issue. The purpose of this study was to examine the relationship of adjustment distress and depression, in relation to the Transtheoretical Model constructs of stage of change, processes of change, decisional balance, and self-efficacy for exercise behavior. A convenience sample of 125 type 2 diabetics between the ages of 33 to 86 (mean age of 62.3), were from a diabetes outpatient education center. Data was collected by mailing the following instruments: demographic survey, Short Geriatric Depression Scale, Problem Areas In Diabetes Survey, and Exercise versions of Stages of Change Scale, Processes of Change Scale, Confidence Scale, and Decisional Balance Scale. Results showed that adjustment distress scores were reported low in precontemplation and the highest in contemplation then decreased across the advanced stages of change. Adjustment distress was found to be significantly related to decisional balance pro and con for exercise. Depression scores fluctuated across the stages with highest scores reported for subjects in the contemplation stage. The lowest scores for depression were seen in the maintenance stage while in comparison, the scores for individuals in action were reported higher than anticipated. Depression was found to be significantly negatively correlated with both processes of change, experiential processes and behavioral processes, and negatively related to self efficacy. Depression and adjustment distress were found to be significantly related to each other among type 2 diabetics. The findings from this study give support to the literature that has demonstrated an association between adjustment distress, depression, and diabetes. The study revealed that negative emotions occur among type 2 diabetics and perhaps may influence an individual's progression across the stages of change. Future research studies are needed to confirm these findings.

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