Association between self-care agency and depression and anxiety in patients with diabetic retinopathy

Bo Zhang,Qin Wang,Lezhi Li,Xuancan Zhang,Li Jiang,Bangshan Liu

doi:10.1186/s12886-021-01883-w

Bo Zhang, Qin Wang + Show 4 more

Open Access

https://doi.org/10.1186/s12886-021-01883-w

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Abstract

BackgroundThis study aimed at investigating: 1) the relationship between self-care agency and depression and anxiety; 2) the sociodemographic and clinical factors associated with depression and anxiety in patients with diabetic retinopathy (DR) in China.MethodsA cross-sectional study was conducted. One-hundred and five patients with DR were recruited. Self-care agency was assessed by the exercise of self-care agency (ESCA) scale. Depression and anxiety were assessed by the hospital anxiety and depression scale (HADS-D and HADS-A). Pearson or Spearman correlations were performed to assess the association between self-care agency and depression and anxiety. Stepwise multivariate linear regression analyses were conducted to assess the contribution of the sociodemographic and clinical factors to depression and anxiety.ResultsThirty-six (34.3%) and 43 (41.1%) patients exhibited depressive and anxiety symptoms, respectively. Only 24 (22.9%) patients showed a high self-care agency. The ESCA total and subscale scores were negatively correlated depressive symptoms (P < 0.05). Self-care skills were negatively correlated with anxiety symptoms (P < 0.05). ESCA total score, rural residence, history of hypertension and visual acuity were associated with depression; self-care skills and diastolic blood pressure were associated with anxiety.ConclusionsSelf-care agency negatively correlates with depression and anxiety in patients with DR. Special attention should be paid to patients living in rural areas and/or those having a history of hypertension when assessing depression and anxiety in patients with DR. Future studies are needed to clarify the causal relationship between self-care agency and depression and anxiety.

Highlights

This study aimed at investigating: 1) the relationship between self-care agency and depression and anxiety; 2) the sociodemographic and clinical factors associated with depression and anxiety in patients with diabetic retinopathy (DR) in China
Self-care skills were negatively correlated with anxiety symptoms (P < 0.01; Table 2)
We found that residence and history of hypertension are associated with depression and diastolic blood pressure (BP) is associated with anxiety in patients with Diabetic retinopathy (DR)

Summary

Introduction

This study aimed at investigating: 1) the relationship between self-care agency and depression and anxiety; 2) the sociodemographic and clinical factors associated with depression and anxiety in patients with diabetic retinopathy (DR) in China. Diabetic retinopathy (DR) is a common microvascular complication of DM. DR is the main cause of preventable blindness and visual impairment (VI) in working aged people [2]. It has been estimated that one third of people with DM in the world have symptoms of DR, and about one in ten of them develop vision-threatening DR. Previous studies have shown that DM is associated with increased risk of depression [4] and anxiety [5], and complications of DM, such as DR, further increase the risks [6, 7]. Rees et al reported that 15.4 and 22.7% of

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