Abstract
Objective : The purpose of this study was to investigate the relationship between type 1 diabetes duration and uncertainty. According to the Reconceptualized Uncertainty in Illness Theory, it was hypothesized that longer duration would be associated with less uncertainty. Research Design and Method : A sample of 379 people with type 1 diabetes recruited from the T1D Exchange completed an online survey. The online survey measured disease duration, uncertainty, and demographic characteristics. Multiple variable linear regression was calculated to test for an association between diabetes duration (in years) and uncertainty in diabetes self-management. Post hoc one-way analysis of variance with Tukey’s HSD test was calculated to investigate uncertainty at five and ten-year disease duration intervals. Results : With adjustment for age, gender, and education, diabetes duration was negatively associated with uncertainty (b = -0.15, p= .03; 95% CI = -0.28, -0.01). Uncertainty was lowest among the 64 participants with a duration equal to or greater than 40 years (M=63.53, SD=15.04). In Tukey’s HSD post hoc test, the mean difference on the uncertainty scores for 5 to < 10 years diabetes duration (n=38, M=72.66, SD=14.51) and 40 or more years diabetes duration was significant (p = 0.02, 95% CI = 0.81, 17.44). Conclusions : Individuals with longer disease duration reported less uncertainty related to self-management, and uncertainty varied by duration interval. These findings provide preliminary information about where to place behavioral interventions designed to reduce uncertainty among individuals with type 1 diabetes.
Highlights
Uncertainty, defined as the inability to determine the meaning of illness-related events [1], characterizes the chronic illness experience [2, 3]
Individuals with longer disease duration reported less uncertainty related to self-management, and uncertainty varied by duration interval
It is possible that as diabetes duration increases, skills in metabolic management and control mature, and uncertainty decreases. This idea is theoretically grounded; according to the Reconceptualized Uncertainty in Illness Theory (RUIT) [3], uncertainty decreases the longer an individual lives with a chronic condition, such as Type 1 diabetes mellitus (T1D)
Summary
Uncertainty, defined as the inability to determine the meaning of illness-related events [1], characterizes the chronic illness experience [2, 3]. Uncertainty is important because it relates to self-management behaviors among those with chronic conditions [4]. Higher levels of uncertainty have been associated with worse self-management behaviors, resulting in poorer outcomes [4]. Due to the need for intensive biological, behavioral, and medication monitoring, uncertainty may be relevant in T1D management [6,7,8]. It is possible that as diabetes duration increases, skills in metabolic management and control mature, and uncertainty decreases. This idea is theoretically grounded; according to the Reconceptualized Uncertainty in Illness Theory (RUIT) [3], uncertainty decreases the longer an individual lives with a chronic condition, such as T1D
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