"Perceived stress" and its associated factors among diabetic patients receiving care from a rural tertiary health care center in South India

BACKGROUND: "Stress" acts as both etiological link and also as an outcome in the case of diabetes mellitus. There is a paucity of literature regarding stress levels and also factors associated with it among diabetic patients in India. OBJECTIVE: To assess the perceived stress levels and their associated factors among diabetic inpatients in a rural tertiary health care center, South India. MATERIALS And METHODS: A facility-based cross-sectional analytical study was conducted among inpatient diabetics seeking care at a rural tertiary care center in Kolar district of Karnataka. A pre-tested semi-structured questionnaire was used to capture the sociodemographic, disease-related, treatment-related and behavior-related characteristics of the inpatients. The outcome of "perceived stress" was captured using a standard questionnaire of Cohen Perceived Stress Scale-10. Poisson regression was used for multivariable analysis, and the association was expressed as prevalence ratio with 95% confidence intervals (CI). RESULTS: Out of the 247 study participants analysed, "perceived stress" was seen among 97 (39.3%) of the participants (95% CI: 33.3%-45.5%). Multivariable analysis showed that factors like younger age, lesser duration of diabetes, presence of any comorbidity, being underweight, having conflicts at work place/home in the last 1 month, and not having enough money for treatment had shown higher levels of "perceived stress." CONCLUSION: About two out of five inpatient diabetics seeking care from rural tertiary health centres had shown to have "perceived stress." There is a need for the inclusion of stress management techniques in the diabetes education program at all levels of health-care systems.