Perceptions and Correlates of Distress Due to the COVID-19 Pandemic and Stress Management Strategies Among Adults With Diabetes: A Mixed-Methods Study.

BACKGROUND: Greater risk of adverse health outcomes and public health measures have increased distress among people with diabetes during the coronavirus-2019 (COVID-19) pandemic. The objectives of this study were to explore how the experiences of people with diabetes during the COVID-19 pandemic differ according to sociodemographic characteristics and identify diabetes-related psychosocial correlates of COVID distress. METHODS: Patients with type 1 or 2 diabetes were recruited from clinics and community health centres in Toronto, Ontario, as well as patient networks. Participants were interviewed to explore the experiences of people with diabetes with varied sociodemographic and clinical identities, with respect to wellness (physical, emotional, social, financial, occupational), level of stress and management strategies. Multiple linear regression was used to assess the relationships between diabetes distress, diabetes self-efficacy and resilient coping with COVID distress. RESULTS: Interviews revealed that specific aspects of psychosocial wellness affected by the pandemic, and stress and illness management strategies utilized by people with diabetes differed based on socioeconomic status, gender, type of diabetes and race. Resilient coping (ß=-0.0517; 95% confidence interval [CI], -0.0918 to -0.0116; p=0.012), diabetes distress (ß=0.0260; 95% CI, 0.0149 to 0.0371; p<0.0001) and diabetes self-efficacy (ß=-0.0184; 95% CI, -0.0316 to -0.0052; p=0.007) were significantly associated with COVID distress. CONCLUSIONS: Certain subgroups of people with diabetes have experienced a disproportionate amount of COVID distress. Assessing correlates of COVID distress among people with diabetes will help inform interventions such as diabetes self-management education to address the psychosocial distress caused by the pandemic.

Evaluation of Experiences and Impact of Patient Engagement on e-Health Research: A Qualitative Study.

BACKGROUND: Health technology has increasingly moved toward adopting a "user-centred design" approach to include the user/patient throughout the innovation and design process; however, few studies have evaluated the patient's experience of such an engagement. OBJECTIVE: The aim of this study was to explore the role of patient engagement (PE) within e-health innovation research. METHOD: Using qualitative descriptive methodology, semi-structured interviews were conducted with eight participants (patient partners and research/development team members). FINDINGS: Key themes were centred on enablers of, challenges to and methods of improving PE. CONCLUSION: PE must be prioritized from study conception, explicitly programmed into study conduct and valued by integrating patient partner input.