{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:36:25Z","timestamp":1791311785685,"version":"4.3.1"},"reference-count":44,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T00:00:00Z","timestamp":1618876800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Yuan General Hospital","doi-asserted-by":"publisher","award":["YGH-19-030"],"award-info":[{"award-number":["YGH-19-030"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Biological Research For Nursing"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purposes:<\/jats:title>\n                    <jats:p>Women with diabetes (WD) are more severely impacted by the consequence of suboptimal diabetes control. This study aims to examine the impact of demographic and disease characteristics, baseline self-stigma, role strain, diabetes distress on Hemoglobin A1C (A1C) levels, quality of life (D-QoL) and 6-month A1C levels in younger WD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This study was a 6-month prospective study. In total, 193 WD aged 20\u201364 years were selected by convenience sampling from three outpatient clinics in Taiwan. Demographic and disease characteristics, self-stigma, role strain, diabetes distress, A1C levels, and D-QoL were collected at baseline. A1C levels were further collected 6 months later. Structural equation modeling was conducted to test the hypothesized model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The final model supported that higher baseline D-QoL directly associated with lower concurrent A1C levels and indirectly associated with lower 6-month A1C levels through baseline A1C levels. Higher baseline self-stigma, role strain, and diabetes distress directly associated with lower baseline D-QoL, and indirectly associated with higher 6-month A1C levels through D-QoL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Improving self-stigma, role strain, and diabetes distress should be considered as promising strategies to improve D-QoL in young WD. D-QoL plays a mediation role between baseline self-stigma, role strain, diabetes distress and subsequent glycemic control in younger WD. Enhancing baseline D-QoL is fundamental to improve subsequent glycemic control.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10998004211009606","type":"journal-article","created":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T03:54:30Z","timestamp":1618890870000},"page":"619-628","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":30,"title":["The Impact of Self-Stigma, Role Strain, and Diabetes Distress on Quality of Life and Glycemic Control in Women With Diabetes: A 6-Month Prospective Study"],"prefix":"10.1177","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9323-7389","authenticated-orcid":false,"given":"Ruey-Hsia","family":"Wang","sequence":"first","affiliation":[{"name":"College of Nursing, Kaohsiung Medical University, Kaohsiung"},{"name":"Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Chin","family":"Lin","sequence":"additional","affiliation":[{"name":"School of Nursing, College of Nursing, Taipei Medical University, Taipei"},{"name":"School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong"},{"name":"Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Tri-Service General Hospital, Taipei"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Chun","family":"Hsu","sequence":"additional","affiliation":[{"name":"Lee Endocrinology Clinic, Pingtung City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiu-Ling","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Nursing, Yuan General Hospital, Kaohsiung"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,4,20]]},"reference":[{"key":"bibr1-10998004211009606","doi-asserted-by":"crossref","unstructured":"American Diabetes Association. 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