PREVALENCE OF BURNOUT AND ITS ASSOCIATED FACTORS AMONG PATIENTS WITH TYPE 2 DIABETES MELLITUS ATTENDING PRIMARY HEALTHCARE CENTERS: A CROSS-SECTIONAL STUDY

*Sarah Adil Koria Okask, Rand Muayad Saadi, Huda Mohammed Yassen AL GBUR

ABSTRACT

Background: Type 2 diabetes mellitus (T2DM) requires continuous self-management, which can impose a substantial psychological burden on patients. Diabetes-related burnout—characterized by emotional exhaustion, frustration, and reduced motivation to sustain self-care—is increasingly recognized as an important consequence of chronic disease management. However, limited evidence exists regarding the prevalence and associated factors of burnout among patients with T2DM attending primary healthcare centers, particularly in resource-limited settings. Objective: To assess the prevalence of diabetes-related burnout and identify its associated factors among patients with T2DM attending primary healthcare centers. Methods: A facility-based cross-sectional study was conducted among 384 adult patients with T2DM attending primary healthcare centers. Participants were recruited using a consecutive sampling approach. Data were collected using a structured questionnaire covering sociodemographic characteristics, clinical variables, psychological and behavioral factors, and diabetes self-management practices. Diabetes-related burnout was assessed using a standardized and validated instrument with a predefined cutoff. Descriptive statistics, chi-square tests, independent-samples t-tests or Mann–Whitney U tests, and binary logistic regression were used for analysis. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported, and p < 0.05 was considered statistically significant. Results: The mean age of participants was 54.2 ± 10.8 years, and 58.3% were female. The prevalence of diabetes-related burnout was 47.9% (n = 184; 95% CI: 42.9%–52.9%). In multivariable logistic regression, factors independently associated with burnout included no formal education (AOR = 2.14, 95% CI: 1.06–4.32, p = 0.034), low monthly income (AOR = 1.98, 95% CI: 1.04–3.77, p = 0.037), taking ≥3 antidiabetic medications (AOR = 2.18, 95% CI: 1.14–4.17, p = 0.018), poor glycemic control with HbA1c >8% (AOR = 2.36, 95% CI: 1.32–4.22, p = 0.004), presence of diabetes-related complications (AOR = 1.68, 95% CI: 1.02–2.77, p = 0.041), depressive symptoms (AOR = 3.24, 95% CI: 1.88–5.58, p < 0.001), high diabetes distress (AOR = 2.76, 95% CI: 1.62–4.70, p < 0.001), low self-efficacy (AOR = 1.94, 95% CI: 1.18–3.19, p = 0.009), medication non-adherence (AOR = 1.62, 95% CI: 1.01–2.60, p = 0.045), and low social support (AOR = 1.74, 95% CI: 1.07–2.83, p = 0.026). The final model demonstrated adequate fit (Hosmer–Lemeshow p = 0.394) and explained approximately 42% of the variance in burnout (Nagelkerke R² = 0.42). Conclusion: Diabetes-related burnout affected nearly half of patients with T2DM attending primary healthcare centers. Lower educational attainment, low income, polypharmacy, poor glycemic control, diabetes-related complications, depressive symptoms, high diabetes distress, low self-efficacy, medication non-adherence, and low social support were independently associated with burnout. These findings highlight the need for routine assessment of emotional burden and integrated psychological and clinical interventions within primary healthcare settings, particularly for patients with limited socioeconomic resources, complex treatment regimens, and poor glycemic control.

Keywords: Type 2 diabetes mellitus; burnout; diabetes distress; primary healthcare; prevalence; associated factors; cross-sectional study.