Belitung Nursing Journal
Vol. 12 No. 5 (2026): September - October

Levels of stress and depression among patients with type 1 and type 2 diabetes mellitus in primary care in Kosovo: A cross-sectional study

Elvana Podvorica (Faculty of Medicine, Department of Nursing and Midwifery, University of Prishtina, Kosovo)
Edmond Zaimi (University Hospital Center "Mother TERESA", Tirana, Albania)
Elizana Petrela (University Hospital Center "Mother TERESA", Tirana, Albania)
Musa Oruqi (College “AMECC REZONANCA”, Faculty of Medical Sciences, Department of Nursing, Kosovo)



Article Info

Publish Date
21 Oct 2026

Abstract

Background: Psychological distress, including stress and depressive symptoms, is common among people with diabetes and may negatively influence self-management and clinical outcomes in primary care settings. Objective: To assess and compare levels of perceived stress and depression among patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Methods: This cross-sectional study included 297 patients with diabetes recruited using convenience sampling from eight primary care centers in Prishtina, Kosovo, between March 2025 and August 2025. Perceived stress was measured using the Perceived Stress Scale (PSS), while depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Demographic characteristics and selected clinical parameters, including waist circumference and systolic and diastolic blood pressure, were obtained from medical records. Categorical and continuous variables were analyzed using chi-square and Mann–Whitney U tests, with Cramér’s V measuring categorical effect size. Statistical significance was set at p < 0.05. Results: Patients with type 1 diabetes mellitus (T1DM) were significantly younger than patients with type 2 diabetes mellitus (T2DM). Exploratory item-level analysis of perceived stress did not demonstrate consistent differences between the groups; however, interpretation of stress-related findings should be approached cautiously due to the low internal consistency of the PSS in the present sample. Depressive symptom severity differed significantly between groups (p = 0.005, Cramér’s V = 0.224). Conclusion: Significant differences were observed in depressive symptom severity between patients with T1DM and T2DM, whereas interpretation of perceived stress findings remains limited. Although these findings support the importance of psychological assessment in diabetes care, they should be interpreted cautiously given the cross-sectional design and methodological limitations of the study. Healthcare professionals, including physicians and nurses,  should routinely screen for depression in diabetes care and provide appropriate follow-up or referral based on symptom severity.

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Journal Info

Abbrev

bnj

Publisher

Subject

Nursing

Description

BNJ contributes to the advancement of evidence-based nursing, midwifery and healthcare by disseminating high quality research and scholarship of contemporary relevance and with potential to advance knowledge for practice, education, management or policy. BNJ welcomes submissions of evidence-based ...