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Volčanšek Š, Lunder M, Janež A. Health-Related Quality of Life Assessment in Older Patients with Type 1 and Type 2 Diabetes. Healthcare (Basel) 2023; 11:2154. [PMID: 37570394 PMCID: PMC10418676 DOI: 10.3390/healthcare11152154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Type 1 (T1D) and type 2 diabetes (T2D) are determinants of health-related outcomes including health-related quality of life (HRQOL). We aimed to determine differences in HRQOL between older adults with T1D and T2D and specific factors influencing HRQOL in this age group. This study used a cross-sectional design with 56 age- and HbA1c-matched T1D and T2D patients (aged 68.9 ± 7.8 years; 55% had T2D). We employed several validated questionnaires (Short Form-36 (SF-36) and the EuroQol-5 Dimensions/Visual Analog Scale (VAS)) to investigate the relationships between HRQOL domains and diabetes type, glycemic control, complications, and comorbidities. T1D was associated with better self-reported general health (assessed with the SF-36 general health domain (p = 0.048) and the EuroQol-5 VAS (p = 0.002), whereas no significant differences in the other SF-36 domains, self-reported diabetes distress, anxiety, or depression were found. Most HRQOL domains were not associated with HbA1c or the presence of diabetes complications. The most significant reduction in HRQOL was experienced by patients with higher BMIs, irrespective of the diabetes type. The obtained HRQOL data could be used in clinical settings for evidence-based patient education focused on specific subgroups of patients, as well as in national healthcare policies, e.g., interventions designed to alleviate obesity.
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Affiliation(s)
- Špela Volčanšek
- Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Zaloška 7, 1000 Ljubljana, Slovenia; (M.L.); (A.J.)
- Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Mojca Lunder
- Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Zaloška 7, 1000 Ljubljana, Slovenia; (M.L.); (A.J.)
- Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Andrej Janež
- Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Zaloška 7, 1000 Ljubljana, Slovenia; (M.L.); (A.J.)
- Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
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Jiang T, Li A, Zhang M, Zhou Z, Wang L, Zhang X, Zhang Y, Zhang Q. Measuring Self-management Among People with Diabetes Mellitus: A Systematic Review of Patient-Reported Diabetes-Specific Instruments in English and Chinese. Adv Ther 2023; 40:769-813. [PMID: 36607543 DOI: 10.1007/s12325-022-02361-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/13/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Effective behavioral management is critical for people with diabetes to achieve glycemic control. Many instruments have been developed to measure diabetes-specific self-management. This review aimed to retrieve existing self-management-related instruments and identify well-validated instruments suitable for clinical research and practice. METHODS First, PubMed, Psych INFO, ERIC, and two Chinese databases (CNKI and Wanfang Data) were searched to identify existing instruments for self-management in diabetes systematically. Second, instruments were screened based on the pre-specified inclusion and exclusion criteria. Third, the psychometric property data of each included instrument were retrieved, and instruments with poor psychometric properties were excluded. Fourth, selected instruments were categorized into four categories: knowledge and health literacy, belief and self-efficacy, self-management behaviors, and composite scales. Finally, recommendations were made according to the application status and quality of the instruments. Instruments in English and Chinese were screened and summarized separately. RESULTS A total of 406 instruments (339 English instruments and 67 Chinese instruments) were identified. Forty-three English instruments were included. Five focused on knowledge and literacy, 12 on belief and self-management perception-related constructs, 21 on self-management and behaviors, and 5 on composite measures. We further recommended 19 English scales with relatively good quality and are frequently applied. Twenty-five Chinese instruments were included, but none were recommended because of a lack of sufficient psychometric property data. CONCLUSION Many English instruments measuring diabetes self-management have been developed and validated. Further research is warranted to validate instruments adapted or developed in the Chinese population.
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Affiliation(s)
- Tian Jiang
- Department of endocrinology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, Anhui, China
| | - Aihua Li
- Sanofi China, 19F, Tower III, Kerry Center 1228 Middle Yan'an Road, Shanghai, China
| | - Minlu Zhang
- Sanofi China, 19F, Tower III, Kerry Center 1228 Middle Yan'an Road, Shanghai, China
| | - Zhou Zhou
- Sanofi China, 19F, Tower III, Kerry Center 1228 Middle Yan'an Road, Shanghai, China
| | - Lu Wang
- Sanofi China, 19F, Tower III, Kerry Center 1228 Middle Yan'an Road, Shanghai, China
| | - Xiaoqian Zhang
- Department of endocrinology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, Anhui, China
| | - Yi Zhang
- Department of endocrinology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, Anhui, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Qiu Zhang
- Department of endocrinology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, Anhui, China.
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Chang W, Xiao D, Fang X, Wang J. Phospholipids in small extracellular vesicles: emerging regulators of neurodegenerative diseases and cancer. Cytotherapy 2021; 24:93-100. [PMID: 34742629 DOI: 10.1016/j.jcyt.2021.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/26/2021] [Accepted: 09/22/2021] [Indexed: 12/16/2022]
Abstract
Small extracellular vesicles (sEVs) are generated by almost all cell types. They have a bilayer membrane structure that is similar to cell membranes. Thus, the phospholipids contained in sEVs are the main components of cell membranes and function as structural support elements. However, as in-depth research on sEV membrane components is conducted, some phospholipids have been found to participate in cellular biological processes and function as targets for cell-cell communication. Currently, sEVs are being developed as part of drug delivery systems and diagnostic factors for various diseases, especially neurodegenerative diseases and cancer. An understanding of the physiological and pathological roles of sEV phospholipids in cellular processes is essential for their future medical application. In this review, the authors discuss phospholipid components in sEVs of different origins and summarize the roles of phospholipids in sEV biogenesis. The authors further collect the current knowledge on the functional roles of sEV phospholipids in cell-cell communication and bioactivities as signals regulating neurodegenerative diseases and cancer and the possibility of using sEV phospholipids as biomarkers or in drug delivery systems for cancer diagnosis and treatment. Knowledge of sEV phospholipids is important to help us identify directions for future studies.
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Affiliation(s)
- Wenguang Chang
- Institute for Translational Medicine, The Affiliated Hospital, College of Medicine, Qingdao University, Qingdao, China.
| | - Dandan Xiao
- Institute for Translational Medicine, The Affiliated Hospital, College of Medicine, Qingdao University, Qingdao, China; School of Basic Medical Sciences, College of Medicine, Qingdao University, Qingdao, China
| | - Xinyu Fang
- Institute for Translational Medicine, The Affiliated Hospital, College of Medicine, Qingdao University, Qingdao, China; School of Basic Medical Sciences, College of Medicine, Qingdao University, Qingdao, China
| | - Jianxun Wang
- School of Basic Medical Sciences, College of Medicine, Qingdao University, Qingdao, China
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Holmes-Truscott E, Cooke DD, Hendrieckx C, Coates EJ, Heller SR, Speight J. A comparison of the acceptability and psychometric properties of scales assessing the impact of type 1 diabetes on quality of life-Results of 'YourSAY: Quality of Life'. Diabet Med 2021; 38:e14524. [PMID: 33445223 DOI: 10.1111/dme.14524] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/07/2021] [Accepted: 01/10/2021] [Indexed: 01/19/2023]
Abstract
AIMS To compare the acceptability, reliability and validity of five contemporary diabetes-specific quality of life (QoL) scales among adults with type 1 diabetes in the United Kingdom and Australia. METHODS Adults with type 1 diabetes (UK = 1139, Australia = 439) completed a cross-sectional, online survey including ADDQoL-19, DCP, DIDP, DSQOLS and Diabetes QoL-Q, presented in randomised order. After completing each scale, participants rated it for clarity, relevance, ease of completion, length and comprehensiveness. We examined scale acceptability (scale completion and user ratings), response patterns, structure (exploratory and confirmatory factor analyses) and validity (convergent, concurrent, divergent and known groups). To assess cross-country reproducibility, analyses conducted on the UK dataset were replicated in the Australian dataset. RESULTS Findings were largely consistent between countries. All scales were acceptable to participants: ≥90% completing all items, and ≥80% positive user ratings, except for DSQOLS' length. Scale structure was not supported for the DCP. Overall, in terms of acceptability and psychometric evaluation, the DIDP was the strongest performing scale while the ADDQoL-19 and Diabetes QoL-Q scales also performed well. CONCLUSIONS These findings suggest that the recently developed brief (7 items), neutrally worded DIDP scale is acceptable to adults with type 1 diabetes and has the strongest psychometric performance. However, questionnaire selection should always be considered in the context of the research aims, study design and population, as well as the wider published evidence regarding both the development and responsiveness of the scales.
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Affiliation(s)
- Elizabeth Holmes-Truscott
- School of Psychology, Deakin University, Geelong, Vic., Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Vic., Australia
| | - Debbie D Cooke
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Christel Hendrieckx
- School of Psychology, Deakin University, Geelong, Vic., Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Vic., Australia
| | - Elizabeth J Coates
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Simon R Heller
- Department of Oncology and Human Metabolism, University of Sheffield, Sheffield, UK
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, Vic., Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Vic., Australia
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Hilliard ME, Marrero DG, Minard CG, Cao VT, de Wit M, DuBose SN, Verdejo A, Jaser SS, Kruger D, Monzavi R, Shah VN, Wadwa RP, Weinstock RS, Thompson D, Anderson BJ. Design and psychometrics for new measures of health-related quality of life in adults with type 1 diabetes: Type 1 Diabetes and Life (T1DAL). Diabetes Res Clin Pract 2021; 174:108537. [PMID: 33189791 DOI: 10.1016/j.diabres.2020.108537] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 10/16/2020] [Accepted: 10/30/2020] [Indexed: 12/17/2022]
Abstract
AIMS To use a three-phase process to develop and validate new self-report measures of diabetes-specific health-related quality of life (HRQOL) for adults with type 1 diabetes. We report on four versions of the Type 1 Diabetes and Life (T1DAL) measure for people age 18-25, 26-45, 46-60, and over 60 years. METHODS We first conducted qualitative interviews to guide measure creation, then piloted the draft measures. We evaluated psychometric properties at six T1D Exchange Clinic Network sites via completion of T1DAL and validated measures of related constructs. Participants completed the T1DAL again in 4-6 weeks. We used psychometric data to reduce each measure to 23-27 items in length. Finally, we obtained participant feedback on the final measures. RESULTS The T1DAL-Adult measures demonstrated good internal consistency (α = 0.85-0.88) and test-retest reliability (r = 0.77-0.87). Significant correlations with measures of general quality of life, generic and diabetes-specific HRQOL, diabetes burden, self-management, and glycemic control demonstrated validity. Factor analyses yielded 4-5 subscales per measure. Participants were satisfied with the final measures and reported they took 5-10 min to complete. CONCLUSIONS The strong psychometric properties of the newly developed self-report T1DAL measures for adults with type 1 diabetes make them appropriate for use in clinical research and care.
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Affiliation(s)
- Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States.
| | - David G Marrero
- University of Arizona Health Sciences, Tucson AZ, United States
| | - Charles G Minard
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, United States
| | - Viena T Cao
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States
| | - Maartje de Wit
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | | | - Sarah S Jaser
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Davida Kruger
- Division of Endocrinology, Diabetes, Bone and Mineral Disorders, Henry Ford Medical Center, Detroit, MI, United States
| | - Roshanak Monzavi
- Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of University of Southern California, Los Angeles, CA, United States
| | - Viral N Shah
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - R Paul Wadwa
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Ruth S Weinstock
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States
| | - Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Barbara J Anderson
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States
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Self-Reported Satisfaction to Treatment, Quality of Life and General Health of Type 2 Diabetes Patients with Inadequate Glycemic Control from North-Eastern Romania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063249. [PMID: 33801100 PMCID: PMC8004112 DOI: 10.3390/ijerph18063249] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 11/22/2022]
Abstract
Type 2 diabetes mellitus (T2DM) undermines health and quality of life (QoL). This cross-sectional study surveyed 138 consenting T2DM patients from North-Eastern Romania with regard to their satisfaction with treatment, diabetes-related impact on QoL, and general health. The Romanian versions of Diabetes Treatment Satisfaction Questionnaire (DTSQ), Audit of Diabetes Dependent Quality of Life (ADDQoL-19), and 36-Item Short Form Health Survey (SF-36) questionnaires were used. Self-reports were analyzed in conjunction with clinical and metabolic profiling. The patients were 57.86 ± 8.82 years old, 49.3% men, treated with oral glucose-lowering drugs, presenting with inadequate glycemic control but without cardiovascular manifestations. The mean DTSQ and ADDQoL scores were 25.46 ± 0.61 and −2.22 ± 1.2, respectively. Freedom to eat, holidays, journeys, leisure, physical health, sex life, freedom to drink, and feelings about the future scored below average. The mean SF-36 physical and mental health scores were 47.78 ± 1.03 and 50.44 ± 1.38, respectively. The mean SF-6D score was 0.59 ± 0.04 (generated retrospectively using SF-36 data). Negative associations were significant between ADDQoL, age (r = −0.16), and body mass index (r = −0.23), p < 0.01. Overall scores did not correlate with diabetes duration (except DTSQ, r = −1.18, p = 0.02) or HbA1c. The results confirm other researchers’ findings in Europe and nearby countries. Our patients seemed satisfied with treatment despite glycemic imbalance and viewed diabetes as a burden on QoL and especially freedom to eat.
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Health care access and health-related quality of life among people with diabetes in the Southern Cone of Latin America-a cross-sectional analysis of data of the CESCAS I study. Qual Life Res 2020; 30:1005-1015. [PMID: 33247809 DOI: 10.1007/s11136-020-02704-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Little is known on the association of health care access and health-related quality of life (HRQoL) in people with diabetes in the Southern Cone of Latin America (SCLA). METHODS We analyzed data of 1025 participants of CESCAS I. To determine HRQoL, we used the SF-12 physical (PCS-12) and mental component summary (MCS-12). We compared four groups regarding HRQoL: (a) insured people without self-reported barriers to health care, (b) uninsured people without self-reported barriers to health care, (c) insured people with self-reported barriers to health care, and (d) uninsured people with self-reported barriers to health care. We conducted linear regressions with PCS-12 and MCS-12 as outcome. We adjusted for sociodemographic and disease-related factors and having access to a primary physician. RESULTS In the first group, there were 407, in the second 471, in the third 44, and in the fourth group 103 participants. Compared to the first group, PCS-12 was 1.9 points lower (95% Confidence Interval, CI: - 3.5, - 0.3) in the second, 4.5 points (95% CI: - 8.1, - 1) lower in the third, and 6.1 points lower (95% CI: - 8.7, - 3.6) in the fourth group. Compared to the first group, MCS-12 was 0.6 points lower (95% CI: - 2.7, 1.4) in the second, 4.8 points lower (95% CI: - 9.3, - 0.3) in the third, and 5.8 points lower (95% CI: - 9.1, - 2.5) in the fourth group. CONCLUSION In the SCLA, impeded access to care is common in people with diabetes. Self-reported barriers to care may be more important than insurance status in determining HRQoL.
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Hilliard ME, Minard CG, Marrero DG, de Wit M, Thompson D, DuBose SN, Verdejo A, Monzavi R, Wadwa RP, Jaser SS, Anderson BJ. Assessing Health-Related Quality of Life in Children and Adolescents with Diabetes: Development and Psychometrics of the Type 1 Diabetes and Life (T1DAL) Measures. J Pediatr Psychol 2020; 45:328-339. [PMID: 31665389 DOI: 10.1093/jpepsy/jsz083] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 09/19/2019] [Accepted: 09/23/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To develop and validate new measures of diabetes-specific health-related quality of life (HRQOL) for people with type 1 diabetes (T1D) that are brief, developmentally appropriate, and usable in clinical research and care. Here we report on the phases of developing and validating the self-report Type 1 Diabetes and Life (T1DAL) measures for children (age 8-11) and adolescents (age 12-17). METHODS Measure development included qualitative interviews with youth and parents (n = 16 dyads) followed by piloting draft measures and conducting cognitive debriefing with youth (n = 9) to refine the measures. To evaluate the psychometric properties, children (n = 194) and adolescents (n = 257) at three T1D Exchange Clinic Network sites completed the age-appropriate T1DAL measure and previously validated questionnaires measuring related constructs. Using psychometric data, the investigators reduced the length of each T1DAL measure to 21 and 23 items, respectively, and conducted a final round of cognitive debriefing with six children and adolescents. RESULTS The T1DAL measures for children and adolescents demonstrated good internal consistency (α = 0.84 and 0.89, respectively) and test-retest reliability (r = 0.78 and 0.80, respectively). Significant correlations between the T1DAL scores and measures of general quality of life, generic and diabetes-specific HRQOL, diabetes burden, and diabetes strengths demonstrated construct validity. Correlations with measures of self-management (child and adolescent) and glycemic control (adolescent only) demonstrated criterion validity. Factor analyses indicated four developmentally specific subscales per measure. Participants reported satisfaction with the measures. CONCLUSIONS The new T1DAL measures for children and adolescents with T1D are reliable, valid, and suitable for use in care settings and clinical research.
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Affiliation(s)
- Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital
| | - Charles G Minard
- Dan L Duncan Institute for Clinical and Translational Research, Baylor College of Medicine
| | | | - Maartje de Wit
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam
| | - Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine
| | | | | | - Roshanak Monzavi
- Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of University of Southern California
| | - R Paul Wadwa
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus
| | - Sarah S Jaser
- Department of Pediatrics, Vanderbilt University Medical Center
| | - Barbara J Anderson
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital
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Shah H, Shah R, Sanghani H, Lakhani N. Health related quality of life (HRQoL) and its associated surgical factors in diabetes foot ulcer patients. JOURNAL OF CLINICAL AND INVESTIGATIVE SURGERY 2020. [DOI: 10.25083/2559.5555/5.2/83.90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim. To evaluate the health-related quality of life (HRQOL) in DFU patients and its association with different surgical parameters in a tertiary care teaching hospital. Methodology. A total of 70 DFU patients from surgery department were enrolled and their demographic details, surgical examination and treatment related parameter were recorded. HRQOL was evaluated using Cardiff Wound Impact Questionnaire. Association of different surgical parameters as predictors of HRQOL was statistically evaluated. Results. Mean age of the study patients was 53.92 ± 9.27 with male preponderance and male: female ratio of 1.5:1. All the patients in the study suffered from type 2 diabetes and mean duration of the diabetes was 8.0±1.4 year. Mean BMI of the study patients was 23.36 ±1.4. All patients of DFU showed deteriorated HRQOL with mean score of 42.2±15.13 in social domain, 17.12±7.43 in wellbeing, 75.33±27.06 in physical domain and total score of 146.56±45.46. Increasing age, female gender, increased BMI, alcohol addiction found to be significantly associated with the deteriorated quality of life with respect to all four major domains which include Social life (P<0.001), wellbeing (P<0.07), physical symptoms (P<0.001) and Overall Quality of life (P<0.001). Surgical parameters like treatment for ulcer, regular follow up, larger size of ulcer, more than one ulcer, and ulcer on planter surface and chronic and recurrent ulcer significantly affect social domain, wellbeing and physical symptoms and total score (p<0.05). Control of blood sugar levels with non-pharmacological measures, OHA or insulin significantly improve Qol (p<0.05). Conclusions. Surgical parameters like site, size, number and duration of ulcer, treatment and blood sugar control significantly affect Qol. Multidisciplinary approach with holistic view is required for management of DFU patients for better quality of life.
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Brzoza Z, Nabrdalik K, Moos L, Kwiendacz H, Badura-Brzoza K, Jarolim H, Kapeluszna K, Gumprecht J. Chronic Spontaneous Urticaria and Type 1 Diabetes Mellitus-Does Quality of Life Impairment Always Reflect Health Danger? J Clin Med 2020; 9:jcm9082505. [PMID: 32759745 PMCID: PMC7465008 DOI: 10.3390/jcm9082505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/16/2020] [Accepted: 07/30/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND AIMS Chronic spontaneous urticaria (CSU) and diabetes mellitus type 1 (T1DM) may compromise the quality of life (QoL). We decided to compare the QoL of T1DM patients to those suffering from CSU. MATERIALS AND METHODS Sixty-six patients with well-controlled T1DM (male 52%) in the mean age of (SD) 36.3 (11.09) years and 51 patients with CSU (male 33%) in the mean age of (SD) 35.8 (8.53) years were enrolled in this observational study. All the participants completed a Short-Form 36 (SF-36) QoL. RESULTS The QoL related to social functioning was significantly worse among CSU patients. There were differences related to gender found in the group of patients with T1DM-where men tended to declare a better quality of life than women (p = 0.015)-especially in the area of energy/fatigue and pain. It appeared that due to physical and emotional problems occurring in married patients, the QoL is lower in T1DM group in comparison to the CSU one. CONCLUSIONS The patients with CSU presented significantly worse social functioning compared to the ones with T1DM. This fact proves the QoL impairment level is not always related to the level of health danger. The differences in the QoL related to gender and marital status found among T1DM patients point to the necessity for further exploration in a larger group of patients. Due to the fact that optimal disease management should ensure patient's good emotional well-being, there is a need for additional psychological and social care for patients from those two groups.
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Affiliation(s)
- Zenon Brzoza
- Department of Internal Medicine with Division of Allergology, Institute of Medical Sciences, University of Opole, 45-401 Opole, Poland; (L.M.); (K.K.)
- Correspondence:
| | - Katarzyna Nabrdalik
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesiain Katowice, 40-055 Katowice, Poland; (K.N.); (H.K.); (H.J.); (J.G.)
| | - Lukasz Moos
- Department of Internal Medicine with Division of Allergology, Institute of Medical Sciences, University of Opole, 45-401 Opole, Poland; (L.M.); (K.K.)
| | - Hanna Kwiendacz
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesiain Katowice, 40-055 Katowice, Poland; (K.N.); (H.K.); (H.J.); (J.G.)
| | - Karina Badura-Brzoza
- Department of Psychiatry in Tarnowskie Góry, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Hanna Jarolim
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesiain Katowice, 40-055 Katowice, Poland; (K.N.); (H.K.); (H.J.); (J.G.)
| | - Katarzyna Kapeluszna
- Department of Internal Medicine with Division of Allergology, Institute of Medical Sciences, University of Opole, 45-401 Opole, Poland; (L.M.); (K.K.)
| | - Janusz Gumprecht
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesiain Katowice, 40-055 Katowice, Poland; (K.N.); (H.K.); (H.J.); (J.G.)
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Xia A, Yau KW, Tang TS. When qualitative data contradict quantitative data: diabetes distress in the Chinese-Canadian community. Diabet Med 2020; 37:963-970. [PMID: 31498471 DOI: 10.1111/dme.14129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2019] [Indexed: 12/13/2022]
Abstract
AIMS To use both quantitative and qualitative approaches to characterize the diabetes distress profile of Chinese-Canadians with Type 2 diabetes and to better understand their experience of living with diabetes. METHODS We recruited 40 Chinese-Canadian adults with Type 2 diabetes who completed a Mandarin- or Cantonese-language diabetes education programme in Richmond, British Columbia. Using a mixed-methods sequential explanatory research design, participants first completed a 15-item Chinese version of the Diabetes Distress Scale, which included three subscales: emotional burden, regimen-related distress, and physician distress. The self-report survey was followed by a semi-structured interview that addressed the following diabetes-related topics: perspectives towards the healthcare team, emotional health, diabetes-related concerns and stressors, diabetes diagnosis experience, and sources of social support and diabetes education. RESULTS The mean (sd) scores for total distress 1.5 (0.5), emotional burden 1.7 (0.7), regimen-related distress 1.4 (0.5), and physician distress 1.4 (0.9), fell within the 'low distress' range (< 2.0). Qualitative analysis of semi-structured interviews showed that some participants were dissatisfied with diabetes care providers and experienced emotional challenges, particularly early in their diagnosis. Other themes that emerged included eating distress, fear of complications, language barriers, and medication concerns. CONCLUSIONS Not only did the qualitative findings from semi-structured interviews capture aspects of diabetes distress that were not included in the quantitative survey, it also uncovered inconsistencies between the two datasets. To more accurately understand the diabetes distress experience of any ethnic community, both quantitative and qualitative approaches contribute unique value.
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Affiliation(s)
- A Xia
- School of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - K W Yau
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - T S Tang
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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12
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Wong ELY, Xu RH, Cheung AWL. Measurement of health-related quality of life in patients with diabetes mellitus using EQ-5D-5L in Hong Kong, China. Qual Life Res 2020; 29:1913-1921. [PMID: 32140920 PMCID: PMC7295714 DOI: 10.1007/s11136-020-02462-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2020] [Indexed: 01/06/2023]
Abstract
Purpose This study aimed to estimate the health preference scores of the Chinese population with Diabetes Mellitus (DM) using the EQ-5D-5L Hong Kong (HK) population tariff according to different sociodemographic characteristics in HK. Methods Data were obtained from a cross-sectional, territory-wide study of patient experience on specialist outpatient services in a public setting in HK. The EQ-5D-5L HK was used to collect the patients’ health status. A total of 2326 respondents were reported to suffer from DM, and their information was elicited and used for the analysis in this study. A robust ANOVA method was used to compare the differences in EQ-5D-5L index scores among subgroups. Binary logistic regressions were used to predict the probability of respondents reporting full health, and ordinal least square (OLS) model was used to assess the relationship between DM and health-related quality of life (HRQoL). Results The mean EQ-5D-5L index score for DM patients was 0.84. A total of 229 EQ-5D health states were reported. Altogether, 47.5% of the respondents reported having some problems with pain/discomfort, followed by mobility (26.4%), usual activities (26.0%), and anxiety/depression (23.5%). Logistic regression and OLS models indicated that male and fully employed respondents were less likely to report having problems with any of the five dimensions and index score of EQ-5D than female and non-fully employed respondents. The findings of OLS model also showed that DM patients that experience comorbidity with three and more chronic conditions were more likely to show a lower index score than respondents who reported living with DM alone. Conclusion The EQ-5D index scores varied among DM patient characteristics and were more highly impaired with multimorbidity status. Interventions targeting at-risk subgroups, such as modifying single-diseased guidelines, might be helpful to improve their HRQoL. Electronic supplementary material The online version of this article (10.1007/s11136-020-02462-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Eliza Lai Yi Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Richard Huan Xu
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
| | - Annie Wai Ling Cheung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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13
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Abstract
The success of diabetes technologies depends on the attitudes and behavior of the individuals who choose to adopt them. Real-time continuous glucose monitoring, continuous subcutaneous insulin infusion, and sensor-augmented pump systems may positively affect diabetes-related quality of life (QOL), although the influence on QOL outcomes seems to be modest and the results from randomized controlled trials are limited and controversial. In contrast, more consistently positive QOL-related responses are apparent from observational data. The newer generations of devices hold the promise for more strongly enhancing diabetes-related QOL. Appropriate training and ongoing support are likely to be the key to successful uptake.
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Affiliation(s)
- William H Polonsky
- Behavioral Diabetes Institute, 5405 Oberlin Drive, Suite 100, San Diego, CA 92121, USA; University of California, San Diego, San Diego, CA, USA.
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14
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Sayyed Kassem L, Aron DC. The assessment and management of quality of life of older adults with diabetes mellitus. Expert Rev Endocrinol Metab 2020; 15:71-81. [PMID: 32176560 DOI: 10.1080/17446651.2020.1737520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 02/28/2020] [Indexed: 12/11/2022]
Abstract
Introduction: As the population ages, the number of older adults with diabetes mellitus will continue to rise. The burden of diabetes on older adults is significant due to the disease itself, its complications, and its treatments. This is compounded by geriatric syndromes such as frailty and cognitive dysfunction. Consequently, health and diabetes-related quality of life (QoL) are diminished.Areas covered: This article reviews the value of assessing QoL in providing patient-centered care and the associations between QoL measures and health outcomes. The determinants of QoL particular to diabetes and the older population are reviewed, including psychosocial, physical, and cognitive burdens of diabetes and aging and the impact of hypoglycemia on QoL. Strategies are described to alleviate these burdens and improve QoL, and barriers to multidisciplinary patient-centered care are discussed. QoL measurement instruments are reviewed.Expert opinion: The goals of treating diabetes and its complications should be considered carefully along with each patient's capacity to withstand the burdens of treatment. This capacity is reduced by socioeconomic, psychological, cognitive, and physical factors reduces this capacity. Incorporating measurement of HRQoL into clinical practices is possible, but deficiencies in the systems of health-care delivery need to be addressed to facilitate their use.
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Affiliation(s)
- Laure Sayyed Kassem
- Endocrinology Section, Northeast Ohio Veterans Healthcare System, Cleveland, OH, USA
- Department of Medicine, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - David C Aron
- Endocrinology Section, Northeast Ohio Veterans Healthcare System, Cleveland, OH, USA
- Department of Medicine, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
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Pereira EV, Tonin FS, Carneiro J, Pontarolo R, Wiens A. Evaluation of the application of the Diabetes Quality of Life Questionnaire in patients with diabetes mellitus. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2020; 64:59-65. [PMID: 32187271 PMCID: PMC10522290 DOI: 10.20945/2359-3997000000196] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 12/21/2018] [Indexed: 11/23/2022]
Abstract
Objective Diabetes mellitus (DM) is a chronic disease with great impact on patients' quality of life (QoL). This variable can be measured using reliable, standardized, and validated instruments. The purpose of this study was to evaluate the application and reporting of the Diabetes Quality of Life Measure (DQOL) or the Diabetes Quality of Life for Youths Measure (DQOLY), an adapted version for young patients with DM. Materials and methods A systematic review of interventional and observational studies using the DQOL or DQOLY was performed. Searches were conducted in the electronic databases Medline, Scopus, Web of Science, Lilacs, and SciELO. Results After conducting the searches, 111 studies met the inclusion criteria and were included in the qualitative analysis. Of these, 32 studies were classified as interventional and 79 as observational, with 27,481 patients. The DQOL was applied in 82 studies, the DQOLY in another 27, and two studies used both instruments. DM was classified as type 1 DM in 69 studies and type 2 DM in 35 studies. Six studies included both patients. Improvement in patients' QoL after an intervention was observed in 13 interventional studies. Most of the studies (90%) provide a detailed description of the instrument and 52% the previous validation. The interpretation of the scores obtained varies among the studies, probably due to the differences inherent in cultural validations, translations, and adaptations. Conclusion The application of the instruments in clinical practice must be rigorously standardized and requires an accurate understanding of psychometric and statistical concepts. Arch Endocrinol Metab. 2020;64(1):59-65.
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Affiliation(s)
- Edilene Vieira Pereira
- Departamento de FarmáciaUniversidade Federal do ParanáCuritibaPRBrasil Departamento de Farmácia , Universidade Federal do Paraná (UFPR), Curitiba , PR , Brasil
| | - Fernanda Stumpf Tonin
- Departamento de FarmáciaUniversidade Federal do ParanáCuritibaPRBrasil Departamento de Farmácia , Universidade Federal do Paraná (UFPR), Curitiba , PR , Brasil
| | - Jaqueline Carneiro
- Departamento de FarmáciaUniversidade Federal do ParanáCuritibaPRBrasil Departamento de Farmácia , Universidade Federal do Paraná (UFPR), Curitiba , PR , Brasil
| | - Roberto Pontarolo
- Departamento de FarmáciaUniversidade Federal do ParanáCuritibaPRBrasil Departamento de Farmácia , Universidade Federal do Paraná (UFPR), Curitiba , PR , Brasil
| | - Astrid Wiens
- Departamento de FarmáciaUniversidade Federal do ParanáCuritibaPRBrasil Departamento de Farmácia , Universidade Federal do Paraná (UFPR), Curitiba , PR , Brasil
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16
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Palamenghi L, Carlucci MM, Graffigna G. Measuring the Quality of Life in Diabetic Patients: A Scoping Review. J Diabetes Res 2020; 2020:5419298. [PMID: 32566680 PMCID: PMC7261342 DOI: 10.1155/2020/5419298] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/10/2020] [Accepted: 04/25/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Diabetes mellitus is a widely diffused chronic condition which impacts on several aspects of patients' lives. In the current clinical practice, the implementation in the clinical routine of monitoring systems of patients' outcomes has led to an increased generation and use of several measures for the assessment of patients' quality of life (QOL). Nevertheless, this construct appears to be particularly complex, and its operationalization is variable across different measures. The purpose of this paper is to offer an updated review of the diabetes-specific QOL measures present in scientific literature with a specific focus on the broad domains assessed. METHODS A scoping review was carried out with the purpose of identifying the existing measures in literature and describing their implicit representation of QOL in diabetes care. Five different databases (Scopus; Web of Science Core Collection; Medline; PsycInfo; and Cochrane Central Register of Controlled Trials) were searched with a string including validation studies of adult-only, diabetes-specific QOL measures. Each measure was then qualified according to its structure, a qualitative assessment of the broad domains of QOL it comprises, and finally an overview of the psychometric properties of its first validation. RESULTS 30 scales were identified and assessed. Theme analysis shows that QOL is operationalized with multidimensional surveys comprising of both mental, physical, and social health components. Some scales also consider the impact of societal attitudes, public policies, and context on QOL. CONCLUSION Several self-report measures of QOL specifically developed for diabetic patients exist in scientific literature. The present scoping review reports scales structure, broad domains of QOL, and development purpose. This may help in understanding the concept of QOL in diabetic patients and may also serve the purpose of guiding the reader in the choice of the most appropriate instrument or in the development of a new one.
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Affiliation(s)
- Lorenzo Palamenghi
- EngageMinds HUB - Consumer, Food & Health Engagement Research Center, Department of Psychology, Università Cattolica del Sacro Cuore - Milano, Italy
- Faculty of Agriculture, Food and Environmental Sciences, Università Cattolica del Sacro Cuore, Piacenza, Italy
| | | | - Guendalina Graffigna
- EngageMinds HUB - Consumer, Food & Health Engagement Research Center, Department of Psychology, Università Cattolica del Sacro Cuore - Milano, Italy
- Faculty of Agriculture, Food and Environmental Sciences, Università Cattolica del Sacro Cuore, Piacenza, Italy
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17
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Chen YT, Tan YZ, Cheen M, Wee HL. Patient-Reported Outcome Measures in Registry-Based Studies of Type 2 Diabetes Mellitus: a Systematic Review. Curr Diab Rep 2019; 19:135. [PMID: 31748944 DOI: 10.1007/s11892-019-1265-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Patient-reported outcome measures (PROMs) and patient registries both play important roles in assessing patient outcomes. However, no study has examined the use of PROMs among registries involving patients with type 2 diabetes mellitus (T2DM). Our objective is twofold: first, to review the range of PROMs used in registry-based studies of patients with T2DM; second, to describe associations between these PROMs, T2DM and its complications. RECENT FINDINGS The International Consortium for Health Outcomes Measurement (ICHOM) Diabetes Standard Set recommended routine usage of PROMs to assess psychological well-being, diabetes distress, and depression among patients with T2DM. A wide variety of PROMs were used among the 15 studies included in this review. Quality of life, depressive symptoms and treatment adherence were the most common aspects of T2DM that utilised PROMs for assessment. Adoption of PROMs among registries of patients with T2DM remains uncommon, non-routine and with few that are validated before use.
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Affiliation(s)
- Yu Ting Chen
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore, 117549, Singapore
| | - Yan Zhi Tan
- Department of Health Management and Economics, University of Oslo, Kirkeveien 166, Frederik Holsts hus , 0450, Oslo, Norway
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50 , Rotterdam, PA, 3062, Netherlands
| | - Mcvin Cheen
- Danone Asia Pacific Holdings, 1 Wallich Street, #18-01 Guoco Tower, Singapore, 078881, Singapore
- Medicine Academic Clinical Programme, Duke-NUS Medical School, 8 College Rd, Singapore, 169857, Singapore
| | - Hwee-Lin Wee
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore, 117549, Singapore.
- Department of Pharmacy, Faculty of Science, National University of Singapore, 18 Science Drive 4, Singapore, 117543, Singapore.
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18
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Skovlund SE, Lichtenberg TH, Hessler D, Ejskjaer N. Can the Routine Use of Patient-Reported Outcome Measures Improve the Delivery of Person-Centered Diabetes Care? A Review of Recent Developments and a Case Study. Curr Diab Rep 2019; 19:84. [PMID: 31420754 DOI: 10.1007/s11892-019-1190-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE OF REVIEW In recent years, the recommendation for and use of patient-reported outcome measures (PROMs) in routine diabetes care has significantly increased. We review recent evidence and highlight key opportunities and challenges related to the active clinical use of PROMs to support person-centered diabetes care and focus areas for future research in the area. RECENT FINDINGS Recent pragmatic studies support that integration of multi-dimensional PROMs for diabetes in clinical care as part of a care improvement strategy can be acceptable for and valued by people with diabetes (PWD) and healthcare professionals (HCPs) and may improve multiple aspects of quality of care, including screening, medical care monitoring and decision support, individualization of self-management support and goal-setting, and broader benefits related to active patient participation and person-centred diabetes care. We identify multiple intervention, individual, and care setting characteristics, which influence acceptability, feasibility, implementation, and effectiveness of PROMs in routine care. Recent clinical PROM studies highlight the value of mixed methods research and systematic involvement of PWD, clinicians, and other stakeholders in the design and implementation of questionnaires for patient input in routine diabetes care. We identified a new significant trend towards participatory development of multi-dimensional PROMs with the aim of IT-enabled integration into routine diabetes care to facilitate multiple components of person-centered diabetes care and better clinical, quality of life, and cost outcomes. While results from large-scale randomized controlled studies are still limited, a growing number of pragmatic implementation studies support that user-centric PROM interventions have the potential to facilitate significant improvements in care for PWD.
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Affiliation(s)
- Soren E Skovlund
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark.
- Department of Clinical Medicine, Aalborg University, Søndre Skovvej 15, DK-9000, Aalborg, Denmark.
| | | | - D Hessler
- Family & Community Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - N Ejskjaer
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Søndre Skovvej 15, DK-9000, Aalborg, Denmark
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19
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Holmes-Truscott E, Skovlund SE, Hendrieckx C, Pouwer F, Peyrot M, Speight J. Assessing the perceived impact of diabetes on quality of life: Psychometric validation of the DAWN2 Impact of Diabetes Profile in the second Diabetes MILES - Australia (MILES-2) survey. Diabetes Res Clin Pract 2019; 150:253-263. [PMID: 30880093 DOI: 10.1016/j.diabres.2019.03.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 01/25/2019] [Accepted: 03/07/2019] [Indexed: 12/14/2022]
Abstract
AIMS To investigate the validity and reliability of the 6-item DAWN2 Impact of Diabetes Profile (DIDP), and the modified 7-item DIDP, which includes assessment of dietary freedom. METHODS The online, cross-sectional, Australian MILES-2 survey included the DIDP and other validated measures, to examine convergent, discriminant and known-groups validity. The DIDP was completed by 2207 adults with diabetes (Type 1: n = 1012; Type 2 insulin: n = 504; non-insulin: n = 691). Data were subjected to exploratory factor analysis, internal consistency reliability and univariate statistics, conducted separately by diabetes type/treatment. RESULTS The DIDP was highly acceptable: 99% completion rate. One-factor solutions were supported for the 6-item and 7-item DIDP scales, in all diabetes type/treatment groups (variance explained range: 6-item: 59-67%, 7-item: 55-62%), with satisfactory internal consistency (α = 0.85-0.90). Known-groups validity was demonstrated, by diabetes type and complications presence/absence, as was satisfactory convergent and discriminant validity. CONCLUSIONS The DIDP meets the need for a brief, contemporary, valid and reliable measure of the perceived impact of diabetes on quality of life, suitable for adults with Type 1 or Type 2 diabetes mellitus. The 6-item and 7-item scales have psychometric equivalence. Use of the seventh item can be informed by research questions.
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Affiliation(s)
- Elizabeth Holmes-Truscott
- School of Psychology, Deakin University, Geelong, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia.
| | - Soren E Skovlund
- Steno Diabetes Center North Jutland, Aalborg University Hospital and Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Christel Hendrieckx
- School of Psychology, Deakin University, Geelong, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia.
| | - Frans Pouwer
- School of Psychology, Deakin University, Geelong, VIC, Australia; Department of Psychology, University of Southern Denmark, Odense M, Denmark.
| | - Mark Peyrot
- Loyola University Maryland, Baltimore, MD, USA
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia; Department of Psychology, University of Southern Denmark, Odense M, Denmark; AHP Research, Hornchurch, Essex, UK.
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20
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AlSadrah SA. Impaired quality of life and diabetic foot disease in Saudi patients with type 2 diabetes: A cross-sectional analysis. SAGE Open Med 2019; 7:2050312119832092. [PMID: 30815259 PMCID: PMC6385329 DOI: 10.1177/2050312119832092] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 01/29/2019] [Indexed: 12/31/2022] Open
Abstract
Objectives: This study aimed to assess the overall health-related quality of life in type 2 diabetes mellitus patients with diabetic foot disease compared to diabetic patients without diabetic foot and to identify the clinical utility of this assessment. Methods: A total of 250 consecutive patients with type 2 diabetes mellitus (100/150 with/without diabetic foot, respectively) were interviewed. The questionnaires of the 36-item short-form survey and region-specific foot and ankle ability measure were applied. Wagner–Meggitt wound classification was used for foot-ulcer evaluation. Follow-up of patients for 3–6 weeks was done to identify the potential clinical short outcomes of diabetic foot ulcers. Results: Type 2 diabetes mellitus patients with diabetic foot exhibited poor mental and physical health consequences. Females had more prevalence of forefoot lesions, larger ulcer size, advanced Wagner grade, and higher frequency of unhealed ulcers. Receiver operating characteristic curve analysis demonstrated high value of foot and ankle ability measure and 36-item short-form questionnaires to discriminate type 2 diabetes mellitus patients with and without diabetic foot at cutoff values of 66 and 49.6, respectively. Foot and ankle ability measure questionnaire also showed high performance for differentiating the clinical outcome of foot ulcer. Total foot and ankle ability measure subscale score above the cutoff value of 65.5 could discriminate patients with complete healing and unhealed ulcer lesions at a high sensitivity and specificity. Conclusion: The current findings confirm the impact of diabetic foot disease on type 2 diabetes mellitus overall health-related quality of life reflected in 36-item short-form questionnaire and foot and ankle ability measure questionnaire which showed high discriminative values for type 2 diabetes mellitus patient sub-grouping. Their application in routine clinical health assessment with continuous medical education programs is highly recommended to achieve a better health-related quality of life.
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Affiliation(s)
- Sana A AlSadrah
- Department of Preventive Medicine, Governmental Hospital Khobar, Health Centers in Khobar, Ministry of Health, Khobar, Saudi Arabia
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21
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Levterova BA, Orbetzova M, Levterov G, Dimitrova D, Todorov P. Assessment of the impact of type 2 diabetes on the quality of life by Audit of Diabetes-Dependent Quality-of-Life (ADDQoL-19). BIOTECHNOL BIOTEC EQ 2018. [DOI: 10.1080/13102818.2018.1532319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Boryana Angelova Levterova
- Department of Health Management and Healthcare Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Maria Orbetzova
- Second Department of Internal Diseases, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Georgi Levterov
- Clinic of Endocrinology and Metabolic Diseases, University Hospital “Kaspela” Ltd., Plovdiv, Bulgaria
| | - Donka Dimitrova
- Department of Health Management and Healthcare Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Plamen Todorov
- Department of Propaedeutics of Internal Diseases, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
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Bhagavathula AS, Gebreyohannes EA, Abegaz TM, Abebe TB. Perceived Obstacles Faced by Diabetes Patients Attending University of Gondar Hospital, Northwest Ethiopia. Front Public Health 2018; 6:81. [PMID: 29637064 PMCID: PMC5881243 DOI: 10.3389/fpubh.2018.00081] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 03/05/2018] [Indexed: 12/29/2022] Open
Abstract
Background Diabetes mellitus (DM) is a non-communicable, chronic, and progressive disease that can lead to serious complications and even to premature death. A closer understanding of the DM patients’ specific obstacles will provide a greater clarity of the factors influencing their disease-related quality of life and coping with daily life. The study aimed to evaluate the obstacles of DM patients attending ambulatory clinic of the University of Gondar Hospital (UOGH), Northwest Ethiopia. Methods A cross-sectional study was conducted from February to April 2017 at ambulatory clinic of the UOGH. A validated short version of the diabetic obstacle questionnaire was used. The internal reliability of the questionnaire was checked using Cronbach’s alpha and was found to be 92.5%. To determine any association between each of the nine sections of the questionnaire and age, sex, residence, educational status, and DM type, a binary logistic regression was performed. Results The mean age of respondents was 38.69 ± 15.39 years. Compared with patients with type 1 DM, patients with type 2 DM reported poorer relationships with medical professionals (adjusted odds ratio (AOR): 2.191, p-value = 0.027) and less support from families and friends (AOR: 1.913, p-value = 0.049). Patients coming from rural areas (AOR: 2.947, p = 0.002) and having no formal education (AOR: 2.078, p = 0.029) also received less support from families and friends. Conclusion DM patients in UOGH reported several obstacles related to patients’ relationship with health professionals, lack of support from their friends, lack of knowledge about DM, and lack of motivation to exercise. Effective efforts should be initiated to improve healthier environment to educate, care and preventive services for people with DM.
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Affiliation(s)
- Akshaya Srikanth Bhagavathula
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar-College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Eyob Alemayehu Gebreyohannes
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar-College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Tadesse Melaku Abegaz
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar-College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Tamrat Befekadu Abebe
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar-College of Medicine and Health Sciences, Gondar, Ethiopia.,Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Solna, Sweden
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23
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Wukich DK, Raspovic KM. Assessing Health-Related Quality of Life in Patients With Diabetic Foot Disease: Why Is It Important and How Can We Improve? The 2017 Roger E. Pecoraro Award Lecture. Diabetes Care 2018; 41:391-397. [PMID: 29463665 DOI: 10.2337/dci17-0029] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Patient-reported outcomes (PROs) have become an important subject in the area of diabetes-related foot complications. Self-reported health-related quality of life (HRQOL) surveys can provide a generic measure of overall health (global) and can be disease specific (i.e., diabetes) or even region specific (i.e., lower-extremity function). Analysis of PRO measures utilizing validated instruments allows health care providers to determine whether medical and surgical treatments are providing patients with the highest level of outcome possible and are actually improving HRQOL. The 36-item Short Form (SF-36), EuroQol five-dimension questionnaire (EQ-5D-5L), and Foot and Ankle Ability Measure (FAAM) are examples of commonly used HRQOL surveys. Low HRQOL has been associated with higher rates of hospital admission and mortality in patients with diabetes. Previous studies have demonstrated that patients with diabetes-related foot disease have low self-reported physical quality of life but do not typically report low mental quality of life. The impact of mental quality of life may be underestimated in these patients using the SF-36. In this article, we will discuss several widely used outcome instruments used to measure patient HRQOL and the impact of diabetic foot disease on HRQOL. As health care providers, we must continue to adjust and modify our treatments to achieve the best patient outcomes and associated high quality of life. Assessing PROs will become increasingly important as health care systems transition from a volume-based reimbursement model to a value-based model.
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Affiliation(s)
- Dane K Wukich
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Katherine M Raspovic
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX
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Levterova BA, Levterov GE, Dragova EA, Grudeva TS, Kostourkov YL. Bulgarian version of the Audit of Diabetes-Dependent Quality of Life (ADDQoL-19). BIOTECHNOL BIOTEC EQ 2017. [DOI: 10.1080/13102818.2017.1297689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Boryana Angelova Levterova
- Department of Health Management and Healthcare Еconomics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
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