1
|
Shiraishi M, Lee H, Kanayama K, Moriwaki Y, Okazaki M. Appropriateness of Artificial Intelligence Chatbots in Diabetic Foot Ulcer Management. INT J LOW EXTR WOUND 2024:15347346241236811. [PMID: 38419470 DOI: 10.1177/15347346241236811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Type 2 diabetes is a significant global health concern. It often causes diabetic foot ulcers (DFUs), which affect millions of people and increase amputation and mortality rates. Despite existing guidelines, the complexity of DFU treatment makes clinical decisions challenging. Large language models such as chat generative pretrained transformer (ChatGPT), which are adept at natural language processing, have emerged as valuable resources in the medical field. However, concerns about the accuracy and reliability of the information they provide remain. We aimed to assess the accuracy of various artificial intelligence (AI) chatbots, including ChatGPT, in providing information on DFUs based on established guidelines. Seven AI chatbots were asked clinical questions (CQs) based on the DFU guidelines. Their responses were analyzed for accuracy in terms of answers to CQs, grade of recommendation, level of evidence, and agreement with the reference, including verification of the authenticity of the references provided by the chatbots. The AI chatbots showed a mean accuracy of 91.2% in answers to CQs, with discrepancies noted in grade of recommendation and level of evidence. Claude-2 outperformed other chatbots in the number of verified references (99.6%), whereas ChatGPT had the lowest rate of reference authenticity (66.3%). This study highlights the potential of AI chatbots as tools for disseminating medical information and demonstrates their high degree of accuracy in answering CQs related to DFUs. However, the variability in the accuracy of these chatbots and problems like AI hallucinations necessitate cautious use and further optimization for medical applications. This study underscores the evolving role of AI in healthcare and the importance of refining these technologies for effective use in clinical decision-making and patient education.
Collapse
Affiliation(s)
- Makoto Shiraishi
- Department of Plastic and Reconstructive Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Haesu Lee
- Department of Plastic and Reconstructive Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Koji Kanayama
- Department of Plastic and Reconstructive Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuta Moriwaki
- Department of Plastic and Reconstructive Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Mutsumi Okazaki
- Department of Plastic and Reconstructive Surgery, The University of Tokyo Hospital, Tokyo, Japan
| |
Collapse
|
2
|
Hamid YH, Mohammed M, Hamid S, Mohamedahmed W, Ahmed O. Impact of Diabetic Foot Ulcer on the Health-Related Quality of Life of Diabetic Patients in Khartoum State. Cureus 2024; 16:e52813. [PMID: 38389641 PMCID: PMC10883763 DOI: 10.7759/cureus.52813] [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: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Background This is a novel study from Sudan aimed at comparing health-related quality of life (HRQoL) between diabetic foot ulcer (DFU) patients and diabetes patients without DFU. Additionally, this study aimed to determine the factors correlating with lower HRQoL. Methodology A descriptive, cross-sectional study with a comparative group was conducted in three diabetes centers in Khartoum, Sudan, in 2020. A total of 120 Sudanese diabetic patients (mean age = 52 years) were divided into two groups, without DFU and with DFU, and interviewed in person. Demographic and clinical variables were recorded. HRQoL was evaluated using the standardized RAND-36 (36-Item Short Form Health Survey) survey for all participants. HRQoL domains and total scores were compared in the two groups using the t-test. Inference against sociodemographic data was determined using Pearson's test and analysis of variance. Results The DFU group (36 males, 24 females) scored significantly lower in five (yet higher in two out of the eight subscales) compared to the non-DFU diabetic group (31 males, 29 females). Energy/fatigue levels remained insignificant. Being a female (p = 0.03), painful ulcers (p = 0.001), insulin use (p = 0.04), and newly developed ulcers (p = 0.005) were associated with lower HRQoL total scores in the DFU group. However, educational levels had a positive correlation (p = 0.02). Conclusions DFU patients have lower HRQoL than diabetic patients without ulcers. They need more support, including disease-specific education, realistic expectations (regarding ulcer's impact, healing, and management), physical rehabilitation, and culturally sensitive assessment tools.
Collapse
Affiliation(s)
- Yusra H Hamid
- Community Medicine, Faculty of Medicine, University of Khartoum, Khartoum, SDN
| | - Mathani Mohammed
- General Surgery, Sudan Medical Specialization Board, Khartoum, SDN
| | - Safaa Hamid
- General Surgery, Sudan Medical Specialization Board, Khartoum, SDN
| | | | - Osama Ahmed
- Community Medicine and Public Health, National University, Khartoum, SDN
| |
Collapse
|
3
|
Mendonça L, Antunes B, Rigor J, Martins-Mendes D, Monteiro-Soares M. Characterizing palliative care needs in people with or at risk of developing diabetic foot ulcers. Ther Adv Endocrinol Metab 2022; 13:20420188221136770. [PMID: 36406834 PMCID: PMC9666889 DOI: 10.1177/20420188221136770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/15/2022] [Indexed: 11/16/2022] Open
Abstract
AIMS Diabetic foot ulcers (DFUs) have a significant impact on a patient's quality of life and life expectancy, with mortality rates comparable with malignant diseases. However, there is a lack of data regarding palliative care needs in this population. We aimed to characterize palliative care needs in people under diabetic foot surveillance using the Integrated Palliative care Outcome Scale (IPOS) and EuroQol-5D three-level version (EQ-5D-3L) and to assess differences between those with and without a DFU. METHODS We conducted a cross-sectional study with consecutive sampling inclusion of patients followed in a tertiary hospital's Diabetic Foot Clinic between February and October 2019 with (n = 20) and without (n = 42) active DFU. RESULTS The most frequent symptoms encountered were pain, weakness or lack of energy, sore or dry mouth and drowsiness. Patients with an active DFU were significantly more likely to report feeling anxious or worried in comparison with those without (95% versus 55%, p = 0.002). Only 10% of the participants with an active DFU said that they were always able to share how they felt with family and friends as much as they wanted in comparison with 45% of those without (p = 0.006). CONCLUSION Our study identified palliative care needs in patients under diabetic foot surveillance with and without DFU, including a significant presence of physical symptoms. Patients in both groups showed signs of emotional/psychological distress, with a higher manifestation in patients with DFU. To the best of our knowledge, this is the first study addressing and characterizing palliative care needs in this population.
Collapse
Affiliation(s)
- Liliane Mendonça
- MEDCIDS – Departamento de Medicina da
Comunidade Informação e Decisão em Saúde, Faculty of Medicine, University of
Porto, Portugal
| | - Bárbara Antunes
- Primary Care Unit, Department of Public Health
and Primary Care, University of Cambridge, Cambridge, UK
| | - Joana Rigor
- Centro Hospitalar de Vila Nova de Gaia/Espinho,
EPE, Vila Nova de Gaia, Portugal
| | | | | |
Collapse
|
4
|
Fakhri M, Abdan M, Ramezanpour M, Dehkordi AH, Sarikhani D. Systematic Review and Meta-Analysis on Quality of Life in Diabetic Patients in Iran. Int J Prev Med 2021; 12:41. [PMID: 34211672 PMCID: PMC8223913 DOI: 10.4103/ijpvm.ijpvm_327_19] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 09/20/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Diabetes is the fifth leading cause of death in the world, which reduces the patients' quality of life (QOL) and is considered as an important subject especially in medicine and medical community. The present study aimed at investigating the QOL of diabetic patients in Iran through meta-analysis. Methods: The search was conducted using relevant keywords in national and international databases including Iranmedex, SID, Magiran, IranDoc, Medlib, Science Direct, PubMed, Scopus, Cochrane, Embase, Web of Science. Questionnaires WHOQOL, SF-36, SF-20, DQOL, QOL, PedsQL, ADDQOL, D-39, DQOL-BCI, SWED-QUAL, IRDQOL, PHG-2, EQ-5D, and IDQOL-BCI were used to assess the QOL. Heterogeneity of studies was assessed using I2 index. Data were analyzed using STATA version 11. Results: In 96 studies of 17,994 people, the mean score of QOL in diabetic patients was based on the questionnaires WHOQOL [66.55 (95% CI: 45.83, 87.26)], D-39 [129.43 (95%CI: 88.77, 170.10)], SF-36 [65.64 (95% CI: 59.82, 71.46)], SF-20 [46.50 (95% CI: 37.19, 55.81], DQOL [61.19 (95% CI: 35.73, 86.66)], QOL [117.91 (95% CI: -62.97, 298.79)], PedsQL [34.36 (95% CI: -31.49, 100.22)], ADDQOL [41.76 (95% CI: 12.01-71.50)], SWED-QUAL [59.19 (95% CI: 21.15, 97.23)], IRDQOL [105.92 (95% CI: 102.73, 109.10)], PHG-2 [61.00 (95%CI: 59.63, 62.37)], EQ-5D [0.62 (95% CI: 0.61, 0.64)], DQOL-BCI [3.40 (95% CI: 3.31, 3.49)], and IDQOL-BCI [22.63 (95% CI: -2.38, 47.64)]. Conclusions: The QOL of diabetic patients was evaluated according to different types of questionnaires and the QOL of diabetic patients was found to be lower than normal population.
Collapse
Affiliation(s)
- Moloud Fakhri
- Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran Sari, University of Medical Sciences, Sari, Iran
| | - Mohsen Abdan
- Research Center for Environmental Determinants of Health (RCEDH), School of Public Health, Kermanshah Uninversity of Medical Sciences, Kermanshah, Iran
| | - Melina Ramezanpour
- Medical Student at school of medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Hasanpour Dehkordi
- Social Determinants of Health Research Center, School of Allied Medical Sciences, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Diana Sarikhani
- Research Center for Environmental Determinants of Health (RCEDH), School of Public Health, Kermanshah Uninversity of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
5
|
Kristianto H, Waluyo A, Gayatri D. Relationship between diabetic foot ulcers profile and ankle brachial index score: A preliminary study. ENFERMERIA CLINICA 2021. [DOI: 10.1016/j.enfcli.2020.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
6
|
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.
Collapse
|
7
|
A Longitudinal Study on the Association Between Diabetic Foot Disease and Health-Related Quality of Life in Adults With Type 2 Diabetes. Can J Diabetes 2020; 44:280-286.e1. [DOI: 10.1016/j.jcjd.2019.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 07/25/2019] [Accepted: 08/19/2019] [Indexed: 01/13/2023]
|
8
|
Khunkaew S, Fernandez R, Sim J. Demographic and clinical predictors of health-related quality of life among people with type 2 diabetes mellitus living in northern Thailand: A cross-sectional study. Health Qual Life Outcomes 2019; 17:177. [PMID: 31796044 PMCID: PMC6889205 DOI: 10.1186/s12955-019-1246-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 11/15/2019] [Indexed: 11/14/2022] Open
Abstract
Background Type 2 Diabetes Mellitus (T2DM) is a chronic disease which is growing global health problems. However, research on such prediction of health-related quality of life (HRQOL) in Thailand is limited, in particular on the demographic and clinical characteristic in each HRQOL domains. Therefore, the aim of the present study was to determine the demographic and clinical predictors of health-related quality of life among people with type 2 diabetes mellitus (T2DM) in Northern Thailand. Methods A cross-sectional study of people with T2DM at a large teaching hospital in Northern Thailand was conducted. The HRQOL was evaluated using the Thai version of Diabetes-39. Descriptive analysis was used to summarize the demographic and HRQOL scores. Multiple regression analysis was used to determine the predictors of overall HRQOL and the predictors of each D-39 dimension. Results A total of 502 people with T2DM were recruited. Forty-one were identified as having diabetic foot ulcers. The mean score for perception of overall HRQOL was 61.18 (SD 18.74). Scores in the D-39 questionnaire showed a poor HRQOL among people with T2DM. The predictors of demographic and clinical characteristics of people with T2DM were calculated for overall HRQOL and all six domains. Conclusion These results demonstrate that people with T2DM have a poor HRQOL. The presence of diabetic foot ulcers and smoking status were identified as significant predictors of low HRQOL in the domains relating to diabetes control, social burden and energy and mobility presence of obesity, receiving insulin injection or a combination of insulin and oral medication were predictors of poor HRQOL in the domain of other health problems and diabetes complications. These findings allow for a nursing care plan for diabetes management to achieve optimal glycaemic control and improve their HRQOL.
Collapse
Affiliation(s)
- Saneh Khunkaew
- Boromarajonani of Nursing College Uttaradit, Praboromarajchanok Institute, 38/40 Jasadabordit Rd, Muang Uttaradit, 50300, Thailand.
| | - Ritin Fernandez
- School of Nursing, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia
| | - Jenny Sim
- School of Nursing, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia
| |
Collapse
|
9
|
Lozano-Platonoff A, Contreras-Ruiz J, Dominguez-Cherit J, Cardenas-Sanchez A, Alvarez-Rivero V, Martínez-Regalado JA. Translation, cross-cultural adaptation and validation of the "Cardiff wound impact schedule," a wound-specific quality of life instrument, to the native Spanish of Mexican patients. Int Wound J 2019; 17:167-173. [PMID: 31713315 DOI: 10.1111/iwj.13253] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/26/2019] [Accepted: 10/04/2019] [Indexed: 11/30/2022] Open
Abstract
The aim of this study was to translate into Mexican Spanish, cross-culturally adapt and validate the wound-specific quality of life (QoL) instrument Cardiff wound impact schedule (CWIS) for Mexican patients. This instrument went through the full linguistic translation process based on the guidelines of Beaton et al (Beaton DE, Bombardier C, Guillemin F, Ferraz MB, Guidelines for the process of cross-cultural adaptation of self-report measures, Spine Phila Pa, 1976, 2000, 318-391). We included a total of 500 patients with chronic leg ulcers. The expert committee evaluated the Face validity and they agreed unanimously that the instrument was adequate to assess the QoL of these patients, covering all relevant areas presented by them. The content validity index obtained was of 0.95. The construct validity demonstrated moderately significant correlations between related sub-scales of CWIS and SF-36 (P = .010 to P < .001). The instrument was able to discriminate between healed and unhealed ulcers. The instrument obtained an overall Cronbach's alpha of .952, corresponding to an excellent internal consistency (.903-.771 alpha range for domains). The CWIS can be appropriately used to assess the health-related QoL of Mexican patients with chronic leg ulcers.
Collapse
Affiliation(s)
- Adriana Lozano-Platonoff
- Section of Wound and Ostomy Care Center. Division of Dermatology, "Dr. Manuel Gea González" General Hospital, Mexico City, Mexico
| | - Jose Contreras-Ruiz
- Section of Wound and Ostomy Care Center. Division of Dermatology, "Dr. Manuel Gea González" General Hospital, Mexico City, Mexico
| | - Judith Dominguez-Cherit
- Section of Wound and Ostomy Care Center. Division of Dermatology, "Dr. Manuel Gea González" General Hospital, Mexico City, Mexico.,Department of Dermatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Andrea Cardenas-Sanchez
- Section of Wound and Ostomy Care Center. Division of Dermatology, "Dr. Manuel Gea González" General Hospital, Mexico City, Mexico
| | - Valeria Alvarez-Rivero
- Section of Wound and Ostomy Care Center. Division of Dermatology, "Dr. Manuel Gea González" General Hospital, Mexico City, Mexico
| | | |
Collapse
|
10
|
Sonal Sekhar M, Unnikrishnan M, Vijayanarayana K, Rodrigues GS. Impact of patient-education on health related quality of life of diabetic foot ulcer patients: A randomized study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2019. [DOI: 10.1016/j.cegh.2018.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
11
|
Khunkaew S, Fernandez R, Sim J. Health-Related Quality of Life and Self-Care Management Among People With Diabetic Foot Ulcers in Northern Thailand. SAGE Open Nurs 2019; 5:2377960819825751. [PMID: 33415216 PMCID: PMC7774360 DOI: 10.1177/2377960819825751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/13/2018] [Accepted: 12/28/2018] [Indexed: 11/17/2022] Open
Abstract
Diabetic foot ulcers (DFUs) are a common complication of diabetes that impacts on the health-related quality of life (HRQOL). Foot care is an important factor in the self-care management of patients with DFUs. The objective of this study was to investigate the HRQOL and foot care management of people with DFUs. A cross-sectional study involving 41 people with DFUs was conducted at a large tertiary hospital in Northern Thailand. The Diabetic Foot Ulcer Scale-Short Form and the VA-Diabetes Foot Care Survey were used to assess the HRQOL and foot care management among people with DFUs. The majority of the participants were female (n = 24, 58.5%), and the mean age was 62.13 years. The scores for HRQOL in the six domains were as follows: leisure (66.95 ± 28.03), physical health (68.93 ± 28.51), dependence or daily life (80.08 ± 25.23), negative emotions (71.23 ± 29.48), worried about ulcers (62.20 ± 31.97), and bothered by ulcer care (69.36 ± 25.20). High scores indicate a high (good) HRQOL. Less than a third of the participants reported that they had received education about foot care management. Almost all participants reported that they washed their feet daily; however, a large proportion did not test the water temperature or use lubricants on their feet. Most of the participants did not have a mirror for checking under their feet (48.8%), and there was a lack of knowledge about how to use a mirror for foot inspections (51.2%). This study provides guidance for clinicians on the content and delivery of diabetes education programs for people with diabetes (and DFUs) in Northern Thailand. The findings provide guidance on existing knowledge and the need for programs to address barriers to foot self-care management both in terms of skills and attitudes.
Collapse
Affiliation(s)
- Saneh Khunkaew
- School of Nursing, University of Wollongong,
New South Wales, Australia
| | - Ritin Fernandez
- School of Nursing, University of Wollongong,
New South Wales, Australia
| | - Jenny Sim
- School of Nursing, University of Wollongong,
New South Wales, Australia
| |
Collapse
|
12
|
Khunkaew S, Fernandez R, Sim J. Health-related quality of life among adults living with diabetic foot ulcers: a meta-analysis. Qual Life Res 2018; 28:1413-1427. [PMID: 30565072 DOI: 10.1007/s11136-018-2082-2] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To undertake a systematic review of the literature to investigate the HRQOL among adults living with DFUs. METHODS A systematic search of the medical and nursing/health content databases including MEDLINE, CINAHL, and PsycINFO was conducted up to November 2018. The methodological quality of each study was assessed independently by all authors using the Joanna Briggs Institute checklist. Data analysis was conducted using the Comprehensive Meta-analysis software. All analyses were performed using random-effects models and heterogeneity was quantified. RESULTS A total of 12 studies were included in the review. Overall, the HRQOL of participants in the studies was poor on four of eight subscales in the SF-36: physical functioning (mean = 42.75, SE 1.5); role physical (mean = 20.61, SE 3.4); general health (mean = 39.52, SE 1.7); and vitality (mean = 45.73, SE 2.8). In addition, presence of pain, high levels of C-reactive protein (> 10 mg/L), ulcer size > 5 cm2, Ankle Brachial Index < 0.9, high glycosylated haemoglobin and body mass index > 25 kg/m2 were associated with poorer HRQOL in people with DFUs. CONCLUSIONS This review has provided evidence indicating that people with DFUs have a significantly lower HRQOL. Evidence-based interventions to improve the HRQOL in this group of people is needed.
Collapse
Affiliation(s)
- Saneh Khunkaew
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Building 41, Wollongong, NSW, 2522, Australia.
| | - Ritin Fernandez
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Building 41, Wollongong, NSW, 2522, Australia
- Centre for Research in Nursing and Health, St George Hospital, Research and Education Building, Level 1, Kogarah, NSW, 2217, Australia
| | - Jenny Sim
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Building 41, Wollongong, NSW, 2522, Australia
| |
Collapse
|
13
|
Rezaei S, Hajizadeh M, Kazemi A, Khosravipour M, Khosravi F, Rezaeian S. Determinants of health-related quality of life in Iranian adults: evidence from a cross-sectional study. Epidemiol Health 2017; 39:e2017038. [PMID: 28823119 PMCID: PMC5675977 DOI: 10.4178/epih.e2017038] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 08/15/2017] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVES This study aimed to measure the level and determinants of health-related quality of life (HRQoL) in adults in Kermanshah, a city in the western region of Iran. METHODS Convenience sampling was employed to obtain a sample of 998 adults aged 18 years and older (646 males and 352 females) in the city of Kermanshah. A 2-part self-administered questionnaire was used to collect data over the period between March 1 and May 30, 2017. The first part was designed to collect information on socio-demographic characteristics, socioeconomic status, and lifestyle factors (10 items). The second part consisted of the EuroQoL 5-dimensions (EQ-5D) EuroQoL-3-level and the EuroQoL visual analog scale (EQ-VAS) questions. A multiple linear regression model was used to determine the factors associated with the EQ-5D index and EQ-VAS score among study participants. RESULTS The mean values for the EQ-5D index and the EQ-VAS score were 0.74 (standard deviation [SD], 0.19) and 80.9 (SD, 16.5), respectively. The highest percentage of self-reported problems (‘some’ and ‘severe’ problems) across the 5 dimensions of the EQ-5D index were associated with the dimensions of anxiety/depression (35.3%) and pain/discomfort (32.9%). The percentage of self-reported problems for the dimensions of usual activities, mobility, and self-care were 19.0, 12.8, and 8.9%, respectively. Our regression analyses indicated that there were statistically significant positive associations between being physically active, monthly household income per capita, and post-secondary education and the EQ-5D index and EQ-VAS score. In contrast, negative associations were found between older age, being married, having a chronic disease, and smoking and the EQ-5D index and EQ-VAS score. A negative association was also found between being uninsured and the EQ-5D index. CONCLUSIONS Our findings suggest that interventions aiming to improve physical activity, to prevent chronic diseases, and to reduce the smoking rate among adults living in the city of Kermanshah may improve their HRQoL.
Collapse
Affiliation(s)
- Satar Rezaei
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Hajizadeh
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Ali Kazemi
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Khosravipour
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Khosravi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahab Rezaeian
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
14
|
Nemcová J, Hlinková E, Farský I, Žiaková K, Jarošová D, Zeleníková R, Bužgová R, Janíková E, Zdzieblo K, Wiraszka G, Stepien R, Nowak-Starz G, Csernus M, Balogh Z. Quality of life in patients with diabetic foot ulcer in Visegrad countries. J Clin Nurs 2017; 26:1245-1256. [DOI: 10.1111/jocn.13508] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Jana Nemcová
- Jessenius Faculty of Medicine in Martin; Comenius University in Bratislava; Martin Slovak Republic
| | - Edita Hlinková
- Jessenius Faculty of Medicine in Martin; Comenius University in Bratislava; Martin Slovak Republic
| | - Ivan Farský
- Jessenius Faculty of Medicine in Martin; Comenius University in Bratislava; Martin Slovak Republic
| | - Katarína Žiaková
- Jessenius Faculty of Medicine in Martin; Comenius University in Bratislava; Martin Slovak Republic
| | - Darja Jarošová
- Faculty of Medicine; University of Ostrava; Ostrava Czech Republic
| | | | - Radka Bužgová
- Faculty of Medicine; University of Ostrava; Ostrava Czech Republic
| | - Eva Janíková
- Faculty of Medicine; University of Ostrava; Ostrava Czech Republic
| | | | | | | | | | | | | |
Collapse
|
15
|
Sriyani KA, Gunawardena N, Wasalathanthri S, Hettiarachchi P. Validation of Sinhala Version of Cardiff Wound Impact Schedule in Patients with Diabetic Leg and Foot Ulcers. Asian Nurs Res (Korean Soc Nurs Sci) 2016; 10:240-245. [PMID: 27692255 DOI: 10.1016/j.anr.2016.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 06/16/2016] [Accepted: 06/21/2016] [Indexed: 01/16/2023] Open
|
16
|
Allan J, Munro W, Figgins E. Foot deformities within the diabetic foot and their influence on biomechanics: A review of the literature. Prosthet Orthot Int 2016. [PMID: 26209425 DOI: 10.1177/0309364615592705] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Diabetes mellitus causes a multitude of complications. Foot ulceration is one complication with serious consequences, amputation. Foot deformities contribute to ulcer development. It would be advantageous to ascertain whether foot deformities are preventable as their presence increases amputation risk. OBJECTIVES The objectives were to understand the development of foot deformities in diabetes and explore their biomechanical effects. STUDY DESIGN Literature review. METHODS In February 2014 CINAHL, Embase, Ovid and Medline were searched. Studies in English of adults with Diabetes that reported neuropathy, foot deformities or associated gait abnormalities were included for review. All study designs were considered. The articles' quality was considered high overall, assessed using SIGN and CARS. RESULTS In total, 17 studies were reviewed. The main themes identified in relation to foot deformities were nerve function, intrinsic foot muscles, muscle weakness and limited joint mobility. Nerve function and intrinsic foot muscle atrophy did not display definitive associations with foot deformities. However, muscle weakness and limited joint mobility were associated with foot deformities, although the relationship is still unclear. CONCLUSION The development of common foot deformities in diabetes is not well understood. The literature did not support the common belief that motor neuropathy, atrophy and muscle imbalance cause foot deformities. CLINICAL RELEVANCE An understanding of the aetiology of foot deformities in diabetes mellitus may allow for pro-active management of the foot in anticipation of the development of foot deformities and ulceration. If the aetiology of deformity was established preventative treatment may reduce the incidence of foot deformities and resultant ulcerations and amputations.
Collapse
Affiliation(s)
- Joanne Allan
- National Centre for Prosthetics and Orthotics, University of Strathclyde, Glasgow, UK
| | - William Munro
- Anatomical Concepts (UK) Ltd and Munro Bolton Orthotics Ltd, Clydebank, UK
| | - Elaine Figgins
- National Centre for Prosthetics and Orthotics, University of Strathclyde, Glasgow, UK
| |
Collapse
|
17
|
Sekhar MS, Thomas RR, Unnikrishnan MK, Vijayanarayana K, Rodrigues GS. Impact of diabetic foot ulcer on health-related quality of life: A cross-sectional study. Semin Vasc Surg 2015; 28:165-71. [PMID: 27113283 DOI: 10.1053/j.semvascsurg.2015.12.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Studies have reported that health-related quality of life (HRQoL) is adversely affected by diabetic foot ulcer (DFU). There is a paucity of data on the effects of foot ulcers on HRQoL of diabetes patients in our population. Because South-Asians, especially Indians, have unique features related to diabetes and its complications, generalizing the data about their effect on HRQoL from any other part of the world is not a pragmatic approach. This study evaluated the impact of foot ulcers on HRQoL of diabetes patients. This cross-sectional study, conducted in Kasturba Hospital, Manipal (coastal South India), included 200 DFU patients in a study group (SG) and 200 diabetes patients in a control group (CG). The RAND-36 questionnaire was employed for evaluating HRQoL scores for the patients in both groups. DFU patients also completed the Diabetic Foot Ulcer Scale-Short Form questionnaire. Independent t-test was used to test the differences in mean scores. Results found that both CG and SG have "poor" HRQoL (mean score <50) on all the subscales except for two in CG. There is a statistically significant difference between groups (P < 0.05) on all eight of the subscales of HRQoL. For both CG and SG, the Physical Component Summary domain score (44.9 ± 6.3 v 28.4 ± 3.4) and Mental Component Summary domain score (42.5 ± 3.8 v 29.5 ± 7.1) were poor. There were significant differences between CG and SG for both mean Physical Component Summary score and Mental Component Summary score of HRQoL (p < 0.05). The Diabetic Foot Ulcer Scale-Short Form found that HRQoL is very poor for DFU patients on all six domains. The study concludes that DFU patients have very poor HRQoL compared with diabetic patients. Likewise, the diabetic foot is associated with severely impaired HRQoL in both physical and mental health aspects. This study will help to develop a patient education model for DFU patients by looking at the various HRQoL domains that are adversely affected by the presence of foot ulcer.
Collapse
Affiliation(s)
- M Sonal Sekhar
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal, India 576104.
| | - Roy Raymol Thomas
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal, India 576104
| | - M K Unnikrishnan
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal, India 576104
| | - K Vijayanarayana
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal, India 576104
| | | |
Collapse
|
18
|
[Sciatic perineural catheters: an alternative analgesia for diabetic patients]. Can J Anaesth 2015; 63:468-74. [PMID: 26601976 DOI: 10.1007/s12630-015-0541-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 10/15/2015] [Accepted: 11/12/2015] [Indexed: 10/22/2022] Open
Abstract
INTRODUCTION Patients with diabetes mellitus have chronic neuropathic pain. The aim of our study was to 1) evaluate the feasibility of providing analgesia with a long-term sciatic perineural catheter in a medical unit for diabetic patients and 2) evaluate its effectiveness. METHODS A prospective, monocentric, non-randomized study was conducted over two years. All diabetic patients with an ineffective optimal systemic treatment were included. Written consent was obtained. Popliteal-sciatic nerve catheters were inserted under ultrasound guidance; ropivacaine was started. The primary endpoint was pain at Day 2. Pain intensity was measured using a numeric rating scale (NRS). Secondary endpoints were patient's pain relief, the impact on quality of life, and morphine consumption, evaluated at Day 0, Day 2, at the time of catheter removal, and one month after catheter removal. RESULTS Feasibility was evaluated over one year. Fifty-five perineural catheters were placed in 32 patients. The median duration of catheter placement across patients was 13 [4-23] days. No toxic or infectious complications were seen. Effectiveness was evaluated during the second year of the study. Seventeen catheters were placed in 12 patients; 83% of patients had a NRS score ≤3 at Day 2. More than 70% of patients experienced pain relief while the catheter was in place and at one month after its removal. The impact on quality of life was negligible. Morphine consumption was less on Day 2, at the time of catheter removal and one month after removal. CONCLUSION The use of sciatic perineural catheters as an alternative analgesia technique in a non-surgical environment for diabetic patients with chronic pain was possible and effective.
Collapse
|
19
|
Maderal AD, Vivas AC, Zwick TG, Kirsner RS. Diabetic foot ulcers: evaluation and management. Hosp Pract (1995) 2014; 40:102-15. [PMID: 23086099 DOI: 10.3810/hp.2012.08.994] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Diabetic foot ulcers (DFUs) are a common complication of diabetes and present a significant health risk to patients, as well as impose a large economic burden. Evaluation for contributory factors that may impact general health or healing, such as hyperglycemia, peripheral artery disease, neuropathy, and nutritional status, is of the utmost importance. Management of DFUs requires involvement of a multidisciplinary team and a standardized approach to patient care. Standard therapy for DFUs includes offloading and debridement. Assessment and control of infection are critical, including determining the severity of the infection, which may drive therapeutic approaches. For recalcitrant ulcers, adjuvant therapies are used to hasten the healing process, and newer therapies are under investigation.
Collapse
Affiliation(s)
- Andrea D Maderal
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL
| | | | | | | |
Collapse
|
20
|
Huang Y, Wu M, Xing P, Xie T, Cao Y, Qian P, Ruan H. Translation and Validation of the Chinese Cardiff Wound Impact Schedule. INT J LOW EXTR WOUND 2014; 13:5-11. [PMID: 24659621 DOI: 10.1177/1534734614521233] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The objectives of the study were to translate the Cardiff Wound Impact Schedule (CWIS), a disease-specific quality-of-life measure, into Chinese, and to evaluate its psychometric properties. The CWIS went through the full linguistic translation process and was evaluated in patients with current diabetic foot ulcers (DFU). Patients were categorized using the Wagner grade. Mean CWIS scores were compared between categories to evaluate the scale’s ability to differentiate ulcer severity (Wagner grade). There were a total of 131 consecutive patients included in the study. Except item A22 (I am confident that the wound I have will heal), the results of item–domain correlation ( r ranged from .391 to .827) and small-group analysis (critical ratio, P < .05) were satisfactory. Furthermore, the Chinese CWIS also demonstrated good criterion validity when correlated with the Short Form-36 ( r = .79, P < .01). After deleting item 22, exploratory factor analysis of the items confirmed the existence of 3 hypothesized domains, physical symptoms and daily living (12 items), social life (7 items), and well-being (6 items), and totally explained 57.194% of the variance. The internal consistency of all scales of the Chinese CWIS was consistently high (Cronbach’s α ranged from .789 to .929). Split-half reliability was 0.748. Sensitivity was demonstrated between patients with different etiologies of diabetic foot ulcer and those with different ulcer severity (Wagner grade). From the authors’ view, the lately validated Chinese CWIS has good psychometric performance and may be appropriately used to assess the health-related quality of life of Chinese patients with DFUs.
Collapse
Affiliation(s)
- Yao Huang
- Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - MinJie Wu
- Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Ting Xie
- Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - YeMin Cao
- Shanghai TCM-Integrated Hospital, Shanghai, China
| | - Peifen Qian
- Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hong Ruan
- Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
21
|
Nyanzi R, Wamala R, Atuhaire LK. Diabetes and quality of life: a Ugandan perspective. J Diabetes Res 2014; 2014:402012. [PMID: 24724107 PMCID: PMC3958803 DOI: 10.1155/2014/402012] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 01/03/2014] [Accepted: 01/21/2014] [Indexed: 12/02/2022] Open
Abstract
Quality of life of diabetic patients is not a new concept in literature. The contentious issue however is whether factors associated in literature with quality of life apply to diabetic patients in Uganda. A sample of 219 outpatients attending Mulago diabetic clinic--a national referral hospital in Uganda--is used to provide an understanding of this issue. Quality of life is assessed in the dimensions of role limitation due to physical health, emotional health, treatment satisfaction, physical endurance, and diet satisfaction based on a five-point Likert scale. The analysis is made by patients' characteristics, medical conditions, lifestyle factors, and type of medication using frequency distributions, summary statistics, and a Poisson regression. In the results, we confirm a consensus regarding the influence of age and education level on the quality of life in the dimensions of role limitation and physical endurance (P < 0.05). A similar conclusion is reached with regards to impact of diabetic foot ulcers in the dimension of physical endurance. Thus, the factors associated with quality of life are not entirely unique to diabetic patients in the country.
Collapse
MESH Headings
- Age Factors
- Cost of Illness
- Cross-Sectional Studies
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 1/ethnology
- Diabetes Mellitus, Type 1/physiopathology
- Diabetes Mellitus, Type 1/therapy
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/ethnology
- Diabetes Mellitus, Type 2/physiopathology
- Diabetes Mellitus, Type 2/therapy
- Diabetic Angiopathies/epidemiology
- Diabetic Angiopathies/ethnology
- Diabetic Angiopathies/prevention & control
- Educational Status
- Female
- Hospitals, Public
- Hospitals, Urban
- Humans
- Hypertension/complications
- Hypertension/epidemiology
- Hypertension/ethnology
- Hypertension/prevention & control
- Male
- Middle Aged
- Outpatient Clinics, Hospital
- Physical Endurance
- Prevalence
- Quality of Life
- Referral and Consultation
- Role
- Uganda/epidemiology
Collapse
|
22
|
Alavi A, Sibbald RG, Mayer D, Goodman L, Botros M, Armstrong DG, Woo K, Boeni T, Ayello EA, Kirsner RS. Diabetic foot ulcers: Part I. Pathophysiology and prevention. J Am Acad Dermatol 2014; 70:1.e1-18; quiz 19-20. [PMID: 24355275 DOI: 10.1016/j.jaad.2013.06.055] [Citation(s) in RCA: 170] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 06/17/2013] [Accepted: 06/23/2013] [Indexed: 12/24/2022]
Abstract
Diabetes mellitus is a serious, life-long condition that is the sixth leading cause of death in North America. Dermatologists frequently encounter patients with diabetes mellitus. Up to 25% of patients with diabetes mellitus will develop diabetic foot ulcers. Foot ulcer patients have an increased risk of amputation and increased mortality rate. The high-risk diabetic foot can be identified with a simplified screening, and subsequent foot ulcers can be prevented. Early recognition of the high-risk foot and timely treatment will save legs and improve patients' quality of life. Peripheral arterial disease, neuropathy, deformity, previous amputation, and infection are the main factors contributing to the development of diabetic foot ulcers. Early recognition of the high-risk foot is imperative to decrease the rates of mortality and morbidity. An interprofessional approach (ie, physicians, nurses, and foot care specialists) is often needed to support patients' needs.
Collapse
Affiliation(s)
- Afsaneh Alavi
- Department of Medicine (Dermatology), University of Toronto, Toronto, Ontario, Canada; Wound Care Centre, Women's College Hospital, Toronto, Ontario, Canada.
| | - R Gary Sibbald
- Department of Medicine (Dermatology), University of Toronto, Toronto, Ontario, Canada; Department of Medicine (Dermatology) and Public Health, University of Toronto, Toronto, Ontario, Canada; Wound Care Centre, Women's College Hospital, Toronto, Ontario, Canada
| | - Dieter Mayer
- Clinic for Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland
| | | | - Mariam Botros
- Wound Care Centre, Women's College Hospital, Toronto, Ontario, Canada
| | - David G Armstrong
- Department of Surgery, the University of Arizona College of Medicine/SALSA, Tucson, Arizona
| | - Kevin Woo
- Faculty of Nursing, Queen's University, Kingston, Ontario, Canada
| | - Thomas Boeni
- Department of Prosthetics and Orthotics, University of Zurich, Zurich, Switzerland
| | | | - Robert S Kirsner
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, Florida
| |
Collapse
|
23
|
Kiadaliri AA, Najafi B, Mirmalek-Sani M. Quality of life in people with diabetes: a systematic review of studies in Iran. J Diabetes Metab Disord 2013; 12:54. [PMID: 24354933 PMCID: PMC7968439 DOI: 10.1186/2251-6581-12-54] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 09/23/2013] [Indexed: 12/28/2022]
Abstract
Evaluation of health-related quality of life (HRQoL) among people with diabetes has been growing in Iran over the last decade. The main aim of the current study was to systematically review the characteristics of these studies and examine quality of their findings. Persian (SID, Magiran) and English (Pubmed, Medline, Web of Science, CINAHL, Scopus, PsycINFO and ERIC) databases were systematically searched using the search terms: “diabetes” AND “quality of life” AND “Iran”. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A total of 46 studies passed the inclusion criteria and were included in the review. The included studies were conducted in 20 out of 30 provinces of the country. Most studies investigated HRQoL among people with type 2 diabetes. The Short Form Health Survey (SF-36) and WHO quality of life instruments (WHOQOL) were the main instruments used in these studies. Studies showed that people with diabetes had lower HRQoL than people without diabetes. Better socioeconomic status and better control of cardiovascular risk factors were associated with better HRQoL among the patients with diabetes. In general, the predictors of HRQoL among Iranian patients were similar to their international counterparts implying that diabetes patients share many common features. The reviewed studies suffer from major methodological and reporting flaws which limit validity and generalizability of their findings.
Collapse
Affiliation(s)
- Aliasghar A Kiadaliri
- Division of Health Economics, Department of Clinical Sciences, Malmö University Hospital, Lund University, Malmö, Sweden.
| | | | | |
Collapse
|
24
|
Haghpanah S, Nasirabadi S, Ghaffarpasand F, Karami R, Mahmoodi M, Parand S, Karimi M. Quality of life among Iranian patients with beta-thalassemia major using the SF-36 questionnaire. SAO PAULO MED J 2013; 131:166-72. [PMID: 23903265 PMCID: PMC10852107 DOI: 10.1590/1516-3180.2013.1313470] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 02/13/2012] [Accepted: 09/12/2012] [Indexed: 01/19/2023] Open
Abstract
CONTEXT AND OBJECTIVE Patients with beta-thalassemia major (β-TM) experience physical, psychological and social problems that lead to decreased quality of life (QoL). The aim here was to measure health-related QoL and its determinants among patients with β-TM, using the Short Form-36 (SF-36) questionnaire. DESIGN AND SETTING Cross-sectional study at the Hematology Research Center of Shiraz University of Medical Sciences, in southern Iran. METHODS One hundred and one patients with β-TM were randomly selected. After the participants' demographics and disease characteristics had been recorded, they were asked to fill out the SF-36 questionnaire. The correlations of clinical and demographic factors with the QoL score were evaluated. RESULTS There were 44 men and 57 women of mean age 19.52 ± 4.3 years (range 12-38). On two scales, pain (P = 0.041) and emotional role (P = 0.009), the women showed significantly lower scores than the men. Lower income, poor compliance with iron-chelating therapy and presence of comorbidities were significantly correlated with lower SF-36 scores. These factors were also found to be determinants of worse SF-36 scores in multivariate analysis. CONCLUSIONS We showed that the presence of disease complications, poor compliance with iron-chelating therapy and poor economic status were predictors of worse QoL among patients with β-TM. Prevention and proper management of disease-related complications, increased knowledge among patients regarding the importance of managing comorbidities and greater compliance with iron-chelating therapy, along with psychosocial and financial support, could help these patients to cope better with this chronic disease state.
Collapse
Affiliation(s)
- Sezaneh Haghpanah
- MD, MPH. Assistant Professor and Internal Manager, Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Shiva Nasirabadi
- BSc. Master’s Student and Genetics Specialist, Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Fariborz Ghaffarpasand
- MD. Physician, Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Rahmatollah Karami
- MD. Physician, Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mojtaba Mahmoodi
- MD. Physician, Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Shirin Parand
- MA. Assistant Editor, Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mehran Karimi
- MD. Professor of Pediatric Hematology and Oncology, Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
25
|
Yao H, Ting X, Minjie W, Yemin C, Xiqiao W, Yuzhi J, Ming T, Weida W, Peifen Q, Shuliang L. The Investigation of Demographic Characteristics and the Health-Related Quality of Life in Patients With Diabetic Foot Ulcers at First Presentation. INT J LOW EXTR WOUND 2012; 11:187-93. [PMID: 23008342 DOI: 10.1177/1534734612457034] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To investigate the characteristics of diabetic patients with foot ulcers, their health-related quality of life (HRQoL), and the link between them. The study population included 131 consecutive patients presenting in a diabetic foot clinic with a new foot ulcer between December 1, 2011, and May 1, 2012. The authors collected sociodemographic data, foot and ulcer characteristics using the Wagner Grade, and HRQoL (using the SF-36 Scale) information; 54.2% of the patients were in Wagner 2 or Wagner 3 categories. In all the 8 SF-36 subscales and in the SF-36 summary scales, the patients with diabetic foot ulcer had significantly poorer HRQoL than the general population in China ( P < .01). Their Wagner Grade had negative correlation with all the SF-36 subscales and the summary scales ( P < .05). In conclusion, new diabetic foot ulcers were already in poor condition when patients first visited the diabetic foot clinic. Concomitantly, patients had worse HRQoL compared with the general population. More effective interventions are needed to improve their self-care level and HRQoL.
Collapse
Affiliation(s)
- Huang Yao
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Xie Ting
- Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wu Minjie
- Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Cao Yemin
- Shanghai TCM-Integrated Hospital, Shanghai, China
| | - Wang Xiqiao
- Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiang Yuzhi
- Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tian Ming
- Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wu Weida
- Shanghai TCM-Integrated Hospital, Shanghai, China
| | - Qian Peifen
- Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lu Shuliang
- Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
26
|
Javanbakht M, Abolhasani F, Mashayekhi A, Baradaran HR, Jahangiri noudeh Y. Health related quality of life in patients with type 2 diabetes mellitus in Iran: a national survey. PLoS One 2012; 7:e44526. [PMID: 22952989 PMCID: PMC3431351 DOI: 10.1371/journal.pone.0044526] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Accepted: 08/03/2012] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The aim of this study was to measure health-related quality of life (HRQoL) in Iranian people with Type 2 Diabetes Mellitus using two different measures and examines which socio-demographic and diabetes-related characteristics are associated with better quality of life based on a nationally distributed sample. METHODS A multi-stage cluster sampling method was used to select 3472 subjects as a part of Iranian surveillance of risk factors of non-communicable disease (ISRFNCD). EuroQol-5 Dimensions questionnaire (EQ-5D) and Visual Analog Scale (VAS) were employed to measure HRQoL. Binary logistic and Tobit regression models were used to investigate factors associated with EQ-5D results. RESULTS The mean age of subjects was 59.4 years (SD = 11.7), 61.3% were female and had 8.08 years (SD = 6.7) known duration of diabetes. The patients reported "some or extreme problems" most frequently in Pain/Discomfort (69.3%) and Anxiety/Depression (56.6%) dimensions of EQ-5D. The mean EQ-5D and VAS score were 0.70 (95% CI 0.69-0.71) and 56.8 (95% CI 56.15-57.5) respectively. Female gender, lower education, unemployment, long duration of diabetes, diabetes-related hospitalization in past years and having nephropathy and lower extremity lesions were associated with higher probabilities of reporting "some or extreme problems" in most dimensions of EQ-5D in binary logistic regression models. The same factors in addition to retinopathy were significantly associated with lower levels of HRQoL in Tobit regression analysis too. CONCLUSIONS The study findings indicate that patients with diabetes in Iran suffer from relatively poor HRQoL. Therefore much more attention should be paid to main determinants of HRQoL to identify and implement appropriate policies for achieving better management of diabetes and ultimately improving the quality of life of diabetic patients in this region.
Collapse
Affiliation(s)
- Mehdi Javanbakht
- Health Care Management and Economic Research Center, School of Health Care Management, Tehran University of Medical Sciences, Tehran, Iran.
| | | | | | | | | |
Collapse
|