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Mihevc M, Virtič Potočnik T, Zavrnik Č, Šter MP, Klemenc-Ketiš Z, Poplas Susič A. Beyond diagnosis: Investigating factors influencing health-related quality of life in older people with type 2 diabetes in Slovenia. Prim Care Diabetes 2024; 18:157-162. [PMID: 38320938 DOI: 10.1016/j.pcd.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 01/11/2024] [Accepted: 01/21/2024] [Indexed: 02/08/2024]
Abstract
AIMS To examine the present state of health-related quality of life (HRQOL) among elderly individuals with type 2 diabetes (T2D) receiving integrated care and identify risk factors associated with low HRQOL. METHODS A multi-centre cross-sectional survey among elderly individuals with T2D, treated in Slovenian urban and rural primary care settings was performed. HRQOL was investigated using EuroQol 5-dimension (EQ-5D) questionnaire and Appraisal of Diabetes Scale (ADS). Furthermore, socio-demographic, clinical, and laboratory data were collected. Low HRQOL was defined as EQ-5D utility score <10%. Statistical analysis was performed using univariate and multivariate binary logistic regression statistics. RESULTS Examining 358 people with median age of 72 (range 65-98) years and with a mean EQ-5D utility score of 0.80, the study found that lower HRQOL correlated with older age, higher body mass index (BMI), lower education, elevated depressive symptoms, increased challenges across all EQ-5D dimensions, and less favourable appraisal of diabetes. When considering age, gender, education, and HbA1c, the main predictors of low HRQOL were BMI (OR 1.35, 95% CI 1.04-1.76, p = 0.025) and ADS score (OR 1.63, 95% CI 1.13-2.35, p = 0.009). CONCLUSIONS To improve HRQOL, integrated care models should consider interventions that target mental health, obesity prevention, chronic pain management, diabetes education, self-management, and treatment plan personalisation.
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Affiliation(s)
- Matic Mihevc
- University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia; Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia.
| | - Tina Virtič Potočnik
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia; University of Maribor, Faculty of Medicine, Department of Family Medicine, Taborska ulica 8, SI-2000 Maribor, Slovenia
| | - Črt Zavrnik
- University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia; Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia
| | - Marija Petek Šter
- University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia
| | - Zalika Klemenc-Ketiš
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia; University of Maribor, Faculty of Medicine, Department of Family Medicine, Taborska ulica 8, SI-2000 Maribor, Slovenia
| | - Antonija Poplas Susič
- University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia; Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia
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Choi GW, Chang SJ. Correlation of health-related quality of life for older adults with diabetes mellitus in South Korea: theoretical approach. BMC Geriatr 2023; 23:491. [PMID: 37580707 PMCID: PMC10426193 DOI: 10.1186/s12877-023-04186-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/20/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND While some studies have explored the health-related quality of life (HRQOL) of older adults with diabetes mellitus (DM) in South Korea using a theoretical framework, these studies suffer sample-related limitations, as they focus only on a specific subgroup of older adults. To address this gap, this study aimed to investigate the predictors of HRQOL of older adults with DM in South Korea, using extensive national data and based on the theory of Health-Related Quality of Life in South Korean Older Adults with Type 2 Diabetes (The HIKOD theory). METHODS A secondary data analysis was conducted using data from 1,593 participants aged 65 years and older with DM sourced from the 2015-2019 Korea National Health and Nutrition Examination Survey (KNHANES). The variables included in this study are as follows: demographic factors (gender, age, household income, and education level), disease-specific factors (duration of DM, treatment of DM, and control of HbA1c), barriers (number of comorbidities), resources (living alone status), psychosocial factors (perceived stress), and health-promoting behaviors (physical activity and fundus examination). Considering the complex sampling design employed in this study, statistical analyses including Rao-Scott chi-square tests, correlation analysis, and hierarchical multiple regression analysis were conducted. RESULTS Mobility (45.0%) was the HRQOL dimension with which participants experienced the highest number of problems. Number of comorbidities (r = -0.36, p < 0.001), living alone status (rpb = 0.16, p < 0.001), perceived stress (rpb = 0.14, p < 0.001), and physical activity (rpb = 0.12, p < 0.001) were correlated with HRQOL. While adjusting for background factors, HRQOL was negatively predicted by higher number of comorbidities (estimate B = -0.03, p < 0.001), living alone (estimate B = -0.03, p = 0.043), higher perceived stress (estimate B = -0.09, p < 0.001), and lower physical activity (estimate B = -0.03, p < 0.001). CONCLUSION Complex and diverse factors influence HRQOL among older adults with DM in South Korea. To improve their HRQOL, intervention programs that integrally regard HRQOL, along with various predictors, are necessary.
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Affiliation(s)
- Gi Won Choi
- College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea (BK21) four project, College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Sun Ju Chang
- College of Nursing and The Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Hsieh HM, Lin CH, Weng SF, Lin PC, Liu TL, Huang CJ. Health-related quality of life, medical resource use and physical function in patients with diabetes mellitus and depression: A cross-sectional analysis from the National Health and Nutrition Examination Survey. J Affect Disord 2023; 327:93-100. [PMID: 36754091 DOI: 10.1016/j.jad.2023.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND Patients with either diabetes (DM) or depression (DP) are prone to developing other diseases and require more medical resources than do the general population. This study aimed to examine health-related quality of life, medical resource use, and physical function of patients with both diabetes mellitus and depression, and the magnitude of effects among patients with different combinations of comorbid diseases. METHODS A retrospective cross-sectional study was conducted using the National Health and Nutrition Examination Survey data from 2009 to 2014. Total 16,159 patients were studied and classified into one of 4 groups: both DM and DP(DM+/DP+), DM+/without DP(DP-), without DM (DM-)/DP+, and DM-/DP-, according to the perceived score in Patient Health Questionnaire and diabetes questionnaire in NHANES. Health-related quality of life (HRQoL), medical resource use, and physical function were measured as outcomes of interests. Multivariate logistic regression models were used. RESULTS Compared with DM-/DP- patients, the DM+/DP+ (adjusted odds ratio [AOR]: 2.59; 95 % CI: 1.77-3.80) and DM-/DP+ (AOR: 2.44; 95 % CI: 1.94-3.06) had greater likely to have worse health. In addition, the DM+/DP+ (AOR: 5.40; 95 % CI: 1.30-22.41) and DM+/DP- (AOR: 2.49; 95 % CI: 1.91-3.25) were more likely to have medical visits, and worse physical function. CONCLUSIONS This study found that both depression and diabetes mellitus worsen HRQoL, increase medical resource use, and decrease physical function. Depression status should be considered by clinicians treating diabetes mellitus patients in order to improve their HRQoL, reduce medical resource use, and improve physical function.
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Affiliation(s)
- Hui-Min Hsieh
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ching-Hua Lin
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Shih-Feng Weng
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Healthcare Administration and Medical Informatics, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pai-Cheng Lin
- Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Jen Huang
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Taiwan; Department of Psychiatry, School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Ferreira PL, Morais C, Pimenta R, Ribeiro I, Amorim I, Alves SM. Empowerment and Knowledge as Determinants for Quality of Life: A Contribution to a Better Type 2 Diabetes Self-Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4544. [PMID: 36901554 PMCID: PMC10001584 DOI: 10.3390/ijerph20054544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/22/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
The purpose of this study was to assess how knowledge and empowerment impact the quality of life (QoL) of a person with type 2 diabetes, leading to better communication and disease management. We conducted a descriptive and observational study of individuals with type 2 diabetes. The Diabetes Empowerment Scale-Short Form (DES-SF), Diabetes Knowledge Test (DKT), and EQ-5D-5L were used, in addition to sociodemographic and clinical characteristics. Evaluating the variability in the DES-SF and DKT in relation to the EQ-5D-5L and identifying possible sociodemographic and clinical determinants were conducted using univariate analyses followed by a multiple linear regression model to test whether the factors significantly predicted QoL. A total of 763 individuals were included in the final sample. Patients aged 65 years or older had lower QoL scores, as well as patients who lived alone, had less than 12 years of education, and experienced complications. The insulin-treated group showed higher scores in DKT than the non-insulin-treated group. It was also found that being male, being under 65 years of age, having no complications present, and having higher levels of knowledge and empowerment predicted higher QoL. Our results show that DKT and DES are still determinants of QoL, even after adjusting for sociodemographic and clinical characteristics. Therefore, literacy and empowerment are important for the improvement of the QoL of people with diabetes, by enabling them to manage their health conditions. New clinical practices focused on education, increasing patients' knowledge, and empowerment may contribute to better health outcomes.
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Affiliation(s)
- Pedro L. Ferreira
- Centre for Health Studies and Research, University of Coimbra, 3004-512 Coimbra, Portugal
- Faculty of Economics, University of Coimbra, 3004-512 Coimbra, Portugal
| | - Carminda Morais
- Centre for Health Studies and Research, University of Coimbra, 3004-512 Coimbra, Portugal
- Superior School of Health, Polytechnic of Viana do Castelo, 4900-314 Viana do Castelo, Portugal
| | - Rui Pimenta
- Centre for Health Studies and Research, University of Coimbra, 3004-512 Coimbra, Portugal
- School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
| | - Inês Ribeiro
- Centre for Health Studies and Research, University of Coimbra, 3004-512 Coimbra, Portugal
| | - Isabel Amorim
- Centre for Health Studies and Research, University of Coimbra, 3004-512 Coimbra, Portugal
- Superior School of Health, Polytechnic of Viana do Castelo, 4900-314 Viana do Castelo, Portugal
| | - Sandra Maria Alves
- Centre for Health Studies and Research, University of Coimbra, 3004-512 Coimbra, Portugal
- School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
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Tan ESS, Chin SAFX, Sathapan MSP, Dewi AD, Amini F, Bustami NA, Tan PY, Ho YB, Tan CK. Mental Health and the COVID-19 Pandemic: Observational Evidence from Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4046. [PMID: 36901057 PMCID: PMC10001641 DOI: 10.3390/ijerph20054046] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
The interplay of physical, social, and economic factors during the pandemic adversely affected the mental health of healthy people and exacerbated pre-existing mental disorders. This study aimed to determine the impact of the COVID-19 pandemic on the mental health of the general population in Malaysia. A cross-sectional study involving 1246 participants was conducted. A validated questionnaire consisting of the level of knowledge and practice of precautionary behaviors, the Depression, Anxiety, and Stress Scales (DASS), and the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF) was used as an instrument to assess the impacts of the COVID-19 pandemic. Results revealed that most participants possessed a high level of knowledge about COVID-19 and practiced wearing face masks daily as a precautionary measure. The average DASS scores were beyond the mild to moderate cut-off point for all three domains. The present study found that prolonged lockdowns had significantly impacted (p < 0.05), the mental health of the general population in Malaysia, reducing quality of life during the pandemic. Employment status, financial instability, and low annual incomes appeared to be risk factors (p < 0.05) contributing to mental distress, while older age played a protective role (p < 0.05). This is the first large-scale study in Malaysia to assess the impacts of the COVID-19 pandemic on the general population.
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Affiliation(s)
- Eugenie Sin Sing Tan
- Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur 56000, Malaysia
| | | | | | - Astrid Disimond Dewi
- Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur 56000, Malaysia
| | - Farahnaz Amini
- Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur 56000, Malaysia
| | - Normina Ahmad Bustami
- Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur 56000, Malaysia
| | - Pui Yee Tan
- Faculty of Environment, University of Leeds, Leeds LS2 9JT, UK
| | - Yu Bin Ho
- Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang 43400, Malaysia
| | - Chung Keat Tan
- Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur 56000, Malaysia
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Shah C, Keerthi BY, Gali JH. An observational study on health-related quality of life and persistent symptoms in COVID-19 patients after hospitalization at a tertiary care centre. Lung India 2023; 40:12-18. [PMID: 36695253 PMCID: PMC9894290 DOI: 10.4103/lungindia.lungindia_126_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 10/23/2022] [Accepted: 11/02/2022] [Indexed: 01/01/2023] Open
Abstract
Aim The study aims to determine persistent symptoms and effects of COVID-19 infection on the quality of life (QOL) at 1 and 3 months after the acute phase of the disease in mild, moderate and severe cases. Methods The prospective observational study was conducted among patients with confirmed COVID-19 who had been treated and discharged after hospitalization from February 2021 to June 2021. All patients were interviewed at 1 and 3 months post discharge to assess persisting symptoms and health-related QOL. QOL was assessed using European Quality Of Life 5-Dimensions 3-Levels (EQ-5D-3L) and EuroQol-visual analogue scales (EQ-VAS). Results In total, 388 out of 479 discharged following COVID-19 infection were included. The median age of patients was 48 years, with 62.6% male predominance. Most of the COVID-19 cases were mild (67.01%). Most common presenting symptom was fever (69.8%). EQ-5D-3L showed that the problems reported at 3-month follow-up were significantly less when compared to 1-month follow-up (p < 0.001), and QOL significantly improved after 3 months in non-intensive care unit (ICU) patients when compared to ICU patients (p = 0.007). The mean EQ-VAS score significantly improved at 3 months when compared to 1 month (80.34 ± 12.77 vs. 91.69 ± 12.34; P < 0.001). The severity of illness was correlated with QOL (p < 0.007). Conclusion The study results demonstrate ongoing improvement in the QOL and persistent symptoms, while a minority still were symptomatic after 3 months post-COVID-19 illness.
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Affiliation(s)
- Chirali Shah
- Department of Pulmonary Medicine, Telangana Institute of Medical Sciences and Research, Gachibowli, Hyderabad, Telangana, India
| | - B. Y Keerthi
- Department of General Medicine, Telangana Institute of Medical Sciences and Research, Gachibowli, Hyderabad, Telangana, India
| | - Jayasri Helen Gali
- Department of Pulmonary Medicine, Telangana Institute of Medical Sciences and Research, Gachibowli, Hyderabad, Telangana, India
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Saleh-Ghadimi S, Dehghan P, Sarmadi B, Maleki P. Improvement of sleep by resistant dextrin prebiotic in type 2 diabetic women coincides with attenuation of metabolic endotoxemia: involvement of gut-brain axis. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2022; 102:5229-5237. [PMID: 35306660 DOI: 10.1002/jsfa.11876] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 03/12/2022] [Accepted: 03/20/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Resistant dextrin, as a prebiotic and functional food, may possess favorable effects in type 2 diabetes. This study was conducted to assess whether supplementation with resistant dextrin can improve sleep and quality of life in obese type 2 diabetic women. RESULTS In this randomized controlled trial, female obese type 2 diabetic patients (n = 76) were randomly assigned into intervention group (n = 38) and placebo group (n = 38), and received 10 g day-1 of resistant dextrin or maltodextrin for a period of 8 weeks, respectively. Sleep quality and quality of life (QOL) were assessed by Pittsburgh Sleep Quality Index (PSQI) and SF-36 health survey, respectively. Fasting blood samples were driven to measure serum bacterial endotoxin, fasting blood sugar, glycosylated hemoglobin (HbA1c), pro-inflammatory/anti-inflammatory biomarkers (IL-18, IL-6, IL-10, TNF-α), and biomarkers of hypothalamic-pituitary-adrenal (HPA) axis function [tryptophan (TRP), adrenocorticotropic hormone (ACTH), kynurenine (KYN), cortisol]. Supplementation with resistant dextrin improved sleep (P < 0.001) and QOL (P < 0.001) significantly. It also caused a significant decrease in levels of endotoxin, HbA1c, IL-18, IL-6, TNF-α and a significant increase in IL-10 levels. Significant and positive correlations were found between endotoxin (r = 0.488, P = 0.003), IL-6 (r = 0.436, P = 0.008), IL-18 (r = 0.475, P = 0.003), cortisol (r = 0.545, P = 0.048), KYN/TRP (r = 0.527, P = 0.001), and PSQI scores. CONCLUSIONS It is concluded that resistant dextrin improves sleep and QOL in obese women with type 2 diabetes. Its beneficial effects may be attributed in part to modulation of glycemia, metabolic endotoxemia and subsequently a decrease in biomarkers of inflammation and HPA axis activity. © 2022 Society of Chemical Industry.
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Affiliation(s)
- Sevda Saleh-Ghadimi
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parvin Dehghan
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bahareh Sarmadi
- Department of Nutrition Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Parham Maleki
- Student Research Committee, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Carter N, Li J, Xu M, Li L, Fan X, Zhu S, Chahal P, Chattopadhyay K. Health-related quality of life of people with type 2 diabetes and its associated factors at a tertiary care clinic in Ningbo, China: A cross-sectional study. Endocrinol Diabetes Metab 2022; 5:e353. [PMID: 35780497 PMCID: PMC9471595 DOI: 10.1002/edm2.353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/21/2022] [Accepted: 05/28/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The burden of type 2 diabetes (T2DM) in China is increasing, with potential impacts on the health-related quality of life (HRQoL) of those who develop the disease. Context-specific assessment of HRQoL and its associated factors informs the development of contextually appropriate interventions to improve HRQoL. This study aimed to determine the HRQoL and its associated factors in people with T2DM at a tertiary care clinic in Ningbo, China. METHODS A cross-sectional survey was undertaken among 406 people with T2DM in 2020-21. The primary outcome was HRQoL measured using EQ VAS and EQ-5D index from the EQ-5D-3L questionnaire. Multivariable regression analysis was used to determine the factors associated with HRQoL scores. RESULTS The mean (± standard deviation) EQ VAS score was 68.7 (13.8). Median (interquartile range) EQ-5D index was 1 (0.027). Prevalence of problems in HRQoL domains was as follows: pain/discomfort (15.7%), anxiety/depression (13.3%), mobility (5.4%), self-care (3.5%) and managing usual activities (5.2%). The ≥60 years age group had a mean EQ VAS score 8.7 points higher (95% CI 3.4, 13.9; p < .001) than the 18-39 years age group. Those with T2DM >10 years had a mean EQ VAS score 8.6 points lower than those with a duration <1 year (-12.8, -4.4; p = .001). A T2DM duration >10 years was associated with a reduction in the EQ-5D index of 0.029 (-0.041, -0.016; p < .001) compared with a duration <1 year. CONCLUSIONS Depression/anxiety and pain/discomfort are important domains of reduced HRQoL for this population. A longer duration of T2DM is associated with reduced HRQoL scores, including both EQ VAS and EQ-5D index. Increasing age may be counterintuitively associated with an increase in EQ VAS score in this population, potentially reflecting a 'paradox of aging' process. Future work should focus on developing, evaluating and implementing interventions to improve HRQoL in T2DM, such as strategies to manage pain and mental health conditions.
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Affiliation(s)
- Naomi Carter
- Lifespan and Population Health Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jialin Li
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
| | - Miao Xu
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
| | - Li Li
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
| | - Xuelan Fan
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
| | - Shuyan Zhu
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
| | - Pritpal Chahal
- Lifespan and Population Health Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK.,Health Education England, Leeds, UK
| | - Kaushik Chattopadhyay
- Lifespan and Population Health Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK.,The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Nottingham, UK
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Masriadi M, Alam RI, Junaidin J, Firdaus EK, Asnaniar WOS, Padhila NI, Maryani L, Agus AI, Amir H, Hidayat R, Fitriani F. Predictors that affect the Quality of Life Patient with Diabetes Mellitus: A Systematic Review. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8887] [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
BACKGROUND: Diabetes mellitus is a disease that has received worldwide attention because its incidence continues to increase so that more research is needed, especially regarding the quality of life of diabetes mellitus patients considering that quality of life is one of the targets of diabetes mellitus management therapy.
AIM: The purpose of the literature review is to review the factors that affect the quality of life of diabetes mellitus patients.
METHOD: Literature reviews are conducted based on issues, methodologies, equations, and further research proposals.
RESULTS: There is an influence of sociodemographic factors and behavioral factors of self-care activities on the quality of life of diabetes mellitus patients.
CONCLUSION: Sociodemographic factors and behavioral factors of self-care activities affect the quality of life of patients with diabetes mellitus.
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Seah SJ, Harding SC, Pay JY, Wang J, Aw S, Lam J, Lim RBT. Sociodemographic characteristics associated with self-care and quality of life among community-dwelling older adults with type 2 diabetes. Prim Care Diabetes 2022; 16:179-187. [PMID: 34955386 DOI: 10.1016/j.pcd.2021.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/18/2021] [Accepted: 12/15/2021] [Indexed: 11/19/2022]
Abstract
AIMS To assess how well community-dwelling older adults in Singapore were coping with their diabetes, and the sociodemographic characteristics that were associated with their level of coping. METHODS This was a cross-sectional study involving 257 older adults. Multiple regression was used to assess the associations between various sociodemographic characteristics and coping measures of present quality of life and level of self-care. RESULTS Older adults mainly sought care in the primary care setting. They were not coping well given their mean scores for diabetes-dependent quality of life and the self-care index were -3.57 and 3.55 respectively. Compared to those with post-secondary education, individuals who had no formal (adjusted B -0.92, p 0.003), primary level (adjusted B -0.76, p < 0.001) and secondary level (adjusted B -0.50, p < 0.02) education reported lower present quality of life. Those with prior lowest skill level occupations were less likely to consume a healthy diet per week than those with prior highest skill level occupations (adjusted B -1.48, p 0.004). CONCLUSIONS There should be provision of diabetes self-care interventions targeting older adults in Singapore especially for those with lower education and work skill levels. As the first line of contacts, primary care providers should advocate for diabetes self-care and develop community-based interventions for these priority groups.
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Affiliation(s)
- Siang Joo Seah
- Health Systems & Behavioural Sciences, Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building, 12 Science Drive 2, #10-01, Singapore 117549, Singapore City, Singapore; Centre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore City, Singapore
| | | | - Jin Yu Pay
- Tsao Foundation, Singapore City, Singapore
| | - Jing Wang
- Tsao Foundation, Singapore City, Singapore
| | - Su Aw
- Tsao Foundation, Singapore City, Singapore
| | | | - Raymond Boon Tar Lim
- Health Systems & Behavioural Sciences, Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building, 12 Science Drive 2, #10-01, Singapore 117549, Singapore City, Singapore.
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Cao N, Hao Z, Niu L, Zhang N, Zhu H, Bao H, Yan T, Fang X, Xu X, Li L, Liu Y, Xia Y, Su X, Zhang X. The Impact of Risk Factor Control on Health-Related Quality of Life in Individuals with High Cardiovascular Disease Risk: A Cross-sectional Study Based on EQ-5D Utility Scores in Inner Mongolia, China. J Epidemiol Glob Health 2022; 12:133-142. [PMID: 34978710 PMCID: PMC8907362 DOI: 10.1007/s44197-021-00028-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives To assess the impact of cardiovascular disease (CVD) risk factor control on health-related quality of life (HRQoL), as well as the other influencing factors of HRQoL among high CVD risk individuals. Methods From 2015 to 2017, residents of six villages or communities in Inner Mongolia, selected using a multi-stage stratified cluster random sampling method, were invited to complete a questionnaire and undergo physical examination and laboratory testing. We selected participants whose predicted 10-year risk for CVD exceeded 10% as those with high CVD risk. HRQoL in individuals with high CVD risk was investigated based on the EuroQol-5 Dimension (EQ-5D) scale. The Chinese utility value integral system was used to calculate EQ-5D utility scores, and the Tobit regression model was used to analyze the influencing factors of HRQoL among individuals with high CVD risk. Results Of 13,359 participants with high CVD risk, 65.63% reported no problems in any of the five dimensions; the most frequently reported difficulty was pain/discomfort. The median utility score was 1.000 (0.869, 1.000). Participants with hypertension, and uncontrolled glycemic and blood lipids had lower HRQoL. In addition, sex, age, living environment, education level, household income, and medical insurance were influencing factors of HRQoL. Conclusion Sex, age, living environment, education level, household income, medical insurance, hypertension, and whether glycemic and blood lipids control or not are related to HRQoL of high CVD risk individuals.
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Affiliation(s)
- Ning Cao
- Public Health College, Inner Mongolia Medical University, Hohhot, China
| | - Zhihui Hao
- People's Hospital of Inner Mongolia Autonomous Region, Hohhot, China
| | - Liwei Niu
- Public Health College, Inner Mongolia Medical University, Hohhot, China
| | - Nan Zhang
- Public Health College, Inner Mongolia Medical University, Hohhot, China
| | - Hao Zhu
- Public Health College, Inner Mongolia Medical University, Hohhot, China
| | - Han Bao
- Public Health College, Inner Mongolia Medical University, Hohhot, China
| | - Tao Yan
- Public Health College, Inner Mongolia Medical University, Hohhot, China
| | - Xin Fang
- Public Health College, Inner Mongolia Medical University, Hohhot, China
| | - Xiaoqian Xu
- Public Health College, Inner Mongolia Medical University, Hohhot, China
| | - Lehui Li
- Public Health College, Inner Mongolia Medical University, Hohhot, China
| | - Yan Liu
- Public Health College, Inner Mongolia Medical University, Hohhot, China
| | - Yuan Xia
- Public Health College, Inner Mongolia Medical University, Hohhot, China
| | - Xiong Su
- Public Health College, Inner Mongolia Medical University, Hohhot, China
| | - Xingguang Zhang
- Public Health College, Inner Mongolia Medical University, Hohhot, China.
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Alsuwayt S, Almesned M, Alhajri S, Alomari N, Alhadlaq R, Alotaibi A. Quality of life among type II diabetic patients attending the primary health centers of King Saud Medical City in Riyadh, Saudi Arabia. J Family Med Prim Care 2021; 10:3040-3046. [PMID: 34660444 PMCID: PMC8483077 DOI: 10.4103/jfmpc.jfmpc_175_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 02/17/2021] [Accepted: 04/04/2021] [Indexed: 11/04/2022] Open
Abstract
Background/Aim Type 2 diabetic patients (T2DM) have lower quality of life (QoL) compared to the general population. This study was conducted to determine QoL of T2DM patients and analyze factors that affect patients' QoL. Methods We conducted this cross-sectional study in January to February of 2019 at several primary care health centers (PCHC) in Riyadh, Saudi Arabia. All adult T2DM patients were invited to participate in the study. We used the EQ-5D-3L and EQ VAS tools to determine the patients' health state and their self-rated overall health. Results A total of 274 T2DM patients were surveyed, 149 (54.4%) were males. The mean age was 59.7 ± 10.4 years. Of the five EQ-5D-5L domains, self-care had the highest proportion that reported no problem (n = 183, 66.8%). The mobility domain had the highest proportion of reported severe problems (n = 37, 13.5%) and extreme problems (n = 7, 2.6%). Nineteen (6.9%) patients reported with a full state of health. The mean EQVAS was 65.9 ± 22.1, with only 24.1% reported as between 81-100%. Females, patients above 75 years old, those who are in the low socioeconomic income, unemployed, widow had lower EQ VAS. Conclusion Males, with higher socioeconomic status, employed, married and younger patients experience better QoL compared to their counterparts. The overall health related QoL among our diabetic patients is low. These findings suggest improvement of health-related QoL, and more efforts should be invested in patient education particularly among patients who are in the low socioeconomic status, the elderly, females and the unemployed.
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Affiliation(s)
- Saleh Alsuwayt
- Academy of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | - Mohammed Almesned
- Head Department of Family and Community Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | - Shahad Alhajri
- Epidemiology Specialist, Ministry of Health, Saudi Arabia
| | - Naif Alomari
- Academy of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | - Razan Alhadlaq
- Academy of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | - Abdullah Alotaibi
- Academy of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
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Jankowska A, Golicki D. EQ-5D-5L-based quality of life normative data for patients with self-reported diabetes in Poland. PLoS One 2021; 16:e0257998. [PMID: 34587218 PMCID: PMC8480847 DOI: 10.1371/journal.pone.0257998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 09/16/2021] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION The new, five-level EQ-5D generic questionnaire (EQ-5D-5L) has never been used among diabetes patients in Poland. OBJECTIVES To develop health-related quality of life (HRQoL) norms for patients with self-reported diabetes, based on a large representative sample of the general Polish population, using the EQ-5D-5L. MATERIALS AND METHODS Members of the general public, selected via multistage stratified sampling, filled in the EQ-5D-5L questionnaire and answered a question about the presence of diabetes. We estimated three types of EQ-5D-5L outcomes: limitations within domains, EQ VAS and EQ-5D-5L index. Multiple linear regression was used to examine the relationship between sociodemographic characteristics and HRQoL, both in patients with diabetes and the general population sample. RESULTS Among 2,973 respondents having complete EQ-5D-5L data, 255 subjects (8.6%) self-reported diabetes. Treatment with insulin, other drugs, combination therapy or lack of drug treatment was declared by 22.0%, 48.6%, 5.1% and 24.3% of patients, respectively. Respondents with diabetes had a lower EQ VAS score (18.5 points difference on a 100-points scale) and a lower EQ-5D-5L index score (0.135 difference; scale range: 1.59). The multivariate analysis showed that the factors independently improving the HRQoL in the general population were secondary or higher education, and factors reducing HRQoL were female sex, belonging to an older age group, being treated because of diabetes with insulin, other drugs or combination treatment. Respondents diagnosed with diabetes but not treated with drugs showed a decrease in EQ VAS scores, but not in the EQ-5D-5L index. CONCLUSIONS Diabetes leads to HRQoL deterioration in all age groups when compared to matched general population respondents without diabetes. The most significant HRQoL reduction experience older patients with a basic level of education. Obtained EQ-5D-5L normative data may be used in the clinical care of patients with diabetes and health technology assessment of new anti-diabetic drugs.
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Affiliation(s)
| | - Dominik Golicki
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland
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Hsieh PL, Yang FC, Hu YF, Chiu YW, Chao SY, Pai HC, Chen HM. Continuity of Care and the Quality of Life among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study in Taiwan. Healthcare (Basel) 2020; 8:healthcare8040486. [PMID: 33202699 PMCID: PMC7712194 DOI: 10.3390/healthcare8040486] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Understanding factors associated with the quality of life (QoL) of patients with type 2 diabetes (T2DM) is an important health issue. This study aimed to explore the correlation between continuity of care and quality of life in patients with T2DM and to probe for important explanatory factors affecting quality of life. Methods: This study used a cross-sectional correlation research design. Convenience sampling was adopted to recruit 157 patients, aged 20–80 years and diagnosed with T2DM in the medical ward of a regional hospital in central Taiwan. Results: The overall mean (standard deviation, SD) QOL score was 53.42 (9.48). Hierarchical regression linear analysis showed that age, depression, two variables of potential disability (movement and depression), and the inability to see a specific physician or maintain relational continuity with medical providers were important predictors that could effectively explain 62.0% of the variance of the overall QoL. Conclusions: The relationship between patients and physicians and maintaining relational continuity with the medical providers directly affect patients’ QoL during hospitalization and should be prioritized clinically. Timely interventions should be provided for older adult patients with T2DM, depression, or an inability to exercise to maintain their QoL.
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Affiliation(s)
- Pei-Lun Hsieh
- Department of Nursing, College of Health, National Taichung University of Science and Technology, Taichung City 40343, Taiwan;
| | - Fu-Chi Yang
- College of General Education, National Chin-Yi University of Technology, Taichung City 41170, Taiwan;
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Yi-Fang Hu
- Kuang Tien General Hospital, Taichung, Taichung City 433401, Taiwan;
| | - Yi-Wen Chiu
- Department of Nursing, Chung Shan Medical University, Taichung City 40201, Taiwan; (Y.-W.C.); (H.-C.P.)
| | - Shu-Yuan Chao
- Department of Nursing, Hungkuang University, Taichung City 43302; Taiwan;
| | - Hsiang-Chu Pai
- Department of Nursing, Chung Shan Medical University, Taichung City 40201, Taiwan; (Y.-W.C.); (H.-C.P.)
| | - Hsiao-Mei Chen
- Department of Nursing, Chung Shan Medical University, Taichung City 40201, Taiwan; (Y.-W.C.); (H.-C.P.)
- Correspondence: ; Tel.: +886-4-24730022 (ext. 12103); Fax: +886-4-23248173
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Pan CW, Zhang RY, Luo N, He JY, Liu RJ, Ying XH, Wang P. How the EQ-5D utilities are derived matters in Chinese diabetes patients: a comparison based on different EQ-5D scoring functions for China. Qual Life Res 2020; 29:3087-3094. [PMID: 32533422 DOI: 10.1007/s11136-020-02551-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVES In China, multiple approaches to calculating EQ-5D utilities are available, including the two EQ-5D-3L (3L2014 and 3L2018) scoring functions, the EQ-5D-5L (5L) scoring function, and the crosswalk function linking the 3L utilities and 5L health states. The study compared utilities derived from them in terms of agreement and discriminative power; and assessed whether the use of different approaches may affect QALY estimation in Chinese type 2 diabetes (T2D) patients. METHODS Cross-sectional data of 289 T2D patients who self-completed both the 5L and 3L questions were used. Agreement were examined using intraclass correlation coefficient (ICC) and Bland-Altman plots. The ability of the EQ-5D utilities in differentiating the patients with and without clinical conditions was evaluated using F-statistics. Their influence on QALY estimation was assessed adopting mean absolute difference (MAD) in utility values between the patients. RESULTS The ICC values were 0.881 (3L2014-3L2018), 0.958 (5L-c5L2014), and 0.806 (5L-c5L2018). The two 3L utilities and the three 5L utilities had poor agreement at the lower end of utility scale according to Bland-Altman plots. The 3L2018 utilities had lower F-statistics compared to the 3L2014 utilities; the two c5L utilities had larger or similar F-statistics compared to the 5L utilities. The mean MADs were 0.138 (5L), 0.116 (3L2014), 0.115 (c5L2014), 0.055 (c5L2018), and 0.055 (3L2018). CONCLUSION The 3L2014 utilities is more discriminative than the 3L2018 utilities; and the two c5L utilities have no worse discriminative power compared with the 5L utilities. The choice of the approach to calculating the EQ-5D utilities is likely to affect QALY estimates.
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Affiliation(s)
- Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Ruo-Yu Zhang
- School of Public Health, Fudan University, Shanghai, China
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Jun-Yi He
- School of Public Health, Fudan University, Shanghai, China
| | - Rui-Jie Liu
- School of Public Health, Fudan University, Shanghai, China
| | - Xiao-Hua Ying
- School of Public Health, Fudan University, Shanghai, China
| | - Pei Wang
- School of Public Health, Fudan University, Shanghai, China.
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China.
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EFFECT OF EATING ATTITUDES OF INDIVIDUALS WITH TYPE 2 DIABETES UPON QUALITY OF LIFE. INTERNATIONAL JOURNAL OF HEALTH SERVICES RESEARCH AND POLICY 2020. [DOI: 10.33457/ijhsrp.726014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Evaluation of health-related quality of life using EQ-5D in China during the COVID-19 pandemic. PLoS One 2020; 15:e0234850. [PMID: 32555642 PMCID: PMC7302485 DOI: 10.1371/journal.pone.0234850] [Citation(s) in RCA: 131] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 06/03/2020] [Indexed: 12/13/2022] Open
Abstract
Objective Since December 2019, an increasing number of cases of the 2019 novel coronavirus disease (COVID-19) infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been identified in Wuhan, Hubei Province, China. Now, more cases have been reported in 200 other countries and regions. The pandemic disease not only affects physical health who suffered it, but also affects the mental health of the general population. This study aims to know about the impact of the COVID-19 epidemic on the health-related quality of life (HRQOL) of living using EQ-5D in general population in China. Methods An online-based survey was developed and participants were recruited via social media. The questionnaires included demographic and socioeconomic data, health status, the condition epidemic situation and EQ-5D scale. The relationships of all factors and the scores of EQ-5D were analyzed. Logistic regression model were used to the five health dimensions. Results The respondents obtained a mean EQ-5D index score of 0.949 and a mean VAS score of 85.52.The most frequently reported problem were pain/discomfort (19.0%) and anxiety/depression (17.6%). Logistic regression models showed that the risk of pain/discomfort and anxiety/depression among people with aging, with chronic disease, lower income, epidemic effects, worry about get COVID-19 raised significantly. Conclusion The article provides important evidence on HRQOL during the COVID-19 pandemic. The risk of pain/discomfort and anxiety/depression in general population in China raised significantly with aging, with chronic disease, lower income, epidemic effects, worried about get COVID-19 during the COVID-19 pandemic. The results from each categorical data can be used for future healthcare measures among general population.
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