Health-related quality of life in elderly diabetic outpatients in Vietnam

Insulin therapy in type 2 diabetes: Insights into clinical efficacy, patient-reported outcomes, and adherence challenges

Insulin therapy plays a crucial role in the management of type 2 diabetes as the disease progresses. Over the past century, insulin formulations have undergone significant modifications and bioengineering, resulting in a diverse range of available insulin products. These products show distinct pharmacokinetic and pharmacodynamic profiles. Consequently, various insulin regimens have em-erged for the management of type 2 diabetes, including premixed formulations and combinations of basal and bolus insulins. The utilization of different insulin regimens yields disparate clinical outcomes, adverse events, and, notably, patient-reported outcomes (PROs). PROs provide valuable insights from the patient's perspective, serving as a valuable mine of information for enhancing healthcare and informing clinical decisions. Adherence to insulin therapy, a critical patient-reported outcome, significantly affects clinical outcomes and is influenced by multiple factors. This review provides insights into the clinical effectiveness of various insulin preparations, PROs, and factors impacting insulin therapy adherence, with the aim of enhancing healthcare practices and informing clinical decisions for individuals with type 2 diabetes.

Effectiveness of health-promoting lifestyle training on mental well-being, vitality, and quality of life of elderly with diabetes

This study aimed to investigate the effectiveness of health-promoting lifestyle (HPL) training on the mental well-being, vitality, and quality of life (QoL) of the elderly with diabetes. This was a quasi-experimental study based on a pre-test-post-test design with experimental and control groups. The statistical population consisted of all elderly with diabetes who were members of the Diabetes Association of Ahvaz in 2021, of whom 40 elderlies were selected as the sample through the convenience sampling method. The participants were randomly assigned to experimental and control groups. The participants in the experimental group attended eight 90-min sessions of HPL training. The data were statistically analyzed using the multivariate analysis of covariance in SPSS-17. The mean ± SD of the post-test scores of mental well-being, vitality, and QoL was 39.90 ± 4.80, 23.00 ± 3.31, and 35.00 ± 6.13 in the experimental group and 33.85 ± 4.81, 17.80 ± 3.15, and 29.15 ± 4.67 in the control group. The post-test results revealed a significant difference between the two groups in all of these three variables, as the HPL training significantly improved the mental well-being, vitality, and QoL of participants in the experimental group. Health professionals are recommended to apply HPL training, along with other training and therapeutic methods, to improve the health-related characteristics of such patients.

Impact of COVID-19 on health-related quality of life in the general population: A systematic review and meta-analysis

The World Health Organization declared coronavirus disease of 2019 as an epidemic and public health emergency of international concern on January 30th, 2020. Different factors during a pandemic can contribute to low quality of life in the general population. Quality of life is considered multidimensional and subjective and is assessed by using patient reported outcome measures. The aim and objective of this review is to assess the impact of coronavirus disease of 2019 and associated factors on the Quality of Life in the general population. This review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A protocol was registered in the international Prospective Register of Systematic Reviews database(CRD42021269897). A comprehensive electronic search in PubMed, EBSCO Host Research Databases, MEDLINE and Google scholar search engine was conducted. A total number of 1,7000,074 articles were identified from electronic search. 25 full text articles were retained for qualitative synthesis and seventeen articles for quantitative analysis. Seven main quality of life scales were used to assess the quality of life of the general population; World Health Organization Quality of Life-bref, EuroQuality of Life-Five dimensions, Short Form, European Quality of Life Survey, coronavirus disease of 2019 Quality of Life, General Health Questionnaire12 and My Life Today Questionnaire. The mean World Health Organization Quality of Life-brief was found to be 53.38% 95% confidence interval [38.50-68.27] and EuroQuality of Life-Five dimensions was 0.89 95% confidence interval [0.69-1.07]. Several factors have been linked to the Coronavirus disease of 2019 such as sociodemographic factors, peoples living with chronic diseases, confinement and financial constraints. This review confirms that the Coronavirus disease of 2019 pandemic affected the quality of life of the general population worldwide. Several factors such as sociodemographic, peoples living with chronic diseases, confinement and financial constraints affected the quality of life.

Relationship between three dietary indices and health-related quality of life among rural elderly in China: a cross-sectional study

Purpose

This study aimed to explore the association between health-related quality of life (HRQOL) and diet quality using three evidence-based dietary indices among older people in rural China.

Methods

This cross-sectional study included 1,258 rural older people (mean age 72.32 years; 55.6% female). HRQOL was assessed using the European Five Dimension Health Scale (EQ-5D), and dietary intake was assessed using a Food Frequency Questionnaire. Three dietary scoring indices, including the Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension, and Dietary Diversity Score (DDS), were calculated to assess and analyze the relationship between these dietary indices and quality of life.

Results

The EQ-5D score was 0.95 ± 0.10, and the EQ-Visual Analog Scale (VAS) score was 76.76 ± 14.44. All three groups with higher dietary indices had higher quality of life scores. After controlling for covariates in multivariate adjusted binary logistic regression analyzes, participants in the top tertile of DDS had higher quality of life scores than those in the bottom tertile. DDS was consistently associated with EQ-5D (Model 2: OR = 1.567, p = 0.001; Model3: OR = 1.351, p = 0.044) and EQ-VAS (Model 2: OR = 1.830, p < 0.001; Model 3: OR = 1.383, p = 0.047), significantly different from the other groups.

Conclusion

Older people in rural China who adhere to various foods experience a better quality of healthy life.

Correlation of health-related quality of life for older adults with diabetes mellitus in South Korea: theoretical approach

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.

Severity and Factors Associated with Depressive Symptoms Among Type 2 Diabetic Patients in Vietnam

Background

Diabetes and psychiatric disorders often co-occur. The prevalence of depression in a person with diabetes is two times higher than that of the general population. During the last decade, the prevalence of diabetes in Vietnam has nearly doubled. However, there is little data regarding depressive symptoms among people with diabetes. Therefore, this study aims to explore the level of depressive symptoms and its associated factors among patients with type 2 diabetes mellitus in Hanoi, Vietnam.

Methodology

A cross-sectional study was conducted among 519 patients diagnosed with type 2 diabetes at the Agricultural General Hospital, one of the largest primary care hospitals for diabetes in Hanoi, Vietnam. Patient Health Questionnaire-9 (PHQ-9) was used to assess the severity of depressive symptoms. Multivariate Tobit and logistic regression models were applied to examine factors associated with the severity of depressive symptoms and medication adherence.

Results

Approximately 45.2% of participants were identified as having depressive symptoms at different levels. The proportion of patients with mild, moderate, moderately severe, and severe depressive symptoms is 36.0%, 7.6%, 1.4%, and 0.2% respectively. Regarding the treatment process, patients being treated for their diabetes for a longer time were more likely to have depressive symptoms. Depression was positively linked to currently drinking alcohol (Coef = 1.04; 95% CI = 0.30-1.78), having comorbidities (Coef = 1.08; 95% CI = 0.15; 2.01) and having irregular physical activities (Coef = -1.28; 95% CI = -2.18; -0.38). Patients with severe depressive symptoms (higher PHQ-9 score) were more likely to be non-adherent to their medications in the last month (AOR = 1.30; 95% CI = 1.17; 1.46).

Conclusion

Our study shows that a high percentage of patients with diabetes have depressive symptoms. There is a strong association between having depressive symptoms and non-adherence to medications in the last month. To reduce the risk of developing depressive symptoms, depression should be screened at the initial treatment process and patients should be advised to avoid alcohol and to engage in physical activities regularly.

Identification of post-COVID-19 condition phenotypes, and differences in health-related quality of life and healthcare use: a cluster analysis

The aim of this cross-sectional study was to identify post-COVID-19 condition (PCC) phenotypes and to investigate the health-related quality of life (HRQoL) and healthcare use per phenotype. We administered a questionnaire to a cohort of PCC patients that included items on socio-demographics, medical characteristics, health symptoms, healthcare use, and the EQ-5D-5L. A principal component analysis (PCA) of PCC symptoms was performed to identify symptom patterns. K-means clustering was used to identify phenotypes. In total, 8630 participants completed the survey. The median number of symptoms was 18, with the top 3 being fatigue, concentration problems, and decreased physical condition. Eight symptom patterns and three phenotypes were identified. Phenotype 1 comprised participants with a lower-than-average number of symptoms, phenotype 2 with an average number of symptoms, and phenotype 3 with a higher-than-average number of symptoms. Compared to participants in phenotypes 1 and 2, those in phenotype 3 consulted significantly more healthcare providers (median 4, 6, and 7, respectively, p < 0.001) and had a significantly worse HRQoL (p < 0.001). In conclusion, number of symptoms rather than type of symptom was the driver in the identification of PCC phenotypes. Experiencing a higher number of symptoms is associated with a lower HRQoL and more healthcare use.

Health-related quality of life and associated factors among COVID-19 individuals managed with indian traditional medicine: A cross-sectional study from south India

Introduction

Coronavirus disease-2019 (COVID-19) had a multidimensional impact on human life. It affects the health-related quality of life (HRQoL) which is a perceived measure of physical and mental health. We estimated the EuroQol utility value for COVID-19 and the associated factors for those managed at Siddha COVID care centres in Tamil Nadu.

Methods

A cross-sectional study was conducted by a telephonic interview of 2000 randomly selected COVID-19 adults tested positive during June 2020 to Jan 2021. We collected sociodemographic, clinical and EQ-5D-5L profile. Mean EQ-5D-5L summary utility values and EQ-VAS scores were estimated. Multivariate regression was used to examine the factors associated with EQ-5D-5L. Study protocol was approved by the Institutional ethics committee of Government Siddha Medical College, Chennai (GSMC-CH-3401/ME-2/050/2021). The committee waived the written informed consent considering the pandemic situation of emerging infectious diseases.

Results

We interviewed 1047 participants. Of the total 68% were males with the median age (IQR) of 38 (29-51) years. The mean EQ-5D-5L utility score and EQ-VAS scores are 0.98 ± 0.05 and 92.14 ± 0.39 respectively. COVID-19 asymptomatic group reported a mean utility score of 0.99 ± 0.03 which is relatively more than the symptomatic group (0.97 ± 0.06),. EQ-VAS score was also reported high among the asymptomatic (95.45 ± 5.95) than the symptomatic (91.40 ± 8.69COVID-19.

Conclusion

The severity of illness and the comorbidity are significantly associated with a low HRQoL of COVID-19 patients.

Predicting Factors of Health-Related Quality of Life Among Adults With Type 2 Diabetes: A Systematic Review

Introduction

One of the most important outcomes of diabetes care and treatment is an improvement in patients' health-related quality of life (HRQoL).

Objective

This study aimed to review the empirical evidence regarding the predictors of HRQoL among adults with type 2 diabetes mellitus (T2DM).

Methods

To find all English-language articles published between 2012 and 2022, a comprehensive literature search was conducted using ProQuest, Scopus, PubMed, Science Direct, and CORE. Cross-sectional studies were the focus of this analysis. Search terms included "type 2 diabetes" OR "T2DM" AND "health-related quality of life" OR "HRQoL" AND ("predicting factors" OR "influencing factors" OR "associated factors"). The original search yielded a total of 1,089 studies, from which 35 met the review's inclusion criteria. The systematic review protocol was registered with PROSPERO CRD42023431229.

Results

The final analysis comprised 24,346 people with type 2 diabetes and used data from 35 cross-sectional studies conducted during the preceding decade. Socio-demographic factors (age, marital status, gender, monthly income, education, area of residence, and religiosity), patient-centered factors (diabetes knowledge and self-efficacy), disease characteristics (comorbidities, duration of diabetes, and insulin treatment), self-management behaviors (physical activity, medication adherence, and frequent glucose checks), and family support were found to be predictors of HRQoL.

Conclusion

A diabetes program to enhance the HRQoL among people with T2DM is highly encouraged to address these factors, which can be focused on promoting self-management behaviors, diabetes distress management, and encourage family support.

Psychosocial factors associated with mental health and quality of life during the COVID-19 pandemic among low-income urban dwellers in Peninsular Malaysia

Background and aims

Mental well-being among low-income urban populations is arguably challenged more than any other population amid the COVID-19 pandemic. This study investigates factors associated with depression and anxiety symptoms and quality of life among Malaysia’s multi-ethnic urban lower-income communities.

Methods

This is a community-based house-to-house survey conducted from September to November 2020 at the Petaling district in Selangor, Malaysia. Five hundred and four households were identified using random sampling, and heads of eligible households were recruited. Inclusion criteria were age ≥18 years with a monthly household income ≤RM6960 (estimated $1600) without acute psychiatric illness. The PHQ-9, GAD-7 and EQ-5D were used for depression, anxiety, and quality of life, respectively. Multivariable logistic regression was performed for the final analysis.

Results

A total of 432 (85.7%) respondents with a mean age of 43.1 years completed the survey. Mild to severe depression was detected in 29.6%, mild to severe anxiety in 14.7%, and problematic quality of life in 27.8% of respondents. Factors associated with mild to severe depression were younger age, chronic health conditions, past stressful events, lack of communication gadgets and lack of assets or commercial property. While respiratory diseases, marital status, workplace issues, financial constraints, absence of investments, substance use and lack of rental income were associated with mild to severe anxiety. Attributing poverty to structural issues, help-seeking from professionals, and self-stigma were barriers, while resiliency facilitated good psychological health. Problematic quality of life was associated with depression, older age, unemployment, cash shortage, hypertension, diabetes, stressful life events and low health literacy.

Conclusions

A high proportion of the sampled urban poor population reported mild to severe anxiety and depression symptoms. The psychosocial determinants should inform policymakers and shape future work within this underserved population.

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

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.

Evaluating the Impact of Therapy on Quality of Life in Type 2 Diabetes: A Literature Review of Utilities Associated with Treatment-Related Attributes

Introduction

Treatment-related attributes and process characteristics such as dosing frequency, timing flexibility, ease of use of injection devices and unpleasant side-effects may have small but measurable effects on quality of life (QoL) in people with type 2 diabetes (T2D). A literature review was performed to identify recently published utility values quantifying the effect of treatment-related attributes on QoL.

Methods

Literature search strategies were designed using high-level medical subject heading (MeSH) terms supplemented with free-text terms and searches were run in March 2020 in the PubMed, Embase and Cochrane Library databases. For inclusion, studies were required to be published in full-text form, in English, since 2010 and report utility values (elicited using either direct or indirect methods) for treatment-related attributes or process characteristics including side effects, change in weight/body mass index (BMI), dosing frequency and timing flexibility, device attributes (e.g. needle handling, requirement for reconstitution) and convenience (e.g. waiting time).

Results

A total of 30 studies were included in the review, of which all but three were conducted in people with T2D. The EQ-5D was the most commonly used elicitation method (fourteen studies), followed by time tradeoff (TTO) methodology. Treatment-related adverse events and inconveniences such as needle handling in administration devices and waiting time were consistently associated with lower QoL, whereas lower dosing frequency and increased timing flexibility with dosing were consistently associated with utility benefits. The relationship between change in BMI and QoL was non-linear and influenced by baseline BMI.

Conclusion

Treatment-related attributes and process characteristics are associated with minor changes in QoL, which should be taken into account in long-term health economic modeling of new treatments and administration devices.

Validation of the European Quality of Life-5 Dimensions, 3-Level Version (EQ-5D-3L) in Patients With Osteoporotic Vertebral Fracture and Comparing Their Health-Related Quality of Life with That of the General Population in Korea

Objective

This study examined the validity of the European Quality of Life-5 dimensions, 3-Level version (EQ-5D-3L) in patients with osteoporotic vertebral compression fractures (OVCF) and compared the health-related quality of life (HRQOL) of these patients with that of the general population in Korea.

Methods

Study participants completed several questionnaires, such as the EQ-5D-3L, 12-item short-form health survey version 2.0 (SF-12v2), Roland-Morris disability questionnaire (RMQ), and Pain Numeric Rating Scale (Pain NRS). Spearman’s correlation analyses of the questionnaire results were conducted to examine the discriminant and convergent validity of the EQ-5D-3L. Finally, EQ-5D-3L results from study participants were compared with those from the comparison group of the general population that were match-sampled according to age and sex from the 2013 Korean National Health and Nutritional Examination Survey.

Results

Spearman’s correlation coefficients between EQ-5D-3L and pain NRS, SF-12v2, and RMQ were statistically significant. The coefficients between the relevant dimensions, such as mobility in the EQ-5D-3L and physical functioning in the SF-12v2, were higher than those between irrelevant ones. Problems reported by study participants in each dimension of EQ-5D-3L showed statistically significant lower scores in pain NRS, PCS, and MCS from the SF-12v2 and RMQ scores. In comparison with the general population, the problems reported in the patient group were statistically higher than those reported by the general population.

Conclusion

This study showed that EQ-5D-3L will be useful for patients with OVCF in Korea because it could be valid. The HRQOL of patients with OVCF was very low in all dimensions of the EQ-5D-3L.

Emotional Distress is Associated with Lower Health-Related Quality of Life Among Patients with Diabetes Using Antihypertensive and/or Antihyperlipidemic Medications: A Multicenter Study in Indonesia

Objective

To evaluate the associations between different types of diabetes distress and health-related quality of life (HRQOL) among patients with type 2 diabetes (T2DM) using antihypertensive and/or antihyperlipidemic medications in Indonesia and to explore the differences between those using only antihypertensive, only antihyperlipidemic, or both medications.

Methods

A multicenter cross-sectional study was conducted in Community Health Centers in three cities in Indonesia among patients with T2DM aged at least 18 years who were using antihypertensive and/or antihyperlipidemic medications. Diabetes distress subscales (emotional, regimen-related, interpersonal, and physician-related distress) and HRQOL were assessed using a validated diabetes distress scale-17 and EQ-5D-5L scale, respectively. Multiple linear regression models were used to evaluate the associations between different types of diabetes distress and HRQOL adjusting for confounders.

Results

Most of the 503 participants were females (67.6%) and aged 60–69 years (40.8%). Emotional distress was negatively associated with HRQOL among the whole group of patients (β: −0.08; 95% confidence interval (CI): −0.10, −0.05; p < 0.001). This association was similar across all therapeutic subgroups. Regimen-related distress (β: −0.06; 95% CI: −0.09, −0.03; p < 0.001) and interpersonal distress (β: −0.02; 95% CI: −0.05, −0.01; p = 0.022) were negatively associated, whereas physician-related distress (β: 0.04; 95% CI: 0.01, 0.07; p = 0.037) was positively associated with HRQOL among the whole group. These associations were also observed among those using only antihypertensive medication.

Conclusion

Emotional distress affects HRQOL in T2DM patients treated for cardiovascular comorbidities, independent of antihypertensive and/or antihyperlipidemic medication use.

The association between diabetes mellitus and HRQoL of older people in Shanghai

Background

This study aimed to explore the association between diabetes mellitus and health-related quality of life (HRQoL) of older people in Shanghai, China, especially regarding the differences in each aspect of the EQ-5D and how large the score gaps are between older people with and without diabetes.

Methods

A total of 11,103 people of either sex older than 60 years were enrolled from 17 districts of Shanghai. The EQ-5D-3L was used to assess the HRQoL of older people. The Wilcoxon rank sum test and t-test were used to compare the difference in HRQoL between people with or without diabetes. After univariate regression, multiple linear regression and ordinal logistic regression were conducted to evaluate the influence of diabetes mellitus and other confounding variables on the EQ VAS scores and on the five dimensions of the EQ-5D.

Results

Twelve percent of all participants had diabetes mellitus, and the proportion was almost the same between men and women. The EQ VAS scores of people with diabetes mellitus were approximately 3.70 points lower than those of people without diabetes (95% CI = -4.40,  -2.99, p < 0.001) after adjusting for confounding variables. People with diabetes mellitus had increased problems with mobility (OR = 1.57, 95% CI = 1.33, 1.85), self-care (OR = 1.65, 95% CI = 1.35, 2.01), usual activities (OR = 1.78, 95% CI = 1.51, 2.11), pain/discomfort (OR = 1.42, 95% CI = 1.24, 1.64), and anxiety/depression (OR = 1.33, 95% CI = 1.07, 1.64).

Conclusions

This study showed that diabetes mellitus was associated with the HRQoL of older people and that older people with diabetes had poorer performance in every aspect of EQ-5D measurements.

Evaluation of the mental health of health professionals in the COVID-19 era. What mental health conditions are our health care workers facing in the new wave of coronavirus?

BACKGROUND

The aims of this study were to analyse the mental health and health-related quality of life (HRQoL) of a broad sample of healthcare workers (HCWs) in Spain and to identify potential factors that have a significant effect on their mental health and HRQoL.

METHOD

This prospective cohort study comprised 2089 HCWs who completed the Generalized Anxiety Disorder 7-item (GAD-7) Scale, the Patient Health Questionnaire-9 (PHQ-9), the Impact Event Scale-Revised (IES-R), the Insomnia Severity Index (ISI), and the health-related quality of life Questionnaire (EQ-5D). Sociodemographic and clinical data in relation to Covid-19 were also recorded. Descriptive statistics, univariable analysis and multivariable linear regression models were applied to identify factors associated with mental health and HRQoL.

RESULTS

80.87% of participants were female and 19.13% male; 82.38% were aged under 55 years; 39.13% were physicians and 50.17% were nurses or auxiliaries; 80.42% of the health workers have directly treated patients with Covid-19 and 12.28% have themselves tested positive for Covid-19. 38.58% of HCWs had clinical depression; over half (51.75%) had clinical anxiety; 60.4% had clinical stress; and 21.57% had clinical insomnia. Older professionals (>55 years) reported lower rates of anxiety, depression, insomnia, and stress. Having worked directly with Covid-19 patients appears to be an explanatory variable of suffering greater anxiety, depression, stress and insomnia, and of having a worse HRQoL amongst our HCWs. The group of HCWs suffering the worst mental state were nursing home workers.

CONCLUSIONS

Our study confirms that symptomatology of anxiety, depression, stress, insomnia, and HRQoL were affected amongst HCW during the Covid-19 pandemic.

Health-related quality of life among people with type 2 diabetes mellitus - A multicentre study in Bangladesh

AIMS

This study aimed to explore the health-related quality of life and the various demographics and clinical characteristics associated with it among people with type 2 diabetes mellitus in Bangladesh.

METHODS

A total of 1253 participants with type 2 diabetes were recruited from a cross-sectional and retrospective study conducted in Bangladesh in 2017. Participants were recruited from six rural and urban diabetes hospitals. The health-related quality of life of the participants was assessed using the validated EuroQol-5D-5L scale and EuroQol-VAS score. Information was collected via face-to-face interviews and existing medical records. Data was analysed using univariate and multivariable regression analyses with bootstrap resampling.

RESULTS

The average health-related quality of life was 0.64 (±0.20) for EQ-5D-5L score and 61.69 (±34.98) for EQ-VAS score. Old age, low income, low education level, residing in an urban area, longer duration of diabetes, being physically inactive, the presence of macro- and/or micro-vascular complications, impaired cognitive function, being depressed and having anxiety were related to poor health-related quality of life.

CONCLUSION

The health-related quality of life among people with type 2 diabetes in Bangladesh is low, and various socio-demographic and psychological factors and diabetes-related complications are associated with it. This finding will help reform treatments and enforce lifestyle modifications to ensure that the burden of diabetes on people's quality of life is minimal.

Impact of Neck and Shoulder Pain on Health-Related Quality of Life in a Middle-Aged Community-Living Population

Purpose

Neck and shoulder pain (NSP) is very common in the general population. However, scarce information exists on the relationship between NSP and health-related quality of life (HRQOL) outcomes in this population. The present study described NSP prevalence and its impact on the HRQOL of middle-aged and older persons undergoing a routine medical checkup.

Methods

This study recruited 318 subjects (125 males and 193 females; average age, 63.4 years) in good health, collected underwent anthropometric measurements, physical function examinations, and blood testing. This study defined NSP as the presence of muscle tension, stiffness, pressure, or dull pain in areas between the neck and the arch of the scapular. Study subjects were divided into two groups (NSP (+) and NSP (-) groups). The subjects completed questions on the Medical Outcomes Study 36-item short-form health survey (SF-36) and the EuroQol 5-dimension, 5-level version (EQ-5D-5L) tool.

Results

Of the patients, 150 and 168 were NSP (+) and NSP (-), respectively. The NSP complaint rate was 47.2%. The NSP (+) group had younger and more female participants than the NSP (-) group. In the multivariate regression analysis, the NSP (+) group had lower physical QOL based on the SF-36 physical component summary (odds ratio (OR), 2.45) and lower mental QOL based on the SF-36 mental component summary (OR, 2.05). Overall, the NSP (+) group had a higher risk of having low QOL scores (EQ-5D-5L index; OR, 1.76).

Conclusions

The NSP (+) rate in healthy middle-aged and older persons was 47.2%. Furthermore, NSP (+) status was directly related poor HRQOL. NSP is a predictor of suboptimal physical and mental QOL. Therefore, NSP prevention or intervention for NSP may improve middle-aged and older adults' QOL.

Impact of knowledge, attitude, and practices of Type 2 diabetic patients: A study in the locality in Vietnam

BACKGROUND

Disease knowledge, appropriate attitude, and proper practices play an important role in disease control and reduction of diabetes-related complications and deaths. This study aims to investigate the impact of knowledge, attitude, and practices (KAPs) of Type 2 diabetic patients' outcomes.

MATERIALS AND METHODS

A cross-sectional research was conducted on a group of 102 Type 2 diabetic participants in 17 communities in Tam Binh District, Vinh Long Province, Vietnam. The research tool employed the KAP questionnaire using IBM SPSS 22 to analyze the data.

RESULTS

The participants' average age was 57.02 ± 6.323 years. The proportion of women was 76.5% (three times higher than men). The knowledge score of the participants was low (30.04 ± 12.823), the attitude toward score of diabetics was moderate (61.544 ± 29.99), and the practice of self-care score was low (50.59 ± 14.881). There were also some significant relationships between KAPs with ethnicity, marital status, diabetic duration, location, employment status, and treatment method. In addition, there were only significant differences between the self-care practice groups and patients' attitude toward Type 2 diabetes.

CONCLUSION

There is a significant relationship between KAP with some participants' characteristics. The KAPs of the diabetic patients in Tam Binh district are still low. This result showed that although the patient's attitude towards disease was good, it was not enough for them to practice good self-control due to poor knowledge.

Characteristics of Diabetic Ageing Patients in Nursing Homes: One Center Experience in Turkey

Introduction

Due to its widespread distribution and effects, type 2 diabetes is a frequently researched topic. However, the amount of information about type 2 diabetes in nursing homes residents is inadequate. The aim of this study is to elucidate on the frequency, treatments, comorbidities, and deaths of nursing home residents diagnosed with type 2 diabetes.

Materials and methods

Type 2 diabetes was evaluated in 612 people accepted to nursing homes as residents between January 2005 and January 2013. Medical records, prescriptions, laboratory results, and comorbidities were evaluated statistically.

Results

Approximately 26% (159) patients of the cohort had either preexisting type 2 diabetes during registration to nursing home or was diagnosed with it during the 8-year follow-up. The prevalence of DM was 25% in males and 26% in females. Average age was 75.7 ± 10.6 in diabetics and 76.7 ± 11.6 in non-diabetics. Hemoglobin, creatinine, triglycerides, HDL-cholesterol, and CRP values were not found to be different between the groups. Hypertension was diagnosed in 75% of diabetics versus 59% of non-diabetics, hyperlipidemia in 21% versus 7% (P < .01); however, atrial fibrillation was more common in non-diabetics (P = .022). There was no difference for survival rate between diabetic and non-diabetic groups (P = .743).

Conclusion

Approximately 1 out of 4 nursing home residents were found to have diabetes, with females being more affected then males. The survival rates both at the diabetic and non-diabetic patients were detected similar. Glucose, total cholesterol, LDL-cholesterol, and blood pressure values which can all impact survival should be closely watched from early on in the disease progress and their values should be optimized.

Patient-reported outcomes for diabetes and hypertension care in low- and middle-income countries: A scoping review

INTRODUCTION

Patient-reported outcome measures (PROMs) assess patients' perspectives on their health status, providing opportunities to improve the quality of care. While PROMs are increasingly used in high-income settings, limited data are available on PROMs use for diabetes and hypertension in low-and middle-income countries (LMICs). This scoping review aimed to determine how PROMs are employed for diabetes and hypertension care in LMICs.

METHODS

We searched PubMed, EMBASE, and ClinicalTrials.gov for English-language studies published between August 2009 and August 2019 that measured at least one PROM related to diabetes or hypertension in LMICs. Full texts of included studies were examined to assess study characteristics, target population, outcome focus, PROMs used, and methods for data collection and reporting.

RESULTS

Sixty-eight studies met the inclusion criteria and reported on PROMs for people diagnosed with hypertension and/or diabetes and receiving care in health facilities. Thirty-nine (57%) reported on upper-middle-income countries, 19 (28%) reported on lower-middle-income countries, 4 (6%) reported on low-income countries, and 6 (9%) were multi-country. Most focused on diabetes (60/68, 88%), while 4 studies focused on hypertension and 4 focused on diabetes/hypertension comorbidity. Outcomes of interest varied; most common were glycemic or blood pressure control (38), health literacy and treatment adherence (27), and acute complications (22). Collectively the studies deployed 55 unique tools to measure patient outcomes. Most common were the Morisky Medication Adherence Scale (7) and EuroQoL-5D-3L (7).

CONCLUSION

PROMs are deployed in LMICs around the world, with greatest reported use in LMICs with an upper-middle-income classification. Diabetes PROMs were more widely deployed in LMICs than hypertension PROMs, suggesting an opportunity to adapt PROMs for hypertension. Future research focusing on standardization and simplification could improve future comparability and adaptability across LMIC contexts. Incorporation into national health information systems would best establish PROMs as a means to reveal the effectiveness of person-centered diabetes and hypertension care.

Health-related quality of life and associated factors among patients with type II diabetes mellitus: A study in the family medicine center (FMC) of Agricultural General Hospital in Hanoi, Vietnam

The current study aimed to examine the health-related quality of life (HRQoL) and to identify its related factors amongst adult patients with type 2 diabetes mellitus (T2DM). This cross-sectional study recruited randomly 519 patients diagnosed with T2DM for at least 6 months in the Family medicine center (FMC) of Agricultural General Hospital in Hanoi, Vietnam. The Short Form 36 (SF-36) health survey was used to measure their HRQoL. The female patients had lower physical and mental scores than the male patients. Patients with older age, comorbidity, and insulin treatment were more likely to have lower HRQoL. Meanwhile, educational attainment and having frequent exercise were positively associated with HRQoL.

Mental Health and Health-Related Quality-of-Life Outcomes Among Frontline Health Workers During the Peak of COVID-19 Outbreak in Vietnam: A Cross-Sectional Study

PURPOSE

Mental health is an important component of the protection strategy for healthcare workers (HCWs). However, it has not been well described in Vietnam during the COVID-19 outbreak. This study aims to measure the psychological distress and health-related quality-of-life among frontline healthcare workers during the peak of the outbreak in Vietnam.

PATIENTS AND METHODS

We conducted a cross-sectional survey on 173 health workers at two national tertiary hospitals in Hanoi, Vietnam from March to April 2020. The psychological distress was measured by the Depression, Anxiety, and Stress Scale - 21 Items (DASS-21), Impact of Event Scale - Revised (IES-R), and the Insomnia Severity Index (ISI). EQ-5D-5L was used to determine the health-related quality-of-life (HRQoL) outcomes.

RESULTS

Among 173 HCWs, the proportion of reported depression symptoms, anxiety symptoms, and stress was 20.2%, 33.5%, and 12.7%, respectively. The median EQ-5D-5L index score was 0.93 (IQR=0.85-0.94), and the anxiety/depression aspect had the highest reported problems. The most COVID-19-specific concerns among frontline HCWs were the reduction of income (59%) and the increase of living costs (54.3%). HCWs working in the COVID-19-designated hospital had a significantly higher rate of mental health problems and had a lower HRQoL outcome than those working in non-COVID-19-designated hospitals. Other factors associated with psychological distress and sleep problems include age, job title, income, chronic diseases status, and years of working in healthcare settings. HCWs who were ≥30 years old, had higher working years, had higher incomes, and had mental health and sleep problems were more likely to have lower HRQoL scores.

CONCLUSION

We reported a moderate rate of psychological distress and lower HRQoL outcomes among frontline HCWs during the COVID-19 outbreak in Vietnam. Various factors were found to be associated with mental health and HRQoL that might be useful for implementing appropriate interventions for HCWs in low-resource settings.

Predictors of Health-Related Quality of Life in Korean Adults with Diabetes Mellitus

Diabetes mellitus (DM) as a chronic disease is a major public health problem worldwide. It is important to improve the quality of life of people with DM, especially health-related aspects, which should be monitored and managed as part of diabetes management. Accordingly, this study investigated health-related quality of life (HRQoL) and identified predictors of HRQoL in Korean adults with DM using the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII) 2016–2018. This was a cross-sectional study with a stratified multistage probability sampling design that collected data from 1228 participants aged 30–80 years diagnosed with DM. HRQoL was measured using the Euro Quality of Life Five Dimension (EQ-5D) questionnaire. Analyses consisted of one-way analysis of variance, t-tests, chi-squared tests, and general linear regression analyses with complex sampling designs. Results demonstrated that low HRQoL was associated with older age (β = −0.002, 95% CI: −0.003 to −0.001), having elementary school education or less (β = −0.037, 95% CI: −0.061 to −0.014), being unmarried (β = −0.060, 95% CI: −0.078 to −0.040), poor subjective health status (β = −0.074, 95% CI: −0.094 to −0.055), perceived high stress (β = −0.047, 95% CI: −0.066 to −0.028), limited activity (β = −0.105, 95% CI: −0.131 to −0.079), being overweight (β = −0.021, 95% CI: −0.038 to −0.002), or obese (β = −0.016, 95% CI: −0.032 to −0.001), and three or more comorbidities (β = −0.044, 95% CI: −0.085 to −0.001). Comprehensive health care programs to manage these predictors should be provided to improve health-related quality of life of patients with DM.

Health-related quality of life and its associated factors in patients with type 2 diabetes mellitus

Background:

Assessing the health-related quality of life in patients with type 2 diabetes mellitus is important for evaluation of treatment outcome. The purpose of this study was to evaluate the health-related quality of life in type 2 diabetes mellitus patients and its related factors in Yazd.

Methods:

Data were gathered by using the EuroQoL-five-dimension-5 level instrument as well as using medical records of 734 outpatients with type 2 diabetes mellitus who were referred to the largest governmental diabetes center in South of Iran, Yazd province. When appropriate, the Kruskal–Wallis test or the Wilcoxon test was used to test the difference in the health-related quality-of-life scores in each factor. Finally, the adjusted limited dependent variable mixture model was developed to investigate factors associated with health-related quality-of-life scores.

Results:

The mean and median of the EuroQoL-five-dimension-5 level index values of 717 patients who completed the questionnaires were 0.75 ± 0.006 and 0.72 ± 0.20, respectively, and those of the Visual Analogue Scale scores were 69.25 ± 0.63 and 75 ± 30, respectively. The mean scores for health-related quality of life were significantly higher for employed, educated, single, and male patients, as well as patients without comorbidities, diabetes-related complications, and hemoglobin A1c level >7%. Adjusted limited dependent variable mixture model showed that gender, age, marital status, and diabetes-related complications are significant independent predictors of EuroQoL-five-dimension-5 level index value.

Conclusion:

The mean scores for health-related quality of life in patients with type 2 diabetes mellitus were moderate in this study, and this finding is consistent with health-related quality-of-life scores reported in other studies conducted in the Middle East region. Therefore, health-related quality of life should be the most important consideration in the management of patients. In parallel, some factors, especially gender, should be considered to improve health-related quality of life.

Emotional Intelligence and Quality of Life in Elderly Diabetic Patients

BACKGROUND

Coordination of various physical and mental aspects of individuals, including the ability to control difficult conditions and situations has an effect in the prevention and development of various diseases, such as diabetes, and the improvement of the quality of life. Therefore, the purpose of this study was is to determine the effect of emotional intelligence on the quality of life of elderly diabetic patients.

METHODS

This study was conducted in 2018. The statistical population in this cross-sectional study consisted of elderly people referred to the health centers of Kermanshah province in western Iran, who were divided via available sampling into two groups with diabetes and without diabetes. Data gathering tools were a couple of LIPAD Quality of Life and Shrink Emotional Intelligence standard questionnaires. The Data was analysed using software SPSS, 23 th version. Tests were used (T-test, Chi-square, Anova and regression).

RESULTS

Most of them were male (52.72%) and the mean age of the patients was 65.01(±6.08) years old and married. The quality of life score in diabetics and non-diabetics was respectively 51.9 and 50.37 with a standard deviation of 17.73 and 20.54. The mean total score of emotional intelligence in the elderly with diabetes was 99.42 with a standard deviation of 10.37 and non-diabetic subjects were 97.18 with a standard deviation of 18.4.

CONCLUSION

There was no significant difference between the mean scores of quality of life (0.652) and emotional intelligence (0.421) in diabetic and non-diabetic individuals. But, the emotional intelligence has an effect on the quality of life of the elderly people.

Health-Related Quality of Life and its Associated Factors in COVID-19 Patients

OBJECTIVES

Health-related quality of life (HRQoL) is one of the most important outcome measures for patients. The purpose of this study was to evaluate HRQoL and related factors in Coronavirus disease 2019 (COVID-19) patients.

METHODS

A total of 420 COVID-19 patients who had been discharged from hospital were selected using a systematic sampling. The EuroQol 5-dimensional-5 levels (EQ-5D-5L) questionnaire along with medical records of the patients were used to gather the data. The t test and analysis of variance were employed to test the difference between mean EQ-5D-5L scores, and the BetaMix model was used to investigate factors associated with EQ-5D-5L scores.

RESULTS

The mean score for the patients who completed the EQ-5D-5L questionnaire (n = 409) was 0.6125. The EQ-5D-5L scores were significantly higher in males, patients with younger age, those with a low level of education, the employed, patients who worked in uncrowded workplaces, patients without diabetes, and those who were not admitted to intensive care unit. The BetaMix model showed that gender, age, education, employment status, having diabetes, heart failure, and admission to the intensive care unit were significant independent predictors of the EQ-5D-5L index values.

CONCLUSION

The mean score for EQ-5D-5L in COVID-19 patients was low in this study. Some of the factors, especially aging and having diabetes, should be considered in the aftercare of patients to improve their HRQoL.

Factors affecting health-related quality of life among hypertensive patients using the EQ-5D tool

OBJECTIVES

Hypertension (HTN) is a major risk factor for cardiovascular disease, it is an epidemic health problem with 1 billion people affected worldwide. Limited studies have examined the impact of HTN on physical, psychological and social functioning of HTN patients. Furthermore, little is known about factors that impair these domains among these patients. Thus, the aim of the present study is to assess health-related quality of life (HRQoL) and to explore predictors of poor HRQoL in patients with HTN in Jordan.

METHODS

Hypertensive patients visiting cardiology and internal medicine departments were recruited from three major hospitals in Jordan. Patients' Socio-demographics and medical data were collected via direct patient encounters and medical records. The validated Arabic version of EQ-5D tool was used to assess HRQoL. Simple linear regression was performed to explore the factors associated with poor HRQoL.

RESULTS

The mean score of the EQ-5D index of the 300 participants was 0.732 (SD = 0.29, range from -0.594 to 1.0). While extreme problems were only reported by 10% of the participants, most of them reported "some problems" through the five dimensions with the highest percentage (43.3%) for mobility dimension. Gender, monthly income, number of medical conditions, number of medications, number of HTN medications, duration of HTN and the presence of any atherosclerotic cardiovascular diseases were significantly associated with the EQ-5D index value (P-value <.05).

CONCLUSIONS

The current study highlights factors that negatively impact HRQoL in patients with HTN. Such findings should provide useful information for future pharmaceutical care intervention programmes aimed at improving HRQoL and other health outcomes in patients with HTN.

Health-Related Quality of Life in Motorcycle Crash Victims One Year After Injury: A Longitudinal Study in Ho Chi Minh City, Vietnam

Despite the burden of injury associated with motorcycle crashes and injuries in Vietnam, there are no studies investigating health-related quality of life (HRQoL) following a nonfatal motorcycle crash in this country. Therefore, this study aimed to evaluate the change of HRQoL preinjury, and at 6 and 12 months postinjury motorcycle crash in Ho Chi Minh City, Vietnam. Outcome measures were Physical Component Scores (PCS) and Mental Component Scores (MCS) of the Short Form 12 Health Survey (SF-12) version 2 and the EQ-5D. Multilevel mixed models were undertaken. A total of 352 hospitalized motorcyclists were followed-up. Compared with preinjury, the SF-12 PCS reduced by 6.61 points (95% confidence interval [CI] = -8.21 to -5.03) and 5.12 points (95% CI = -6.74 to -3.51) at 12 months postinjury. MCS also reduced by 4.23 points (95% CI = -5.99 to -2.47) at 6 months but increased by 1.29 points (95% CI = -0.49 to 3.08) at 12 months postinjury. The EQ-5D Visual Analogue Scale score decreased by 10.41 points (95% CI = -11.49 to -9.33) at 6 months and 6.48 points (95% CI = -7.58 to -5.38) at 12 months postinjury. The HRQoL among injured motorcycle riders improved between 6 and 12 months after injury but had not returned to the levels before injury.

Effects of Diabetic Complications on Health-Related Quality of Life Impairment in Vietnamese Patients with Type 2 Diabetes

Complications of type 2 diabetes mellitus (T2DM) adversely influence patients' health-related quality of life (HRQOL). This study is aimed at examining HRQOL of T2DM patients, as well as the effects of diabetic complications and comorbidities on HRQOL in this population. This was a hospital-based cross-sectional study on 214 T2DM patients in Hanoi, Vietnam. Short-form 12 version 2 (SF-12v2) and EuroQOL-5 Dimensions-5 Levels (EQ-5D-5L) were employed to measure the HRQOL. The median physical component summary score (PCS), mental component summary score (MCS), and EQ-5D index were 45.6, 56.3, and 0.94, respectively. Having at least one diabetic complication was associated with the reduction of SF-12 scores in social functioning (Diff. = -5.69, 95%CI = -9.24; -2.13), role emotional (Diff. = -1.81, 95%CI = -3.12; -0.51), and MCS (Diff. = -2.55, 95%CI = -5.01; -0.1). Significant decrement of physical functioning, role physical, social functioning, role emotional, and MCS was found in patients having diabetic heart diseases compared to those without diabetic complications. The study revealed that HRQOL of Vietnamese patients with diabetic complications was moderately low, especially in social and mental health perspectives. Strategies to prevent the onset of diabetic complications should be developed as a priority in diabetes management.

Knowledge about Diabetes and Glycemic Control among Diabetic Patients in Saudi Arabia

The prevalence of diabetes in various regions has attracted significant attention of the medical experts. The prevalence of diabetes is expected to increase in the future due to changes in lifestyle and unhealthy diets of individuals. The objective of the study is to identify the extent of knowledge related to diabetes and glycemic controls in various diabetic patients living in Saudi Arabia. A total of 435 patients were recruited using a random sampling technique, while following a cross-sectional design. Patients' knowledge was tested using the Michigan Diabetes Knowledge Test. Findings of the study illustrated that the problem was common among middle-aged male patients. A significant amount of knowledge related to the consumption of medicines, insulin, healthy diet, etc. was found among diabetic patients. Despite the fact that people have adequate knowledge, valuable attention is yet required to provide necessary counselling to people living in Saudi Arabia that may help them to control health risks and mortality.

Improvement in oral health related quality of life among the elderly: a randomized controlled trial

Background

The present study was conducted to determine the impact of educational intervention based on adult learning theory on oral health related quality of life of the elderly.

Materials and methods

This study (IRCT20120910010804N13) was performed with 92 elderly patients referred to the dental clinic of Ahvaz Jundishapur University of medical sciences. Participants were randomly divided into experimental and control groups. The data were gathered by a questionnaire with demographic variables, variables of oral health related quality of the elderly, and variables for assessing the effectiveness of adult learning theory. Following pre-test, educational programs were conducted for the interventional group. After 1 month, the questionnaire was again administered to both groups. Next, the results of pre-test and post-test were analyzed using SPSS-23 at a significance level of 0.05.

Results

Educational intervention was significant in terms of overall oral health related quality of life and the overall effectiveness score of adult learning theory (P < 0.001). There was a significant difference between the two groups in terms of the mean change score of three physical, psychosocial, and pain dimensions following the educational intervention (P < 0.001).

Conclusion

Education based on adult learning theory is recommended for improving oral health related quality of life among the elderly.

Trial registration

Iranian Registry of Clinical Trials, IRCT20120910010804N13. Registered on 2018-12-16.

https://www.irct.ir/trial/35239

As Time Goes by: Anxiety Negatively Affects the Perceived Quality of Life in Patients With Type 2 Diabetes of Long Duration

INTRODUCTION

Age-related medical conditions are increasing worldwide. Type 2 Diabetes mellitus (T2DM) represents a chronic disease, which affects a large amount of general population, accounting for over 90% of diabetes mellitus (DM) cases.

PURPOSE

As psychopathological symptoms frequently occur in medical conditions, our study aimed at exploring whether psychological factors and metabolic control may affect health related quality of life (HRQoL).

METHODS

Forty five patients with T2DM were consecutively recruited and assessed with a psychodiagnostic battery: Hamilton Anxiety Rating Scale (HAM-A), Beck Depression Inventory II edition (BDI-II) and the 36-Item Short Form Health Survey (SF-36), including indexes Physical and Mental Component Summary (PCS, MCS). Moreover, time since DM diagnosis and glycated hemoglobin (HbA1c) values were detected.

RESULTS

Participants (mean age 65.3 ± 5.9 years) had a mean time since diagnosis of 11.6 ± 6.7 years, and showed a good metabolic control as highlighted by mean HbA1c values 7.1 ± 0.9%. Median HAM-A score [25(20.7-30.6)], represented high prevalence of anxious symptoms. A moderate expression of depressive symptoms was observed [BDI-II score: 13(8.3-21.4)]. A multiple regression analysis, after correcting for age, BMI, HbA1c value and BDI-II score, showed the perceived quality of life relative to PCS was significantly related to both disease duration (β = -0.55, p = 0.03, SE = 0.25) and HAM-A scores (β = -0.52, p = 0.04, SE = 0.24). Moreover, both HAM-A (β = -0.67, p = 0.01, SE = 0.26) and BDI-II (β = -0.48, p = 0.02, SE = 0.20) scores were independently predictive of MCS. Metabolic control, instead, was not a significant predictor.

CONCLUSION

Our study suggests a predictive role of both anxiety levels and time since diagnosis in perceived HRQoL in T2DM patients. PCS was associated with anxiety and time since diagnosis and MCS was associated with anxiety and depressive symptoms but not with diabetes duration or metabolic control. These data could be useful to plan T2DM training programs focused on psychological health concerns, possibly leading to a healthy self-management and a better perceived HRQoL, even assisting patients in reducing the negative effect due to the chronicization of T2DM.

Impact of Comorbid Chronic Conditions to Quality of Life among Elderly Patients with Diabetes Mellitus in Vietnam

Type 2 diabetes mellitus (T2DM) is a major cause of disease burden in the elderly population. This study aimed to measure the quality of life (QOL) among patients with T2DM and the associations between co-morbidities and QOL. A cross-sectional study was conducted on 194 patients with T2DM. The minimal clinically important difference (MCID) scores were used to indicate the clinically meaningful differences of comorbidities on quality of life. A Tobit regression was employed to find relationships between QOL and comorbidities. The mean scores of QOL domains were 50.8 (SD = 13.2) in physical, 62.4 (SD = 11.5) in psychological, 52.3 (SD = 10.2) in social relationship, and 64.3 (SD = 10.1) in environmental. Digestive and neuropsychiatric diseases had the strongest negative associations with physical QOL of patients. Neuropsychiatric diseases also had the biggest effect on psychological and environmental QOL. Meanwhile, in the social domain, respiratory diseases had the greatest effect. In conclusion, patients with T2DM struggled to perform physical functions. In addition, comorbidities significantly reduced the QOL of T2DM patients.