Health-related quality of life and associated factors among type 2 diabetic adult patients in Debre Markos Referral Hospital, Northwest Ethiopia

Designing and Implementing a Customized Questionnaire to Assess the Attitude of Patients with Diabetes

Background/Objectives: Diabetes mellitus presents significant management challenges, requiring comprehensive glycemic control, patient education, self-management, and routine monitoring. The study aims to evaluate existing tools and develop a customized questionnaire to investigate the multifaceted impact of diabetes mellitus on patients' lives through a novel questionnaire. Methods: Utilizing Survey Monkey, we efficiently collected data from 150 diabetic patients during annual evaluations over five months (March 2024-July 2024). The sample included 88 men (58.67%) and 62 women (41.33%), with a notable representation of participants having a family history of diabetes (63.42%) and varying levels of education (20% with higher education). Statistical analyses were conducted using IBM SPSS (Version 20.0), and structural equation modeling (SEM) through Amos, including exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to validate the instrument and assess its psychometric properties. Results: The questionnaire targets four critical domains: the role of physical activity in diabetes management, the effects of diabetes on social relationships, the emotional status of diabetic patients, and the influence of diet on metabolic control. Conclusions: The findings provide valuable insights into patient attitudes toward diabetes management, emphasizing the importance of physical activity, social dynamics, emotional well-being, and dietary practices in improving health outcomes for individuals with diabetes.

The role of social role strain, psychological resources and perceiving diabetes as a priority with self-care in women with type 2 diabetes mellitus

BACKGROUND

The burden of Type 2 Diabetes Mellitus (T2DM) has increased globally and a significant number of Malaysian women are being affected by this disease. Self-care plays a vital role in improving glycemic control and preventing complications. However, women with diabetes face barriers to practising good self-care. This study aimed to determine factors associated with self-care in women with T2DM: social role strain, psychological resources (problem-focused coping and social support) and perception of diabetes as a priority.

METHODS

A cross-sectional study was conducted among women with T2DM between January and April 2023 in a public primary care clinic in Seremban, Malaysia. The study instrument consists of the Summary of Diabetes Self-care Activities (SDSCA), scale for Measuring Role Strain in Women with Diabetes, problem-focused coping from brief COPE, Multidimensional Scale of Perceived Social Support (MSPSS) and an item to assess the perception of diabetes as a priority.

RESULTS

A total of 346 women participated in the study (mean age = 60.67, SD = 10.12). Most were elderly (60.4%), Indian (48.3%), had low education (80.6%) and from lower income (70.8%). The mean score for self-care was 2.81 (SD 0.80) days, indicating a suboptimal level. Multiple linear regression analysis revealed that higher income (β = 0.82, [95% CI 0.04, 1.59], p = 0.039), problem-focused coping (β = 0.47,[95% CI 0.03, 0.06],p < 0.001), and perceiving diabetes as a priority (β = 0.04, [95% CI 0.004, 0.09], p = 0.031) were positively associated with self-care. Meanwhile, older age (β= -0.02, [95% CI -0.03, -0.01], p < 0.001), low education (β = -0.25, [95% CI -0.03, -0.01], p = 0.007) and social role strain (β = -0.02, [95% CI -0.03, -0.01], p = 0.003) were negatively associated.

CONCLUSIONS

Our findings highlighted that women with a higher social role strain, older age and low education have poor self-care. In contrast, those with higher income, utilising problem-focused coping and prioritising diabetes, exhibit better self-care. Interventions for women with T2DM should focus on assisting them to alleviate their social role strain and develop their coping skills. Additionally, involving family in the intervention would help women prioritise self-care.

The association between quality of life and diabetes: the Bushehr Elderly Health Program

BACKGROUND AND OBJECTIVE

Considering the importance of diabetes and its increased prevalence with aging, this study aimed to evaluate the association between diabetes status and quality of life (QOL) and the determining factors in individuals over 60.

METHODS

Two thousand three hundred seventy-five individuals including 819 (34.5%) with diabetes, aged 69.4 ± 6.4, from Bushehr Elderly Health Program (BEHP) were enrolled. We categorized the participants as non-diabetic, controlled diabetic, and poorly controlled diabetic. The QOL was assessed using the SF-12 questionnaire. The physical (PCS) and mental (MCS) component summaries of QOL were estimated. We compared the SF-12 domains and components between the categories using ANOVA. Further, the association of diabetes status with PCS and MCS was assessed after adjustment for possible confounders including age, sex, depression, cognitive impairment, physical activity, and other relevant factors using linear regression analysis.

RESULTS

Individuals with diabetes had lower PCS (40.9 ± 8.8 vs. 42.7 ± 8.6, p-value < 0.001), and MCS scores (45.0 ± 10.2 vs. 46.4 ± 9.4, p-value < 0.001) compared to participants without diabetes. No significant differences were observed in PCS or MCS scores between controlled or poorly controlled individuals with diabetes. Diabetes status was associated with PCS and MCS scores in univariable analysis. Regarding physical component of QOL, after adjusting for other confounders, poorly controlled diabetes was significantly associated with PCS [beta: -1.27 (-2.02, -0.52)]; some other determinants include depression [-7.66 (-8.51, -6.80)], male sex [3.90 (3.24,4.57)], and good physical activity [1.87 (1.17,2.57)]. As for the mental component, controlled diabetes was significantly associated with MCS [-1.17 (-2.13, -0.22)]; other contributing factors include depression [-14.35 (-15.34, -13.37)], male sex [1.97 (1.20,2.73)], good physical activity [-1.55 (-2.35, -0.75)], and smoking [-1.42 (-2.24, -0.59)]. BMI had an inverse association with PCS [-0.19 (-0.26, -0.13)] and a direct association with MCS [0.14 (0.07,0.21)].

CONCLUSION

Individuals with diabetes exhibited reduced QOL scores. Upon adjusting for other variables, it was found that uncontrolled diabetes correlated with decreased PCS scores, whereas controlled diabetes was linked to lower MCS scores. Factors such as depression and being female were identified as contributors to diminished QOL in both physical and mental aspects. These results have the potential to guide healthcare decision-making, facilitating the creation of tailored interventions aimed at improving the QOL for individuals with diabetes, with a specific focus on women and depression.

The relationship between diabetes burden and health-related quality of life in elderly people with diabetes

BACKGROUND

One of the most common chronic diseases in the elderly is diabetes. When diabetes is not well controlled, it can cause complications and affect health-related quality of life. Determining the burden of diabetes in elderly patients can provide a good health-related quality of life.

AIM

The study was conducted to examine the relationship between diabetes burden and health-related quality of life in elderly patients with diabetes.

METHODS

This is a descriptive and correlational study of 207 patients who applied to the diabetes outpatient clinics of a private and a public hospital in Istanbul. Respondents were completed with "Personal Information Form for Elderly People", "Elderly Diabetes Burden Scale" and the "Quality of Life in the Elderly Scale". Data were analyzed by SPSS. The tests used are Kolmogorov-Smirnov, Mann-Whitney U, Kruskal Wallis and Spearman Correlation tests.

RESULTS

The mean total score from the Elderly Diabetes Burden Scale was 47.13 ± 11.95 (18-88), and the mean score from the Quality of Life in the Elderly Scale was 19.36 ± 7.00. In the study, as the total diabetes burden score of the elderly patients increased, the Quality of Life in the Elderly Scale score decreased. There was a difference between the mean total score of the Elderly Diabetes Burden Scale and gender, education, living alone and using oral antidiabetic (p < 0.05).

CONCLUSIONS

As a result it was determined, a negative correlation was found between the diabetes CASP-19 scale total score and the total EDBS. Determining the burden of diabetes and affecting factors in elderly is important in terms of increasing the health-related quality of life. It may be recommended to plan diabetes education programs that will reduce the burden of diabetes and increase the health-related quality of life in elderly patients.

Factors predicted quality of life of people with type 2 diabetes in western Ethiopia

BACKGROUND

Multiple factors predict the quality of life of adults with diabetes. However, the relationships of demographics, self-management practice, and support status with the quality of life of people with diabetes are unknown. Therefore, the study aimed to assess factors related with the quality of life of adults with type 2 diabetes in western Ethiopia.

METHODS

A hospital-based cross-sectional study involving adults with type 2 diabetes was conducted in western Ethiopia from June 02, 2020, to August 31, 2020. Convenience sampling technique was used in selecting subjects. The translated and psychometrically tested summary of diabetes self-management activities (expanded), diabetes quality of life, and diabetes care profile support scales were used in measuring self-management practice, quality of life, and support status, respectively. Data were collected via face-to-face interviews. Factors related with quality of life were examined through bivariate analysis and multivariable linear regression. In all statistical tests, P value <0.05 and confidence level that excluded zero were considered statistically significant.

RESULTS

A total of 417 adults with type 2 diabetes participated in the study. In a multivariable linear regression, seven factors including age, male, homemakers, those separated/divorced, number of years since diabetes diagnosis, self-management practice and support needed were related with quality of life. Male patients (β = 2.786, 95% CI = 1.285 to 4.287, p < 0.001), homemakers (β = 0.366, 95% CI = 0.056; 0.677, p = 0.021), self-management practice (β = 4.528, 95% CI = 3.851 to 5.205, p < 0.001) and those who needed support from their families or peers (β = 1.623, 95% CI = 0.458; 2.788, p = 0.006) were related positively with quality of life whereas those who separated or divorced (β = -1.698, 95% CI = -3.371 to -0.025, p = 0.047), older age (β = -0.195, 95% CI = -0.269 to -0.121, p < 0.001) and those who lived with diabetes for a longer duration (β = -2.206, 95% CI = -4.151 to -0.261, p = 0.026) were related negatively with quality of life.

CONCLUSION

Quality of life of people with type 2 diabetes living in western Ethiopia was predicted positively by being male, homemakers, having self-management practice, and support needed, whereas negatively influenced by old age, separation or divorce, and long diabetes life. Thus, encouraging self-management practice, and continuous family or friend support are necessary to enhance quality of life of people with type 2 diabetes. Further study should employ random sampling techniques and involve participants from multiple study settings to increase representativeness of the samples.

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.