Changes in the level of knowledge of diabetes among elderly with diabetes in Slovenia in the period 2011-2020

Person-Centred Diabetes Care: Examining Patient Empowerment and Diabetes-Specific Quality of Life in Slovenian Adults with Type 2 Diabetes

Patient empowerment is crucial for promoting and strengthening health. We aimed to assess patient empowerment and diabetes-specific health-related quality of life (HRQoL) in adults with type 2 diabetes (T2D). A multi-centre, cross-sectional survey was conducted among adults with T2D in urban and rural primary care settings in Slovenia between April and September 2023. The survey utilised convenience sampling and included sociodemographic and clinical data, the Diabetes Empowerment Scale (DES), and the Audit of Diabetes-Dependent QoL (ADDQoL). The study included 289 people with T2D and a mean age of 67.2 years (SD 9.2). The mean overall DES score was 3.9/5 (SD 0.4). In a multivariable linear regression model, higher empowerment was significantly associated with residing in a rural region (p = 0.034), higher education (p = 0.028), and a lack of comorbid AH (p = 0.016). The median overall ADDQoL score was -1.2 (IQR [-2.5, -0.6]). The greatest negative influence of diabetes on HRQoL was observed in the domain 'Freedom to eat', followed by 'Freedom to drink', 'Leisure activities', and 'Holidays'. Despite high empowerment among adults with T2D, the condition still imposes a personal burden. Integrated primary care models should prioritise the importance of implementing targeted interventions to enhance diabetes empowerment, address comorbidities, and improve specific aspects of QoL among individuals with T2D.

Assessing the reliability and validity of the Slovenian version of the Appraisal of Diabetes Scale (ADS-S) in type 2 diabetes patients

Managing type 2 diabetes (T2D) effectively is a considerable challenge. The Appraisal of Diabetes Scale (ADS) has proven valuable in understanding how individuals perceive and cope with their condition. This study aimed to evaluate the psychometric properties of the Slovenian version of ADS (ADS-S). We recruited a sample of 400 adult individuals with T2D from three primary healthcare centers in Slovenia, ensuring an average of 57 cases per individual item. The psychometric evaluation included internal consistency, test-retest reliability, construct validity, and discriminant validity. Confirmatory factor analysis (CFA) was additionally performed to evaluate the fit of one- and two-factor models. After excluding incomplete questionnaires, 389 individuals participated, averaging 72.0±7.5 years, with 196 men and 193 women. ADS-S exhibited acceptable internal consistency (Cronbach's α = 0.70) and strong test-retest reliability (interclass correlation = 0.88, p <0.001). Criterion validity was established through significant correlations between ADS-S score and EQ-5D utility score (r = -0.34, p <0.001), EQ-VAS score (r = -0.38, p <0.001), and HbA1c >7.5% (r = 0.22, p = 0.019). Discriminant validity assessment found no significant correlation between ADS-S score and age, but a significant correlation with female gender (r = 0.17, p = 0.001). CFA results supported a two-factor structure (psychological impact of diabetes and sense of self-control) over a one-factor structure, as indicated by model fit indicators. ADS-S stands as a valid and reliable tool for assessing psychological impact and self-control in Slovenian T2D patients. Future research should explore adding items for capturing secondary appraisal of diabetes and studying the influence of female gender on ADS scores.

Facilitators and Barriers to Scaling-Up Integrated Care for Arterial Hypertension and Type 2 Diabetes in Slovenia: Qualitative Study

Introduction

Arterial hypertension and type 2 diabetes are significant contributors to global non-communicable disease-related mortality. Integrated care, centred on person-centred principles, aims to enhance healthcare quality and access, especially for vulnerable populations. This study investigates integrated care for these diseases in Slovenia, providing a comprehensive analysis of facilitators and barriers influencing scalability.

Methods

Qualitative methods, including focus group discussions and semi-structured interviews, were employed in line with the grounded theory approach. Participants represented various levels (micro, meso and macro), ensuring diverse perspectives. Data were collected from May 2019 to April 2020, until reaching saturation. Transcripts were analysed thematically using NVivo software.

Results

Nine categories emerged: Governance, Health financing, Organisation of healthcare, Health workforce, Patients, Community links, Collaboration/Communication, Pharmaceuticals, and Health information systems. Some of identified barriers were political inertia and underutilisation of research findings in practice; outdated health financing system; accessibility challenges, especially for vulnerable populations; healthcare workforce knowledge and burnout; patients' complex role in accepting and managing their conditions; collaboration within healthcare teams; and fragmentation of health information systems. Peer support and telemedicine were the only two potential solutions identified.

Conclusions

This study offers a comprehensive evaluation of integrated care for hypertension and type 2 diabetes in Slovenia, featuring insights into facilitators and barriers. These findings have implications for policy and practice. Monitoring integrated care progress, refining strategies, and enhancing care quality for patients with these two diseases should be priorities in Slovenia.

Patient knowledge about diabetes: Illness symptoms, complications and preventive personal lifestyle factors

AIMS

Knowledge plays a vital role in making better decisions for treatment. Patients should be educated about the knowledge of the disease. This study aimed to know patient knowledge about diabetes illness symptoms, complications, and preventive personal lifestyle factors.

METHODS

A cross sectional research design was used to know diabetes knowledge among 261 diabetes patients. Descriptive analysis and logistic regression were used to analyze collected data.

RESULTS

A total 261 respondents were included in this study. 71.26 % were male and 28.74% were females, and their mean age was 30.41 ±7.4 years. About 45.2 % of the respondents earned excellent knowledge ratings. The study concluded that frequent urination (94.6%), increased thirst (86.6%) and slow healing of cuts and wounds (88.5%) were the common symptoms of diabetes. Respondents knew that a family history of diabetes mellitus is the most significant risk factor, followed by being overweight /obesity (89.7%). Most respondents indicated that insulin injection (92%) and avoiding sugary foods (91.6%) were the best ways to control blood sugar. Even though work related to the medical field (p=001) and age (p=0.018) were significantly and positively associated with knowledge, the association of gender, income, level of education, medical field related education, nationality, and marital position with knowledge were not significant.

CONCLUSIONS

Our study findings has confirmed that respondents have good level of knowledge about diabetes mellitus (DM) and the associated risk factors, symptoms and chronic complications. Age and work related to the medical field have displayed a significant association with respondent's knowledge about risk factors, symptoms and complications of diabetes.

Self-Care Experiences of Empty-Nest Elderly Living With Type 2 Diabetes Mellitus: A Qualitative Study From China

Background

The number of type 2 diabetes mellitus (T2DM) cases among empty-nest elderly increases with increasing aging in China. Self-care plays an important role in preventing and reducing adverse outcomes of diabetes; however, few studies focus on self-care experiences of empty-nest elderly with T2DM.

Objective

To explore self-care experiences for a chronic disease among empty-nest elderly patients with T2DM in mainland China.

Methods

A descriptive phenomenological design was used in this study. Semi-structured interviews were conducted for 15 empty-nesters with T2DM. Interviews were implemented in department of endocrinology at a tertiary teaching hospital located in Shandong province, east of China.

Results

The participants were poorly adept with monitoring their blood glucose and lacked the ability to deal with abnormal blood glucose levels. Most participants had a good relationship with medication and physical activity. Living without children was perceived as a benefit that improved dietary management and is a disadvantage in terms of economic and emotional support and access to medical resources. Elderly empty-nesters also lacked knowledge about diabetes and paid little attention to potential complications.

Conclusion

Empty-nest elderly patients with T2DM value medication compliance and lifestyle modification more than blood glucose monitoring, complication prevention, and coping with negative emotions. Friends and spouses play indispensable roles in patients' self-care motivation and maintenance. Diabetes education on self-care, access to medical resources, and social support is needed for better diabetes management.