Health-related quality of life and social support in adolescents with type 1 diabetes

The association between malocclusion and health-related quality of life in adolescents: A mediation analysis

This study investigated the role of oral health-related functional limitations and social well-being, self-perceived health, psychosocial factors, and social support in mediating the impact of malocclusion on health-related quality of life (HRQoL). A school-based 6-month cohort study was conducted with 376 12-year-old deprived adolescents. Measures at baseline included malocclusion (DAI score), dental caries, sociodemographic characteristics, psychosocial traits (self-esteem, sense of coherence, oral health beliefs), and social support. The oral health-related functional limitations and symptoms (social well-being) domains of the CPQ11-14 , self-perceived health, and HRQoL (Kiddo-KINDL) were evaluated at the 6-month follow-up. Associations between observed and latent variables (social support, psychosocial factors, and HRQoL) were evaluated using structural equation modelling, according to the Wilson and Cleary theoretical model. Malocclusion was indirectly associated with worse HRQoL, mediated by functional limitations, social well-being, and self-perceived health. Better psychosocial status was directly associated with better HRQoL, and higher social support was indirectly associated with better HRQoL via psychosocial factors. Dental caries experience, female sex, and lower family income were indirectly associated with worse HRQoL. The impact of malocclusion on HRQoL was mediated by oral health-related functional limitations, social well-being, and self-perceived health. Sociodemographic and psychosocial factors, and social support also impacted HRQoL.

Relationships among social support, coping style, self-stigma, and quality of life in patients with diabetic foot ulcer: A multicentre, cross-sectional study

Patients with diabetic foot ulcer have a significantly lower quality of life. Quality of life could be connected to other psychological or social processes. The purpose of this study was to examine the relationships between social support, decision regret, self-stigma, and quality of life in patients with diabetic foot ulcers. The sample of the study consisted of 229 diabetic foot ulcer patients. Data were collected from September 2019 to March 2020. The demographic and clinical information, the Stigma Scale for Chronic Illness, Medical Coping Scale, Social Support Scale, and Quality of Life scale were used to assess the quality life for diabetic foot ulcer. Pearson correlation coefficient and structural equation modelling were used for data analysis. The quality of life was negatively correlated with self-stigma, positively correlated with social support, giving up coping, and not significantly correlated with confrontation coping and avoidance coping. Self-stigma has significant indirect effects on quality of life through social support and coping style. Further clinical intervention strategies for decreasing self-stigma as well as strengthening social support and positive coping styles are needed to inform diabetic foot ulcer patients, thus improving their quality of life.

Psychometric validation of the MIND Youth Questionnaire (MY-Q) to assess quality of life in Spanish patients with type 1 diabetes between 12 and 25 years old

AIM

Validate in Spanish the Monitoring Individual Needs in Diabetes Youth Questionnaire (MY-Q), a multi-dimensional self-report HRQoL questionnaire designed for paediatric diabetes care.

DESIGN AND METHODS

After translation, 209 patients diagnosed with type 1 diabetes, between 12 and 25 years old were assessed. The patients belonged to 12 hospitals in Spain.

RESULTS

Exploratory factor analysis including one-factor up to seven-factor solutions were tested. The three-factor solution (Negative Impact of Diabetes, Empowerment and Control of Diabetes and Worries) was the most parsimonious model with adequate fit: χ²(723)=568.856 (p<0.001), CFI=0.913, RMSEA=0.072 [0.064, 0.080], SRMR=0.075. The three-factor solution and the grouping of the items followed a clear rationale. Cronbach's alpha was 0.816 for Negative Impact, 0.700 for Empowerment and Control and 0.795 for Worries. The study of the relationship between the MY-Q dimensions and socio-demographics variables show a relationship between age and the MY-Q: F(6,410)=10.873 (p<0.001), η²=0.137. Participants younger than 14 years old showed greater scores on Empowerment and Control when compared to participants between 14 and 17 years old (p=0.021); statistically significant differences were found for the participants 18 years old or older, who showed lower levels of Worries than the younger patients. Concurrent validity found that the dimension of Negative Impact of Diabetes was positively related to WHO-5, and the PedsQL Diabetes Module.

CONCLUSION

The Spanish version of the MY-Q to measure HRQoL in patients with type 1 diabetes between the ages of 12 and 25, has adequate psychometric properties and conceptual and semantic equivalence with the original version in Dutch.

Effects of the Information-Motivation-Behavioral Skills Model on Metabolic Control of Adolescents with Type 1 Diabetes in Turkey: Randomized Controlled Study

PURPOSE

To evaluate the effects of information-motivation-behavioral skills model interventions given by nurses during home visits on the knowledge levels, personal and social motivation levels, behavioral skills, and HbA1C levels of adolescents with poor glycemic control.

DESIGN AND METHODS

The present study was designed as randomized controlled trial. 50 adolescents with type 1 diabetes were equally divided into study and control groups. Socio-Demographic Form, Diabetes Information Evaluation Form, The Child Attitude Toward Illness Scale, The Multidimensional Scale of Perceived Social Support, and Diabetes Management Self-Efficacy Scale were utilized in data collection. The scales were administered at the beginning of the study and six months later. HbA1c levels of adolescents were evaluated in the third and sixth months. Multiple home visits and phone calls were made to each participant in the intervention group. Interventions to improve the information-motivation-behavioral skills model-based knowledge, personal and social motivation, and behavioral skills were applied during the home visits.

RESULTS

As a result of information-motivation-behavioral skills model-based interventions, knowledge levels (p<0.001), personal motivation levels (p = 0.001), social motivation levels (p = 0.004), and behavioral skills (p<0.001) of the study group improved. Additionally, HbA1c levels decreased significantly in the third (p<0.001) and sixth months (p<0.001).

CONCLUSION

Information-Motivation-Behavioral Skills Model-based intervention effectively improved glycemic control among adolescents with type 1 diabetes.

PRACTICE IMPLICATIONS

Nurses should develop strategies to increase personal motivation, social motivation, and behavioral skills to training programs planned for adolescents with type 1 diabetes.

Association of Formal and Informal Social Support With Health-Related Quality of Life Among Chinese Rural Elders

Objectives: To explore the association of formal and informal social support with health-related quality of life (HRQOL) among Chinese rural elders and further investigate the influence of quantity and quality of social support on their HRQOL. Methods: The sample of 4189 Chinese rural elders over 60 years old was acquired from the 2015 China Health and Retirement Longitudinal Study (CHARLS). The HRQOL was evaluated by EQ-5D-3L questionnaire. The social support assessment was mainly based on the social support rating scale (SSRS), and Tobit regression analysis was used to explore the impact of social support on HRQOL. Results: The average EQ-5D index score (0 to 1) of the Chinese rural elders was 0.78 ± 0.16. Participants who were male or with better education were found to have higher scores. Those elders living alone, suffering from chronic diseases or disabled acquired lower scores. As for formal social support, higher medical or pension insurance and more social activities statistically significantly possessed higher scores. As for informal social support, higher number of offspring had a significant association with lower scores, while more contact with children and financial support from family were shown to be statistically significantly associated with higher scores after controlling for sociodemographic characteristics. The quality of social support is more important than its quantity. An interesting finding was that the EQ-5D index scores did not support the Chinese traditional belief that ‘the more children, the more blessings’. Conclusions: The EQ-5D index scores of the rural elders in China is above the median level based on the scores of EQ-5D. Social support is significantly associated with elderly peoples’ quality of life. The results would be significant for accurately improving the life quality of Chinese rural elders from the perspective of social support.

Evaluation of the quality of life in individuals with amputations in relation to the etiology of their amputation. A case-control study

Objectives: Several studies indicate that limb amputations have a negative influence in the quality of life of those individuals who underwent amputation surgery. The aims of this study were to evaluate the quality of life in Mexican individuals with limb amputations compared with a control group, to identify demographic and clinical differences related to the etiology of the amputation, and to determine if they are associated with the quality of life observed in these patients. Methods: All participants were recruited from the Hospital "Dr Gustavo A. Rovirosa Pérez". The quality of life of all participants was evaluated using SF-36. Results: Individuals with amputations of vascular or trauma etiology, showed a diminished health-related quality of life when compared with the control group (p < .001). We observed that individuals with amputations due to trauma were younger, mostly single, with more upper limb amputations and with a shorter period since amputation at the current assessment in comparison to individuals with amputations. Conclusions: Although limb amputation represents a surgical procedure necessary to preserve the life of a person, our results support that it negatively impacts the health-related quality of life of these individuals. Regardless of the etiology of the amputation, rehabilitation programs are primarily focused on reintegrating individuals to their everyday life. However, these programs may have poor results when patients have a poor quality of life. Therefore, quality of life assessment and early inclusion in programs that aim to improve the quality of life of individuals with amputations should be always taken into consideration.

Family Support and Its Association with Glycemic Control in Adolescents with Type 1 Diabetes Mellitus in Riyadh, Saudi Arabia

The prevalence of type 1 diabetes mellitus (T1DM) among children in Saudi Arabia is increasing with unfavorable outcomes. Therefore, in addition to pharmacotherapy, other measures should be studied regarding psychological aspects mainly among adolescents. The family, which acts as the primary caregiver at this age, may play a major role in disease management. Thus, this study is aimed at assessing the perception of adolescents about the behaviors of their families initially and at investigating the correlation between these behaviors and glycemic control. Up to our knowledge, there was no study in Saudi Arabia that addressed this issue previously. This cross-sectional observational study assessed adolescents aged 10-19 years diagnosed with T1DM on insulin and receiving follow-up care at the King Saud University Medical City in Riyadh, Saudi Arabia. Data were collected via telephone interview and the verified "Modified Diabetes Social Support Questionnaire-Family version". Glycemic control was then assessed using the most recent hemoglobin A1c (HbA1c) level recorded in their electronic files. Fifty-six adolescents participated in this study with an equal sex distribution (each n = 28). Almost all participants were Saudis, and the majority were living in Riyadh (n = 41). The mean age was 16.1 ± 2.41 years with a mean of 6.1 ± 4.14 years history of diabetes. The mean HbA1c level was 9.6 ± 2.12%. Participants perceived all behaviors as supportive with "support in critical situations" being the highest (77.3%) and the only factor significantly related to HbA1c (p = 0.017). Age was significantly related to all factors (p > 0.05). Family plays a major role in the management of diabetes. Their supportive behaviors are perceived by their family members diagnosed with T1DM, but there has been no optimal association with disease control. However, the involvement of the family can aid in decreasing possible complications of the disease by intervening in critical situations.

Health-related quality of life of maltreated children and adolescents who attended a service center in Brazil

PURPOSE

This study's aim was to evaluate the health-related quality of life (HRQoL) and associated factors of maltreated children and adolescents.

METHODS

This cross-sectional study consisted of individuals between 8 and 17 years of age who were victims of maltreatment. The KIDSCREEN-52 was used to measure their HRQoL. Socioeconomic and demographic data were collected, as well as information about the type of abuse, type of perpetrator, and psychological support adherence. The Kruskal-Wallis test was used to analyze the scores of the KIDSCREEN-52 by the independent variables.

RESULTS

One hundred and thirteen victims answered the questionnaire. Girls and adolescents had a lower overall HRQoL score (p < 0.05). Children who suffered from sexual abuse had a lowest score on the moods and emotions dimension than children who suffered from physical abuse (p < 0.05). There was a lowest score on the autonomy dimension among the children who suffered maltreatment by an extrafamilial perpetrator than those who were victimized by an intrafamilial perpetrator (p < 0.05). A lower score on the psychological well-being was observed among the children who adhered to the psychological support program provided by the service compared to those who terminated the service before completion (p < 0.05).

CONCLUSIONS

Adolescents and girls were associated with lower HRQoL scores. There was no association between the overall HRQoL score and the characteristics of the maltreatment; however, the type of abuse and the victim's relationship with the perpetrator were only related to some dimensions. These findings may assist maltreatment care providers in planning strategies to reduce the consequences that violence may cause.