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Langendoen-Gort M, Groeneveld L, Prinsen CAC, Beulens JW, Elders PJM, Halperin I, Mukerji G, Terwee CB, Rutters F. Patient-reported outcome measures for assessing health-related quality of life in people with type 2 diabetes: A systematic review. Rev Endocr Metab Disord 2022; 23:931-977. [PMID: 35779199 PMCID: PMC9515038 DOI: 10.1007/s11154-022-09734-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2022] [Indexed: 11/26/2022]
Abstract
Patient-Reported Outcome Measures (PROMs) are important tools to assess outcomes relevant to patients, with Health-Related Quality Of Life (HRQOL) as an important construct to be measured. Many different HRQOL PROMs are used in the type 2 diabetes field, however a complete overview of these PROMs is currently lacking. We therefore aimed to systematically describe and classify the content of all PROMs that have specifically been developed or validated to measure (aspects of) HRQOL in people with type 2 diabetes. A literature search was performed in PubMed and EMBASE until 31 December 2021. Studies on the development or validation of a PROM measuring HRQOL, or aspects of HRQOL, in people with type 2 diabetes were included. Title and abstract and full-text screening were conducted by two independent researchers and data extraction was performed independently by one of the researchers. Data were extracted on language in which the PROM was developed, target population, construct(s) being measured, names of (sub)scales and number of items per (sub)scale. In addition, all PROMs and subscales were classified according to specific aspects of HRQOL based on the Wilson & Cleary model (symptom status, functional status, general health perceptions) to aid researchers in PROM selection. In total 220 studies were identified that developed or validated PROMs that measure (aspects of) HRQOL in people with type 2 diabetes. Of the 116 unique HRQOL PROMs, 91 (of the subscales) measured symptom status, 60 measured functional status and 26 measured general health perceptions. In addition, 16 of the PROMs (subscales) measured global quality of life. 61 of the 116 PROMs (subscales) also include characteristics of the individual (e.g. aspects of personality, coping) or environment (e.g. social or financial support) and patient-reported experience measures (PREMs, e.g. measure of a patient's perception of their personal experience of the healthcare they have received, e.g. treatment satisfaction), which are not part of the HRQOL construct. Only 9 of the 116 PROMs measure all aspects of HRQOL based on the Wilson & Cleary model. Finally, 8 of the 116 PROMs stating to measure HRQOL, measured no HRQOL construct. In conclusion, a large number of PROMs are available for people with type 2 diabetes, which intend to measure (aspects of) HRQOL. These PROMs measure a large variety of (sub)constructs, which are not all HRQOL constructs, with a small amount of PROMs not measuring HRQOL at all. There is a need for consensus on which aspects of HRQOL should be measured in people with type 2 diabetes and which PROMs to use in research and daily practice. PROSPERO: CRD42017071012. COMET database: http://www.comet-initiative.org/studies/details/956 .
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Affiliation(s)
- Marlous Langendoen-Gort
- General Practice, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Lenka Groeneveld
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Cecilia A C Prinsen
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Methodology, Amsterdam, The Netherlands
| | - Joline W Beulens
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, The Netherlands
| | - Petra J M Elders
- General Practice, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, The Netherlands
| | - Ilana Halperin
- Department of Medicine, Temerty Faculty of Medicine, Sunnybrook Health Sciences Center, King's College Circle, University of Toronto, Toronto, ON, Canada
| | - Geetha Mukerji
- Department of Medicine, Temerty Faculty of Medicine, Sunnybrook Health Sciences Center, King's College Circle, University of Toronto, Toronto, ON, Canada
- Women's College Hospital Institute for Health System Solutions and Virtual Care, 76 Grenville Street, Toronto, ON, Canada
| | - Caroline B Terwee
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Methodology, Amsterdam, The Netherlands
| | - Femke Rutters
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands.
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands.
- Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, The Netherlands.
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Ekong G, Chou C, Lakin J, Hardin A, Fox B, Hunt C, Kavookjian J. Pharmacist-led motivational interviewing for diabetes medication adherence in a worksite wellness program. J Am Pharm Assoc (2003) 2020; 60:e224-e229. [DOI: 10.1016/j.japh.2020.07.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/23/2020] [Accepted: 07/25/2020] [Indexed: 10/23/2022]
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Speight J, Holmes-Truscott E, Hendrieckx C, Skovlund S, Cooke D. Assessing the impact of diabetes on quality of life: what have the past 25 years taught us? Diabet Med 2020; 37:483-492. [PMID: 31797443 DOI: 10.1111/dme.14196] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2019] [Indexed: 01/06/2023]
Abstract
Over the past 25 years, there has been significant acknowledgement of the importance of assessing the impact of diabetes on quality of life. Yet, despite the development of several diabetes-specific quality of life measures, the challenges we faced in 1995 remain. There is little consensus on the definition of quality of life because of the complexity and subjectivity of the concept. General quality of life comprises several domains of life, and these are highly individualized. Assessing the impact of diabetes on these life domains adds to the complexity. While comprehensive diabetes-specific quality-of-life measures typically increase respondent burden, brief questionnaires may not capture all relevant/important domains. Today, the lack of resolution of these challenges may explain why the impact of diabetes on quality of life is not systematically assessed in research or clinical care. Few researchers report detailed rationales for assessment, there is often a mismatch between the concept of interest and the measure selected, and data are misinterpreted as assessing the impact of diabetes on quality of life when, in reality, related but distinct constructs have been assessed, such as diabetes distress, treatment satisfaction or health status. While significant efforts are being made to increase routine monitoring of psychological well-being and understand the lived experience, no guidelines currently recommend routine clinical assessment of diabetes-specific quality of life, and there is no consensus on which questionnaire(s) to use. The gaps identified in this review need urgent attention, starting with recognition that assessment of diabetes-specific quality of life is as important as biomedical markers, if we are to improve the lives of people with diabetes.
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Affiliation(s)
- J Speight
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - E Holmes-Truscott
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - C Hendrieckx
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - S Skovlund
- Steno Diabetes Centre Northern Denmark, Aalborg University Hospital, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - D Cooke
- School of Health Sciences, University of Surrey, Guildford, UK
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Santos RLBD, Campos MR, Flor LS. Fatores associados à qualidade de vida de brasileiros e de diabéticos: evidências de um inquérito de base populacional. CIENCIA & SAUDE COLETIVA 2019; 24:1007-1020. [DOI: 10.1590/1413-81232018243.09462017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 03/06/2017] [Indexed: 11/21/2022] Open
Abstract
Resumo Buscou-se avaliar as associações entre condições de saúde e características sociodemográficas em relação à qualidade de vida (QV) na população brasileira; bem como estimar os principais fatores associados às chances de uma melhor QV entre diabéticos. Trata-se de um estudo com dados obtidos do inquérito de base populacional realizado no Brasil, em 2008. Foram analisados 12.423 brasileiros, com idade ≥ 20 anos, cujos 935 eram diabéticos. Os desfechos de QV foram mensurados por meio dos componentes sumários do instrumento SF-36. Tanto para a população geral quanto para diabéticos, a QV teve seus escores agrupados em “acima” e “abaixo da média” para configurar desfechos binários. Foram realizadas regressões logísticas para obtenção das razões de prevalências ajustadas às chances de QV acima da média, controlando por variáveis sociodemográficas e de saúde. Resultados apontaram que as mulheres diabéticas com ≥ 65 anos, sedentárias, pertencentes à classe D/E e com mais morbidades apresentam maiores chances de uma pior QV física e mental. Para a população geral além desses fatores, não ter um companheiro e ser analfabeto proporcionou uma pior QV. O sedentarismo e a classe D/E apresentaram maior influência para pior QV entre diabéticos quando comparado à população total.
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Levterova BA, Orbetzova M, Levterov G, Dimitrova D, Todorov P. Assessment of the impact of type 2 diabetes on the quality of life by Audit of Diabetes-Dependent Quality-of-Life (ADDQoL-19). BIOTECHNOL BIOTEC EQ 2018. [DOI: 10.1080/13102818.2018.1532319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Boryana Angelova Levterova
- Department of Health Management and Healthcare Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Maria Orbetzova
- Second Department of Internal Diseases, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Georgi Levterov
- Clinic of Endocrinology and Metabolic Diseases, University Hospital “Kaspela” Ltd., Plovdiv, Bulgaria
| | - Donka Dimitrova
- Department of Health Management and Healthcare Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Plamen Todorov
- Department of Propaedeutics of Internal Diseases, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
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Visockienė Ž, Narkauskaitė-Nedzinskienė L, Puronaitė R, Mikaliūkštienė A. Validation of the LITHUANIAN version of the 19-item audit of diabetes dependent quality of life (ADDQOL - LT) questionnaire in patients with diabetes. Health Qual Life Outcomes 2018; 16:206. [PMID: 30382867 PMCID: PMC6211431 DOI: 10.1186/s12955-018-1033-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 10/16/2018] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Currently there is no diabetes-specific quality of life (QOL) instrument available in Lithuanian language. We aimed to develop a Lithuanian version of a widely-used individualised instrument - the Audit of Diabetes Dependent Quality of Life questionnaire (ADDQOL-19) and assess the validity and reliability in patients with type 1 and type 2 diabetes mellitus (DM). METHODS This study was conducted at the Primary Care and Endocrinology Outpatient Clinics in Vilnius. The ADDQOL was translated from the original English (UK) into Lithuanian using a standardized methodology of forward and back translation. After cognitive "debriefing" the validity and reliability of LT-ADDQOL questionnaire were assessed in a sample of 138 diabetes patients. Cronbach's alpha coefficient, factor analysis, independent t tests and ANOVA were used. RESULTS There were 106 participants with type 2 and 32 with type 1 DM included in the study with a mean age of 55.5 years (± 14.5) and 56.2% women. The Cronbach's alpha coefficient was 0.908 and most of items loading values onto one single factor were larger than 0.40 (varied from 0.41 to 0.77), indicating good internal consistency and reliability of instrument. CONCLUSIONS We developed the Lithuanian version of ADDQOL-19 which is a valid and reliable instrument to measure impact of diabetes on QOL. It could be further used by clinicians and researchers for comprehensive assessment of QOL in adults with diabetes.
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Affiliation(s)
- Žydrūnė Visockienė
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | | | - Roma Puronaitė
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Aldona Mikaliūkštienė
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
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Ahammed A, Pathan F, Afsana F, Ahammed I, Mir AS, Yusuf A. The Burden of Severe Hypoglycemia on Quality of Life among Diabetes Mellitus Patients in a Tertiary Level Hospital of Bangladesh. Indian J Endocrinol Metab 2018; 22:499-504. [PMID: 30148097 PMCID: PMC6085957 DOI: 10.4103/ijem.ijem_338_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE This study aimed to determine the impact of hypoglycemia on health-related quality of life from a patient perspective. MATERIALS AND METHODS A cross-sectional study was conducted in 164 type 2 diabetes patients admitted due to severe hypoglycemia from August 2015 to October 2016 at Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, in Dhaka. Impact of severe hypoglycemia on health-related quality of life in diabetic patients was evaluated using the disease-specific questionnaire audit of diabetes-dependent quality of life-19 (ADDQOL-19). RESULTS The median ADDQOL score was calculated at -3.31. Totally, 88 (53.7%) patients reported an ADDQOL score of - 3.31 or more, and 76 (46.3%) patients had an ADDQOL score of less than -3.31 (lower quality of life [QoL]). After considering weighting, "Freedom to eat" (mean Weighted Impact Score-6.32 ± 1.94) was the most and "Holidays" (mean Weighted Impact Score-0.96 ± 0.19) was the least affected QoL domains, respectively. In multivariate logistic regression analysis, severe hypoglycemia impact on ADDQOL was related with age (odds ratio [OR] 0.932, 95% confidence intervals [CIs] 0.897-0.969, P < 0.001), sex (OR 0.088, 95% CIs 0.023-0.338, P < 0.001), glycated hemoglobin (%) (OR 0.613, 95% CIs 0.422-0.890, P = 0.010), and marital status (OR 9.264, 95% CIs 2.467-34.790, P = 0.001). CONCLUSIONS The results of this analysis suggest hypoglycemia impacts heavily on the well-being and quality of life of people with diabetes, and every effort should be made to minimize hypoglycemia while aiming for good glycemic control.
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Affiliation(s)
- Afsar Ahammed
- Department of Physiotherapy, National Institute of Traumatology and Orthopedic Rehabilitation, Dhaka, Bangladesh
| | - Faruque Pathan
- Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation in Diabetes Endocrine and Metabolic Disorders, Dhaka, Bangladesh
| | - Faria Afsana
- Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation in Diabetes Endocrine and Metabolic Disorders, Dhaka, Bangladesh
| | - Imran Ahammed
- Officer on Special Duty, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Ahmed Salam Mir
- Department of Endocrinology, Dhaka Central International Medical College and Hospital, Dhaka, Bangladesh
| | - Abdullah Yusuf
- Department of Microbiology, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh
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Lindberg I, Torbjørnsen A, Söderberg S, Ribu L. Telemonitoring and Health Counseling for Self-Management Support of Patients With Type 2 Diabetes: A Randomized Controlled Trial. JMIR Diabetes 2017; 2:e10. [PMID: 30291058 PMCID: PMC6238841 DOI: 10.2196/diabetes.6884] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 05/03/2017] [Accepted: 05/25/2017] [Indexed: 12/28/2022] Open
Abstract
Background The prevalence of diabetes is increasing among adults globally, and there is a need for new models of health care delivery. Research has shown that self-management approaches encourage persons with chronic conditions to take a primary role in managing their daily care. Objective The objective of this study was to investigate whether the introduction of a health technology-supported self-management program involving telemonitoring and health counseling had beneficial effects on glycated hemoglobin (HbA1c), other clinical variables (height, weight, body mass index, blood pressure, blood lipid profile), and health-related quality of life (HRQoL), as measured using the Short Form Health Survey (SF-36) version 2 in patients with type 2 diabetes. Methods This was a pragmatic randomized controlled trial of patients with type 2 diabetes. Both the control and intervention groups received usual care. The intervention group also participated in additional health promotion activities with the use of the Prescribed Healthcare Web application for self-monitoring of blood glucose and blood pressure. About every second month or when needed, the general practitioner or the diabetes nurse reviewed the results and the health care activity plan. Results A total of 166 patients with type 2 diabetes were randomly assigned to the intervention (n=87) or control (n=79) groups. From the baseline to follow-up, 36 patients in the intervention group and 5 patients in the control group were lost to follow-up, and 2 patients died. Additionally, HbA1c was not available at baseline in one patient in the intervention group. A total of 122 patients were included in the final analysis after 19 months. There were no significant differences between the groups in the primary outcome HbA1c level (P=.33), and in the secondary outcome HRQoL as measured using SF-36. A total of 80% (67/87) of the patients in the intervention group at the baseline, and 98% (47/50) of the responders after 19-month intervention were familiar with using a personal computer (P=.001). After 19 months, nonresponders (ie, data from baseline) reported significantly poorer mental health in social functioning and role emotional subscales on the SF-36 (P=.03, and P=.01, respectively). Conclusions The primary outcome HbA1c level and the secondary outcome HRQoL did not differ between groups after the 19-month follow-up. Those lost to follow-up reported significantly poorer mental health than did the responders in the intervention group. Trial Registration Clinicaltrials.gov NCT01478672; https://clinicaltrials.gov/ct2/show/NCT01478672 (Archived by WebCite at http://www.webcitation.org/6r4eILeyu)
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Affiliation(s)
- Inger Lindberg
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Astrid Torbjørnsen
- Faculty of Medicine, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.,Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Siv Söderberg
- Department of Nursing Sciences, Mid Sweden University, Östersund, Sweden
| | - Lis Ribu
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
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Levterova BA, Levterov GE, Dragova EA, Grudeva TS, Kostourkov YL. Bulgarian version of the Audit of Diabetes-Dependent Quality of Life (ADDQoL-19). BIOTECHNOL BIOTEC EQ 2017. [DOI: 10.1080/13102818.2017.1297689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Boryana Angelova Levterova
- Department of Health Management and Healthcare Еconomics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
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Daher AM, AlMashoor SHA, Winn T. Performance of the Malay Audit of Diabetes Dependent Quality of Life-18 and Associates of Quality of Life among Patients with Type 2 Diabetes Mellitus from Major Ethnic Groups of Malaysia. PLoS One 2016; 11:e0163701. [PMID: 27695086 PMCID: PMC5047628 DOI: 10.1371/journal.pone.0163701] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Accepted: 09/13/2016] [Indexed: 11/18/2022] Open
Abstract
Introduction Diabetes Mellitus (DM) is notorious for its metabolic effect, acute and chronic complications and impact on Quality of Life (QoL). Successful intervention to improve QoL necessitates a valid and reliable measurement tool to identify areas of concern to patients with diabetes. Objectives To (1) assess the factor structure of the Malay Audit of Diabetes Dependent Quality of Life-18 (ADDQoL-18) questionnaire; (2) determine the impact of DM on QoL; and (3) identify areas of concern to patients with type 2 DM from three major ethnic groups in Malaysia. Methods Data was obtained from a cross sectional study involving 256 patients with type 2 DM attending the diabetes clinic of the National University of Malaysia Medical Centre. The Malay version of ADDQoL-18 survey was translated from its English version according to standard guidelines and administered by a trained research assistant. Exploratory Factor Analysis (EFA) with oblimin rotation was used to determine factor structure of the data. Confirmatory Factor Analysis (CFA) was used to confirm the factor structure. Hierarchical liner regression was used to determine factors associated with QoL. Results Unforced factor solution yielded two factors for the whole sample. Forced one factor solution was ascertained for the whole sample and for each ethnic group. Loadings ranged between 0.588 and 0.949. Reliability coefficients were all higher than 0.955. CFA showed that the two factor model had better fit statistics. QoL was associated with the use of insulin and desired glycaemic control, longer diabetes duration, worry about diabetes, and diabetes complications. Conclusions The Malay ADDQoL-18 is a valid tool to be used among patients with diabetes from different ethnic groups in Malaysia. The use of insulin to achieve desired glycaemic control had more negative impact on QoL than the use of tablets and/or dietary changes.
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Affiliation(s)
- Aqil M. Daher
- Department of Community Medicine, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Sungai Besi, Kuala Lumpur, Malaysia
- * E-mail:
| | - Syed Hassan A. AlMashoor
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Batu Caves, Selangor, Malaysia
| | - Than Winn
- Department of Community Medicine, Faculty of Medicine, MAHSA University, Kuala Lumpur, Malaysia
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Peach G, Romaine J, Wilson A, Holt PJE, Thompson MM, Hinchliffe RJ, Bradley C. Design of new patient-reported outcome measures to assess quality of life, symptoms and treatment satisfaction in patients with abdominal aortic aneurysm. Br J Surg 2016; 103:1003-11. [DOI: 10.1002/bjs.10181] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 02/11/2016] [Accepted: 03/02/2016] [Indexed: 11/09/2022]
Abstract
Abstract
Background
No condition-specific patient-reported outcome measures exist for patients with abdominal aortic aneurysm (AAA). The aim of this work was to develop three questionnaires to assess quality of life (QoL), symptoms and treatment satisfaction in patients with AAA.
Methods
Semistructured interview techniques were used to explore patients' experiences of having an AAA in a series of focus groups and in-depth interviews. The information gathered was used to inform design and selection of items for the new tools; the overall structure of the new questionnaires was based on tools developed previously for patients with diabetes and other conditions.
Results
Fifty-four patients (51 men, 3 women; mean age 71·9 years) were recruited from four NHS Trusts to participate in focus groups or interviews, either while under surveillance, or following AAA repair (using open or endovascular techniques). The Aneurysm-Dependent Quality of Life Questionnaire (AneurysmDQoL) is an individualized measure of the impact of AAA on patients' QoL. Twenty-three domains were chosen specifically for their relevance to patients with AAA, with a further two overview items to assess overall QoL and the impact of AAA on QoL. The Aneurysm Symptom Rating Questionnaire (AneurysmSRQ) is a 44-item measure assessing physical and psychological symptoms reported by patients with AAA. The Aneurysm Treatment Satisfaction Questionnaire (AneurysmTSQ) contains 11 items, suitable for patients before and after surgical intervention.
Conclusion
The iterative development process reported here has confirmed that these three new tools have good face and content validity for patients with AAA.
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Affiliation(s)
- G Peach
- St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK
| | - J Romaine
- Health Psychology Research Ltd, Royal Holloway, University of London, Egham, UK
| | - A Wilson
- Health Psychology Research Ltd, Royal Holloway, University of London, Egham, UK
| | - P J E Holt
- St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK
| | - M M Thompson
- St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK
| | - R J Hinchliffe
- St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK
| | - C Bradley
- Health Psychology Research Ltd, Royal Holloway, University of London, Egham, UK
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Validity and reliability of the 19-item Audit of Diabetes-Dependent Quality of Life (ADDQoL-19) questionnaire in Chinese patients with type 2 diabetes mellitus in primary care. Qual Life Res 2016; 25:2373-8. [DOI: 10.1007/s11136-016-1263-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2016] [Indexed: 01/02/2023]
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Papazafiropoulou AK, Bakomitrou F, Trikallinou A, Ganotopoulou A, Verras C, Christofilidis G, Bousboulas S, Μelidonis Α. Diabetes-dependent quality of life (ADDQOL) and affecting factors in patients with diabetes mellitus type 2 in Greece. BMC Res Notes 2015; 8:786. [PMID: 26666403 PMCID: PMC4678457 DOI: 10.1186/s13104-015-1782-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 11/30/2015] [Indexed: 11/10/2022] Open
Abstract
Background Diabetes mellitus type 2 (T2D) is a chronic metabolic disease with a great impact on health status and quality of life (QoL) in terms of physical, social, and psychological well-being. The aim of the present study was to measure diabetes-dependent QoL and affecting factors in patients with T2D. Methods Study population was consisted by 258 subjects with T2D attending diabetic outpatient clinics of General Hospitals of Piraeus “Tzaneio” and Nikaia “Ag.Panteleimon” during September–December 2014. The Audit of Diabetes-Dependent Quality of Life questionnaire was carried out in all study participants. Results Diabetes mellitus type 2 had a negative impact to QoL in 37.3 % of the study participants while 32.9 % believed that their life would have been better without the presence of T2D. Diabetes had negative impact on working life (−1.3 ± 0.6), health status (−1.3 ± 0.2), family (−1.3 ± 0.6) and sexual life (−1.3 ± 0.3), future perspectives (−1.3 ± 0.4) and dietary habits (−1.7 ± 0.2). The results of logistic regression analysis showed that QoL was related with age [odds ratio (OR) 0.94, 95 % confidence intervals (CIs) 0.91–1.98, P = 0.008] and marital status (OR 0.43, 95 %CIs 0.21–0.90, P = 0.03). Conclusions The results of the present study showed that T2D per se has a negative impact to patient’s QoL most of all affecting working life, health status, family and sexual life, future perspectives and dietary habits. Age and marital status were the only determinants of QoL.
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Affiliation(s)
- Athanasia K Papazafiropoulou
- 1st Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, 1 Zanni and Afentouli Street, 185 36, Piraeus, Greece.
| | - Florentia Bakomitrou
- 3rd Internal Medicine Department and Diabetes Center, General Hospital of Nikaia, Athens, Greece.
| | - Aikaterini Trikallinou
- 1st Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, 1 Zanni and Afentouli Street, 185 36, Piraeus, Greece.
| | - Asimina Ganotopoulou
- 1st Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, 1 Zanni and Afentouli Street, 185 36, Piraeus, Greece.
| | - Chris Verras
- 1st Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, 1 Zanni and Afentouli Street, 185 36, Piraeus, Greece.
| | - George Christofilidis
- 1st Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, 1 Zanni and Afentouli Street, 185 36, Piraeus, Greece.
| | - Stavros Bousboulas
- 3rd Internal Medicine Department and Diabetes Center, General Hospital of Nikaia, Athens, Greece.
| | - Αndreas Μelidonis
- 1st Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, 1 Zanni and Afentouli Street, 185 36, Piraeus, Greece.
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14
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Browne JL, Nefs G, Pouwer F, Speight J. Depression, anxiety and self-care behaviours of young adults with Type 2 diabetes: results from the International Diabetes Management and Impact for Long-term Empowerment and Success (MILES) Study. Diabet Med 2015; 32:133-40. [PMID: 25131861 DOI: 10.1111/dme.12566] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 06/08/2014] [Accepted: 08/11/2014] [Indexed: 01/21/2023]
Abstract
AIM Young adults with Type 2 diabetes have higher physical morbidity and mortality than other diabetes sub-groups, but differences in psychosocial outcomes have not yet been investigated. We sought to compare depression and anxiety symptoms and self-care behaviours of young adults with Type 2 diabetes with two matched control groups. METHODS Using cross-sectional survey data from the Australian and Dutch Diabetes Management and Impact for Long-term Empowerment and Success (MILES) studies, we matched 93 young adults (aged 18-39 years) with Type 2 diabetes (case group) with: (i) 93 older adults ( ≥ 40 years) with Type 2 diabetes (Type 2 diabetes control group; matched on country, gender, education, diabetes duration and insulin use) and (ii) 93 young adults with Type 1 diabetes (Type 1 diabetes control group; matched on country, gender, age and education). Groups were compared with regard to depression symptoms (nine-item Patient Health Questionnaire), anxiety symptoms (seven-item Generalised Anxiety Disorder questionnaire) and frequency of selected self-care behaviours (single item per behaviour). RESULTS Participants in the case group had higher depression scores (Cohen's d = 0.40) and were more likely to have clinically meaningful depressive symptoms (Cramer's V = 0.23) than those in the Type 2 diabetes control group. Participants in the case group had statistically equivalent depression scores to the Type 1 diabetes control group. The groups did not differ in anxiety scores. Those in the case group were less likely than both control groups to take insulin as recommended (Cramer's V = 0.24-0.34), but there were no significant differences between the groups in oral medication-taking. The case group were less likely than the Type 2 diabetes control group to eat healthily (Cramer's V = 0.16), and less likely than the Type 1 diabetes control group to be physically active (Cramer's V = 0.15). CONCLUSIONS Our results suggest that Type 2 diabetes is as challenging as Type 1 diabetes for young adults and more so than for older adults. Young adults with Type 2 diabetes may require more intensive psychological and self-care support than their older counterparts.
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Affiliation(s)
- J L Browne
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia - Vic, Melbourne, VIC, Australia; Centre for Mental Health and Wellbeing Research, School of Psychology, Deakin University, Burwood VIC, Australia
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15
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Guglani R, Shenoy S, Sandhu JS. Effect of progressive pedometer based walking intervention on quality of life and general well being among patients with type 2 diabetes. J Diabetes Metab Disord 2014; 13:110. [PMID: 25493265 PMCID: PMC4260197 DOI: 10.1186/s40200-014-0110-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 11/08/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND To determine the effectiveness of two goal setting pedometer based walking program for people with type 2 diabetes, one employing supervised exercise group with pedometer and the other employing self reported group with pedometer. METHODS A total of 102 type 2 diabetic outpatients (28 women, 74 men) between the age of 40-70 years were recruited and randomly allocated into 3 groups: supervised exercise group with pedometer (Group A), self reported exercise group with pedometer (Group B) and a control group (Group C) for 16 weeks. Subjects were asked to respond to the Audit of Diabetes Dependent Quality of Life (ADDQoL) and well being questionnaire at two occasions i.e. 0 week and after 16 weeks of intervention. Paired t test were used within the groups to compare Mean ± SD for all the parameters at baseline and at the end of 16 weeks. Differences between the groups were compared using analysis of variance (ANOVA). Statistical difference was further analyzed by Post hoc analysis using Bonferroni method. RESULTS The item "Freedom to eat" had the highest negative impact among all the subgroups. Other domains that were adversely affected by diabetes are 'leisure activity', 'do physically', 'physical appearance', 'self confidence', 'future' and 'financial situation'. In the group A significant reduction were noted among all the items except long distance journey (p<0.05). In the group B participants experienced reduction among all the domains except long distance journey, sex life and living condition. CONCLUSION Pedometer determined activity has the potential to improve the quality of life. Supervised Walking using a pedometer was found more effective in improving quality of life and general wellbeing for Asian Indians with type 2 diabetes. CLINICAL TRIAL REGISTRY INDIA CTRI [CTRI/2012/10/003034].
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Affiliation(s)
- Ruchika Guglani
- Faculty of Sports Medicine and Physiotherapy, Guru Nanak Dev University, 143005 Amritsar, India
| | - Shweta Shenoy
- Faculty of Sports Medicine and Physiotherapy, Guru Nanak Dev University, 143005 Amritsar, India
| | - Jaspal Singh Sandhu
- Faculty of Sports Medicine and Physiotherapy, Guru Nanak Dev University, 143005 Amritsar, India
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16
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Prazeres F, Figueiredo D. Measuring quality of life of old type 2 diabetic patients in primary care in Portugal: a cross-sectional study. J Diabetes Metab Disord 2014; 13:68. [PMID: 24963468 PMCID: PMC4068079 DOI: 10.1186/2251-6581-13-68] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 06/12/2014] [Indexed: 01/29/2023]
Abstract
BACKGROUND With the increasing prevalence of diabetes in patients aged over 75, the task of ensuring a good quality of life became even greater. This study aimed to evaluate quality of life of the very elderly (≥75 years) type 2 diabetic primary care patient, in an urban family practice setting. METHODS A cross sectional study was conducted. Quality of life (QoL) was assessed with the Portuguese version of EASY-Care. Descriptive and inferential analyses were performed. RESULTS Eighty three elderly type 2 diabetics were included in the study, with a mean age of 80.9 ± 4.3 years old. Most were women, widowed or married, with low educational levels, living with family members in urban areas and presented medium/low incomes. Participants were diagnosed with diabetes for 11.2 ± 10.1 years. Most of them were treated with oral antidiabetic agents, presented complications of diabetes and had good glycemic control. Despite that, excess weight, uncontrolled blood pressure and poor lipid management were noticed. In general, the participants perceived a positive quality of life. The worst perceived domain was "mental health and well-being". Within the sociodemographic variables, gender, monthly income, and living arrangements interfered the most with the quality of life domains. Studied clinical variables affected quality of life very modestly. CONCLUSIONS In an urban primary care setting, when treating very elderly type 2 diabetic patients, and despite good glycemic control, attention should be paid to the QoL of women, the low income diabetics, their living arrangements and thoroughly evaluate the mental health and well-being of these patients.
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Affiliation(s)
- Filipe Prazeres
- Faculdade de Medicina, Universidade de Coimbra, Polo III – Polo das Ciências da Saúde, 3000-548 Coimbra, Portugal
- Faculdade de Ciências da Saúde, Universidade da Beira Interior, 6200-506 Covilhã, Portugal
| | - Daniela Figueiredo
- School of Health Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
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Rodríguez-Mañas L, Bayer AJ, Kelly M, Zeyfang A, Izquierdo M, Laosa O, Hardman TC, Sinclair AJ, Moreira S, Cook J. An evaluation of the effectiveness of a multi-modal intervention in frail and pre-frail older people with type 2 diabetes--the MID-Frail study: study protocol for a randomised controlled trial. Trials 2014; 15:34. [PMID: 24456998 PMCID: PMC3917538 DOI: 10.1186/1745-6215-15-34] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 12/11/2013] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Diabetes, a highly prevalent, chronic disease, is associated with increasing frailty and functional decline in older people, with concomitant personal, social, and public health implications. We describe the rationale and methods of the multi-modal intervention in diabetes in frailty (MID-Frail) study. METHODS/DESIGN The MID-Frail study is an open, randomised, multicentre study, with random allocation by clusters (each trial site) to a usual care group or an intervention group. A total of 1,718 subjects will be randomised with each site enrolling on average 14 or 15 subjects. The primary objective of the study is to evaluate, in comparison with usual clinical practice, the effectiveness of a multi-modal intervention (specific clinical targets, education, diet, and resistance training exercise) in frail and pre-frail subjects aged ≥70 years with type 2 diabetes in terms of the difference in function 2 years post-randomisation. Difference in function will be measured by changes in a summary ordinal score on the short physical performance battery (SPPB) of at least one point. Secondary outcomes include daily activities, economic evaluation, and quality of life. DISCUSSION The MID-Frail study will provide evidence on the clinical, functional, social, and economic impact of a multi-modal approach in frail and pre-frail older people with type 2 diabetes. TRIAL REGISTRATION ClinicalTrials.gov: NCT01654341.
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Affiliation(s)
| | | | | | | | | | | | | | - Alan J Sinclair
- Institute of Diabetes for Older People (IDOP), University of Bedfordshire, Putteridge Bury Campus, Hitchin Road, Luton, Bedfordshire LU2 8LE, UK.
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18
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Affiliation(s)
- Alan Sinclair
- Institute of Diabetes for Older People, University of Bedfordshire, Luton LU2 8LE, UK.
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19
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Liu J. Impact of diabetes mellitus on pneumonia mortality in a senior population: results from the NHANES III follow-up study. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2013; 10:267-71. [PMID: 24133515 PMCID: PMC3796701 DOI: 10.3969/j.issn.1671-5411.2013.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Revised: 06/17/2013] [Accepted: 08/24/2013] [Indexed: 11/18/2022]
Abstract
Objective To examine whether diabetes mellitus increases the risk of pneumonia mortality among seniors in the U.S. general population. Methods & Results The NHANES III follow-up study data were used. After excluding individuals from other minorities, being hospitalized with pneumonia in the previous year at baseline, or death of pneumonia during the first year of follow-up, a total of 3,707 subjects aged 65 years or older (1,794 men and 1,913 women) who had no missing information on variables for the analysis were included. Approximately 16% of seniors at baseline were diabetics, which was defined as either having been diagnosed by a physician, currently taking pills/insulin lowering blood glucose, or HbA1c higher than 6.4%. During an average 11 years of follow-up, a total of 98 deaths due to pneumonia were recorded (ICD-10: J12–J18). Cox-regression models were used to estimate the risk association between pneumonia mortality and diabetes mellitus. After adjustment for the covariates at baseline, the hazard ratios of pneumonia death were 1.30 (95% CI: 0.64–2.70) for pre-diabetics and 2.28 (95% CI: 1.18–4.39) for diabetics, respectively. Among those covariates, only age (HR (95% CI); 1.16 (1.13–1.20)), gender as female (0.35 (0.22–0.61)) and physical fitness measured as having no problem walking 1+ mile during the previous month (0.38 (0.20–0.67)) reached statistical significance. Conclusions The results suggest that diabetes mellitus is a strong risk predictor of pneumonia mortality and the evaluation of physical fitness may also be useful in the risk prediction of pneumonia mortality for seniors.
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Affiliation(s)
- Jian Liu
- Brock University, 500 Glenridge Ave., St. Catharines, Ontario, Canada
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20
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Bourdel-Marchasson I, Druet C, Helmer C, Eschwege E, Lecomte P, Le-Goff M, Sinclair AJ, Fagot-Campagna A. Correlates of health-related quality of life in French people with type 2 diabetes. Diabetes Res Clin Pract 2013; 101:226-35. [PMID: 23831112 DOI: 10.1016/j.diabres.2013.05.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 04/04/2013] [Accepted: 05/30/2013] [Indexed: 01/31/2023]
Abstract
AIM Diabetes is known to impair health-related quality of life (HrQol). Our aim was to analyse a comprehensive set of potential determinants of HrQol in a large sample of patients with diabetes. METHODS This study is based on the ENTRED 2007 study, a representative sample of adults (18 years and older) with diabetes. Data were extracted from postal self-reported questionnaires (from patients and medical practitioners) and from reimbursements from the National health insurance data system. HrQol was assessed with the MOS SF-12 for mental (MCS) and physical (PCS) component summaries. Multivariate linear regression models were used to analyse the variables associated with HrQol. RESULTS SF-12 MCS and PCS were available in 2832 patients with T2DM, with a mean age 64 years (1715 males, 56%). Lower income, severe hypoglycaemic episodes, hospitalisation ≥24 h, instrumental daily living (IADL) restriction, low satisfaction for social support and an HbA1c within the 8.1-10.0% range were associated with lower MCS rating, whereas an older age and male gender were associated with higher MCS. Older age, female sex, higher BMI, lower income, insulin treatment, macrovascular complications, severe hypoglycaemic episodes, hospitalisation ≥24 h, and IADL restriction were associated with lower PCS values whereas having no need for social support was associated with higher PCS values. DISCUSSION HrQol associated factors are multiple but mainly linked with socio-demographic factors, diabetes complications and satisfaction for social support. A patient centred approach should be tested to prevent impairment of HrQol and thus to decrease the burden of diabetes. Assessment of social support should be included.
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Isla Pera P, Moncho Vasallo J, Guasch Andreu O, Ricart Brulles MJ, Torras Rabasa A. Impact of simultaneous pancreas-kidney transplantation: patients' perspectives. Patient Prefer Adherence 2012; 6:597-603. [PMID: 22936846 PMCID: PMC3429156 DOI: 10.2147/ppa.s35144] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Few qualitative studies of simultaneous pancreas-kidney transplantation (SPK Tx) have been published. The aims of this study were to explore from the perspective of patients, the experience of living with diabetes mellitus type 1 (T1DM), suffering from complications, and undergoing SPK Tx with good outcome; and to determine the impact of SPK Tx on patients and their social and cultural environment. METHODS We performed a focused ethnographic study. Twenty patients were interviewed. Data were analyzed using content analysis and constant comparison following the method proposed by Miles and Huberman. RESULTS A functioning SPK Tx allowed renal replacement therapy and insulin to be discontinued. To describe their new situation, patients used words and phrases such as "miracle", "being reborn" or "coming back to life". Although the complications of T1DM, its surgery and treatment, and associated psychological problems did not disappear after SPK Tx, these were minimized when compared with the pretransplantation situation. CONCLUSION For patients, SPK Tx represents a recovery of their health and autonomy despite remaining problems associated with the complications of T1DM and SPK Tx. The understanding of patients' existential framework and their experience of disease are key factors for planning new intervention and improvement strategies.
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Affiliation(s)
- P Isla Pera
- Public Health Department, Nursing School, Universitat de Barcelona, Barcelona
- Correspondence: Pilar Isla Pera, Campus Universitari Ciències de la Salut, Universitat Barcelona, Feixa Llarga s/n, L’Hospitalet de Llobregat 08907, Spain, Tel +34 934 024 241, Fax +34 934 024 297, Email
| | - J Moncho Vasallo
- Community Nursing, Preventive Medicine and Public Health and History of Science, Universidad Alicante
| | | | - MJ Ricart Brulles
- Institut Clínic de Nefrología i Urología, Hospital Clínic de Barcelona
| | - A Torras Rabasa
- Institut Clínic de Nefrología i Urología, Hospital Clínic de Barcelona
- Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
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