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Amini H, Meskarpour-Amiri M, Hosseini MS, Farjami M, Ashtari S, Vahedian-Azimi A, Sathyapalan T, Sahebkar A. Correlation between socio-demographic characteristics, metabolic control factors and personality traits with self-perceived health status in patients with diabetes: A cross-sectional study. J Diabetes Metab Disord 2024; 23:797-808. [PMID: 38932851 PMCID: PMC11196552 DOI: 10.1007/s40200-023-01354-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/18/2023] [Indexed: 06/28/2024]
Abstract
Purpose This study aimed to assess the relationship between metabolic control factors, socio-demographic characteristics, personality traits, and self-perceived health status in diabetes. Methods This cross-sectional study included 318 patients with type 1 and 2 diabetes (DM). Participants completed a questionnaire-based survey, which included the NEO Personality Inventory-Revised to measure five personality dimensions and the SF-12 survey to assess self-perceived health status. Binary logistic regression was performed to analyze the data, with socio-demographic characteristics, clinical data, and nutrition status as independent variables, and self-perceived health status (categorized as poor or good condition) as the dependent variable. Unadjusted and adjusted binary logistic regression analyses were used to examine the association between personality traits (high vs. low) and metabolic control factors (good control vs. bad control) with health status scores. Results 60.7% of the participants with diabetes in the study described their health as "good." The results indicated that female gender (OR: 0.314, 95%CI: 0.105-0.938, P = 0.038), age > 60 years (OR: 0.263, 95%CI: 0.117-0.592, P = 0.001), comorbidities (OR: 0.314, 95%CI: 0.178-0.556, P = 0.001), DM complications (OR: 0.531, 95%CI: 0.337-0.838, P = 0.007), diabetic neuropathy (OR: 0.562, 95%CI: 0.356-0.886, P = 0.013), and diabetic ulcer (OR: 0.130, 95%CI: 0.023-0.747, P = 0.022) were independent variables associated with a "poor" health status. However, regular physical activity (OR: 3.144, 95%CI: 1.209-8.175, P = 0.019) and a healthy nutritional diet (OR: 2.456, 95%CI: 1.421-4.245, P < 0.001) were associated with a higher likelihood of a "good" self-perceived health status. Conclusion Preventive programs and interventions aimed at improving self-perceived health among patients with diabetes should focus on increasing regular physical activity and promoting a healthy nutritional status. These actions should be particularly targeted towards female and older patients with higher neuroticism traits.
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Affiliation(s)
- Hossein Amini
- Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | | | - Mohammad Farjami
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Ashtari
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Thozhukat Sathyapalan
- Academic Diabetes Endocrinology and Metabolism, Hull York Medical School, University of Hull, UK of Great Britain and Northern Ireland, Hull, UK
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Hayashino Y, Okamura S, Tsujii S, Ishii H. Diabetes Distress Is Associated With Future Risk of Progression of Diabetic Nephropathy in Adults With Type 2 Diabetes: A Prospective Cohort Study (Diabetes Distress and Care Registry at Tenri [DDCRT23]). Can J Diabetes 2023; 47:519-524. [PMID: 37164214 DOI: 10.1016/j.jcjd.2023.04.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 04/20/2023] [Accepted: 04/29/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVES Our aim in this study was to investigate the prospective association between diabetes distress assessed with Problem Areas in Diabetes (PAID) survey scores at baseline and the subsequent risk of development or progression of diabetic nephropathy in people with type 2 diabetes. METHODS Longitudinal data were acquired from 2,845 individuals with type 2 diabetes registered in a Japanese diabetes registry. A Cox proportional hazards model was used to adjust for possible confounders to examine the prospective association between baseline diabetes distress (PAID score ≥40) and the development or progression of albuminuria. RESULTS Mean patient age, body mass index, and glycated hemoglobin level were 64.8 years, 24.5 kg/m2, and 57.4 mmol/mol (7.5%), respectively. We did not observe a significant association between diabetes distress and the subsequent risk of diabetic nephropathy development from normoalbuminuria to microalbuminuria/macroalbuminuria (multivariable-adjusted hazard ratio [HR]=0.95 over 4.2 years, 95% confidence interval [CI] 0.77 to 1.17, p=0.640); however, we identified a significant association for progression from microalbuminuria to macroalbuminuria (multivariable-adjusted HR=1.34 over 7.0 years, 95% CI 1.01 to 1.80, p=0.045). Stratification by sex revealed a significant association between diabetes distress and the subsequent risk of progressing diabetic nephropathy (HR=1.45, 95% CI 1.06 to 1.98, p=0.019) in males, but not females (HR=1.42, 95% CI 0.95 to 2.14, p=0.087). CONCLUSIONS Diabetes distress at baseline, assessed using the PAID survey, was associated with a subsequent risk of progressing diabetic nephropathy independent of possible confounders in males, but not females, with type 2 diabetes.
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Affiliation(s)
- Yasuaki Hayashino
- Department of Endocrinology, Tenri Hospital, Tenri City, Nara, Japan.
| | - Shintato Okamura
- Department of Endocrinology, Tenri Hospital, Tenri City, Nara, Japan
| | - Satoru Tsujii
- Department of Endocrinology, Tenri Hospital, Tenri City, Nara, Japan
| | - Hitoshi Ishii
- Department of Doctor-Patient Relationships, Nara Medical University, Kashihara, Nara, Japan
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Due-Christensen M, Bruun LD, Joensen LE, Norgaard O, Andersen TH. Psychosocial aspects and perspectives of adult-onset type 1 diabetes: A systematic scoping review. Diabet Med 2023; 40:e15073. [PMID: 36807612 DOI: 10.1111/dme.15073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/21/2022] [Accepted: 02/17/2023] [Indexed: 02/22/2023]
Abstract
AIM To map existing research on psychosocial aspects of adult-onset type 1 diabetes (T1D), including psychosocial health status, ways psychosocial aspects may affect management of T1D in everyday life, and interventions targeting management of adult-onset T1D. METHODS We conducted a systematic search in MEDLINE, EMBASE, CINAHL and PsycInfo. Search results were screened with predefined eligibility criteria, followed by data extraction of the included studies. Charted data were summarized in narrative and tabular form. RESULTS We included 10 reports describing nine studies from the 7302 identified in the search. All studies were conducted in Europe. Participant characteristics were missing in several studies. Five of the nine studies incorporated psychosocial aspects as the main aim of the study. Limited information on psychosocial aspects was available in the remaining studies. We identified three overarching themes related to psychosocial aspects: (1) the impact of the diagnosis on everyday life, (2) the influence of psychosocial health on metabolic levels and adaptation, and (3) provision of self-management support. CONCLUSIONS Research focussing on psychosocial aspects of the adult-onset population is scarce. Future research should involve participants across the adult life age span and from a wider geographical area. Sociodemographic information should be collected to explore different perspectives. Further exploration of suitable outcome measures considering adults' limited experience of living with the condition is needed. This would help to better understand how psychosocial aspects may affect management of T1D in everyday life and thus enable healthcare professionals to provide appropriate support to adults with new-onset T1D.
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Affiliation(s)
- Mette Due-Christensen
- Department of Health Promotion, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Herlev, Denmark
- Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - L D Bruun
- Danish Diabetes Knowledge Center, Department of Education, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - L E Joensen
- Department of Health Promotion, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - O Norgaard
- Danish Diabetes Knowledge Center, Department of Education, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - T H Andersen
- Danish Diabetes Knowledge Center, Department of Education, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
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Marques RDMB, Rodrigues MLDM, Marini ACB, Santos CRDC, Schincaglia RM. Associated factors with the quality of life of adolescents with type 1 diabetes. Clin Nutr ESPEN 2021; 42:387-392. [PMID: 33745610 DOI: 10.1016/j.clnesp.2020.12.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 12/15/2020] [Accepted: 12/18/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND & AIMS The impact of Type 1 diabetes on adolescence can have consequences on the quality of life (QoL), which can affect its growth, development and management of the disease. Thus, the objective of this study was to evaluate the QoL related to the health of adolescents with type 1 diabetes and if socioeconomic, demographic, clinical and anthropometric factors can be associated with it. METHODS Cross-sectional study with adolescents with Type 1 diabetes mellitus (T1DM) of both sexes and between 10 and 18 years old. QoL was assessed by the Quality of Life Instrument for Young Diabetics (total score and its dimensions - Satisfaction, Impact and Concerns) and socioeconomic and demographic, clinical and anthropometric data were evaluated. RESULTS Among 53 adolescents with T1DM, more than 13% of adolescents rated QoL as poor. The worst QoL in the Satisfaction dimension was associated with overweight, assessed by the body mass index; the increased cardiometabolic risk, assessed by waist circumference; the adolescent's later age at diagnosis (11-17 years); and the adolescent's older age (15-18 years). The worst QoL assessed in the Impact dimension was associated with the female sex. The Concerns dimension and the Total QoL score were not associated with socioeconomic and demographic, clinical, and anthropometric variables. CONCLUSIONS We conclude that the QoL Satisfaction dimension of adolescents with T1DM is associated with their age, age at diagnosis, overweight and increased waist circumference, while the Impact dimension is associated with sex, and the Concerns dimension and the Total QoL score were not associated with the factors studied. Knowing the importance of QoL and its related factors, it is necessary to propose health activities and strategies for the all-around improvement of these patients.
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Affiliation(s)
- Rosana de Morais Borges Marques
- Nutrition Course at the Federal University of Goiás, Rua 227 s / n - Setor Leste Universitário, Goiânia, GO, 74605-080, Brazil.
| | - Maria Luiza de Moura Rodrigues
- Nutrition Course at the School of Social and Health Sciences at the Pontifical Catholic University of Goiás. Praça Universitária, 1440 - Setor Universitário, Goiânia, GO, 74605-010, Brazil.
| | - Ana Clara Barreto Marini
- Faculty of Medicine, Federal University of Goiás, Rua 235, s / n, Setor Leste Universitário, CEP: 74605-050, Brazil.
| | - Camila Rodrigues da Cunha Santos
- Urgencies State Hospital of Goiânia Doctor Valdemiro Cruz, Av. 31 de Março with 5 radial, s / n, Setor Pedro Ludovico, CEP: 74820-200, Brazil.
| | - Raquel Machado Schincaglia
- Nutrition Course at the School of Social and Health Sciences at the Pontifical Catholic University of Goiás. Praça Universitária, 1440 - Setor Universitário, Goiânia, GO, 74605-010, Brazil.
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Kane NS, Hoogendoorn CJ, Commissariat PV, Schulder TE, Gonzalez JS. Glycemic control and self-rated health among ethnically diverse adolescents with type 1 diabetes. Pediatr Diabetes 2020; 21:69-76. [PMID: 31589350 PMCID: PMC7362987 DOI: 10.1111/pedi.12928] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/06/2019] [Accepted: 09/24/2019] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE Patient-reported outcomes have received increased attention as treatment outcomes and indicators of wellbeing. A1c has been criticized as lacking patient-centered relevance because individuals are often unaware of their A1c, and studies also often fail to show a benefit of intensive control on quality of life. The goal of the present study was to examine self-rated health (SRH) in relation to diabetes self-care behaviors, socioeconomic factors, treatment regimen characteristics, and glycemic control among predominately Hispanic and African American adolescents with type 1 diabetes (T1D). METHODS Adolescents with T1D (N = 84) were recruited for a cross-sectional study evaluating psychosocial factors and identity development. SRH, self-care behaviors, treatment regimen, and demographic variables were collected through self-report while glycemic control (A1c) was determined through chart review. RESULTS Participants were predominantly racial and ethnic minorities (48% Hispanic, 27% African American; 52% female, M age 15.9, M diabetes duration 6.8, M A1c 10% [86 mmol/mol]). Significant bivariate relationships emerged between SRH and sex, A1c, self-care behavior, and insulin delivery method. Covariate-adjusted regression models showed only A1c was significantly and independently related to SRH. Mediation analyses illustrated a significant indirect effect for A1c between self-care and SRH. CONCLUSION These findings suggest glycemic control is associated with self-ratings of health among ethnically diverse adolescents with T1D. SRH appears to be an appropriate patient-reported outcome that is sensitive to glycemic control in this population.
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Affiliation(s)
- Naomi S. Kane
- War Related Illness and Injury Study Center (WRIISC), VA New Jersey Health Care System, East Orange, New Jersey,Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York
| | | | - Persis V. Commissariat
- Pediatric, Adolescent, and Young Adult Section, Section on Clinical, Behavioral, and Outcomes Research, Joslin Diabetes Center, Boston, Massachusetts,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Talia E. Schulder
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York
| | - Jeffrey S. Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York,Department of Medicine (Endocrinology) and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York,The Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine, Bronx, New York,The New York Regional Center for Diabetes Translation Research (NY-CDTR), Albert Einstein College of Medicine, Bronx, New York
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Castellano-Guerrero AM, Guerrero R, Ruiz-Aranda D, Perea S, Pumar A, Relimpio F, Mangas MA, Losada F, Martínez-Brocca MA. Gender differences in quality of life in adults with long-standing type 1 diabetes mellitus. Diabetol Metab Syndr 2020; 12:64. [PMID: 32695233 PMCID: PMC7367231 DOI: 10.1186/s13098-020-00571-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 07/13/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND To assess gender differences in Quality of life (QoL) and in sociodemographic, clinical and psychological factors associated with impaired QoL in adults with long-standing type 1 diabetes mellitus (DM1). METHODS Cross-sectional evaluation in a random cohort of DM1 adult patients from a tertiary care hospital. QoL was evaluated using translated and validated self-administered Diabetes QoL questionnaire (Es-DQoL), and results transformed into a 0-100 scale. Psychological assessment included a planned psychological interview and self-reported questionnaires (Beck Depression Inventory II, State-Trait Anxiety Inventory Form Y, Fear of hypoglycaemia Scale, Medical Outcomes Study Social Support Survey). RESULTS A total of 312 patients (51.6% male; 38.2 ± 12.7 years; HbA1c 7.5 ± 1.1% (58.5 ± 14.2 mmol/mol); 20.4 ± 12.0 years of DM1) were included in the analysis. Male and female subgroups showed similar sociodemographic and diabetes-related features and comparable social support. Among female patients, higher frequency of depression [31.7% (IC95% 26.2-40.8) vs. 14.9% (IC95% 10.1-20.8), p < 0.05] and anxiety [23.2% (IC95% 19.3-33.14) vs. 13.0% (IC95% 8.1-18.4), p < 0.05] and severity of depressive and anxious symptoms were also found. Compared to male patients, female patients showed lower QoL [75 (IC95% 73.6-77.5) vs. 80 (IC95% 75.7-83.1), p < 0.05] and scored significantly worse in subscale Diabetes-related worries [69 (IC95% 50.0-81.0) vs. 75 (IC95% 72.9-79.0), p < 0.05]. Fear of hypoglycemia and severity of depressive and anxious symptoms were factors independently associated to lower QoL in men and women while high frequency of glycemic excursions was a female-specific predictive one. CONCLUSIONS Adult women with long-standing DM1 showed lower QoL probably related to higher frequency and severity of psychopathological syndromes. Depressive and anxious symptoms and, among women, exposure to glycemic excursions were identified as modifiable, QoL-related variables. Educational, technological and psychological interventions are needed in order to improve QoL in DM1 patients.
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Affiliation(s)
- Ana María Castellano-Guerrero
- Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen Macarena, Avenida Dr Fedriani 3, 41009 Seville, Spain
| | - Raquel Guerrero
- Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Seville, Spain
| | | | - Sofia Perea
- Dpt. of Genetics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Alfonso Pumar
- Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Seville, Spain
| | - Federico Relimpio
- Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Seville, Spain
| | - Miguel Angel Mangas
- Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Seville, Spain
| | - Fernando Losada
- Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Seville, Spain
| | - Maria Asunción Martínez-Brocca
- Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen Macarena, Avenida Dr Fedriani 3, 41009 Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Seville, Spain
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Taloyan M, Amri A, Hjörleifsdottir Steiner K, Lamian F, Ostenson CG, Salminen H. Extent of the association between self-rated health and place of birth: a cross-sectional study among people at high risk of developing pre-diabetes and diabetes in Sweden. BMJ Open 2019; 9:e028757. [PMID: 31843819 PMCID: PMC6924764 DOI: 10.1136/bmjopen-2018-028757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The first aim was to determine the extent of the relationship between place of birth and self-rated health (SRH) in primary healthcare patients born outside Sweden and those born in Sweden. The second aim was to investigate whether socioeconomic and lifestyle factors explained any differences. SETTING Two academic primary healthcare centres in Stockholm County, Sweden. PARTICIPANTS 825 patients at high risk of developing pre-diabetes and diabetes, aged 18-74 years, attending academic healthcare centres in areas with large numbers of immigrants, 56.8% born abroad and 43.2% born in Sweden. Patients with a diagnosis of diabetes were excluded. Inclusion criteria were based on previous research showing that people born in Middle Eastern and Asian countries who live in Sweden have a high prevalence of and risk for diabetes. OUTCOME SRH was dichotomised as optimal (very good/good) and suboptimal (fair/bad/very bad) and compared in those born outside Sweden and in Sweden. RESULTS There was a statistically significant difference in the SRH of the two groups (p=0.008). Logistic regression analysis showed a crude OR for reduced SRH of 1.46 (95% CI 1.10 to 1.92) in patients born outside Sweden. After controlling for education, employment and marital status, the OR increased to 1.50 (95% CI 1.11 to 2.02). After controlling for physical activity and smoking, it decreased to 1.36 (95% CI 1.00 to 1.85). CONCLUSION Socioeconomic and lifestyle factors influenced SRH. It could therefore be useful for clinicians to consider these factors when providing care for patients born outside Sweden and resettled in areas with large numbers of immigrants.
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Affiliation(s)
- Marina Taloyan
- Academic Primary Healthcare Centre, Region Stockholm, Stockholm, Sweden
- Division of Family Medicine and Primary Care, Department of Neurobiology, Science and Society, Karolinska Institutet, Stockholm, Sweden
| | - Amina Amri
- Study Programme in Medicine, Karolinska Institute, Stockholm, Sweden
| | - Kristin Hjörleifsdottir Steiner
- Division of Family Medicine and Primary Care, Department of Neurobiology, Science and Society, Karolinska Institutet, Stockholm, Sweden
| | - Fahimeh Lamian
- Jakobsberg Academic Primary Healthcare, Stockholm, Sweden
| | - Claes-Goran Ostenson
- Endocrine and Diabetes Unit, Department of Molecular Medicine and Surgery, Karolinska institutet, Stockholm, Sweden
| | - Helena Salminen
- Division of Family Medicine and Primary Care, Department of Neurobiology, Science and Society, Karolinska Institutet, Stockholm, Sweden
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Mirhoseiny S, Geelvink T, Martin S, Vollmar HC, Stock S, Redaelli M. Does task delegation to non-physician health professionals improve quality of diabetes care? Results of a scoping review. PLoS One 2019; 14:e0223159. [PMID: 31603900 PMCID: PMC6788697 DOI: 10.1371/journal.pone.0223159] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE As a result of unhealthy lifestyles, reduced numbers of healthcare providers are having to deal with an increasing number of diabetes patients. In light of this shortage of physicians and nursing staff, new concepts of care are needed. The aim of this scoping review is to review the literature and examine the effects of task delegation to non-physician health professionals, with a further emphasis on inter-professional care. RESEARCH DESIGN AND METHODS Systematic searches were performed using the PubMed, Embase and Google Scholar databases to retrieve papers published between January 1994 and December 2017. Randomised/non-randomised controlled trials and studies with a before/after design that described the delegation of tasks from physicians to non-physicians in diabetes care were included in the search. This review is a subgroup analysis that further assesses all the studies conducted using a team-based approach. RESULTS A total of 45 studies with 12,092 patients met the inclusion criteria. Most of the interventions were performed in an outpatient setting with type-2 diabetes mellitus patients. The non-physician healthcare professionals involved in the team were nurses, pharmacists, community health workers and dietitians. Most studies showed significant improvements in glycaemic control and high patient satisfaction, while there were no indications that the task delegation affected quality of life scores. CONCLUSIONS The findings of the review suggest that task delegation can provide equivalent glycaemic control and potentially lead to an improvement in the quality of care. However, this review revealed a lack of clinical endpoints, as well as an inconsistency between the biochemical outcome parameters and the patient-centred outcome parameters. Given the vast differences between the individual healthcare systems used around the world, further high-quality research with an emphasis on long-term outcome effects and the expertise of non-physicians is needed.
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Affiliation(s)
- Sanas Mirhoseiny
- Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne, Cologne, Germany
| | - Tjarko Geelvink
- Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne, Cologne, Germany
| | - Stephan Martin
- Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
- West-German Center of Diabetes and Health, Düsseldorf Catholic Hospital Group, Düsseldorf, Germany
| | - Horst Christian Vollmar
- Department of General Practice, Faculty of Medicine, Ruhr-Universität Bochum, Gebäude MAFO 1/61, Bochum, Germany
| | - Stephanie Stock
- Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne, Cologne, Germany
| | - Marcus Redaelli
- Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne, Cologne, Germany
- Institute of General Practice and Family Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany
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LaBarbera B, Dvorak J, Zhang Y, Jeter K, Talsania M, Beck J. Diabetes-related events in adolescents and young adults: opportunities for psychosocial interventions. PSYCHOL HEALTH MED 2019; 24:1148-1157. [PMID: 30971099 DOI: 10.1080/13548506.2019.1597976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study was conducted to evaluate predictive factors of diabetes-related emergency room (ER) visits and hospitalizations among adolescents and young adults (AYA) with type 1 diabetes (T1D). Baseline demographic, medical, and psychosocial variables were collected for 177 AYA with T1D. Medical records were reviewed to identify ER visits and hospitalizations related to diabetes. Those with diabetes-related events had significantly higher hemoglobin A1c (A1c) values at baseline (p = 0.0001) and during an average 3.36 years of follow-up (p < 0.0001). Participants with events were more likely to have Medicaid or no insurance vs. private insurance (p = 0.0006) and were more likely to be on multiple daily injections vs. insulin pumps (p = 0.0159). Participants with events reported greater diabetes impact on their lives and their parents reported less autonomy in AYA with events (p = 0.0435). These results suggest that when participants were transferring from pediatric to adult care services, factors such as A1c, insurance status and diabetes treatment are associated with diabetes-related events. Further research is needed to elucidate a causative relationship and develop focused interventions to reduce diabetes-related events during this high-risk time. Autonomy should be further explored to determine its role in diabetes-related events during this transition period.
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Affiliation(s)
- Brenton LaBarbera
- a University of Oklahoma Health Sciences Center , Oklahoma City , OK , USA
| | - Justin Dvorak
- a University of Oklahoma Health Sciences Center , Oklahoma City , OK , USA
| | - Ying Zhang
- a University of Oklahoma Health Sciences Center , Oklahoma City , OK , USA
| | - Kathryn Jeter
- a University of Oklahoma Health Sciences Center , Oklahoma City , OK , USA
| | - Mitali Talsania
- a University of Oklahoma Health Sciences Center , Oklahoma City , OK , USA
| | - Joni Beck
- a University of Oklahoma Health Sciences Center , Oklahoma City , OK , USA
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Abualula NA, Rodan MF, Milligan RA, Jacobsen KH. Self-rated health among American adolescents with type 1 diabetes in the T1D Exchange Clinic Registry. J Diabetes Complications 2018; 32:83-88. [PMID: 29092790 DOI: 10.1016/j.jdiacomp.2017.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 08/28/2017] [Accepted: 09/20/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND The goal of this study was to examine the self-rated health (SRH) of adolescents with type 1 diabetes (T1D). METHODS A logistic regression analysis of baseline data from adolescents in the United States included in the T1D Exchange Clinic Registry in 2010-2012 was conducted. Participants were 13-18years old at the time of enrollment in the registry and had been diagnosed with T1D at least one year before enrollment (n=5799). RESULTS Half (49.0%) of the participants were female, 46.3% were ages 16-18years, 22.5% were non-white, 35.7% did not have private/military health insurance, and 78.8% had HbA1c levels >7.5%, indicating poor T1D management, 20.7% reported having diabetes-related stress often or very often, and 46.4% used insulin injections or pens rather than a pump. In total, 10.3% (n=600) of the participants rated their health as poor or fair and 59.3% (n=3439) rated their health as very good or excellent. Participants with poor or fair SRH were more likely than those with very good or excellent SRH to be female (adjusted OR=1.7(1.4, 2.1)), 16 to 18years old (OR=2.1(1.7, 2.5)), and non-white (OR=2.7(2.2, 3.4)), to be without private or military insurance (OR=2.4(2.1, 3.0)), to have HbA1c levels >7.5% (OR=3.3(2.4, 4.7)), to report having diabetes-related stress often or very often (OR=6.1(5.1, 7.2)), and to use an injection or pen rather than a pump (OR=2.1(1.6, 2.4)). CONCLUSIONS Because adolescents with T1D who report lower SRH are more likely to have uncontrolled blood glucose and frequent diabetes-related stress, use of pumps and stress-reduction strategies may improve SRH among adolescents with T1D.
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Affiliation(s)
- Nada A Abualula
- College of Nursing, Taibah University, Universities Road, Medina, Saudi Arabia; School of Nursing, George Mason University, Fairfax, VA 22030, USA.
| | - Margaret F Rodan
- School of Nursing, George Mason University, Fairfax, VA 22030, USA.
| | - Renee A Milligan
- School of Nursing, George Mason University, Fairfax, VA 22030, USA.
| | - Kathryn H Jacobsen
- Department of Global & Community Health, George Mason University, Fairfax, VA 22030, USA.
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Hakkarainen P, Sund R, Arffman M, Koski S, Hänninen V, Moilanen L, Räsänen K. Working people with type 1 diabetes in the Finnish population. BMC Public Health 2017; 17:805. [PMID: 29025404 PMCID: PMC5639775 DOI: 10.1186/s12889-017-4723-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 09/06/2017] [Indexed: 01/13/2023] Open
Abstract
Background The incidence of type 1 diabetes is increasing worldwide. Since so little is known about work life of individuals with type 1 diabetes, we examined incidence and prevalence trends of type 1 diabetes among working-aged Finns. We also investigated the employment rate and how workers with type 1 diabetes perceive their health and work ability, and their intended retirement age. Methods We analyzed changes in the incidence, prevalence, and employment rate using nationwide multi-register-based FinDM data, and estimated a Self-Rated Health, Work Ability Score, and inquired about retirement intentions of 767 working individuals with type 1 diabetes in a cross-sectional survey. All estimates were compared to the corresponding data of the Finnish general population. Results The average annual age-standardized incidence rate of type 1 diabetes among men aged 18–39 was 29 per 100,000/year; the incidence rate has increased by 33% from 1992 to 2007. Among women, the incidence remained at 16 per 100,000/year. Among working-aged (18–64) people, the age-standardized prevalence of type 1 diabetes increased by 39% among women and 33% among men. Two out of every three working aged individuals with type 1 diabetes were in the labor force; this is about 10% lower than in the Finnish population. The average age-standardized employment rate among those individuals with type 1 diabetes belonging to the labor force was 82%, compared to 84% in the general population. Working individuals with type 1 diabetes rated their health and work ability as being slightly lower than the general working population, but nonetheless, there were no significant differences in retirement intentions. Conclusions Between 1992 and 2007, the number of working-aged people and workers with type 1 diabetes increased by 35%. Most workers with type 1 diabetes manage as well at work as the general population. Special attention should be paid to workers with type 1 diabetes when they are diagnosed and/or report moderate or poor work ability. Electronic supplementary material The online version of this article (10.1186/s12889-017-4723-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pirjo Hakkarainen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, FI-70211, Kuopio, Finland.
| | - Reijo Sund
- Centre for Research Methods, Department of Social Research, University of Helsinki, Helsinki, Finland.,School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Martti Arffman
- Department of Health and Social Care Systems, National Institute for Health and Welfare, Helsinki, Finland
| | - Sari Koski
- The Finnish Diabetes Association, Tampere, Finland
| | - Vilma Hänninen
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Leena Moilanen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Kimmo Räsänen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, FI-70211, Kuopio, Finland
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12
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Hassan M, Musa N, Abdel Hai R, Fathy A, Ibrahim A. Assessment of health-related quality of life in Egyptian adolescents with type 1 diabetes: DEMPU survey. J Pediatr Endocrinol Metab 2017; 30:277-283. [PMID: 28236627 DOI: 10.1515/jpem-2016-0147] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 01/02/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Type 1 diabetes (T1D) is a serious chronic illness that imposes significant morbidity and mortality with a major impact on the quality of life (QoL) that became a core issue in diabetes care. Understanding the effect of diabetes on QoL is important for day-to-day clinical management and also for public health policy initiatives aiming at improving health outcomes for those with diabetes. The objective of the study was to assess the QoL in adolescents with T1D and assess the applicability of the use of the "Quality of Life for Youth" questionnaire at the Diabetes, Endocrine and Metabolism Pediatric Unit (DEMPU) clinic. METHODS One hundred and fifty adolescents (82 males and 68 females) (10-18 years), with T1D of at least 1 years' duration, completed the questionnaire that evaluated symptoms related to diabetes, treatment, activities, parent issues, worries about diabetes and health perception. Higher scores indicated a more negative impact of diabetes and poorer QoL. RESULTS Males showed a significantly better mean QoL score than females (p=0.004). Different age groups showed different QoL scores (p=0.047). Urban adolescents had a better QoL than rural counterparts (p=0.02). Adolescents with poor QoL had generally lower educational level (p=0.02). Better metabolic control was associated with a better QoL (p=0.01). However, duration of diabetes and body mass index (BMI) had no statistically significant effect on QoL. CONCLUSIONS QoL had a variable significant association with certain socio-demographic and clinical characteristics of diabetics (sex, residence, educational level as well as metabolic control).
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Hussain T, Akle M, Nagelkerke N, Deeb A. Comparative study on treatment satisfaction and health perception in children and adolescents with type 1 diabetes mellitus on multiple daily injection of insulin, insulin pump and sensor-augmented pump therapy. SAGE Open Med 2017; 5:2050312117694938. [PMID: 28321303 PMCID: PMC5347412 DOI: 10.1177/2050312117694938] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 01/25/2017] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Diabetes management imposes considerable demands on patients. Treatment method used has an impact on treatment satisfaction. We aim to examine the relationship between treatment satisfaction and health perception with the method used for treatment of type 1 diabetes mellitus in children and adolescents. SUBJECTS AND METHOD We have interviewed patients with type 1 diabetes mellitus using questionnaires to assess treatment satisfaction and health perception. Patients were divided into three groups based on treatment used: multiple daily injection, insulin pump and sensor-augmented pump therapy. Comparison of scores was done between the groups. RESULTS A total of 72 patients were enrolled (36 males). Mean age (standard deviation) was 11.4 (4.4) years and duration of diabetes of 4.9 (3.5) years. Mean (standard deviation) HbA1c was 8.1 (1.2). Median (range) duration of sensor use was 17.7 (3-30) days/month. Mean scale for treatment satisfaction and health perception questions was 25.3, 29.7 and 31.7 and 60, 79.7 and 81 for the multiple daily injection, pump and sensor-augmented pump, respectively (p = 0.00). Significant difference was seen between the multiple daily injection and both other groups. Sensor-augmented pump group scored higher than the pump group. However, the difference was not statistically significant. Duration of sensor use showed no correlation with treatment satisfaction. CONCLUSION The method used for diabetes treatment has an impact on patients' satisfaction and health perception in children and adolescents with type 1 diabetes mellitus. Insulin pump users have a higher treatment satisfaction and better health perception than those on multiple daily injection. Augmenting pump therapy with sensor use adds value to treatment satisfaction without correlation with the duration of the sensors use.
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Affiliation(s)
- Tara Hussain
- Paediatric Endocrinology Department, Mafraq Hospital, Abu Dhabi, United Arab Emirates
| | - Mariette Akle
- Paediatric Endocrinology Department, Mafraq Hospital, Abu Dhabi, United Arab Emirates
| | - Nico Nagelkerke
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Asma Deeb
- Paediatric Endocrinology Department, Mafraq Hospital, Abu Dhabi, United Arab Emirates
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Cheung R, Young Cureton V, Canham DL. Quality of Life in Adolescents With Type 1 Diabetes Who Participate in Diabetes Camp. J Sch Nurs 2016; 22:53-8. [PMID: 16435931 DOI: 10.1177/10598405060220010901] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Quality of life in adolescents with Type 1 diabetes is a growing area of interest in pediatric research. The complex diabetes regimen imposes challenges for an adolescent. Adolescents diagnosed with diabetes are a group that appears to be at risk for having a poor health-related quality of life. Although research supports the positive relationship of social support and well-being in adolescents, there are few studies discussing quality of life in adolescents that are based on the factor of social support. This study compared the quality of life in adolescents with Type 1 diabetes who have attended at least one diabetes camp to the quality of life of those who have never attended diabetes camp. Results provided evidence of the value of social support.
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Affiliation(s)
- Ruth Cheung
- Fremont Unified School District, Fremont, CA, USA
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15
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Kalyva E, Abdul-Rasoul M, Kehl D, Barkai L, Lukács A. A cross-cultural study on perceived health-related quality of life in children and adolescents with type 1 diabetes mellitus. J Diabetes Complications 2016; 30:482-7. [PMID: 26809901 DOI: 10.1016/j.jdiacomp.2015.12.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 12/14/2015] [Accepted: 12/22/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study investigated whether culture can affect self- and proxy-reports of perceived diabetes-specific health-related quality of life of children and adolescents with type 1 diabetes when taking into account glycemic control, gender and age. METHODS A total of 416 patients aged between 8 and 18 years--84 (Greece), 135 (Hungary) and 197 (Kuwait)--and their parents completed the Pediatric Quality of Life Inventory 3.0. Diabetes Module. RESULTS Gender and age did not have any effect on perceived diabetes-specific health-related quality of life. Significant differences were detected among countries in self- and proxy-reports of diabetes-specific health-related quality of life when controlling for glycemic control. More specifically, Greek patients with type 1 diabetes and their parents reported significantly worse disease-specific health-related quality of life than their peers from Kuwait and Hungary. Moreover, culture affected the level of agreement between self- and proxy-reports with parents from Kuwait underestimating their children's diabetes-specific health-related quality of life. CONCLUSION The impact of culture on self- and proxy-reports of diabetes-specific health-related quality of life warrants further investigation, since it might suggest the need for differential psychosocial treatment.
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Affiliation(s)
- Efrosini Kalyva
- Department of Psychology, The International Faculty of the University of Sheffield, City College, Department of Psychology, 24 Proxenou Koromila Street, 546 22 Thessaloniki, Greece.
| | - Majedah Abdul-Rasoul
- Department of Pediatrics, Faculty of Medicine, Kuwait University, POBox 24923 Safat, P Code 13110, State of Kuwait
| | - Dániel Kehl
- Department of Statistics, Faculty of Business and Economics, University of Pécs, H- 7624 Pécs, Ifjúság Street 6, Hungary
| | - László Barkai
- Velkey László Center for Child Health, H-3526 Miskolc, Szentpéteri kapu 72-76, Hungary; Institute of Basic Health Sciences, Faculty of Health Care, University of Miskolc, H-3515 Miskolc-Egyetemváros, Miskolc, Hungary
| | - Andrea Lukács
- Institute of Basic Health Sciences, Faculty of Health Care, University of Miskolc, H-3515 Miskolc-Egyetemváros, Miskolc, Hungary
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Rostami S, Parsa-Yekta Z, Najafi-Ghezeljeh T, Vanaki Z, Zarea K. Self-perception in Iranian adolescents with diabetes: a qualitative study. J Diabetes Metab Disord 2015; 14:36. [PMID: 26064863 PMCID: PMC4462089 DOI: 10.1186/s40200-015-0163-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 04/14/2015] [Indexed: 11/24/2022]
Abstract
Background It is obvious that self-perception can play an important role in the development of self-management behaviours among adolescents with diabetes to promote their health and quality of life. This study seeks to explain self-perception in adolescents with diabetes. Method This qualitative study, which is of “grounded theory” type, was performed in 2013 in Ahvaz, Iran, through semi-structured interviews with ten adolescents with type 1 diabetes, two parents and a nurse, who were chosen objectively. Data analysis was performed using Strauss and Corbin 1998 method. Results Four main theme was obtained from the analysis of data, and the consequence theme was inferred as follows: getting insight (knowledge acquisition and belief management), perceiving similarities with others (not hiding the disease, showing the illness is normal, and accepting an active role in the family), and self-care management (independent control of food and treatment regimen and understanding of capabilities to manage the future of life and manage the daily activities of life), and life satisfaction (perception of being healthy and having a normal life). Conclusion Getting insight into the disease is the most important part of perceiving similarities with others and offering self-care, which can provide a person’s positive perception of himself/herself and the illness, as well as life satisfaction for their adolescent over time. These results are an operational guide for personnel providing health care services, especially diabetes specialist nurses.
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Affiliation(s)
- Shahnaz Rostami
- Chronic Disease Care Research Centre, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Parsa-Yekta
- Nursing Care Research center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Najafi-Ghezeljeh
- Nursing Care Research center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Vanaki
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Kourosh Zarea
- Chronic Disease Care Research Centre, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Ribeiro ÍJS, Boery RNDO, Casotti CA, Freire IV, Boery EN. Qualidade de Vida de hipertensos atendidos na Atenção Primária à Saúde. SAÚDE EM DEBATE 2015. [DOI: 10.1590/0103-110420151050002011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objetivou-se analisar a Qualidade de Vida de hipertensos em Jequié-BA, e identificar possíveis fatores depressores. Trata-se de um estudo de corte transversal no qual aplicaram-se dois questionários e examinou-se cada indivíduo. A média da Qualidade de Vida geral foi de 67,5 [IC: 64.21-70.78]. O domínio manifestações psicológicas apresentou média de 88.01 [IC: 86.57-89.44] e o domínio manifestações somáticas 91.84 [IC: 90.76 - 92.91]. A Qualidade de Vida dos usuários acometidos por hipertensão arterial foi satisfatória. Quanto aos fatores depressores da Qualidade de Vida identificou-se que a escolaridade e a raça/cor dos entrevistados influenciam de forma acentuada nesta quantificação.
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Hanna KM, Weaver MT, Slaven JE, Fortenberry JD, DiMeglio LA. Diabetes-related quality of life and the demands and burdens of diabetes care among emerging adults with type 1 diabetes in the year after high school graduation. Res Nurs Health 2014; 37:399-408. [PMID: 25164122 DOI: 10.1002/nur.21620] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2014] [Indexed: 11/12/2022]
Abstract
The roles of glycemic control, diabetes management, diabetes care responsibility, living independently of parents, and time since high school graduation in predicting diabetes-related quality of life (DQOL) were examined in 184 emerging adults with type 1 diabetes. Data were collected at graduation and 1 year later. Analyses controlling for selected covariates were completed using generalized linear mixed models. Better diabetes management was associated with more positive responses on all four dimensions of DQOL. Impact and worry of DQOL were greater in the presence of depressive symptoms, and life satisfaction was lower. DQOL life satisfaction was lower in those living independently of parents. Young women reported poorer diabetes-related health status than did young men. Time since graduation was not linked to DQOL. Further research is needed on ways to improve DQOL in conjunction with diabetes management and on ways that families can support DQOL when youth live independently.
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Affiliation(s)
- Kathleen M Hanna
- Carol M Wilson Endowed Chair, College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE, 68198-5330
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van Dijk PR, Logtenberg SJJ, Groenier KH, Keers JC, Bilo HJG, Kleefstra N. Fifteen-year follow-up of quality of life in type 1 diabetes mellitus. World J Diabetes 2014; 5:569-576. [PMID: 25126403 PMCID: PMC4127592 DOI: 10.4239/wjd.v5.i4.569] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 04/11/2014] [Accepted: 05/19/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To evaluate metabolic control and health-related quality of life (HRQOL) in a type 1 diabetes mellitus (T1DM) population.
METHODS: As part of a prospective cohort study, 283 T1DM patients treated with various insulin treatment modalities including multiple daily injections (MDI) and continuous subcutaneous insulin infusion (CSII) were examined annually. HRQOL was measured using the SF-36 and EuroQol questionnaires. Data regarding HRQOL, glycaemic and metabolic control from baseline and follow-up measures in 2002 and 2010 were analysed. Linear mixed models were used to calculate estimated values and differences between the three moments in time and the three treatment modalities.
RESULTS: Significant changes [mean Δ (95%CI)] in body mass index [2.4 kg/m2 (1.0, 3.8)], systolic blood pressure [-6.4 mmHg (-11.4, -1.3)] and EuroQol-VAS [-7.3 (-11.4, -3.3)] were observed over time. In 2010, 168 patients were lost to follow-up. Regarding mode of therapy, 52 patients remained on MDI, 28 remained on CSII, and 33 patients switched from MDI to CSII during follow-up. Among patients on MDI, HRQOL decreased significantly over time: mental component summary [-9.8 (-16.3, -3.2)], physical component summary [-8.6 (-15.3, -1.8)] and EuroQol-VAS [-8.1 (-14.0, -2.3)], P < 0.05 for all. For patients using CSII, the EuroQol-VAS decreased [-9.6 (-17.5, -1.7)]. None of the changes over time in HRQOL differed significantly with the changes over time within the other treatment groups.
CONCLUSION: No differences with respect to metabolic and HRQOL parameters between the various insulin treatment modalities were observed after 15 years of follow-up in T1DM patients.
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Abdul-Rasoul M, AlOtaibi F, Abdulla A, Rahme Z, AlShawaf F. Quality of life of children and adolescents with type 1 diabetes in Kuwait. Med Princ Pract 2013; 22:379-84. [PMID: 23428425 PMCID: PMC5586761 DOI: 10.1159/000347052] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Accepted: 01/13/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To evaluate the health-related quality of life (HRQoL) of children and adolescents with type 1 diabetes (T1DM) in Kuwait using the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scale and PedsQL 3.0 Diabetes Module, and to identify the risk factors associated with unsatisfactory QoL and their effects on metabolic control. SUBJECTS AND METHODS A total of 436 patients (2-18 years) with T1DM (>6 months) and 389 healthy controls, with the parents of both groups, completed the Arabic Generic Core Scale. Those with T1DM also completed the Arabic Diabetes Module. RESULTS The mean total score of the PedsQL Diabetes Module was 70.2 ± 9.8 reported by children and 59.9 ± 11.1 reported by parents (higher scores indicate better QoL). Young age and long duration of diabetes were associated with poor QoL (p < 0.001). Boys had better total scores than girls in most age groups (70.3 ± 9.3 vs. 52.3 ± 7.2, p < 0.001); however, girls did better than boys regarding treatment barriers and adherence (71.3 ± 7.8 vs. 68.1 ± 6.2, p < 0.005). Higher HbA1c values were associated with lower QoL scores (31.1 ± 5.1 at HbA1c of 15% vs. 82.5 ± 6.1 at HbA1c of 6%, p < 0.0001). CONCLUSION HRQoL of children and adolescents with T1DM was consistently poorer than controls. Parents consistently reported poorer QoL scores than their children. We recommend that more support should be provided for the care of children with diabetes in Kuwait.
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Affiliation(s)
- M Abdul-Rasoul
- Department of Pediatrics, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait, Kuwait.
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21
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Hanna KM. A framework for the youth with type 1 diabetes during the emerging adulthood transition. Nurs Outlook 2012; 60:401-10. [PMID: 22226223 PMCID: PMC3324668 DOI: 10.1016/j.outlook.2011.10.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 10/03/2011] [Accepted: 10/30/2011] [Indexed: 10/14/2022]
Abstract
Emerging adulthood, a developmental period from late adolescence to the late twenties, is a critical transition for youths with type 1 diabetes. This article proposes a framework for emerging adults with diabetes during this transitional time, integrating theoretical writings on transitions and emerging adulthood with empirical findings from younger adolescents with diabetes, about whom more is known. Key health, developmental, and behavioral outcomes are proposed, as well as key influential personal and environmental characteristics. Influential transitional events for this age group are also discussed relative to these outcomes and to personal and environmental characteristics. This framework provides a guide for longitudinal studies on the transition to young adulthood among emerging adults with type 1 diabetes. Identifying key times and influential factors will provide information for designing future effective interventions to improve glycemic control and quality of life for these youths as they transition to adulthood.
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Affiliation(s)
- Kathleen M Hanna
- Indiana University School of Nursing, Indianapolis, IN 46202, USA.
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Ten-year change in self-rated quality of life in a type 1 diabetes population: Wisconsin Epidemiologic Study of Diabetic Retinopathy. Qual Life Res 2012; 22:1245-53. [PMID: 22872499 DOI: 10.1007/s11136-012-0245-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2012] [Indexed: 12/18/2022]
Abstract
PURPOSE To investigate a 10-year change of quality of life and associated factors in a population with type 1 diabetes. METHODS The Medical Outcome Study Short Form-36 (SF-36) was administered in participants (n = 520) at the 1995-1996 and 2005-2007 examination phases of the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR). Physical (PCS) and mental (MCS) component summary scores were calculated. The associations between changes of quality of life and demographic, socioeconomic, and clinical factors were analyzed. RESULTS PCS score decreased (p < 0.001) and MCS score increased (p < 0.001) after 10 years. The development of cardiovascular disease and the presence of limb amputation were associated with decrease in the PCS score. Those who were working and retired had increased MCS; those who were working and stopped had a decrease in the MCS score. Change in visual acuity and diabetic retinopathy status did not have a significant impact in health-related quality of life scores. CONCLUSIONS Our findings reinforce the necessity to make every attempt to decrease complications of diabetes in individuals with long-term type 1 diabetes in order to attenuate the diminished quality of life associated with those complications such as cardiovascular disease. Change in employment status, likely due to development of these complications, was also strongly associated with poorer quality of life and suggests the benefits of preventing or decreasing complications to keep people with type 1 diabetes in the workforce.
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Novato TDS, Grossi SAA. Fatores associados à qualidade de vida de jovens com diabetes mellitus do tipo 1. Rev Esc Enferm USP 2011; 45:770-6. [DOI: 10.1590/s0080-62342011000300032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Accepted: 09/06/2010] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo foi realizar a revisão bibliográfica acerca dos fatores que podem influenciar a Qualidade de Vida Relacionada à Saúde (QV) dos adolescentes com diabetes mellitus tipo 1, por meio da estratégia de PICO. As bases de dados utilizadas foram PubMed/MEDLINE, ISI Web of Knowledge e EMBASE. O maior levantamento dos artigos foi possível com a combinação de descritores padronizados e não padronizados. Apesar da QV ser um construto específico de avaliação dos aspectos relacionados às repercussões da saúde, doença e tratamento, os fatores sócio-demográficos, psicossociais e relacionados à família parecem influenciar de forma significativa na QV.
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Ismail H. Self-rated health and factors influencing responses among young Egyptian type 1 diabetes patients. BMC Public Health 2011; 11:216. [PMID: 21473776 PMCID: PMC3087681 DOI: 10.1186/1471-2458-11-216] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Accepted: 04/07/2011] [Indexed: 11/30/2022] Open
Abstract
Background Patients diagnosed with type 1 diabetes mellitus (T1DM) face major daily challenges. Self-rated health (SRH) is a global measure of an individual's health related quality of life (HRQoL) and is based on the question, "In general, how would you rate your health?" Subjects rate their health as excellent, very good, good, poor or very poor. Our objective was to determine the HRQoL using the SRH measure and determine factors influencing responses. We hypothesized that better SRH responses were associated with shorter diabetes duration, better compliance and better glycemic control. Methods The standardized SRH measure was the instrument used for health related quality of life assessment. Logistic regression analysis was used to examine the association between SRH responses and selected variables. Results 124 subjects, 64 females (51.6%) and 60 males (48.4%) were included. Average age was 13.08 (±3.19) and average diabetes duration was 5.82 (±1.60), while the mean HbA1C was 8.02 (±1.60). The majority rated their health as good (31%), 29% rated it as excellent, 11% as very good, 14% as poor and 15% as very poor. Regression analysis showed that regular exercise was the only predictor that was independently and significantly associated with a "better" self-health rating, with an OR of 12.84, CI of 1.425-115.727 and a p value of 0.023. Conclusion Regular exercise among Egyptian children with T1DM is strongly associated with a "better" overall health related quality of life and should be repeatedly encouraged.
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Affiliation(s)
- Heba Ismail
- Cairo University Specialized Children's Hospital, Cairo, Egypt.
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Austin S, Senécal C, Guay F, Nouwen A. Effects of gender, age, and diabetes duration on dietary self-care in adolescents with type 1 diabetes: a Self-Determination Theory perspective. J Health Psychol 2011; 16:917-28. [PMID: 21430132 DOI: 10.1177/1359105310396392] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study tests a model derived from Self-Determination Theory (SDT) (Deci and Ryan, 2000) to explain the mechanisms by which non-modifiable factors influence dietary self-care in adolescents with type 1 diabetes (n = 289). SEM analyses adjusted for HbA1c levels revealed that longer diabetes duration and female gender were indicative of poorer dietary self-care. This effect was mediated by contextual and motivational factors as posited by SDT. Poorer autonomy support from practitioners was predominant in girls with longer diabetes duration. Perceived autonomous motivation and self-efficacy were indicative of greater autonomy support, and led to better dietary self-care.
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Kalyva E, Malakonaki E, Eiser C, Mamoulakis D. Health-related quality of life (HRQoL) of children with type 1 diabetes mellitus (T1DM): self and parental perceptions. Pediatr Diabetes 2011; 12:34-40. [PMID: 20546163 DOI: 10.1111/j.1399-5448.2010.00653.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The aim of the study was to evaluate health-related quality of life (HRQoL) in children and adolescents with type 1 diabetes mellitus (T1DM) in Greece compared with healthy controls and to identify the effect of age, gender, age of onset of disease, and metabolic control on perceptions of HRQoL. A total of 117 children and adolescents with T1DM aged 5-18, their parents, and 128 matched healthy children and adolescents participated. Children and adolescents completed PedsQL™ 4.0 Generic Core Scales. Children and adolescents with T1DM also completed the PedsQL™ 3.0 Diabetes Module, while their parents completed the proxy-reports of both the PedsQL™ 4.0 Generic Core Scales and the PedsQL™ 3.0 Diabetes Module. The results demonstrated that children and adolescents with T1DM had lower general HRQoL compared with healthy matched children and adolescents. Parents of children and adolescents with diabetes reported that the illness has a greater affect on their children's lives than the children themselves. Finally, the results indicated that later age of onset of diabetes, less hyperglycemic episodes, lower glycosylated hemoglobin (HbA1c), older age, and male gender were associated with better general HRQoL and diabetes-specific HRQoL. The findings have implications for designing effective therapeutic interventions aimed at improving the HRQoL of children and adolescents with T1DM.
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Affiliation(s)
- Efrosini Kalyva
- Department of Psychology, City College, 24 Proxenou Koromila Street, Thessaloniki, Greece.
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Abstract
OBJECTIVE We aimed to evaluate whether age-matched women with and without early-stage breast cancer differentially experience sexual problems over time and whether changes in patients' problems differ by type of surgical procedure. METHODS We conducted four interviews (4-6 wk, 6 mo, and 1 and 2 y) after tumor resection (patients) or after a negative/benign screening mammogram (controls). Mixed-effects models with repeated ordinal measurements tested the effects of time and diagnostic group (stages 0, I, and IIA vs controls) and, for patients, the effects of time and type of surgical procedure (mastectomy vs lumpectomy) using a newly developed nine-item sexual-problem measure. Two-sided P values < 0.05 were considered significant. RESULTS Using data from 1,033 women (17.3% stage 0, 33.4% stage I/IIA, and 49.3% controls; mean age, 57.1 y; 23.1% nonwhite; 64.7% married), two factors measuring problems with sexual attractiveness and sexual interest/enjoyment emerged in exploratory factor analysis (alpha > or = 0.74 for each subscale and the nine-item measure). Patients and controls reported few sexual problems on average, but controls were more likely to report sexual problems on the nine-item measure over time and stage I patients were less likely to report problems with sexual attractiveness over time (each P < 0.05) compared with at baseline. Patients who underwent mastectomy (35.7%) were 2.7 times more likely to report sexual problems on the nine-item measure at 2-year follow-up compared with baseline (P = 0.0339). CONCLUSIONS Patients and controls experienced few sexual problems over time, and in fact, controls were more likely to report sexual problems at subsequent interviews, whereas patients were not.
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Rona RJ, Hooper R, French C, Jones M, Wessely S. The meaning of self-perception of health in the UK armed forces. Br J Health Psychol 2010; 11:703-15. [PMID: 17032493 DOI: 10.1348/135910705x84575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES We assessed the characteristics of self-perception of health (SPH) in relation to psychological distress and physical symptoms, and willingness of servicemen to see their Medical Officer (MO) by their SPH rating. DESIGN We randomly selected 4,500 servicemen to receive either a full or an abridged screening questionnaire. MEASURES The full questionnaire included 6 items from the short-form 36 and the question on SPH, the General Health Questionnaire-12, the post-traumatic stress disorder checklist and 15 symptoms. The abridged questionnaire included a subset of items from the full questionnaire. All 'screen-positive' and a random 'screen-negative' sample were invited to see an MO. RESULTS 67.1% out of 4,500 servicemen completed the questionnaires. SPH was strongly associated with a summary short form-36 (SF-36) measure. There was a strong association between SPH and all assessment scales regardless of length of the questionnaires (p<.001). Even among those with very good or excellent SPH, high scores denoting psychological distress were prevalent (8.1%). Good SPH provided the largest variations in symptoms and scores. Servicemen with a poor/fair SPH were no more likely to accept a visit to the MO than the rest. CONCLUSIONS SPH is an excellent question for surveillance because it is highly associated with psychological health but, at an individual level, it may convey different meanings depending on the person's individual interpretation of the term health. Symptomatic social avoidance may be high among servicemen who have a poor/fair SPH and methods, such as buddy support, may be helpful in decreasing isolation among those who may need professional support.
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Affiliation(s)
- Roberto J Rona
- King's College London, King's Centre for Military Health Research, London, UK.
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Kartal A, İnci FH. A cross-sectional survey of self-perceived health status and metabolic control values in patients with type 2 diabetes. Int J Nurs Stud 2010; 48:227-34. [PMID: 20678769 DOI: 10.1016/j.ijnurstu.2010.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Revised: 06/30/2010] [Accepted: 07/05/2010] [Indexed: 11/24/2022]
Abstract
BACKGROUND The prevalence of diabetes is increasing worldwide. Diabetes and other chronic disorders play an important role in how patients perceive their health status, this perception being an important component of general health. OBJECTIVES The purpose of this study is to determine self-perceived health status and metabolic control in patients with type 2 diabetes and to understand the relationship between perceived health status and metabolic control in diabetic participants. DESIGN This is a cross-sectional survey. SETTING The research population was diabetes sufferers registered with the Turkish Diabetes Society in Denizli Province, Turkey. PARTICIPANTS A convenience sample composed of 110 patients with type 2 diabetes mellitus. METHODS The research data were collected using three tools. The first of these was a "Socio-demographic Data Form" to gather information on the diabetes patients. The second was a survey on the patients' self-perceived health (how do rate your state of health in general) in which the patients were asked to rate their own health in one of five categories: very good, good, fair, bad and very bad. For the statistical analysis, the study group was divided into two groups: "good", consisting of those who classified their health as either very good or good; and "poor", those who gave other responses. The third type of data was collected by measuring metabolic control outcomes [glycosylated hemoglobin (HbA(1C)), fasting blood sugar (FBS), non-fasting blood sugar, total cholesterol, high-density lipoproteins (HDL) and triglycerides] for each participant. RESULTS Approximately half of the diabetic participants surveyed have poor self-perceived health. In terms of the values of HbA(1C), an important indicator of metabolic control levels, it was found that only 24.5% of the participants surveyed had good metabolic control. There was found to be a statistically significant difference between self-perceived health and levels of HbA(1C); 68% of participants who had high HbA(1C) values evaluated their health as good, whereas 63.9% of those who had poor HbA(1C) values evaluated their health as bad. Age, level of education, mode of treatment, adherence to treatment and level of exercise were factors that were found to have statistically significant differences from, and therefore an influence on, self-reported health. CONCLUSION When working with diabetes patients, as soon as the diagnosis has been made, it is recommended that information both on subjective perceptions of health and on perceptions of the illness (health perceptions, health beliefs related to the illness) are evaluated and objective data (metabolic control values) are gathered.
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Affiliation(s)
- Asiye Kartal
- Pamukkale University School of Health Denizli, Turkey.
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Sparud-Lundin C, Ohrn I, Danielson E. Redefining relationships and identity in young adults with type 1 diabetes. J Adv Nurs 2010; 66:128-38. [PMID: 20423440 DOI: 10.1111/j.1365-2648.2009.05166.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM This paper is a report of a study exploring the meaning of interactions with and supports of self-management from parents and other significant others for young adults with type 1 diabetes. BACKGROUND Adolescence and young adulthood is known to be a critical period for people living with diabetes in terms of diabetes control, which is why support from significant others is of utmost importance during the transition to adult life. METHOD A grounded theory approach was used. Interviews with 13 young adults with type 1 diabetes and 13 parents 2 years after transfer to adult diabetes care were conducted during 2006-2007. Internet communication between young people on a diabetes website was also included in the constant comparative analysis. FINDINGS Transition to adult life for young adults with diabetes was characterized by a relational and reflexive process leading to ongoing redefinition of relationships and identity. Parents were perceived as the most reliable supporters, compared to partners, siblings and other significant others. Chat friends can also become important through emotional, social and diabetes-related support in internet communication. The young adults showed growing awareness of their own capacities, shortcomings and emotional reactions, reflections which contribute to a redefinition of self. CONCLUSION Further research is needed to explore how contemporary interactions contribute to development of the self. By focusing on supporting relationships, nurses are in a strategic position to develop knowledge and modify clinical programmes that promote diabetes management and care by taking supporting interactions into account from a contemporary point of view.
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Affiliation(s)
- Carina Sparud-Lundin
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
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Liu Y, Pérez M, Schootman M, Aft RL, Gillanders WE, Ellis MJ, Jeffe DB. A longitudinal study of factors associated with perceived risk of recurrence in women with ductal carcinoma in situ and early-stage invasive breast cancer. Breast Cancer Res Treat 2010; 124:835-44. [PMID: 20446031 DOI: 10.1007/s10549-010-0912-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Accepted: 04/21/2010] [Indexed: 11/28/2022]
Abstract
Breast cancer patients' perceived risk of recurrence has been associated with psychological distress. Little is known about the change of patients' perceived risk of recurrence over time and factors associated with their recurrence-risk perceptions. We prospectively recruited 549 newly diagnosed early-stage breast cancer patients; patients completed interviews at 6 weeks, 6 months, 1 year, and 2 years after definitive surgical treatment. A random-effects regression model with repeated ordinal measurements was used to estimate the relationship between perceived risk of recurrence and demographic, medical, and psychosocial factors. We analyzed data from 535 patients [34% ductal carcinoma in situ (DCIS); 20% non-white] who reported their perceived risk at one or more interviews. At the first interview, 16% reported having no lifetime risk of recurrence, and another 16% reported ≥ 50% risk of recurrence, including 15% of DCIS patients. Patients who were white (OR = 5.88, 95% CI 3.39-10.19) and had greater state anxiety (OR = 1.04, 95% CI 1.02-1.07) were more likely, while patients who received radiotherapy (OR = 0.72, 95% CI 0.54-0.96) and had more social support (OR = 0.59, 95% CI 0.46-0.75) were less likely to report higher risk of recurrence. Cancer stage was not significantly associated with perceived risk of recurrence. Perceived risk of recurrence did not change significantly over time. Educating early-stage breast cancer patients about their actual risk could result in more realistic recurrence-risk perceptions, and increasing social support could help alleviate anxiety associated with exaggerated risk perceptions.
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Affiliation(s)
- Ying Liu
- Division of Health Behavior Research, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63108, USA.
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Maslakpak MH, Anoosheh M, Fazlollah A, Ebrahim H. Iranian diabetic adolescent girls’ quality of life: perspectives on barriers. Scand J Caring Sci 2010; 24:463-71. [DOI: 10.1111/j.1471-6712.2009.00736.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Franciosi M, Maione A, Pomili B, Amoretti R, Busetto E, Capani F, Bruttomesso D, Di Bartolo P, Girelli A, Leonetti F, Morviducci L, Ponzi P, Vitacolonna E, Nicolucci A. Correlates of quality of life in adults with type 1 diabetes treated with continuous subcutaneous insulin injection. Nutr Metab Cardiovasc Dis 2010; 20:7-14. [PMID: 19747804 DOI: 10.1016/j.numecd.2009.02.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2008] [Revised: 02/20/2009] [Accepted: 02/20/2009] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS Aim of this study was to identify subgroups of adults with Type 1 Diabetes Mellitus (T1DM) treated with Continuous Subcutaneous Insulin Infusion (CSII) at higher risk of poor quality of life (QoL). A sample of consecutive patients completed the Diabetes Specific Quality of Life Scale (DSQOLS), investigating the daily burden and restrictions related to diabetes. Lower DSQOLS scores indicate worse QoL perception. METHODS AND RESULTS The main results were obtained by using a regression-tree technique (RECursive Partitioning and AMalgamation - RECPAM) and multivariate logistic regression. Overall, 472 patients aged between 18 and 55 years were recruited by 43 Italian centers. RECPAM analysis led to the identification of 5 classes characterized by a marked difference in QoL. Male patients not reporting episodes of ketoacidosis and using CSII for >2 years had the lowest likelihood of scoring in the lower tertile of the DSQOLS summary score, and thus represented the reference category. Patients who reported > or =1 ketoacidosis episodes (OR = 5.4; 95% CI 2.4-12.1) and female patients with a duration of diabetes of <10 years (OR = 5.9; 95% CI 2.6-13.5) had the highest likelihood of reporting poor QoL, while females with longer diabetes duration (OR = 2.4; 95% CI 1.3-4.7) and males treated with CSII for < or =2 years (OR = 2.2; 95% CI 1.1-4.6) showed a two-fold risk of poor QoL. Patient age, diabetic complications and civil status were globally predictive variables associated with poor QoL. CONCLUSION We identified subgroups of T1DM individuals treated with CSII showing a major impairment in QoL. Specific strategies are needed to help the patient cope with this therapeutic modality, especially during the initial phase of treatment.
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Affiliation(s)
- M Franciosi
- Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S. Maria Imbaro (CH), Italy
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Al-Akour N, Khader YS, Shatnawi NJ. Quality of life and associated factors among Jordanian adolescents with type 1 diabetes mellitus. J Diabetes Complications 2010; 24:43-7. [PMID: 19464929 DOI: 10.1016/j.jdiacomp.2008.12.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2008] [Revised: 10/08/2008] [Accepted: 12/03/2008] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Quality of life (QoL) is a significant indicator of the outcome of the treatment in chronic diseases. The purpose of the study was to assess the QoL of Jordanian adolescents with type 1 diabetes mellitus and its associated factors. METHODS A total of 145 adolescents with type 1 diabetes mellitus were invited to participate in the study during their regular visits to outpatient clinics. The subjects were recruited from the National Center for Diabetes, Endocrine and Genetic Diseases in Amman, the capital of Jordan, and from three main hospitals in the north of Jordan between October 2007 and February 2008. A short form of the Diabetes Quality of Life for Youth (DQLQY-SF) questionnaire was used. The DQLQY-SF consists of 22 items on two subscales (disease impact and worries) with higher scale scores indicating increase frequency of problems and lower QoL. RESULTS The mean (S.D.) age of the participants was 14.1 (3.1) years and the mean (S.D.) diabetes duration was 3.7 (2.9) years. This study showed that adolescents perceived their QoL as low. The mean (S.D.) of DQLQY-SF total score was 56.4 (18.0). The mean was 36.2 (10.1) for the impact scale, 17.9 (8.9) for worries about diabetes, and 2.2 (1.2) for health perception. Multivariate analysis showed that more impact of diabetes, worries about diabetes, and worse overall QoL were associated with shorter diabetes duration, higher HbA(1c) values, being a girl, and older age. CONCLUSIONS The QoL of Jordanian adolescents with type 1 diabetes was low. Better glycemic control may contribute to the improvement of QoL.
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Affiliation(s)
- Nemeh Al-Akour
- School of Nursing, Jordan University of Science and Technology (JUST), Irbid, Jordan.
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Lee S, Grant D. The effect of question order on self-rated general health status in a multilingual survey context. Am J Epidemiol 2009; 169:1525-30. [PMID: 19363097 DOI: 10.1093/aje/kwp070] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Current practices recommend placing a self-rated health question before specific health items in survey questionnaires to minimize potential order effects. Because this recommendation is based on data collected in English, its applicability to other languages is unknown. This study examines whether there is an order effect associated with self-rated health for interviews conducted in English and Spanish languages. An experiment was conducted by using the 2007 California Health Interview Survey, where questions on self-rated health were inserted in 1 of 2 locations: preceding and following question items on specific chronic conditions. Respondents were randomly assigned to 1 of 2 versions of the locations by the split-half method. Although no order effect was present in the English interviews, the authors found a significant and large effect with Spanish interviews: Self-rated health appeared much worse when asked before chronic conditions than when asked after them. This order effect was larger among females than males. Order effects for self-rated health differ by interview language; inferences about the health status of Spanish-speaking populations (and potentially Latinos) depend on question order. If maintaining comparability is important, the authors' finding contradicts current recommendations, as inserting the self-rated health question before specific questions led to larger differences in health status between English and Spanish speakers.
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Affiliation(s)
- Sunghee Lee
- Center for Health Policy Research and Department of Biostatistics, School of Public Health, University of California, Los Angeles, California 90025, USA.
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Page RM, Suwanteerangkul J. Self-rated health, psychosocial functioning, and health-related behavior among Thai adolescents. Pediatr Int 2009; 51:120-5. [PMID: 19371291 DOI: 10.1111/j.1442-200x.2008.02660.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Despite the popularity of self-rated health (SRH) in Western countries as a useful public health tool, it has only rarely been used in Asian countries. The purpose of the current study was to determine whether measures of psychosocial functioning and health-related factors differ according to SRH in a school-based sample of Thai adolescents. METHODS The survey was given to 2519 adolescents attending 10 coeducational secondary high schools in Chiang Mai Province, Thailand and included measures of psychosocial functioning (loneliness, hopelessness, shyness, perceptions of social status, self-rated happiness, and perception of physical attractiveness) and certain health-related factors (height/weight, physical activity, eating breakfast, sleep). RESULTS The proportion of boys (5.1%) reporting that they were not healthy was similar to the proportion of girls (4.6%) making the same rating. These adolescents showed a pattern of overall poor health risk. Compared to adolescent peers who rated their health as healthy or very healthy, they were less physically active, got less sleep, were more likely to be overweight, and scored lower on loneliness, shyness, hopelessness, and self-rated happiness. CONCLUSIONS The present pattern of poor health risk warrants attention and supports the merit of using SRH in adolescent health assessment. SRH is easy to obtain and simple to assess and single-item assessments of SRH appear to be valid measures of health status in adults and adolescent. Interventions, such as health counseling, mental health counseling, and health education, can target adolescents who rate themselves as 'not healthy' or report poor health status.
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Affiliation(s)
- Randy M Page
- Department of Health Science, Brigham Young University, Provo, Utah 84602, USA.
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Koch CG, Khandwala F, Blackstone EH. Health-related quality of life after cardiac surgery. Semin Cardiothorac Vasc Anesth 2009; 12:203-17. [PMID: 18805855 DOI: 10.1177/1089253208323411] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Health-related quality of life (HRQOL) assessments are designed to reflect a patient's perspective of how a disease has affected their overall health status. Patient-centered outcomes are of value both for risk assessment and as an outcome measure. Strategies for analyzing HRQOL data are inconsistent primarily because the data frequently do not meet underlying assumptions of traditional methods for statistical analyses and require a careful analytic approach.
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Araújo AF, Souza MEA, Menezes CA. Qualidade de vida e aspectos socioeconômicos em diabéticos tipo 1. ACTA ACUST UNITED AC 2008; 52:1124-30. [DOI: 10.1590/s0004-27302008000700008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2007] [Accepted: 07/07/2008] [Indexed: 02/21/2023]
Abstract
OBJETIVOS: Avaliar a qualidade de vida (QV) em diabéticos tipo 1 assistidos na Associação dos Diabéticos de Itabuna, BA (ASDITA), e verificar suas relações com as variáveis clínicas e sociodemográficas (escolaridade, renda familiar e ocupação). MÉTODOS: Foram estudados 34 pacientes (γ = 88%, ε = 5%; 53% mulheres, média de idade 20,4 ± 8,4 anos e média de tempo de diagnóstico 5,7 ± 4,9 anos), por meio de entrevista e antropometria (medidas de peso e altura). RESULTADOS: O perfil sociodemográfico da amostra revelou renda familiar per capita de 0,70 ± 0,56 salários mínimos, 53% possuíam o ensino fundamental, 64,7% eram estudantes. Em média, a qualidade de vida (QV) foi regular (58,8%). Não interferiram na QV: escolaridade, ocupação, etnia, índice de massa corpórea, número de aplicações diárias de insulina e perfil de monitoração da glicemia capilar. Associaram-se a pior QV: sexo feminino, ser adulto, tempo de diagnóstico maior ou igual a dez anos e baixa renda familiar. CONCLUSÕES: A QV destes pacientes foi inferior ao descrito na literatura, entretanto, estudos adicionais são necessários para comparações com diabéticos em condições socioeconômicas e culturais semelhantes às observadas nesta pesquisa.
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Palta M, Sadek-Badawi M. PedsQL relates to function and behavior in very low and normal birth weight 2- and 3-year-olds from a regional cohort. Qual Life Res 2008; 17:691-700. [PMID: 18459069 DOI: 10.1007/s11136-008-9346-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2007] [Accepted: 04/04/2008] [Indexed: 10/22/2022]
Abstract
STUDY OBJECTIVE To compare PedsQL scores in young children who were very low (< or =1,500 g) or normal birth weight (>2,500 g) and to examine the relationship of the PedsQL score to behavioral and functional scores. METHODS The PedsQL, Achenbach Child Behavior Checklist and the PEDI functional scales were telephone administered to parents of a regional cohort of 672 very low birth weight and 455 normal birth weight children, 2- and 3-years old. PedsQL scales were regressed on behavior, function and health conditions. RESULTS Mean (SD) overall PedsQL score was 91 (8.4) for normal birth weight and 87 (12) for very low birth weight children, and changed little when standardized to the race/ethnicity and maternal education of corresponding Wisconsin births. Mobility function and the CBCL explained 58% of the variance in PedsQL, but the relationship was curvilinear. CONCLUSION The PedsQL is sensitive to health problems of very low birth weight in young children. The PedsQL is quite strongly related to mobility and behavior problems, but scales these differently than do standard instruments. Parents either do not think of subtle issues with child function and behavior without specific prompting or do not perceive them as problems affecting quality of life.
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Affiliation(s)
- Mari Palta
- Department of Population Health Sciences, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA.
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Nicolucci A, Maione A, Franciosi M, Amoretti R, Busetto E, Capani F, Bruttomesso D, Di Bartolo P, Girelli A, Leonetti F, Morviducci L, Ponzi P, Vitacolonna E. Quality of life and treatment satisfaction in adults with Type 1 diabetes: a comparison between continuous subcutaneous insulin infusion and multiple daily injections. Diabet Med 2008; 25:213-20. [PMID: 18201210 DOI: 10.1111/j.1464-5491.2007.02346.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS The aim of this case-control study was to compare quality of life (QoL) and treatment satisfaction in adults with Type 1 diabetes (T1DM) treated with either continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI). METHODS Consecutive patients aged between 18 and 55 years, and attending diabetes clinics for a routine visit, completed the Diabetes-Specific Quality-of-Life Scale (DSQOLS), the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and the SF-36 Health Survey (SF-36). Case (CSII) and control subjects (MDI) were recruited in a 1 : 2 ratio. RESULTS Overall, 1341 individuals were enrolled by 62 diabetes clinics; 481 were cases and 860 control subjects. Cases had a longer diabetes duration and were more likely to have eye and renal complications. Age, school education, occupation and HbA(1c) were similar. Of control subjects, 90% followed glargine-based MDI regimens and 10% used NPH-based MDI regimens. On multivariate analysis, after adjusting for socioeconomic and clinical characteristics, scores in the following areas of the DSQOLS were higher in cases than control subjects: diet restrictions (beta = 5.96; P < 0.0001), daily hassles (beta = 3.57; P = 0.01) and fears about hypoglycaemia (beta = 3.88; P = 0.006). Treatment with CSII was also associated with a markedly higher DTSQ score (beta = 4.13; P < 0.0001) compared with MDI. Results were similar when CSII was compared separately with glargine- or NPH-based MDI regimens. CONCLUSIONS This large, non-randomized, case-control study suggests quality of life gains deriving from greater lifestyle flexibility, less fear of hypoglycaemia, and higher treatment satisfaction, when CSII is compared with either glargine-based or NPH-based MDI regimens.
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Kelley K, Aricak OT, Light RP, Agarwal R. Proteinuria is a determinant of quality of life in diabetic nephropathy: modeling lagged effects with path analysis. Am J Nephrol 2007; 27:488-94. [PMID: 17664865 DOI: 10.1159/000106672] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2007] [Accepted: 06/26/2007] [Indexed: 01/22/2023]
Abstract
BACKGROUND Diabetic nephropathy with overt proteinuria often progresses relentlessly to end-stage renal disease (ESRD). MATERIAL AND METHODS To answer the question whether it is impaired glomerular filtration rate (GFR) or its precursor proteinuria which is more related with multiple domains of health-related quality of life (HRQOL), we measured GFR and proteinuria in 44 patients with type 2 diabetes and overt nephropathy and repeated the measurements after 4 months. 38 patients with ESRD due to diabetic nephropathy served as a control group. We used path analysis to examine the association of baseline proteinuria and GFR with baseline and subsequent HRQOL scales. RESULTS Compared to patients with ESRD, patients with non-dialysis CKD had Kidney Disease Burden (KDB) that was, on a scale from 0 to 100, 19.8 better (95% CI 6.9-32.8) (p = 0.003). Mental component score (MCS) did not differ and physical component score (PCS) was worse in non-dialysis CKD patients by 8.5 (p < 0.001). Proteinuria at baseline was a predictor of PCS, MCS and KDB score at 4 months, suggesting a lagged effect of proteinuria on HRQOL after controlling for the autoregressive effects. GFR was not shown to have a significant impact on HRQOL. One log unit increase in proteinuria was associated with 3.8 (p = 0.011) fall in PCS, 3.3 (p = 0.043) fall in MCS and 10.6 (p = 0.006) fall in KDB. CONCLUSION In patients with advanced diabetic nephropathy, we found that proteinuria has a lagged and profound effect on multiple domains of HRQOL.
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Affiliation(s)
- Ken Kelley
- Inquiry Methodology Program, Indiana University, Bloomington, Ind., USA
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Zullig KJ, Valois RF, Drane JW. Adolescent distinctions between quality of life and self-rated health in quality of life research. Health Qual Life Outcomes 2005; 3:64. [PMID: 16248897 PMCID: PMC1280929 DOI: 10.1186/1477-7525-3-64] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2005] [Accepted: 10/25/2005] [Indexed: 12/03/2022] Open
Abstract
Background In adult quality of life (QOL) research, the QOL construct appears to differ from self-rated health status. Although increased QOL continues to be recognized as an important outcome in health promotion and medical intervention, little research has attempted to explore adolescent perceptual differences between self-rated health and QOL. Methods Correlational analyses were performed between self-rated health, physical health days and mental health days, and QOL. Data were collected from two different public high school adolescent samples during two different time periods (1997 & 2003) in two different geographic regions in the USA (a southern & midwestern state) with two different sample sizes (N = 5,220 and N = 140, respectively) using the CDC Youth Risk Behavior Survey (YRBS). The Centers for Disease Control and Preventions' health-related quality of life scale (HRQOL) provided estimates of self-rated health, physical health days and mental health days, and QOL. Results All correlation coefficients were significant in both samples (p ≤ .0001), suggesting sample size was not a contributing factor to the significant correlations. In both samples, adolescent QOL ratings were more strongly correlated with the mean number of poor mental health days (r = .88, southern sample; r = .89, midwestern sample) than with the mean number of poor physical health days (r = .75, southern sample; r = .79, midwestern sample), consistent with adult QOL research. However, correlation coefficients in both samples between self-rated health and the mean number of poor physical health days was slightly smaller (r = .24, southern, r = .32, midwestern) than that between self-rated health and the mean number of poor mental health days (r = .25, southern, r = .39 midwestern), which is contrary to adult QOL research. Conclusion Similar to adults, these results suggest adolescents are rating two distinct constructs, and that self-rated health and QOL should not be used interchangeably. QOL, in the context of public high school adolescents, is based largely upon self-reported mental health and to a lesser extent on self-reported physical health. Conversely, although self-reported mental health and self-reported physical health both contribute significantly to adolescent self-rated health, mental health appears to make a greater contribution, which is contrary to observations with adults. Health promoting efforts for adolescents may need to focus more on mental health than physical health, when considering population needs and type of micro or macro intervention.
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Affiliation(s)
- Keith J Zullig
- Health Education, Department of Physical Education, Health, & Sport Studies, Miami University, Oxford, OH 45056, USA
| | - Robert F Valois
- Arnold School of Public Health, Department of Health Promotion, Education & Behavior, University of South Carolina, Columbia, SC 29208, USA
- School of Medicine, Department of Family & Preventive Medicine, University of South Carolina, Columbia, SC 29208, USA
| | - J Wanzer Drane
- School of Medicine, Department of Family & Preventive Medicine, University of South Carolina, Columbia, SC 29208, USA
- Arnold School of Public Health, Department of Biostatistics & Epidemiology, University of South Carolina, Columbia, SC 29208, USA
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