Geriatrik Tip 2 Diyabet Hastalarında Nöropatik Ağrı ve Yaşam Kalitesi Arasındaki İlişki

Abstract

Amaç: Çalışma, geriatrik tip 2 diyabetli hastalarda nöropatik ağrı ile yaşam kalitesi arasındaki ilişkiyi değerlendirmek amacıyla tanımlayıcı olarak gerçekleştirildi. Gereç ve Yöntemler: Çalışmanın verileri “Soru Formu, Görsel Analog Skala (VAS), Douleur Neuropathique 4 Soru (DN4) anketi ve Dünya Sağlık Örgütü Yaşam Kalitesi Ölçeği Yaşlı Yetişkinler Modülü (WHOQOL-OLD) kullanılarak toplandı. DN4 anketinde nöropatik ağrı için sınır değer 4/10 ve üzeri olarak belirlendi. WHOQOL-OLD ölçeğinden elde edilen puanlar 24 ile 120 arasında değişti”. Bulgular: 65-79 yaş aralığındaki hastaların dahil edildiği bu çalışmada hastaların çoğunluğu erkek, 65-69 yaş aralığında ve okuma yazma bilmiyorlardı. Geriatrik hastaların çoğunluğunun 10 yıldan uzun süredir tip 2 diyabet hastası olduğu, diyabet tedavisinde insülin ile birlikte oral antidiyabetik ilaç kullandığı ve diyabete ek olarak kronik kardiyovasküler hastalığının da bulunduğu tespit edildi. Hastaların VAS’a göre genel ağrı skor ortalaması 6,27±1,48 iken, DN4’e göre nöropatik ağrı skor ortalaması 8,15±1,14 ve WHOQOL-OLD’a göre genel yaşam kalitesi skor ortalaması 68,67±6,61 olarak bulundu. Sonuç: Çalışmanın sonuçlarına göre, VAS ağrı skoru ile DN4 skoru arasında (r = 0,502, p = 0,001) ve WHOQOL-OLD genel skoru ile DN4 skoru arasında (r = -0,420 p = 0,007) anlamlı korelasyon olduğu ortaya konuldu. Ayrıca, diyabet tanısının süresi (p=0,038), diyabet tedavisinin türü (p=0,018), diyabet kontrolü için hastaneye yatış (p=0,047) ile hastaların DN4 skor ortalamasının anlamlı olduğu bulundu.

Keywords

• Diyabet
• Geriatri
• Hemşirelik
• Nöropatik Ağrı

The Relationship Between Neuropathic Pain and Quality of Life in Geriatric Type 2 Diabetic Patients

Abstract

Aim: This descriptive study was conducted to evaluate the relationship between neuropathic pain and quality of life in geriatric patients with type 2 diabetes. Material and Methods: The data of the study were collected using “Questionnaire Form, Visual Analogue Scale (VAS), Douleur Neuropathique 4 Questions (DN4) questionnaire, and the World Health Organization Quality of Life Instrument Older Adults Module (WHOQOL-OLD). In the DN4 questionnaire, the limit value for neuropathic pain was determined to be 4/10 and above. The scores obtained from the WHOQOL-OLD scale ranged between 24 and 120”. Results: This study, which included patients aged 65-79, found that the majority of the patients were male, 65-69 years old, and illiterate. The majority of the geriatric patients had type 2 diabetes for more than 10 years, were using oral antidiabetic medications along with insulin for their diabetes treatment, and had chronic cardiovascular disease in addition to their diabetes. The patients' mean overall pain score according to the VAS was 6.27±1.48, the mean neuropathic pain score according to the DN4 was 8.15±1.14, and the mean overall quality of life score according to the WHOQOL-OLD was 68.67±6.61. Conclusion: The study results revealed a significant correlation between the VAS pain score and the DN4 score (r=0.502, p=0.001), and between the WHOQOL-OLD overall score and the DN4 score (r=-0.420, p=0.007). Furthermore, the duration of diabetes diagnosis (p = 0.038), the type of diabetes treatment (p=0.018), and hospitalization for diabetes control (p=0.047) were found to be significantly related to the patients' mean DN4 score.

Keywords

• Diabetes
• Geriatrics
• Neuropathic Pain
• Nursing

References

1. 1. Cilingir D, Bulut E. Approach to pain in the elderly. Anatolian Journal of Nursing and Health Sciences. 2017;20:2.
2. 2. Ozdemir L, Koçoğlu G, Sümer H, Nur N, Polat H, Aker A, Bakıcı Z. The prevalence and risk factors of some chronic diseases in the elderly population in Sivas city center. Journal of Cumhuriyet University Faculty of Medicine. 2005;27(3):89-94.
3. 3. Değirmenci Y, Ozışık Karaman HI, Keçeci H. Antidepressant and antiepileptic use in the treatment of neuropathic pain and depression in patients with diabetic neuropathy: A comparison study. Journal of Inönü University Faculty of Medicine. 2011;18(3):149-154.
4. 4. Arı N, Ozdelikara A. The effect of family support on disease acceptance and treatment compliance in type 2 diabetes patients applying to internal medicine clinics: a research article on the Ordu province sample. Turkish Journal of Diabetes and Obesity. 2022;6(1):39-48.
5. 5. World Health Organization (WHO). Global Report On Diabetes. France 2016;20-33. https://apps.who.int/iris/bitstream/ handle/10665/204871/9789241565257_eng.pdf;jsessionid= 9A509513D4EBA8BF0FD32E5EA7AACBAF?sequence=1. Date of access: 20 Ocak 2019.
6. 6. Finucane P, Popplewell P. Diabetes Mellitus Impaired Glucose Regulation in Old Age: The Scale of the Problem. In: Sinclair AJ, Finucane P (Eds.). Diabetes in Old Age. 2th ed. JohnWiley & Sons Ltd. 2001:p.2-39.
7. 7. Civelek GM, Kuşkonmaz ŞM. Pharmacological treatment of painful diabetic neuropathy. Journal of Clinical and Analytical Medicine. 2015; 6(4): 590-594.
8. 8. World Health Organization (WHO). Türkiye Diabetes Program 2015-2020. https://extranet.who.int/ncdccs/Data/TUR_ D1_T%C3%BCrkiye%20Diyabet%20Program%C4%B1%20 2015-2020.pdf, Date of access: 16 Ocak 2019.

9. 9. Callaghan BC, Little AA, Feldman EL, Hughes RAC. Enhanced glucose control for preventing and treating diabetic neuropathy. JohnWiley & Sons Ltd. 2012;13;6(6):CD007543.
10. 10. Snyder MJ, Gibbs LM, Lindsay TJ. Treating painful diabetic peripheral neuropathy: An update. American Academy of Family Physicians. 2016;94(3):227-234.
11. 11. Ministry of Health Turkish Medicines and Medical Devices Agency. Workshop report on current problems and solutions in drug use in the elderly. Ankara, May 2015. http://www.akilciilac. gov.tr/wp-content/uploads/2015/12/Geriatri-Rapor-Son. pdf. Date of access: 20 Ocak 2019.
12. 12. Ziegler D. Painful diabetic neuropathy. Advantage of novel drugs over old drugs. Diabetes care. 2009;32(2):414-419.
13. 13. Corriere M, Rooparinesingh N, Kalyani RR. Epidemiology of diabetes and diabetes complications in the elderly: An emerging public health burden. Current Diabetes Reports. 2013;13(6):805-813.
14. 14. Araki A, Ito H. Diabetes mellitus and geriatric syndromes. Geriatrics Gerontology International. 2009;9:105-114.
15. 15. Paiva PTF, Lima LR, Santos WS, Funguetto SS, Stival MM. The influence of pain on elderly diabetics quality of life. Rev enferm UERJ, Rio de Janeiro. 2019;27:e31517.
16. 16. Ozel F, Yıldırım Y, Fadıloğlu Ç. Pain management in the elderly living in a nursing home. Pain. 2014;26(2):57-64.
17. 17. Vizüel Analog Skala (VAS). Turkish Neurosurgery Society-Spinal and Peripheral Nerve Surgery Group. http://www.spinetr. com/uploads/files/skor/vizuelanalogskala.pdf. Date of access: 25 Ocak 2019.
18. 18. Güngen C, Ertan T, Eker E, Yaşar R, Engin F. The validity and reliability of the Standardized Mini Mental Test in the diagnosis of mild dementia in the Turkish population. Turkish Journal of Psychiatry. 2002;13(4):273-281.
19. 19. Babacan Yıldız G, Ur Ozçelik E, Kolukısa M, Işık At, Gürsoy E, Kocaman G, Çelebi A. The validity and reliability study of the modified mini mental test (MMSE-E) for the uneducated in the diagnosis of Alzheimer’s disease in Turkish population. Turkish Journal of Psychiatry. 2016;27(1):41-46.
20. 20. Unal Çevik I, Sarıoğlu Ay S, Evcik D. A comparison of the DN4 and LANSS Questionnaires in the sessesment of neuropathic pain: validity and reliability of the Turkish version of DN4. The Journal Of Pain. 2010;11(11):1129-1135.
21. 21. Eser S, Saatlı G, Eser E, Baydur H, Fidaner C. World Health Organization Quality of Life Module for the Elderly WHOQOL- OLD: Turkish version validity and reliability results of the Turkey field study. Journal of Turkish Psychiatry. 2010;21(1):37-48.
22. 22. Karaca Sivrikaya S. Care management of the geriatric diabetic. Unsal Avdal E, editor. Current Diabetes Management. 1st Edition. Ankara: Türkiye Clinics. 2019:p.29-33.
23. 23. Karataş G, Ertınmaz Ozkan A, Independent clinical and demographic factors predicting diabetic polyneuropathy. Turkish Journal of Diabetes and Obesity. 2020;4(1):11-15.
24. 24. Gökmen S. Investigation of the effect of diabetic neuropathic pain on depression and quality of life. 2016, Katip Celebi University, Institute of Health Sciences, Master’s thesis, 98 pages, İzmir, (Assoc. Dr. Elif Unsal Avdal).
25. 25. Durmaz B. Causes and evaluation methods of chronic pain in the elderly. Turkish Geriatrics Congress Speech Summaries. 2012;15(suppl):27-28.
26. 26. Tanik N, Sarp U, Uçar M, Celikbilek A, Balbaloglu O, Ak H, Atalay T, Arik HO, Okyay MY, Inan LE. Pain, depression and sleep disorders in patients with diabetic and nondiabetic carpal tunnel syndrome: a vicious cycle. Arg Neuropsiquiatr. 2016;74(3):207-211.
27. 27. Aguiar FLXS, Ramos LFP, Bichara CNC. Detection of pain with neuropathic characteristics in patients with diabetes mellitus assisted in primary care units. Br J Pain. Sao Paulo, 2018;1(1):15-20.
28. 28. Nascimento OJM, Pupe CCB, Cavalcanti EBU. Diabetic neuropathy. Rev Dor São Paulo. 2016;17(suppl 1):46-51.
29. 29. Cong JY, Zhao Y, Xu QY, Zhong CD, Xing QL. Health-related quality of life among Tianjin Chinese patients with type 2 diabetes: a cross-sectional survey. Nurs Health Sci. 2012;14(4):528-34.
30. 30. Onsüz U, Can G. Qualıty of lıfe ın patıents wıth and wıthout ınterventıon ın the management of perıpheral neuropathy assocıated wıth taxane-based treatment. Izmir Democracy University Health Sciences Journal. 2020;3(2):114-134.
31. 31. Girach A, Julian TH, Varrassi G, Paladini A, Vadalouka A, Zis P. Quality of life in painful peripheral neuropathies: A systematic review. Pain Res Manag. 2019;2019:2091960.
32. 32. Akgül Gündoğdu N, Selçuk Tosun A, Balcı Ş. Quality of life and affecting factors in elderly individuals with type 2 diabetes. Turkish Journal of Diabetes and Obesity. 2022;6(2):104-112.
33. 33. Iqbal Z, Azmi S, Yadav R, Ferdousi M, Kumar M, Cuthbertson DJ, Lim J, Malik RA, Alam U. Diabetic peripheral neuropathy: epidemiology, diagnosis, and pharmacotherapy. Clin Ther. 2018,40(6):828-849.
34. 34. Dermanovic Dobrota V, Hrabac P, Skegro D, Smiljanic R, Dobrota S, Prkacin I, Brkljacic N, Peros K, Tomic M, Lukinovic- Skudar V, Basic Kes V. The impact of neuropathic pan and other comorbidities on the quality of life in patients with diabetes. Health Qual Life Outcomes. 2014:3;12:171.
35. 35. Nguyen HTT, Moir MPI, Nguyen TX, Vu AP, Luong LH, Nguyen TN, Nguyen LH, Tran BX, Tran TT, Latkin CA, Zhang MWB, Ho RCM, Vu HTT. Health-related quality of life in elderly diabetic outpatients in Vietnam. Patient Preference and Adherence. 2018;12:1347-1354.
36. 36. Uçgun H, Bayrak O, Taşdemir M. Comparison of physical activity, functional capacity and quality of life between elderly patients with chronic comorbidities and healthy peers: a state hospital example. Turkish Journal of Diabetes and Obesity. 2024;8(3):236-247.
37. 37. Sousa MC, Dias FA, Nascimento JS, Tavares DMS. Correlation of quality of life with knowledge and attitude of diabetic elderly. Invest Educ Enferm. 2016;34(1):180-188.
38. 38. Arslan B, Ozdelikara A. The effect of self-efficacy level on quality of life in patients with type 2 diabetes. Turkish Journal of Diabetes and Obesity. 2023;7(1):30-40.
39. 39. Küçük S, Uludasdemir D, Karşıgil P, Güven I. Determination of healthy lifestyle behaviors and diabetes self-efficacy in patients with type 2 diabetes. Turkish Journal of Diabetes and Obesity. 2023;7(2):112-121.
40. 40. Lima LR, Funghetto SS, Volpe CRG, Santos WS, Funez MI, Stival MM. Quality of life and time since diagnosis of Diabetes Mellitus among the elderly. Rev. Bras. Geriatr. Gerontol. 2018;21(2):176-185.