The Effect of Care Needs on Quality of Life and Chronic Disease Care in Patients with Diabetes

Öz

Aim: The aim of this study was to investigate the effect of care needs on quality of life and chronic disease care in patients with type-2 diabetes. Methods: A cross-sectional and descriptive study. One hundred forty-five patients with type-2 diabetes who were followed-up between January 2016 and January 2017 in the university hospital were included in the study. The "Patient Presentation and Care Management Evaluation Form", "Quality of Life Assessment Scale (EQ-5D-5L)" and "Chronic Illness Care Assessment Scale-Patient Form (PACIC)" were used for the collection of data. One-way ANOVA test, Tukey HDS test, independent two-sample t-test, Kruskal Wallis test, Mann Whitney U test and Pearson correlation analysis were used for the evaluation of data. Results: In this study, the average total PACIC score of patients with type-2 diabetes was found to be satisfactory (3.78±0.79). However, the EQ-5D-5L average score was found to be close to perfect (0.84±0.17). A positive correlation was found between EQ-5D-5L scores and PACIC decision support and goal setting/guidance sub-scale scores, and a negative correlation was found between positive EQ-5D-5L score and body mass index and HbA1c values. A significant correlation was also found between current diabetes treatment compliance and the EQ-5D-5L general health score and PACIC total score. The PACIC decision support and goal setting/guidance sub-scales were found to be significantly different based on the diabetes education status of patients with type-2 diabetes. Conclusions: Planning health education and counseling programs for general care adjustment are recommended for chronic disease management of diabetes. Amaç: Bu çalışmayla; tip 2 diyabetik bireylerde bakım gereksinimlerinin yaşam kalitesi ve kronik hastalık bakımına etkisinin incelenmesi amaçlandı. Yöntem: Kesitsel ve tanımlayıcı bir çalışma. Üniversite hastanesinde Ocak 2016 - Ocak 2017 tarihleri arasında takip edilen tip 2 diyabetli 145 hasta çalışmaya dahil edildi. Verilerin toplanmasında “Hasta Tanıtım ve Bakım Yönetimi Değerlendirme Formu”, “Yaşam Kalitesi Değerlendirme Ölçeği (EQ-5D-5L)” ve “Kronik Hastalık Bakımını Değerlendirme Ölçeği-Hasta Formu (PACIC)” kullanıldı. Verilerin değerlendirilmesinde tek yönlü ANOVA testi, Tukey HDS testi, bağımsız iki örneklem t testi, Kruskal Wallis testi, Mann Whitney U testi ve Pearson korelasyon analizi kullanıldı. Bulgular: Bu çalışmada, tip 2 diyabetli hastaların ortalama toplam PACIC skorları tatmin edici bulundu (3.78 ± 0.79). Ancak, EQ-5D-5L ortalama skorunun mükemmele yakın olduğu bulundu (0,84 ± 0,17). EQ-5D-5L puanları ile PACIC karar desteği ve hedef belirleme / rehberlik alt ölçek puanları arasında pozitif, EQ-5D-5L skoru ve beden kitle indeksi ile HbA1c değerleri arasında negatif bir korelasyon bulundu. Mevcut diyabet tedavisine uyum ile EQ-5D-5L genel sağlık skoru ve PACIC toplam skoru arasında da anlamlı bir ilişki bulundu. PACIC karar desteği ve hedef belirleme / rehberlik alt ölçeklerinin tip 2 diyabetli hastaların diyabet eğitimi durumuna göre anlamlı derecede farklı olduğu bulundu. Sonuçlar: Araştırma sonucunda, tip 2 diyabetlilerin kronik hastalık bakım yönetiminde; genel tedaviye uyumu için sağlık eğitimi ve danışmanlık programları planlanması önerilebilir.

Anahtar Kelimeler

• Type 2 diabetes,care,chronic disease,quality of life

Kaynakça

1. 1. Beaglehole R, Epping-Jordan J, Patel V, et al. Improving the prevention and management of chronic disease in low-income and middle-income countries: a priority for primary health care Lancet. 2008;372(9642):940-9. PMID: 18790317; doi: 10.1016/S0140-6736(08)61404-X.
2. 2. International Diabetes Federation (IDF). Diabetes Atlas- 8th ed. IDF; 2017. ISBN: 978-2- 930229-87-4. Available from: http://diabetesatlas.org/IDF_Diabetes_Atlas_8e_interactive_EN/. Accessed in 2019 (Apr 17).
3. 3. Satman I, Omer B, Tutuncu Y, el al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol. 2013;28(2):169-80. PMID: 23407904; doi: 10.1007/s10654-013-9771-5.
4. 4. International Diabetes Federation (IDF). Diabetes Atlas-7th ed. IDF; 2015. ISBN: 978-2-930229-81- 2. Available from: https://www.idf.org/e-library/epidemiology-research/diabetes-atlas/13-diabetes- atlas-seventh-edition.html). Accessed in 2019 (Apr 17).
5. 5. Kahn CR, Weir GC, King GL, et al. Diabetes: Definition, genetics and pathogenesis. Joslin‘s Diabetes Mellitus. 2008; İstanbul Tıp Kitabevi. İstanbul pp.331-41.
6. 6. Nutting PA, Dickinson WP, Dickinson LM, et al. Use of chronic care model elements is associated with higer-quality care for diabetes. Ann Fam Med. 2007;5(1):14-20. PMID: 17261860; doi: 10.1370/afm.610
7. 7. EQ-5D-5L User Guide, EuroQol Group, Basic Information on how to use the EQ-5D-5L Instrument, Version 2.1, 2015. Date of access: 16.05.2017. Available from: https://euroqol.org/wp- content/uploads/2016/09/EQ-5D 5L_UserGuide_2015.pdf. Accessed in 2019 (Apr 17).
8. 8. Glasgow RE, Wagner EH, Schaefer J, et al. Development and validation of the patient assessment of chronic illness care (PACIC). Medical Care. 2005;43(5):436-44. PMID: 15838407.

9. 9. İncirkuş K, Nahcivan NÖ. Kronik hastalık bakımını değerlendirme ölçeği-hasta formu’nun Türkçe versiyonunun geçerlik ve güvenirliği. DEUHYO ED. 2011;4(1):102-9. Available from: https://toad.halileksi.net/sites/default/files/pdf/kronik-hastalik-bakimini-degerlendirme-olcegi- toad.pdf. Accessed in 2019 (Apr 17).
10. 10. Fransen MP, Beune EJ , Baim-Lance AM, Bruessing RC, Essink-Bot ML. Diabetes self- management support for patients with low health literacy: perceptions of patients and providers. J Diabetes. 2015;7(3):418-25. PMID: 25042519; doi: 10.1111/1753-0407.12191.
11. 11. Wagner EH, Austin BT, Davis C, et al. Improving chronic illness care: Translating evidence into action interventions that encourage people to acquire self-management skills are essential in chronic illness care. Health Affairs. 2001;20(6):64-78. PMID: 11816692; doi: 10.1377/hlthaff.20.6.64.
12. 12. Zyoud SH, Al-Jabi SW, Sweileh WM, et al. Relationship of treatment satisfaction to health-related quality of life among Palestinian patients with type 2 diabetes mellitus: Findings from a cross- sectional study. J Clin Transl Endocrinol. 2015;2(2):66-71. PMID: 29159112; doi: 10.1016/j.jcte.2015.03.002.
13. 13. Rwegerera GM, Moshomo T, Gaenamong M, et al. Health-related quality of life and associated factors among patients with diabetes mellitus in Botswana. Alex J Med. 2018;54(2):111-8. doi: 10.1016/j.ajme.2017.05.010.
14. 14. Saleh F, Ara F, Mumu SJ, Abdul Hafez A. Assessment of health-related quality of life of Bangladeshi patients with type 2 diabetes using the EQ-5D: a cross-sectional study. BMC Res Notes. 2015;8(497):1-8. PMID: 26420245; doi: 10.1186/s13104-015-1453-9.
15. 15. Son N. Assessment of body perception, psychological distress, and subjective quality of life among obese and nonobese subjects in Turkey. Nigerian Journal of Clinical Practice. 2017;20(10):1302-8. doi: 10.4103/1119-3077.219509.
16. 16. Kara K, Çınar S. The relation between diabetes care profile and metabolic control variables. Kafkas J Med Sci. 2011;1(2):57-63. doi: 10.5505/kjms.2011.41736.
17. 17. Sundaram M, Kavookjian J, Patrick JH. Health-related quality of life and quality of life in type 2 diabetes: relationships in a cross-sectional study. Patient. 2009;2(2):121-33. PMID: 22273088 doi: 10.2165/01312067-200902020-00008.
18. 18. Bourdel-Marchasson I, Druet C, Helmer C, et al. Correlates of health-related quality of life in French people with type 2 diabetes. Diabetes Research and Clinical Practie. 2013;101(2):226-35. PMID: 23831112; doi: 10.1016/j.diabres.2013.05.011.
19. 19. Yanık YT, Erol Ö. Evaluation of self-efficacy levels of ındıvıduals wıth type 2 diabetes. Journal of Anatolia Nursing and Health Sciences. 2016;19(3):166-74. doi: 10.17049/ahsbd.22818.
20. 20. D'souza MS, Karkada SN, Parahoo K, et al. Self-efficacy and self-care behaviours among adults with type 2 diabetes. Appl Nurs Res. 2017;36:25-32. PMID: 28720235; doi: 10.1016/j.apnr.2017.05.004.
21. 21. Zyoud SH, Al-Jabi SW, Sweileh WM, et al. Relationship of treatment satisfaction to health-related quality of life among Palestinian patients with type 2 diabetes mellitus: Findings from a cross-sectional study. J Clin Transl Endocrinol. 2015;2(2):66-71. PMID: 29159112; doi: 10.1016/j.jcte.2015.03.002.
22. 22. Kitzler TM, Bachar M, Skrabal F, Kotonko P. Evaluation of treatment adherence in type 1 diabetes: a novel approach. Eur J Clin Invest. 2007;37(3):207-13. PMID:17359488; doi: 10.1111/j.1365-2362.2007.01771.x.
23. 23. Arslan E. Factors affecting compliance of patients with type 2 diabetes mellitus [thesis]. Diyarbakır,Turkey: Dicle University, Faculty of Medicine; 2011;31-42.
24. 24. Ustaalioğlu S, Tan M. Examination of type 2 diabetics attitudes and behaviours against care and treatment. GUSBD. 2017;6(4):12-20. Available from: http://dergipark.gov.tr/download/article- file/370763. Accessed in 2019 (Apr 17).
25. 25. Yıldırım D. Evaluation of the care needs of adults with type 1 diabetes; preliminary study to develop a maintenance model [thesis]. İstanbul, Turkey: İstanbul University, Health Sciences Institute; 2013;37-47.
26. 26. Szecsenyı J, Rosemann T, Joos S, Peters-Klımm F, Mıksch A. German diabetes disease management programs are appropriate for restructuring care according to the chronic care model. Diabetes Care. 2008;31(6):1150-4. PMID: 18299443; doi: 10.2337/dc07-2104.
27. 27. Miller AT, Dimatteo MR. Importance of family/social support and impact on adherence to diabetic therapy. Diabetes Metab Syndr Obes. 2013;6:421-6. PMID: 24232691; doi: 10.2147/DMSO.S36368.
28. 28. Akgüç N. Evaluation of disease perception and treatment compliance in patients with type 2 diabetes [thesis]. İstanbul, Turkey: Haliç University, Health Sciences Institute; 2013;55-109.
29. 29. Baykal A, Kapucu S. Type II diabetes mellitus patients’ adherence to treatment. Journal of Hacettepe University Faculty of Nursing. 2015;2(2):44-58. Available from: http://dergipark.gov.tr/download/article-file/88663. Accessed in 2019 (Apr 17).
30. 30. Bradley C, de Pablos-Velasco P, Parhofer KG, et al. Panorama: A European study to evaluate quality of life and treatment satisfaction in patients with type-2 diabetes mellitus-study design. Primary Care Diabetes. 2011;5(4):231-9. PMID: 21752743; doi: 10.1016/j.pcd.2011.04.004.