Health Care Management and Economic Research Center, School of Health Care Management, Tehran University of Medical Sciences, Tehran, Iran.
PLoS One. 2012;7(8):e44526. doi: 10.1371/journal.pone.0044526. Epub 2012 Aug 30.
The aim of this study was to measure health-related quality of life (HRQoL) in Iranian people with Type 2 Diabetes Mellitus using two different measures and examines which socio-demographic and diabetes-related characteristics are associated with better quality of life based on a nationally distributed sample.
A multi-stage cluster sampling method was used to select 3472 subjects as a part of Iranian surveillance of risk factors of non-communicable disease (ISRFNCD). EuroQol-5 Dimensions questionnaire (EQ-5D) and Visual Analog Scale (VAS) were employed to measure HRQoL. Binary logistic and Tobit regression models were used to investigate factors associated with EQ-5D results.
The mean age of subjects was 59.4 years (SD = 11.7), 61.3% were female and had 8.08 years (SD = 6.7) known duration of diabetes. The patients reported "some or extreme problems" most frequently in Pain/Discomfort (69.3%) and Anxiety/Depression (56.6%) dimensions of EQ-5D. The mean EQ-5D and VAS score were 0.70 (95% CI 0.69-0.71) and 56.8 (95% CI 56.15-57.5) respectively. Female gender, lower education, unemployment, long duration of diabetes, diabetes-related hospitalization in past years and having nephropathy and lower extremity lesions were associated with higher probabilities of reporting "some or extreme problems" in most dimensions of EQ-5D in binary logistic regression models. The same factors in addition to retinopathy were significantly associated with lower levels of HRQoL in Tobit regression analysis too.
The study findings indicate that patients with diabetes in Iran suffer from relatively poor HRQoL. Therefore much more attention should be paid to main determinants of HRQoL to identify and implement appropriate policies for achieving better management of diabetes and ultimately improving the quality of life of diabetic patients in this region.
本研究旨在使用两种不同的测量方法来衡量伊朗 2 型糖尿病患者的健康相关生活质量(HRQoL),并根据全国分布的样本,研究哪些社会人口统计学和糖尿病相关特征与更好的生活质量相关。
采用多阶段聚类抽样法选择 3472 名受试者作为伊朗非传染性疾病危险因素监测(ISRFNCD)的一部分。采用欧洲五维健康量表问卷(EQ-5D)和视觉模拟量表(VAS)来衡量 HRQoL。采用二元逻辑回归和 Tobit 回归模型来研究与 EQ-5D 结果相关的因素。
受试者的平均年龄为 59.4 岁(标准差=11.7),61.3%为女性,糖尿病病程为 8.08 年(标准差=6.7)。患者在 EQ-5D 的疼痛/不适(69.3%)和焦虑/抑郁(56.6%)维度中报告“有一些或极度问题”的频率最高。EQ-5D 和 VAS 的平均得分分别为 0.70(95%置信区间 0.69-0.71)和 56.8(95%置信区间 56.15-57.5)。女性、较低的教育程度、失业、较长的糖尿病病程、过去几年因糖尿病住院以及患有肾病和下肢病变与在 EQ-5D 的大多数维度中报告“有一些或极度问题”的可能性较高相关。在 Tobit 回归分析中,同样的因素加上视网膜病变也与 HRQoL 水平较低显著相关。
研究结果表明,伊朗的糖尿病患者生活质量相对较差。因此,应更加关注 HRQoL 的主要决定因素,以确定和实施适当的政策,实现更好的糖尿病管理,最终提高该地区糖尿病患者的生活质量。