Consorzio Mario Negri Sud, Santa Maria Imbaro, Italy.
Diabet Med. 2013 Jul;30(7):767-77. doi: 10.1111/dme.12245.
The second Diabetes Attitudes, Wishes and Needs (DAWN2) study aimed to assess psychosocial outcomes in people with diabetes across countries for benchmarking.
Surveys included new and adapted questions from validated questionnaires that assess health-related quality of life, self-management, attitudes/beliefs, social support and priorities for improving diabetes care. Questionnaires were conducted online, by telephone or in person.
Participants were 8596 adults with diabetes across 17 countries. There were significant between-country differences for all benchmarking indicators; no one country's outcomes were consistently better or worse than others. The proportion with likely depression [WHO-5 Well-Being Index (WHO-5) score ≤ 28] was 13.8% (country range 6.5-24.1%). Diabetes-related distress [Problem Areas in Diabetes Scale 5 (PAID-5) score ≥ 40] was reported by 44.6% of participants (17.2-67.6%). Overall quality of life was rated 'poor' or 'very poor' by 12.2% of participants (7.6-26.1%). Diabetes had a negative impact on all aspects investigated, ranging from 20.5% on relationship with family/friends to 62.2% on physical health. Approximately 40% of participants (18.6-64.9%) reported that their medication interfered with their ability to live a normal life. The availability of person-centred chronic illness care and support for active involvement was rated as low. Following self-care advice for medication and diet was most common, and least common for glucose monitoring and foot examination, with marked country variation. Only 48.8% of respondents had participated in diabetes educational programmes/activities to help manage their diabetes.
Cross-national benchmarking using psychometrically validated indicators can help identify areas for improvement and best practices to drive changes that improve outcomes for people with diabetes.
第二项糖尿病态度、愿望和需求（DAWN2）研究旨在评估各国糖尿病患者的心理社会结局，以便进行基准比较。
调查包括来自经过验证的问卷的新问题和改编问题，这些问卷评估了与健康相关的生活质量、自我管理、态度/信念、社会支持以及改善糖尿病护理的重点。问卷通过在线、电话或亲自进行。
参与者为来自 17 个国家的 8596 名成年糖尿病患者。所有基准指标均存在显著的国家间差异；没有一个国家的结果始终好于或差于其他国家。可能患有抑郁症的比例[世界卫生组织-5 健康指数（WHO-5）得分≤28]为 13.8%（国家范围为 6.5-24.1%）。44.6%的参与者报告有糖尿病相关困扰[糖尿病问题区域量表 5 分（PAID-5）得分≥40]。12.2%的参与者总体生活质量评为“差”或“非常差”（7.6-26.1%）。糖尿病对所有调查方面都有负面影响，从与家人/朋友的关系（20.5%）到身体健康（62.2%）。约 40%的参与者（18.6-64.9%）报告他们的药物会干扰他们的正常生活能力。个人为中心的慢性病护理和积极参与的支持可用性较低。遵循药物和饮食自我护理建议最为常见，而血糖监测和足部检查则最少见，且存在明显的国家差异。只有 48.8%的受访者参加了糖尿病教育计划/活动，以帮助他们管理糖尿病。
使用心理测量学验证的指标进行跨国基准比较，可以帮助确定需要改进的领域和最佳实践，以改善糖尿病患者的结局。
